Teen Female Athletes Can Benefit From Knee-Hip Training at Puberty to Prevent ACL Injuries

Published Dec. 2016
American Journal of Sports Medicine

Adolescent female athletes who are entering puberty can benefit from core stability training programs to prevent anterior cruciate ligament (ACL) knee injuries, and a new study helps doctors, coaches, trainers and therapists identify the most at-risk athletes.

Female teen athletes are 2-10 times more likely than boys to experience ACL injuries. Researchers from the Division of Sports Medicine uncovered three discernable athlete risk profiles—low (14 percent), moderate (72 percent) and high (14 percent)—based on faulty neuromuscular movement patterns that predict increased knee abduction movement (KAM).

KAM tends to appear in young girls as they enter puberty and increases with age.

“Female athletes do not naturally adapt to the neuromuscular spurt that accompanies puberty,” says Greg Myer, PhD, who collaborated with researchers from the Mayo Clinic and High Point University on this study. “But training programs can help their bodies adapt during puberty and gain the specific skills, strength and body movements needed, especially throughout the knees, hip and core, to be protected from injuries.”

The study, appearing in the American Journal of Sports Medicine, won the O’Donoghue Award from The American Orthopaedic Society for Sports Medicine. The project involved 467 athletes who participated in pre-season jumping, cutting and pivoting activities. Latent profile analysis based on biomechanical landing data identified the moderate- and high-risk groups as most likely to benefit most from ACL-prevention training programs.

The study validates the value of injury-prevention programs, Myer says. It also raises questions about the value of overly specialized sports training programs, which can “tighten up athletes’ motor profiles and close the window of opportunity for a broader set of neuromuscular patterns to develop,” he says.

The single-leg drop (SLD) is one of three testing maneuvers that provided biomechanical landing data used in the study to identify risk profiles for anterior cruciate ligament injuries in adolescent female athletes. The SLD is designed to mimic off-balance landings. Other movements studied as part of this research included a drop vertical jump to measure medial knee collapse and a crossover single-leg drop to elicit both knee abduction motion and trunk motion. Most of the female athletes in the study participated in basketball (48.8%), volleyball (26.6%) or soccer (24.6%).

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Citation

Hewett TE, Ford KR, Xu YY, Khoury J, Myer GD. Utilization of ACL Injury Biomechanical and Neuromuscular Risk Profile Analysis to Determine the Effectiveness of Neuromuscular Training. Am J Sports Med. 2016 Dec;44(12):3146-3151.

A photo of Gregory Myer.

Gregory Myer, PhD