Knee injuries ‘epidemic’ among female athletes

In the last 13 months, the Waconia girls’ basketball team has been disproportionately plagued with knee injuries. Five different players have accrued seven different injuries, mostly torn anterior cruciate ligaments (ACL).

A look at the bench during a game shows knee after knee in hard or soft braces. At least one player is usually on crutches and in street clothes. The only “healthy” looking players are those that are new to the varsity level and a few veterans who have managed to avoid the onslaught of injury.

While the Wildcats may have had a bout of bad luck in the knee injury department, injuries abound on basketball teams across the state. Watertown-Mayer’s Kate Theisen missed most of her senior season this year due to a knee injury; Waconia junior Tommy Gove spent the second half of the season on crutches on the Wildcat boys’ bench. The Mayer Lutheran girls’ team also had a few knee braces always worn during games.

The Waconia girls’ basketball team has been plagued with knee injuries in Carl Pierson’s first 13 months as head coach. Not only does senior Stephanie Dressen (center) sport a knee brace in this Jan. 15 game, but teammates Nicole Dressen (left) and Morgan Iverson also do.

The Waconia girls’ basketball team has been plagued with knee injuries in Carl Pierson’s first 13 months as head coach. Not only does senior Stephanie Dressen (center) sport a knee brace in this Jan. 15 game, but teammates Nicole Dressen (left) and Morgan Iverson also do.

At nearly every school, at least one basketball player is sporting some kind of knee injury.

In his first ten years of coaching, Waconia head coach Carl Pierson had just two students suffer knee injuries. Now in just over one year and two basketball seasons at Waconia, he’s seen seven.

Chris Meyer, MD, of Twin Cities Orthopedic in Waconia agreed that across the country, female non-contact ACL injuries are on the rise.

“Female ACL, at least in the last decade, has been labeled epidemic,” Meyer said.

Non-contact ACL injuries among female athletes have become a new phenomenon and no doctor, research, or clinic has yet to pinpoint exactly why girls are more likely than their male counterparts to suffer such injuries.

Meyer believes part of the problem could stem from athletes, both male and female, specializing in one sport and playing it year round.

“The three-sport athlete is kind of a dinosaur,” Meyer said.

The level of skill it takes to compete in a given sport is at a much higher level now. Any sport can be played nearly year-round, with no offseason to rest the muscles groups involved in that activity, Meyer said. Tougher, and longer, schedules produce more fatigue on the muscles and joints associated with a sport.

“Sports become life,” Jeffrey Mair, DO, also of TCO – Waconia said.

In his recently released book, “Any Given Monday,” Dr. James Andrews agrees that overuse is the main cause of youth sports injuries. He claims that almost 50 percent of sports injuries are from overuse, and at least 60 percent of those could have been prevented.

The knee is especially at risk of injury in “cutting” sports, those that involve sudden jerks or movements, such basketball and soccer.

Meyer said one of the thoughts behind this is that the athlete is surprised or something changes suddenly, the quadricep muscle fires and the athlete twists.

The constant joint pounding and twisting on the hardwood courts can also produce other ACL-associated trauma in other areas of the knee, including cartilage injuries, meniscus tears, and dislocated kneecaps.

Nearly every sports fan has seen the injury and recovery process of local Minnesota professionals like Adrian Peterson and Ricky Rubio. Both took over eight months to return to action, according to Mair. He pointed out that these athletes are being paid to train and rehabilitate for hours a day, multiple days a week. High school athletes simply don’t have those opportunities.

“It’s fairly aggressive to expect high school athletes to be back in six months,” Mair said, when even the professional athletes are taking longer.

Depending on the severity of the injury, basketball players can be kept off the court for weeks, months, or even beyond the one-year mark. A knee strain can take 2-12 weeks to fully recover, while an ACL reconstruction typically takes a minimum of six months. As he sees an increasing number of ACL injuries, Mair said he is becoming more conservative in his return-to-action prognosis, and typically suggests 8-10 months for recovery. He tells his patients their rehab time depends on how hard they work to get healthy.

“You’ve got to prove that  you want to go back,” he said. “Put the time in and prove it.”

A common misconception among athletes is that reconstructed ACLs make the knee stronger than it was before. In truth, athletes are just as at risk to retear a repaired knee than they are to injure the other healthy one. Mair and Meyer agreed that the retear rate is 5-10 percent, while the risk of tearing the other knee is also around 10 percent. Athletes are at the highest risk of retear in the first year post-injury.

Mair said because of the recent publicity and injury rate in Waconia, the community has a heightened sense of awareness about knee injuries to high school athletes. While there are many programs and resources available to help attempt to prevent such injuries, he said two important questions remain: who’s going to pay for the programs and how do you get the healthy athletes to buy into a preventative program pre-injury?

“Kids don’t see the reason why they have to train that way, because they’re not injured,” Mair said.

Pierson is at a loss as to why his team seems more prone to injury. One Wildcatwas hurt in a phy ed class, another was hurt during a varsity game, while a third was injured during the AAU basketball season, but was also playing volleyball and running track concurrently. The last seems to support Meyer’s idea of overuse without an offseason.

“She wasn’t just burning the candle at both ends, she was lighting the middle of it on fire too,” Pierson said.

In Pierson’s mind, the only common denominator among his team’s injuries is not enough time devoted to strength training.

“When you’re not as physically strong, you’re more susceptible to these kinds of severe injuries,” he said.

Injuries don’t just impact a team physically, but emotionally as well. During the 2011-12 season, Pierson said the constant injuries were “pretty traumatic” for the team.

“It just seemed like every week we were getting hit with another extended absence or season-ending injury,” he said.

But this season, any kind of injury setback had little to no emotional impact on the team, as the Wildcats had already learned they could persevere and still play well as a team. With three players coming off ACL injuries for the 2012-13 season, the team felt the residual impact from the previous year’s injuries.

“They weren’t the players they were the year before, but they were still pretty good,” Pierson said.

Already having suffered injuries in the 2011-12 season, Waconia had two players retear their ACLs this season, but played through the injury anyway.

“To their credit, they toughed it out and played through it and helped us,” Pierson said.

Senior Fiona DeMario played 15 games this year on a torn ACL, while other teammates never got official medical clearance to play, but Pierson said doctors and parents agreed that the athlete couldn’t make the injury much worse.  Those athletes opted to play through the pain and be there for the team.

Pierson said he isn’t going to be the one to tell a player she can’t play.

“It it means that much to them, I’m not going to be the one to tell them they can’t play,” he said.

Pierson believes that for his team, it’s a change of mind about strength training to prevent more injuries.

“I feel that we are well behind most of the teams we compete against in terms of strength training.” he said.

Regardless of the preventative methods taken, Mair said athletes are always at risk because of the nature of athletics.

“There’s a risk to it and injuries are going to happen,” he said. “It’s roulette.”

 

Contact Melissa Marohl at melissa.marohl@ecm-inc.com

 
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