The Anterior Cruciate Ligament Injury Gender Difference - Essay Example

ACL Injury Gender Difference Introduction This paper will review the studies that have been undertaken to examine the mechanics of the anterior cruciate ligament (ACL) and in particular, the greater risk of injuries in female athletes as a consequence of participating in sports involving constant jumping and pivoting movements. The ACL is a ligament helps to keep the knee stable and any form of rupture or strain on it can result in decreased ability to control knee movement, leading to scar formation or tissue damage in the knee. Therefore, a biomechanical evaluation is necessary to investigate the causes of the greater rate of injury risk in female athletes compared to males. Movement and skills that contribute to this injury will be looked at closely to establish better ways to execute the skills without leading to a rupture or strain of the ACL. This review will provide an insight into the actions that contribute to more injuries among female athletes and coaches, and how trainers can apply and use this to improve skill and reduce injury risks. ACL rupture is a common injury among many athletes. High rate of incidences are reported yearly with most injuries occurring from non-contact mechanisms. This is often due to lateral pivot during running or landing with a flat foot. Increased incidences of ACL injuries are linked to biomechanical and neuromuscular factors in the female athletes. Lateral positioning of the trunk can contribute to a greater valgus torque of the knee and this is driven by both biomechanical and neuromuscular control. Anatomical Difference Many anatomical differences are associated with injury mechanisms between male and female athletes. Females are shown to have a small ACL and intercondylar notch compared to their male counterparts. A narrow intercondylar notch has the tendency to pinch the ACL during flexion and twisting movements. This creates limited space for the movement of the ligament. A smaller ACL leads to greater tensile loads being placed on the ligament, leading to greater chances of experiencing strains and ruptures. Females have been shown to have a wider pelvis, which leads to a greater angle formation between the femur and tibia. As a consequence of a greater Q angle in females, the ligament is put under a greater force range each time the knee is twisted. Twisting knee with a greater Q angle may lead to a complete ACL tear. When the knee is placed under a great amount of force from movements such as jumps and pivots, the ACL is not able to prevent the tibia from slipping out of its position due to being under constant strain. Neuromuscular Factors The knee joint should be able to produce a quick response to force, otherwise it can be subjected to great strain, leading to ligament rupture. Therefore, coordination of the muscles firing rate and balance should be improved as they play a key role in reflex control of the muscle. Women are shown to display greater knee extension and larger force when landing. According to Kaplan (2002), female athletes might have decreased motor reflex rate in comparison to male athletes. Females also tend to recruit the quadriceps during the landing phase and this places them more at risk of a rupture. Women athletes have also been shown to have greater electromechanical delays. The transmission of electrical signals to the brain via the motor neurons in response to reflex is usually of a shorter duration. Females tend to have a slight difference in reaction times in comparison to males. This delay can reduce the reaction of the muscles to force, therefore, casing the ligaments to stretch for a longer amount of time than normal. Hormonal difference Menstrual cycle causes changes in the level of estrogen, which affects the strength of the ligament. Women have also been shown to sustain ligament injury during the ovulatory stage of the monthly cycle. The increase in the amount of estrogen during this phase has been determined as the cause of such injuries. How to prevent the injury Females tend to have unstable hips and weak lower abdominal muscles. This places them more at risk of an injury. Poor muscular control has been shown to tilt the pelvis forward, which permits for a more internal rotation of the knee. Working on strengthening the abdominal muscles, hip rotators, core muscles and gluteal muscles will produce more stability to the hips while allowing the internal rotation of the knees to be better controlled. Furthermore, training the hamstrings and quadriceps are also essential to prevent ACL injuries. According to (ref), men tend to stabilize their knee joint using muscles, whereas females tend to be more ligament dominant when it comes to stabilizing the knee joint. Thus, it is essential that females train their quadriceps to help strengthen the muscles so that the knee joint can be better controlled. It is also important to train the hamstrings along with the quadriceps so that both group of muscles are working together to hold the knee in a stable position. Improving neuromuscular coordination is also important to correct. Hewitt et al. suggest that practicing in balance related exercises could help improve the coordination of muscles and improve lower body strength. They showed that neuromuscular training produced greater knee stability in females who participated in the training. It their study, Myer et al. (2005) subjected forty-one female basketball, soccer and volleyball players for a period of six weeks to neuromuscular training program for the prevention of lower-extremity injuries. They founds that subjects who underwent the training showed improvement in knee ROM and knee varus and valgus torques in comparison to the untrained group. Neuromuscular training has also been shown to alter the biomechanics of the knee, in particular knee flexion during landing from a jump. Furthermore, to avoid dangerous injuries to the knee, Griffin (ref) suggests athletes land with bent-knees from a jump and to lower the speed when performing a cutting maneuver. During a full extension of the knee, Grifffin’s articles claim that anterior displacement of the tibia as a result of a strong quadriceps contraction could strain the ACL. However, when the knee is flexed during the landing phase, the ACL is under less strain from the quadriceps. To develop better ACL injury prevention, deceleration movements of the knee should be practiced as separate drills such as landing, hoping, and cutting, hence producing quicker physiological responses. In addition, teaching the athletes to perform skills in the correct pattern can help to reduce the likelihood of an injury. Landing with an upright torso and bend knees should be practiced. Finally, wearing correct footwear is extremely important. Athletes’ shoes should minimize rotational friction that is produced by the ground to avoid injury and allow better performance in activities such as hindering and cutting. Read More