Saving Young Knees

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Courtney Corby has learned a lot about her knee in the last year.

After tearing her ACL in a basketball game as a junior and rehabbing her way back to health for her senior athletic season, Corby wrote a research paper on the subject, finding out that as a girl she’s more susceptible to a severe knee injury than her male counterparts.

Saving young knees

Females more at risk for knee injuries, but methods can help

9:14 PM, Jun 16, 2012
Dr. Todd Murphy holds a knee joint model as he discusses ACL tears as Courtney Corvy, 17, of Clyde Township, who tore her ACL in her right knee during the 2011 high school basketball season, is seen at right. / MELISSA WAWZYSKO/TIMES HERALD
Written by
PAUL COSTANZO
Times Herald

Sports

Dr. Todd Murphy holds a knee joint model and demonstrates the motion associated with an ACL tear as Courtney Corvy, 17, of Clyde Township, who tore her ACL in her right knee during the 2011 high school basketball season, is seen at right. / MELISSA WAWZYSKO/TIMES HERALD

Courtney Corby has learned a lot about her knee in the last year.

After tearing her ACL in a basketball game as a junior and rehabbing her way back to health for her senior athletic season, Corby wrote a research paper on the subject, finding out that as a girl she’s more susceptible to a severe knee injury than her male counterparts.

“I found out that because girls have wider hips, the line from their hip to their foot is on an angle, whereas guys are more straight, and it puts more stress on the knee,” the recent Port Huron High graduate said.

There appears to be a rise in severe knee injuries to student athletes in the area, especially in girls, according to Dr. Todd Murphy, who specializes in sports medicine at Orthopedic Associates in Port Huron. Murphy said as many as three of every four non-contact ACL tears he treats are females.

“It’s hard to put a finger on why (there’s an increase),” Murphy said. “It could have to do with a lot more females participating in sports these days, and that’s a good, positive thing. Maybe it’s just one of the results of that, we’re seeing a few more ACL injuries than we have.

“Even in the boys, it’s weird. Two seasons ago for football, we really didn’t see a whole lot. This past season, there were quite a few. But I would say for non-contact injuries, there are a lot more girls than boys, and the scary thing is, they’re younger and younger.”

Murphy cited a study done by the NCAA that compared, sport to sport, the number of ACL tears in males and females. He said that females are two to eight times more at risk than boys to suffer the injury, and that if the contact injuries are taken out of the equation, it’s even higher.

As Corby’s research showed, the angle of the knee is a major reason for that, but it’s not the only reason.

“Some of it has to do with muscular fatigue, but moreso than that, it’s neuromuscular control,” Murphy said. “A lot of girls will land with more of a straight-leg posture from a jump when they’re going into a pivot than a boy will. That puts the ACL at risk.”

While a female’s anatomy cannot be changed, her neuromuscular control can, and Murphy said that goes a long way toward limiting ACL injuries.

He said studies of Division I soccer teams that incorporated neuromuscular training for eight weeks prior to the season showed an almost 75% decrease in ACL tears in those that had gone through the program, as opposed to those who hadn’t.

“It includes stretching, strengthening, a lot of plyometrics,” Murphy said. “(Plyometrics) is a big part of it. It’s more explosive movements where they jump over cones from side to side or front to back; and just sport-specific agility stuff.”

Marine City girls soccer coach Dave Frendt incorporated something similar into his team’s warm-up after seeing a study from Norway on the subject. He said that since he’s started using the new warm-up, he hasn’t had a major knee injury on his team. This after years of having players go down with them.

“Everything is based on running, and balance and core exercises,” Frendt said. “The whole idea is to strengthen your balance and core along with the muscles ... that surround the knee. Plus, teaching them to cut and be better athletes.

“It takes a little longer to do the warm-up, but it’s worth it.”

Murphy added that Corby was able to recover more quickly from her injury because of the strength of her quadriceps, as she had done some powerlifting. Continuing the neuromuscular training after the injury is key, as well, as people who suffer a major knee injury are more at risk to suffer another one, Murphy said.

“I do kind of encourage the kids, after they’ve had it done to at least check out what they’re doing in powerlifting,” Murphy said. “Because a lot of that stuff is very positive.”

The toughest part of rehabilitation, however, can be the mental aspect of an athlete not being able to do what they have always done.

“I was definitely so excited to get back,” Corby said. “I had played since I was 5 years old, year-round, soccer, volleyball, basketball – and I had to go five months without doing anything at all.”

Murphy said once an athlete is released for activity, they are fully released. But getting to that point can take longer than they’d like.

“I won’t let a kid go back before they’re ready,” Murphy said. “Usually around three months they start to feel pretty good. (Corby) knows better than anybody, because every time she came in, it was like torture. It was like, ‘When are you going to sign my form?’

“I always say that it’s my job to make sure you’re ready. You can go out and tear it again, because you tore the best one that you’re ever going to get. I feel like through therapy, we can guide them to a point where we can reduce the risk as much as possible.

“It is a mentally difficult thing to go through. You can’t help but be proud of them when they get through it all.”

Murphy said he has not talked much with area coaches about implementing preventative programs, although he is willing. Richmond’s Mike Pearson, who coaches boys and girls tennis and girls basketball, said he would be willing to listen.

“Oh yeah, anything that’s going to help, if that’s an issue,” Pearson said. “Of course I would do it as a preventative means. I’ve never had any problems with (knee injuries), so I never looked into it.”

Murphy knows that injuries are simply a hazard of playing sports, but that doesn’t mean they can’t be at least curbed a bit.

“I don’t think we’ll ever get it to zero,” Murphy said. “But it would be nice to cut it down a little bit, and some of those programs can help with that.”