(Knee: Side View)
I’ve been thinking a lot about knees lately. Mine were in pretty good shape until a few years ago when I had a bike accident. I lacerated my right patella tendon, and ever since my knee has been somewhat tight and unstable. The good news is that it doesn’t bother me too much, so I’m still able to ski.
Nonetheless, knee issues are not uncommon. A lot of women on TheSkiDiva.com have had problems with their ACL’s, or Anterior Cruciate Ligament. This is one of the four major ligaments in the knee, controlling how far forward the tibia moves under the femur. (The tibia is the larger bone beneath your knee; the femur is your thigh bone). It’s the first ligament that tightens when the knee is straightened. If the knee is forced past this point, that’s when trouble begins.
According to my research, female athletes are nearly three times more likely to suffer an ACL injury than men — a huge difference.
Which leads to the following question:
Oddly enough, no one seems to know exactly, though there are a number of theories. I’m no doctor or medical authority, but they seem to boil down to the following:
• Reduced muscle strength: Women have less muscle strength than men, so we rely more on the ACL to hold the knee in place. This can make the ligament more prone to rupture.
• Knee alignment: The Q angle, or the angle in which the quadriceps meet the femur, is greater in women than it is in men. Because of this, any twisting action can exert greater force on the ACL than it does in men. This, again, can cause it to rupture.
• Hormones: Yes, yet another thing we can chalk up to these buggers. On the up side, hormones can give women’s ligaments and joints greater flexibility. On the down side, if the other ligaments and muscles around the knee are so loose that they can’t absorb stress, then even normal loads or forces may be transferred directly to the ACL. And this can make it, yes, prone to rupture. Some studies even show that the knee can become even looser than normal at specific points within the menstrual cycle, making ACL ruptures even more common.
• Delayed response: It’s also been determined that women’s muscles that stablize the knee may take a millisecond longer to respond than men’s, and that this small difference could lead to an injury.
So what’s to be done? Is there anything, apart from not skiing (heaven forbid), that you can do to keep your ACL injury-free?
The good news is yes. Studies show that improving muscular power and strength can help. These are two different things. Strength refers to the amount of force that can be applied to a muscle, and power to the combined factors of speed and strength. Weights and resistance training are good for the former, and plyometric exercises for the latter. Plyometrics are designed to produce fast, explosive movements in which the muscle is loaded and unloaded in rapid sequence.
My advice: if you want to begin any kind of program to help your ACL, consult a good physical trainer. Start your training well in advance, and your knees will thank you next season.
I hope I haven’t jinxed myself by posting this. I’m a little superstitious, and I wouldn’t want to attract the evil eye. All the same, and not being one to take chances, I hope you don’t mind if I include the following picture. Maybe it’ll help.
Your timing is right on cue. I have been fussing with aging knees for several years and this summer things escalated. I just scheduled an appointment for evaluation. Hoping for news that still puts me on snow this November. I am trying to strengthen the supporting muscle groups and working on balance drills. Good luck to you.
Hope things go well for you, Pat!
I’ve been doing the online ACLstrong course for snow sports this summer. (Signed up via PSIA, but it’s also open to the public.) Not free, but if you pay for something you’re more likely to use it, right? Four weeks+ of 20-25 minute work-outs, to be done 3 or 4 times per week. Developed and supervised by a physiotherapist. Has adjustments for different levels of strength and fitness. It certainly is helping with leg strength and knee stability, even though I have stretched the course out over a longer time, because of other activities. I intend to continue the workouts through the fall and winter. https://aclstrong.com/
Sounds like a great resource, Juanita. Thanks for posting about it.