Why Female Athletes Have A Higher Risk of ACL Injury - Yale Medicine Explains

Transcript

• 00:06The knee is absolutely essential
• 00:08for movement and ability.
• 00:10It allows us to do
• 00:11any activity that we perform
• 00:13from simple walking to running,
• 00:15jumping, dancing, or kicking a
• 00:16ball.
• 00:18A ligament is a tight
• 00:19fibrous band that connects two
• 00:21bones to each other, usually
• 00:22in or around a joint.
• 00:23And what ligaments do is
• 00:24they allow joints to move
• 00:26without becoming unstable.
• 00:28There are four primary ligaments
• 00:30in the knee that we
• 00:30think about. The MCL, the
• 00:32LCL, the PCL, and then
• 00:34most importantly, the ACL.
• 00:36The ACL is in the
• 00:37center of your knee and
• 00:38it basically provides both rotational
• 00:40and forward stability to your
• 00:42knee.
• 00:44So the ligaments have some
• 00:46give to them, but they
• 00:46have a breaking point if
• 00:48a joint is moved in
• 00:49a way that it wasn't
• 00:49meant to.
• 00:51There are two main ways
• 00:51that the ACL gets injured,
• 00:53especially in a sports context.
• 00:54The first is simply if
• 00:55someone gets struck in the
• 00:57knees. But actually, interestingly, just
• 00:58as if not more commonly,
• 01:00are non contact injuries to
• 01:01the ACL. When basically a
• 01:02player stops and turns or
• 01:04twists or moves to the
• 01:05side and the combined force
• 01:07of the body rotating or
• 01:08turning or twisting is too
• 01:09much for the ACL to
• 01:10withstand and it tears.
• 01:12For most athletes,
• 01:14having an ACL tear means
• 01:15having a surgery to reconstruct
• 01:17or in some cases to
• 01:18repair the ligament.
• 01:20So it's unusual for an
• 01:22athlete to return to competitive
• 01:24play in really less than
• 01:25nine months. We're talking about
• 01:27young people who are planning
• 01:28the arc of their lives
• 01:29based on what they can
• 01:30athletically achieve during their teenage
• 01:32years. So an injury can
• 01:33take them far away from
• 01:34where they wanna be.
• 01:42So we know that female
• 01:44athletes are facing an uphill
• 01:46battle. There are lots of
• 01:47different challenges that are unique
• 01:48to them.
• 01:49There are a number of
• 01:50reasons that we've hypothesized that
• 01:52female athletes are more prone
• 01:54to these injuries.
• 01:55Some of them have to
• 01:56do with
• 01:57anatomy. After you go through
• 01:58puberty, your hips get wider
• 01:59and your knees are closer
• 02:00together, which tends to put
• 02:02the knee in a little
• 02:03bit of a risky position.
• 02:05We also think hormone levels
• 02:07may play a role. There,
• 02:08have been observed to be
• 02:09some differences in the frequency
• 02:10of ACL injuries at different
• 02:12portions of the menstrual cycle,
• 02:14for example. And then finally,
• 02:15there's probably a training or
• 02:16a biomechanical
• 02:17and strength difference, and that
• 02:18leads to a little bit
• 02:19of an imbalance. It is
• 02:20really difficult
• 02:22to adjust to this, you
• 02:23know, life altering injury, especially
• 02:25in a period of adolescence.
• 02:27That can change their sense
• 02:28of self, their sense of
• 02:29self worth, how they relate
• 02:31to their peers.
• 02:34It's really important to meet
• 02:36those athletes where they are
• 02:37and then come up with
• 02:38a positive kind of strengths
• 02:40oriented plan to get there.
• 02:47The goal of the program
• 02:48is to provide a safe
• 02:50evidence based medical home for
• 02:52female athletes
• 02:54so that they can get
• 02:55tailored care to themselves to
• 02:57help them reach their peak
• 02:58goals.
• 02:59Our team includes an orthopedic
• 03:01surgeon, non operative sports medicine,
• 03:03adolescent medicine and gynecology, pediatric
• 03:05and adolescent psychology, athletic training,
• 03:07and nursing support.
• 03:09We think we can address
• 03:10a really broad array of
• 03:13potential injuries and issues. Those
• 03:15would include concussions,
• 03:16any type of orthopedic injury.
• 03:18We also though really wanna
• 03:19look at their overall health,
• 03:21so nutritional concerns,
• 03:23concerns related to menstruation.
• 03:25There's so much to be
• 03:26said about the importance of
• 03:27psychology
• 03:28to treating athletes, and we
• 03:29feel that that's a really
• 03:30essential component.
• 03:33There are increased pressures to
• 03:35perform in a certain way.
• 03:36There are body image concerns,
• 03:38and we know that female
• 03:40athletes are at twice as
• 03:42much of risk for experiencing
• 03:44depressive symptoms after an injury.
• 03:46We're working on helping these
• 03:48young athletes navigate that journey.
• 03:52No two athletes and no
• 03:54two
• 03:55teenagers are the same. We
• 03:57have a lot of time
• 03:57that we allocate for each
• 03:58of our patients. We're really
• 04:00able to get to know
• 04:01the whole person and take
• 04:03all of the medical, social,
• 04:04psychological,
• 04:06and orthopedic structural stuff into
• 04:08account.
• 04:09When I see someone who's
• 04:10not just healed from their
• 04:11ACL surgery, but is feeling
• 04:12healthy and feeling ready, feeling
• 04:14mentally strong, feeling like they've
• 04:15got their nutrition worked out
• 04:17and goes back to sport
• 04:18and succeeds and feels great
• 04:19about themselves, that's the best
• 04:20possible feeling.