WEBVTT

NOTE duration: "00:04:28.757"


NOTE Confidence: 0.9947955

00:00:06.160 --> 00:00:07.759
The knee is absolutely essential

NOTE Confidence: 0.9947955

00:00:07.759 --> 00:00:09.059
for movement and ability.

NOTE Confidence: 0.9823917

00:00:09.679 --> 00:00:10.960
It allows us to do

NOTE Confidence: 0.9823917

00:00:10.960 --> 00:00:12.500
any activity that we perform

NOTE Confidence: 0.9823917

00:00:12.785 --> 00:00:14.545
from simple walking to running,

NOTE Confidence: 0.9823917

00:00:14.545 --> 00:00:16.225
jumping, dancing, or kicking a

NOTE Confidence: 0.9823917

00:00:16.225 --> 00:00:16.725
ball.

NOTE Confidence: 0.97513324

00:00:17.505 --> 00:00:18.945
A ligament is a tight

NOTE Confidence: 0.97513324

00:00:18.945 --> 00:00:20.704
fibrous band that connects two

NOTE Confidence: 0.97513324

00:00:20.704 --> 00:00:22.064
bones to each other, usually

NOTE Confidence: 0.97513324

00:00:22.064 --> 00:00:23.185
in or around a joint.

NOTE Confidence: 0.97513324

00:00:23.185 --> 00:00:24.224
And what ligaments do is

NOTE Confidence: 0.97513324

00:00:24.224 --> 00:00:25.765
they allow joints to move

NOTE Confidence: 0.97513324

00:00:25.904 --> 00:00:27.125
without becoming unstable.

NOTE Confidence: 0.9705108

00:00:28.060 --> 00:00:29.740
There are four primary ligaments

NOTE Confidence: 0.9705108

00:00:29.740 --> 00:00:30.460
in the knee that we

NOTE Confidence: 0.9705108

00:00:30.460 --> 00:00:32.300
think about. The MCL, the

NOTE Confidence: 0.9705108

00:00:32.300 --> 00:00:34.220
LCL, the PCL, and then

NOTE Confidence: 0.9705108

00:00:34.220 --> 00:00:35.760
most importantly, the ACL.

NOTE Confidence: 0.9741151

00:00:36.380 --> 00:00:37.260
The ACL is in the

NOTE Confidence: 0.9741151

00:00:37.260 --> 00:00:38.220
center of your knee and

NOTE Confidence: 0.9741151

00:00:38.220 --> 00:00:40.000
it basically provides both rotational

NOTE Confidence: 0.9741151

00:00:40.220 --> 00:00:42.059
and forward stability to your

NOTE Confidence: 0.9741151

00:00:42.059 --> 00:00:42.559
knee.

NOTE Confidence: 0.9755363

00:00:44.195 --> 00:00:45.554
So the ligaments have some

NOTE Confidence: 0.9755363

00:00:45.554 --> 00:00:46.434
give to them, but they

NOTE Confidence: 0.9755363

00:00:46.434 --> 00:00:47.635
have a breaking point if

NOTE Confidence: 0.9755363

00:00:47.635 --> 00:00:48.594
a joint is moved in

NOTE Confidence: 0.9755363

00:00:48.594 --> 00:00:49.394
a way that it wasn't

NOTE Confidence: 0.9755363

00:00:49.394 --> 00:00:50.135
meant to.

NOTE Confidence: 0.95061994

00:00:50.675 --> 00:00:51.475
There are two main ways

NOTE Confidence: 0.95061994

00:00:51.475 --> 00:00:52.754
that the ACL gets injured,

NOTE Confidence: 0.95061994

00:00:52.754 --> 00:00:54.195
especially in a sports context.

NOTE Confidence: 0.95061994

00:00:54.195 --> 00:00:55.234
The first is simply if

NOTE Confidence: 0.95061994

00:00:55.234 --> 00:00:56.590
someone gets struck in the

NOTE Confidence: 0.95061994

00:00:56.590 --> 00:00:58.270
knees. But actually, interestingly, just

NOTE Confidence: 0.95061994

00:00:58.270 --> 00:00:59.410
as if not more commonly,

NOTE Confidence: 0.95061994

00:00:59.550 --> 00:01:00.750
are non contact injuries to

NOTE Confidence: 0.95061994

00:01:00.750 --> 00:01:02.030
the ACL. When basically a

NOTE Confidence: 0.95061994

00:01:02.030 --> 00:01:03.949
player stops and turns or

NOTE Confidence: 0.95061994

00:01:03.949 --> 00:01:05.310
twists or moves to the

NOTE Confidence: 0.95061994

00:01:05.310 --> 00:01:06.750
side and the combined force

NOTE Confidence: 0.95061994

00:01:06.750 --> 00:01:07.950
of the body rotating or

NOTE Confidence: 0.95061994

00:01:07.950 --> 00:01:09.069
turning or twisting is too

NOTE Confidence: 0.95061994

00:01:09.069 --> 00:01:09.950
much for the ACL to

NOTE Confidence: 0.95061994

00:01:09.950 --> 00:01:11.090
withstand and it tears.

NOTE Confidence: 0.9853528

00:01:12.104 --> 00:01:13.244
For most athletes,

NOTE Confidence: 0.9548251

00:01:13.545 --> 00:01:15.145
having an ACL tear means

NOTE Confidence: 0.9548251

00:01:15.145 --> 00:01:17.084
having a surgery to reconstruct

NOTE Confidence: 0.9548251

00:01:17.225 --> 00:01:18.344
or in some cases to

NOTE Confidence: 0.9548251

00:01:18.344 --> 00:01:19.244
repair the ligament.

NOTE Confidence: 0.9851851

00:01:20.344 --> 00:01:21.865
So it's unusual for an

NOTE Confidence: 0.9851851

00:01:21.865 --> 00:01:23.485
athlete to return to competitive

NOTE Confidence: 0.9851851

00:01:23.625 --> 00:01:25.304
play in really less than

NOTE Confidence: 0.9851851

00:01:25.304 --> 00:01:26.505
nine months. We're talking about

NOTE Confidence: 0.9851851

00:01:26.505 --> 00:01:27.700
young people who are planning

NOTE Confidence: 0.9851851

00:01:27.700 --> 00:01:28.819
the arc of their lives

NOTE Confidence: 0.9851851

00:01:28.819 --> 00:01:29.619
based on what they can

NOTE Confidence: 0.9851851

00:01:29.619 --> 00:01:31.619
athletically achieve during their teenage

NOTE Confidence: 0.9851851

00:01:31.619 --> 00:01:32.899
years. So an injury can

NOTE Confidence: 0.9851851

00:01:32.899 --> 00:01:34.020
take them far away from

NOTE Confidence: 0.9851851

00:01:34.020 --> 00:01:35.240
where they wanna be.

NOTE Confidence: 0.98516715

00:01:42.084 --> 00:01:43.925
So we know that female

NOTE Confidence: 0.98516715

00:01:43.925 --> 00:01:45.605
athletes are facing an uphill

NOTE Confidence: 0.98516715

00:01:45.605 --> 00:01:46.645
battle. There are lots of

NOTE Confidence: 0.98516715

00:01:46.645 --> 00:01:48.345
different challenges that are unique

NOTE Confidence: 0.98516715

00:01:48.405 --> 00:01:48.985
to them.

NOTE Confidence: 0.9978642

00:01:49.285 --> 00:01:50.405
There are a number of

NOTE Confidence: 0.9978642

00:01:50.405 --> 00:01:52.245
reasons that we've hypothesized that

NOTE Confidence: 0.9978642

00:01:52.245 --> 00:01:53.765
female athletes are more prone

NOTE Confidence: 0.9978642

00:01:53.765 --> 00:01:54.665
to these injuries.

NOTE Confidence: 0.9993419

00:01:54.965 --> 00:01:55.740
Some of them have to

NOTE Confidence: 0.9993419

00:01:55.740 --> 00:01:56.400
do with

NOTE Confidence: 0.9875837

00:01:56.940 --> 00:01:58.060
anatomy. After you go through

NOTE Confidence: 0.9875837

00:01:58.060 --> 00:01:59.260
puberty, your hips get wider

NOTE Confidence: 0.9875837

00:01:59.260 --> 00:02:00.380
and your knees are closer

NOTE Confidence: 0.9875837

00:02:00.380 --> 00:02:01.900
together, which tends to put

NOTE Confidence: 0.9875837

00:02:01.900 --> 00:02:02.700
the knee in a little

NOTE Confidence: 0.9875837

00:02:02.700 --> 00:02:04.320
bit of a risky position.

NOTE Confidence: 0.982907

00:02:04.860 --> 00:02:06.780
We also think hormone levels

NOTE Confidence: 0.982907

00:02:06.780 --> 00:02:08.085
may play a role. There,

NOTE Confidence: 0.982907

00:02:08.325 --> 00:02:09.285
have been observed to be

NOTE Confidence: 0.982907

00:02:09.285 --> 00:02:10.405
some differences in the frequency

NOTE Confidence: 0.982907

00:02:10.405 --> 00:02:12.245
of ACL injuries at different

NOTE Confidence: 0.982907

00:02:12.245 --> 00:02:13.605
portions of the menstrual cycle,

NOTE Confidence: 0.982907

00:02:13.605 --> 00:02:14.885
for example. And then finally,

NOTE Confidence: 0.982907

00:02:14.885 --> 00:02:16.165
there's probably a training or

NOTE Confidence: 0.982907

00:02:16.165 --> 00:02:16.745
a biomechanical

NOTE Confidence: 0.97656006

00:02:17.125 --> 00:02:18.485
and strength difference, and that

NOTE Confidence: 0.97656006

00:02:18.485 --> 00:02:19.285
leads to a little bit

NOTE Confidence: 0.97656006

00:02:19.285 --> 00:02:20.485
of an imbalance. It is

NOTE Confidence: 0.97656006

00:02:20.485 --> 00:02:21.305
really difficult

NOTE Confidence: 0.9864274

00:02:21.900 --> 00:02:22.860
to adjust to this, you

NOTE Confidence: 0.9864274

00:02:22.860 --> 00:02:24.800
know, life altering injury, especially

NOTE Confidence: 0.9864274

00:02:24.860 --> 00:02:26.400
in a period of adolescence.

NOTE Confidence: 0.997894

00:02:26.780 --> 00:02:28.220
That can change their sense

NOTE Confidence: 0.997894

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of self, their sense of

NOTE Confidence: 0.997894

00:02:29.419 --> 00:02:31.020
self worth, how they relate

NOTE Confidence: 0.997894

00:02:31.020 --> 00:02:31.919
to their peers.

NOTE Confidence: 0.98042697

00:02:33.735 --> 00:02:35.575
It's really important to meet

NOTE Confidence: 0.98042697

00:02:35.575 --> 00:02:37.174
those athletes where they are

NOTE Confidence: 0.98042697

00:02:37.174 --> 00:02:38.215
and then come up with

NOTE Confidence: 0.98042697

00:02:38.215 --> 00:02:39.974
a positive kind of strengths

NOTE Confidence: 0.98042697

00:02:39.974 --> 00:02:41.514
oriented plan to get there.

NOTE Confidence: 0.9761386

00:02:47.360 --> 00:02:48.480
The goal of the program

NOTE Confidence: 0.9761386

00:02:48.480 --> 00:02:50.080
is to provide a safe

NOTE Confidence: 0.9761386

00:02:50.080 --> 00:02:52.480
evidence based medical home for

NOTE Confidence: 0.9761386

00:02:52.480 --> 00:02:53.460
female athletes

NOTE Confidence: 0.96984196

00:02:53.760 --> 00:02:54.880
so that they can get

NOTE Confidence: 0.96984196

00:02:54.880 --> 00:02:56.720
tailored care to themselves to

NOTE Confidence: 0.96984196

00:02:56.720 --> 00:02:58.000
help them reach their peak

NOTE Confidence: 0.96984196

00:02:58.000 --> 00:02:58.500
goals.

NOTE Confidence: 0.9711359

00:02:59.325 --> 00:03:00.764
Our team includes an orthopedic

NOTE Confidence: 0.9711359

00:03:00.764 --> 00:03:02.764
surgeon, non operative sports medicine,

NOTE Confidence: 0.9711359

00:03:02.764 --> 00:03:05.165
adolescent medicine and gynecology, pediatric

NOTE Confidence: 0.9711359

00:03:05.165 --> 00:03:07.405
and adolescent psychology, athletic training,

NOTE Confidence: 0.9711359

00:03:07.405 --> 00:03:08.545
and nursing support.

NOTE Confidence: 0.99680454

00:03:09.245 --> 00:03:10.365
We think we can address

NOTE Confidence: 0.99680454

00:03:10.365 --> 00:03:12.525
a really broad array of

NOTE Confidence: 0.99680454

00:03:12.525 --> 00:03:14.500
potential injuries and issues. Those

NOTE Confidence: 0.99680454

00:03:14.500 --> 00:03:15.720
would include concussions,

NOTE Confidence: 0.9445556

00:03:16.180 --> 00:03:18.040
any type of orthopedic injury.

NOTE Confidence: 0.9445556

00:03:18.100 --> 00:03:19.460
We also though really wanna

NOTE Confidence: 0.9445556

00:03:19.460 --> 00:03:20.660
look at their overall health,

NOTE Confidence: 0.9445556

00:03:20.660 --> 00:03:21.960
so nutritional concerns,

NOTE Confidence: 0.9982144

00:03:22.500 --> 00:03:23.880
concerns related to menstruation.

NOTE Confidence: 0.9928717

00:03:24.660 --> 00:03:25.620
There's so much to be

NOTE Confidence: 0.9928717

00:03:25.620 --> 00:03:26.660
said about the importance of

NOTE Confidence: 0.9928717

00:03:26.660 --> 00:03:27.160
psychology

NOTE Confidence: 0.98266715

00:03:27.505 --> 00:03:29.264
to treating athletes, and we

NOTE Confidence: 0.98266715

00:03:29.264 --> 00:03:30.225
feel that that's a really

NOTE Confidence: 0.98266715

00:03:30.225 --> 00:03:31.125
essential component.

NOTE Confidence: 0.97578496

00:03:32.865 --> 00:03:34.865
There are increased pressures to

NOTE Confidence: 0.97578496

00:03:34.865 --> 00:03:36.225
perform in a certain way.

NOTE Confidence: 0.97578496

00:03:36.225 --> 00:03:37.845
There are body image concerns,

NOTE Confidence: 0.9926727

00:03:38.225 --> 00:03:40.145
and we know that female

NOTE Confidence: 0.9926727

00:03:40.145 --> 00:03:41.849
athletes are at twice as

NOTE Confidence: 0.9926727

00:03:41.849 --> 00:03:43.629
much of risk for experiencing

NOTE Confidence: 0.9926727

00:03:43.690 --> 00:03:45.930
depressive symptoms after an injury.

NOTE Confidence: 0.9926727

00:03:45.930 --> 00:03:48.250
We're working on helping these

NOTE Confidence: 0.9926727

00:03:48.250 --> 00:03:50.590
young athletes navigate that journey.

NOTE Confidence: 0.9665351

00:03:52.489 --> 00:03:54.215
No two athletes and no

NOTE Confidence: 0.9665351

00:03:54.215 --> 00:03:54.715
two

NOTE Confidence: 0.98195183

00:03:55.015 --> 00:03:56.534
teenagers are the same. We

NOTE Confidence: 0.98195183

00:03:56.534 --> 00:03:57.415
have a lot of time

NOTE Confidence: 0.98195183

00:03:57.415 --> 00:03:58.454
that we allocate for each

NOTE Confidence: 0.98195183

00:03:58.454 --> 00:03:59.974
of our patients. We're really

NOTE Confidence: 0.98195183

00:03:59.974 --> 00:04:01.094
able to get to know

NOTE Confidence: 0.98195183

00:04:01.094 --> 00:04:02.614
the whole person and take

NOTE Confidence: 0.98195183

00:04:02.614 --> 00:04:04.234
all of the medical, social,

NOTE Confidence: 0.98195183

00:04:04.295 --> 00:04:04.795
psychological,

NOTE Confidence: 0.9827798

00:04:05.734 --> 00:04:07.690
and orthopedic structural stuff into

NOTE Confidence: 0.9827798

00:04:07.690 --> 00:04:08.190
account.

NOTE Confidence: 0.97026503

00:04:08.730 --> 00:04:09.850
When I see someone who's

NOTE Confidence: 0.97026503

00:04:09.850 --> 00:04:10.890
not just healed from their

NOTE Confidence: 0.97026503

00:04:10.890 --> 00:04:12.330
ACL surgery, but is feeling

NOTE Confidence: 0.97026503

00:04:12.330 --> 00:04:13.610
healthy and feeling ready, feeling

NOTE Confidence: 0.97026503

00:04:13.610 --> 00:04:15.209
mentally strong, feeling like they've

NOTE Confidence: 0.97026503

00:04:15.209 --> 00:04:16.810
got their nutrition worked out

NOTE Confidence: 0.97026503

00:04:16.810 --> 00:04:18.002
and goes back to sport

NOTE Confidence: 0.97026503

00:04:18.002 --> 00:04:19.122
and succeeds and feels great

NOTE Confidence: 0.97026503

00:04:19.122 --> 00:04:20.322
about themselves, that's the best

NOTE Confidence: 0.97026503

00:04:20.322 --> 00:04:21.222
possible feeling.