Guest Opinions

Torn ACL: How we can help female athletes prevent this too-frequent injury

Boise State guard Riley Lupfer shoots a 3-pointer against Air Force in January at Taco Bell Arena. Lupfer set the school’s single-season record for 3-pointers this season.
Boise State guard Riley Lupfer shoots a 3-pointer against Air Force in January at Taco Bell Arena. Lupfer set the school’s single-season record for 3-pointers this season. doswald@idahostatesman.com

Congratulations to Riley Lupfer, Boise State University women’s basketball player, on her fine season. She set the school record for 3-point field goals made in a season. It is always good to see an athlete who is achieving success in her field through hard work, yet remaining modest and humble.

Most readers who saw an article about Lupfer in the Jan. 28 Statesman probably were drawn to Lupfer’s statistics or quotes. As a physical therapist, however, I noticed the photo accompanying the article. In the photo, Lupfer has the basketball and is preparing to shoot. She is squatting with her knees nearly touching. In biomechanics this knee position is referred to as a “valgus” position (ie, “knock-kneed”).

One can also see the defender from Air Force having her left knee in a valgus position. This poor knee position is often seen in female athletes and has been theorized to put ligaments in the knee at risk for injury. Some of these injuries can involve tears of the anterior cruciate ligament (ACL). These are very serious, of course, and require major surgery and extensive physical therapy for the athlete to return to sport, with some athletes never returning to their pre-injury athletic level.

The National Institute of Health has found that “female athletes on average have a 3.5 times greater risk for sustaining noncontact ACL injuries compared with males. This gender discrepancy stems from maladaptive neuromuscular recruitment patterns and poor jumping/landing biomechanics that can lead to greater risk for ACL tears in women.”

Physical therapists are movement specialists who can detect dysfunctional movement patterns in athletes. They can then work with the athletes to correct these dysfunctional patterns, thereby decreasing their risk for injury. I would recommend that every female athlete, with urging from their parents and coaches, consider having a movement evaluation performed by a physical therapist to assess their risk for knee injury. This evaluation would consist of measuring joint range of motion, flexibility, lower extremity strength and core stability. Then, an individualized exercise program consisting of appropriate neuromuscular recruitment patterns and education on proper jumping, cutting and landing biomechanics would be applied to the athlete’s needs.

Some reports calculate that there are as many as 80,000 ACL injuries involving high school female athletes each year. Let’s do all we can to decrease that number. And who knows? We may even ensure that one high school basketball player will avoid a serious knee injury and be able to challenge Lupfer’s records.

Jim Pape is a physical therapist with Saint Alphonsus Rehabilitation Services (STARS). He has 20 years of experience in treating patients in outpatient settings. He currently works in a clinic within the Downtown Y.

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