Last week I evaluated the younger sister of one of my previous clients who let's just say didn't embrace the whole idea of strength training. She loved the idea of doing it, loved the thought of what results she would get after it was done but she just didn't want to put the time in the gym. There were one hundred excuses why she just couldn't get it done. "I don't have time", "I have practice and games" and "I can't get a ride ".

Fast forward to the fall of 2007. Sprint left...cut right...stop...POP! Yup, that was her ACL. GONE! Not only did she lose her ACL but her MCL and medial meniscus a condition also known to orthopedists as the "Terrible Triad" or "Unhappy Triad".

This is actually a time when I hate being right. When I evaluated this young lady a year and a half before I had found what we call an ACL insufficiency witch is basically a knee that has mild to significant instability because the ACL is either naturally loose or the athlete had previously strained or stretched the ligament causing it to be loser than normal. Unfortunately this girl was almost destined to have this injury! Had she taken the proper steps to make some of the corrections recommended to her she would have had at least a 50% less chance of injury. Like I always say injuries are not always preventable but are very reducible with a solid strength program.

So here we are a year and a half later and I have this girls mom sitting in front of me with her younger daughter. She said to me "I guess you know why we are here with the youger one now. I don't want her to go through what my older one endured". If I had a dime for all the times I have heard parents say "we learned alot of hard lessens through experience with the first child", unfortunately I hear it too often. 

ACL injuries right now among female athletes are at epidemic proprtions. Females rupture ACL's at twice the rate of males! Here is a short list of reasons why female athletes are a greater risk:

• During the peak years of puberty for females ages 11-16 estrogen levels are very high causing ligaments to be more lax or loose.
• Females have a wider hip angle also known as Q-Angle or Quadriceps angle which causes a greater stress on the medial or inside portion of the knee. Most females do not strength train and have very weak VMO (Vastus Medialis Oblique) muscles putting them at greater risk of ligament strain because this muscle plays a big role in stabilizing the knee joint.
• At the higher levels of play where they may be playing on travel teams or playing multiple sports, overtraining and over-conditioning occurs (read the 6 reasons why aerobic training is counterproductive in this weeks newsletter) causing breakdown of the soft tissues and reduced recovery time again increasing the risk of injury.

The list can go on and on but where should the female athlete go from here?

• Get in the weight room. The whole idea of strength training doesn't always appeal to many female athletes but ironically in the better female collegiate soccer and lacrosse programs the first stop during pre-season readiness programs is the gym with the programs strength coach. More female athletes need to be introduced to the concept and value of strength training at younger ages during the onset of puberty. Just being a good athlete is no guarantee that her body will stand up to the rigors of constant play!

• Learn how to sprint and run correctly. Females tend to run with a completely different gait pattern than males. They run more upright almost stiff legged without the proper use of the upper extremities. Most often this is caused by a combination of muscle weakness both upper and lower, muscle imbalance and flexibility deficits which are most often very correctable.
• STOP OVER-CONDITIONING! Balance your training with a combination of strength training and anaerobic sprint training. Females in my experience seem to be even more likely to over-train than males because they will more often hit the treadmill or elliptical machine before they would ever go to the gym and lift weights. In my opinion this is the #1 culprit of of why so many athletes burn out on the athletic field. Again read "the six reasons why aerobic training is counterproductive"
• Get yourself, your athlete or if you coach a team into a strength & conditioning program that emphasizes an ACL prevention program! Here at Xceleration all of our female athletes first go through our ACL prevention protocol before they do anything else.

The proof is in the pudding on this one. I think we have seen enough knee injuries in female athletes to conclude that some sort of preventative measure should be taken if they partake in a sport. Why wait until it is too late? So, don't make me say I told you so...