Preventing ACL injuries in girls

It is not uncommon to hear that girls (women) are different from boys (men) — aside from the obvious physical characteristics.  For example, girls are thought to be less athletic and considered to be the weaker sex.  Girls are considered to be slower than boys, experience more injuries than boys, and cannot generate the power needed for quick movements as can boys.  It is possible to go on with still other comparisons, but it would be fruitless, especially if you closely examine each of these beliefs.  You will find that they are only partial truths that have been perpetuated over the years.

Significant differences in speed, power, and explosiveness, do exist between boys and girls but only at the extremes of the normal distribution. For example, the fastest men in the world are faster than the fastest women in the world.  However, and this is most important to remember, the majority of men and women are basically equal in their speed capabilities.  It is possible to find many women faster than men and vice versa.  In fact, women runners in recent Olympic Games have broken men’s speed records set in earlier years!

In regard to ACL injuries women and especially girls have significantly more injuries than the men.  There are a several major reasons for this.  A major one is that there are now many more girls playing sports than ever before. From research and practical experience some of the key objective reasons have been identified for the great number of injuries and all of them can be resolved.

For example, many blame the injuries on the greater Q- angle (the angle of the thighbone in relation to the shin bone) that women and post pubescent girls have.  The wider the hips, the greater the angle of the femur and the greater the Q- angle. This increases the susceptibility to anterior cruciate ligament (ACL) damage.  However, girls who do exercises such as the squat, knee extension, knee curl, and straight leg hip abduction and adduction, rarely if ever experience ACL damage.  Although surgeons note that girls are generally more prone to ACL damage, I believe that most of the women who experience such damage are those who do not strength train most effectively to prevent such injuries. Nor do they have very effective technique in execution of some of the basic sports skills.

Keep in mind that it is important to prepare yourself for the activity in which you will be involved.  Sports such as soccer, field hockey, tennis, lacrosse, volleyball and others are relatively high-stress sports that require many vigorous, dynamic movements.  The forces experienced can be quite great.  Therefore, you should physically prepare your body to be able to withstand these forces especially when playing all-out.  The quick sprints, short stops, starts, tackling, etc., require great levels of fitness and effective execution of the skills involved.  You will not develop the optimal fitness levels or technique needed merely by playing the game, you must do supplementary training — especially weight training — to prepare the body for these stresses.

However, there are still many coaches and parents who believe that early weight training for girls will interfere with their puberty, growth pattern and menstrual cycle.  Because of this they do not advocate any form of weight training for the girls.  They believe that it will interfere with their height, will cause them to bulk up and in time will interfere with their athletic performance.  However, these myths that still persist have been refuted by the scientific research and practical experiences over the last decades.

The key in the early years is to teach the girls how to do various strength exercises and to develop proper technique in the basic skills.  This includes how to jump and how to land after a jump.  This skill has been identified as a leading cause of ACL injuries, when incorrectly executed.  Other skills to be mastered include running, kicking, hitting, throwing, etc. One of the main reasons for teaching these skills at an early age is that most skills are fairly well set by the ages of 11 to 13.  Changes in technique can still be made after these ages but they become increasingly difficult with each passing year.  Thus, greater strength in the early years will help to perfect these skills greatly, especially when coupled with technique. (The use of specialized – dynamic correspondence – exercises)

Most of the gains in strength and skill should come from learning how to do the exercises correctly, not from heavy weight training.  The key in these years is to teach girls how to do various strength exercises and to develop proper technique in execution of the basic skills.  The strength gained in the very early years is secondary to the learning.

When girls are exposed to weight training in the early years, especially learning how to do the exercises, they will not have difficulty with strength training when they get older.  One of the biggest complaints of college coaches of women’s teams is that most of the girls have no prior experience in weight training. This automatically puts them behind some of the other girls who are accomplished exercisers.  As is becoming increasingly evident, without weight training and effective teaching of the basic skills, it is not possible to prevent ACL injuries and reach the levels of performance being seen today.

It can be concluded that weight training, when accompanied by effective skill learning, is timely and beneficial in the prevention of ACL injuries. For more information on this topic see Build a Better Athlete.

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