A torn anterior cruciate ligament, the connective tissue within the knee joint that restricts movement of the tibia under the femur, is the bane of female athletes, especially soccer players. Torn ACLs from playing soccer top the list of knee problems for female athletes, according to tracking by the NCAA of all sports, report the authors of "The Female Athlete's Body Book." Knee ligaments tend to tear during abrupt motions and rarely occur on wet turf since the foot cannot plant as firmly.
Types
The most common knee injuries in soccer are meniscal tears, ligament sprains, particularly of the ACL and cartilage defects, writes exercise physiologist Donald T. Kirkendall in "The Complete Guide to Soccer Fitness and Injury Prevention." ACL problems are the subject of the most research focus for female soccer athletes. Three-quarters of the time, the injury involves no direct contact to the knee and results instead from too-swift deceleration, changing direction and preparing for a landing from a jump. While female athletes in other sports, such as basketball, also subject their knees to twists and stops, these other sports don't have the run volume or quite as many changes of direction as soccer, nor do the players wear cleated shoes.
Mechanics
While twists and stops are common and constant motions in soccer, for unexplained reasons, control of the hip and knee goes wrong, perhaps due to a turf divot, a bump or a loss of concentration, Kirkendall explains. He describes for example a woman who tore her ACL when she whiffed taking a shot. The feet plant unexpectedly, the thigh muscles contract strongly and the tibia slid forward under the femur, tearing the ACL. The athlete experiences swelling, pain and sometimes an audible pop.
Time Frame
While boys and girls land softly and naturally when they are younger, after puberty, girls begin to land stiffly and no longer absorb the shock of landing correctly. Most ACL patients seen for ACL tears are in middle school or high school, Kirkendall notes.
Prevention
Prevention is key to avoid pain, an operation to reconstruct the ACL, rehabilitation time and symptoms of osteoarthritis developing around 15 years after the injury occurs. Female athletes need to consciously work to land from jumps gently with knees widely spaced apart and bent, avoiding a stiff landing with knock knees, Kirkendall writes. It's impossible to land with stiff knees if the knees are spaced. While it would seem learning how to land correctly from a jump would be obvious, coaches need to actually teach girls who play soccer how to maintain a gentle landing around the time they enter puberty. They also need to pivot in three steps with the knees flexed rather than making an abrupt turn, note the authors of "The Female Athlete's Body Book." U.S. Soccer recommends a daily 20-minute program to combat knee injuries, involving warmups, stretches, leg strengthening, plyometrics and agility runs, as well as abs work.
