COLUMBUS, Ohio – From
professional athletes who lack proper conditioning because of a lockout to
high-school girls who are more prone to injury, specific groups are
statistically more likely to injure their anterior cruciate ligaments (ACL)
while playing sports. The Ohio State University Wexner Medical
Center
is helping to
identify and prevent injury for athletes most susceptible to ACL injuries.
“When training is
delayed because of negotiations, and conditioning time is compromised, we risk
our athletes becoming more seriously injured down the road,” said Hewett.
Hewett was
recently invited to speak at the 2013 NBA Physician's meeting about how to
prevent further ACL injuries in professional athletes, and will continue to
work with their athletic trainers and strength coaches to focus on prevention
techniques.
Using
high-tech, infrared cameras and a gym floor tiled with motion-activated
sensors, Hewett and other
researchers at Ohio State’s Sports
Medicine put athletes through various
tests to track and animate their bodies using a 3-D computer program.
Researchers analyze everything from an athlete’s body structure to their
pattern of movement to predict how likely they are to injure their ACLs.
Once
researchers identify these high-risk patients, they develop personalized
exercise programs to strengthen an athlete, or help them correct their form in
order to avoid injury.
“We
use neuromuscular training, which teaches greater core control, better hip and
knee control, and we do that in very challenging, sports-like environments to
mimic conditions from the soccer field to the basketball court,”
said Hewett.
Athletic trainers are
teaching the same techniques to professional athletes as to high school girls
and other at-risk athletes.
“We used to think
these types of injuries were a result of body type or simply couldn’t be helped,”
said Hewett. “But by teaching athletes to move differently while they are
mimicking then playing their sports, we can prevent ACL injuries in groups with
disparities.”
It
was previously thought that females had a higher risk for ACL injury because of
genetics or hormones, but Hewett says the way they control their core
muscles, hips and knee joints causes the increased relative risk for injury.
“For
high-school girls who are 4 to 10 times more likely to injure their ACLs than
boys, you can actually reduce relative risk in women and girls to equal to that
of men and boys,” said Hewett. “We have
shown reductions in relative risk in the range of 60 to 65 percent, which is
enormous.”
In
this case, relative risk is the ratio of the chance of an injury developing
among female athletes who complete the personalized exercise program compared
to those who don’t, Hewett said.
“We make our female
athletes aware of their movement and teach them to square up their knees
properly to keep them from falling in,” sad Hewett. “We also measure their
quadricep-hamstring strength. If their hamstrings are 50 percent or less as
strong as their quadriceps, that means the back of their thighs are less than
half the strength of the front and the risk for injury is high. Through our
personalized training program, we can start rebalancing this strength.”
Researchers now know
enough about ACL injuries that identifying those at risk can be done in a
high-tech laboratory or at home. To determine if a child might be at risk, have
her drop down off a foot-tall box and then immediately go into a high vertical
jump. If right before she lands, her knees go together for half of her landing
or more, she may have a higher-risk for injury.
Hewett says core
strength can be determined using a simple exercise with an “X” of tape on the
floor. The athlete hops on one foot between the four quadrants, counting the
number of touchdowns on the right versus the left foot for 30 second. If there
is a lot of using only one foot, the athletes needs to work on a more symmetric
distribution of core strength to help prevent ACL injury.
“When a woman has torn
one ACL, her relative risk of tearing it again is up to 16 times a person
who has not torn their ACL,” said Hewett. “Once
a female tears her ACL, not only does she have up to a year loss of the
physical activity and benefit of her sport, but she also has between a 50 and
100 percent chance of developing osteoarthritis, which is a disabling knee
condition. In a couple decades, that could mean a full knee replacement, which
we want to avoid at all costs.”
Women basketball
players have the highest sex-disparity relative risk and soccer has the most
ACL injuries overall. Sports like skiing, handball and volleyball also put
girls at risk for ACL injuries, according to Hewett.
“There are more than
120,000 ACL injuries a year in the United States, but we have the potential to
reduce that by more than half, and prevent further even more serious injuries,
which is key,” said Hewett.
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For high-quality video and photos: http://bit.ly/WeDAwh
Contact: Gina Bericchi
a, Wexner Medical Center Public Affairs & Media Relations, 614-293-3737, Gina.Bericchia@osumc.edu
