|
|
Post by soccermonster on Feb 11, 2021 19:15:45 GMT -5
I'm starting to see an increase in ACL injuries amongst our female soccer players and I'm wondering if there is really an opportunity through PT to prevent them.
In the past month I've personally known at least 6 girls in varying age groups from U12 to u17 who has suffered a tear not only with their ACL but MCL as well.
Would love to get some thoughts from parents or coaches if there is any real way to train to prevent these.
It hurts me to hear about these injuries especially during a crucial year and there has to be something that could help to prevent them.
I know that many of these injuries have happened during HS soccer games which is why DA prohibited them in the past but why is it more prevalent during the high school games?
|
|
|
|
Post by oraclesfriend on Feb 11, 2021 19:30:10 GMT -5
As for PT there are several programs that are aimed to prevent them. The PEP program out of Santa Monica is probably the most popular.
If you watch this video look at the girl with the blonde ponytail, red sweatshirt and black shorts. She really needs the program. Her right knee constantly falls inward (valgus) and she is wobbling on the lunges.
These programs only help prevent NONCONTACT ACL injuries. There is no prevention known for preventing contact injuries. I suspect high school causes more injuries (or appears to do so) because of two things: more contact due to less skill/knowledge of when to tackle and possibly overuse. There is new evidence that suggests ACL injuries may be like baseball UCL injuries. Too much stress increases injuries. Many high schools practice or play games 5 days per week and then the kids may have club practice too. That is harder to say. To truly know someone would have to measure injuries per exposure hour for both club and high school. The differences between the two are just speculation on my part from what I have seen.
|
|
|
|
Post by Keeper on Feb 12, 2021 2:17:11 GMT -5
I'm starting to see an increase in ACL injuries amongst our female soccer players and I'm wondering if there is really an opportunity through PT to prevent them. In the past month I've personally known at least 6 girls in varying age groups from U12 to u17 who has suffered a tear not only with their ACL but MCL as well. Would love to get some thoughts from parents or coaches if there is any real way to train to prevent these. It hurts me to hear about these injuries especially during a crucial year and there has to be something that could help to prevent them. I know that many of these injuries have happened during HS soccer games which is why DA prohibited them in the past but why is it more prevalent during the high school games? From my experience the reason I’ve seen and heard so many happening in Hs games and practices is due to bad coaching. So many Hs “coaches” want to work the players for 2+ hours everyday and often don’t build in quality stretching and proper warmups. All of this typically after long and intense club seasons. If the Hs coach isn’t spending at least 30 minutes on stretching and proper warmup then you’re just asking for injuries. Add in those coaches don’t plan appropriate recovery sessions for the days after games, or give players proper recovery time off to allow their bodies to rest. GHSA and Hs sports should really look to limit the amount of hours students are allowed to spend on sports each week like the ncaa does. Something like 7 hours max per week which would include the 2 hours for each game they dress for. |
|
|
|
Post by newposter on Feb 12, 2021 12:10:45 GMT -5
Kids shouldnt be playing club and high school at the same time. Kid played high level club in fall and high school in spring. Workouts and practice formats were nearly the same. The issue is kids overusing same muscle groups due to specializing in one sport. Kid looked forward to January for the month off between seasons along with playing other sports just for fun.
|
|
|
|
Post by baller84 on Feb 12, 2021 14:17:11 GMT -5
Qualified clubs and experienced coaches know what they're doing and have had preventive injury programs in place or in some form for sometime now. Unfortunately it has not been possible for players to attend such programs regularly in the past year due to Covid restrictions. Even so, it's not enough. All coaches who push kids to their limits should know what they're doing. Fatigue and overtraining are major risk factors, and so is bad training. I wonder with some coaching "methods" sometimes ...
|
|
|
|
Post by mightydawg on Feb 12, 2021 14:47:21 GMT -5
It is really nothing new. Girls have always had a higher rate of ACL injuries than boys and girls soccer is one of the leading sports for ACL injuries.
As pre-teens enter into puberty and grow taller and heavier, their risk of ACL injury increases – beginning at age 12 for girls, and age 14 for boys. Girls are at higher risk of ACL injury because after puberty, as their body size increases, girls do usually not develop more muscle power.
In fact, female athletes between 15 and 20 years old account for the largest number of ACL injuries. At the high school level, girls soccer has the most ACL injuries, followed by boys football, girls basketball, girls gymnastics, and boys and girls lacrosse. Among high school and college athletes, females have two to six times higher ACL injury rates than males in similar sports. Compared with boys, girls are more likely to have surgery and less likely to return to sports after an ACL injury.
|
|
|
|
Post by soccerlegacy on Feb 12, 2021 15:02:05 GMT -5
Just antidotally, back when I was in high school, are never or rarely heard of ACL injuries to women athletes. Nowadays, I hear about multiple ones every year. Back then, the training wasn't as rigorous and the women's soccer scene wasn't as intense as it is today. It's just an observation, but overuse or "maximizing" training could be one of the main causes. It's like Tommy John surgeries in youth baseball that were never there in days gone by.
|
|
|
|
Post by rifle on Feb 12, 2021 18:41:22 GMT -5
Couldn’t be the “install it and forget it” artificial turf surfaces, could it?
|
|
|
|
Post by reading1soccer on Feb 12, 2021 19:01:28 GMT -5
When I watch the youth play / practice on turf, I notice they are wearing fg cleats. I was told about a year ago that fg are bad for the knees when worn on turf. A google search will show that this could be true. More club and hs are on turf and most parents don’t fork out the $$ for multiple pairs of cleats.
|
|
|
|
Post by soccerspin on Feb 12, 2021 21:39:59 GMT -5
Kids shouldnt be playing club and high school at the same time. Kid played high level club in fall and high school in spring. Workouts and practice formats were nearly the same. The issue is kids overusing same muscle groups due to specializing in one sport. Kid looked forward to January for the month off between seasons along with playing other sports just for fun. Hard to avoid at 15u due to the school year split. Younger players don’t have anything else to do in the spring as they can’t play down. We’re doing both right now. March will be the most difficult when the SCCL friendlies fire up as there will be full overlap at that time. |
|
|
|
Post by oraclesfriend on Feb 12, 2021 21:50:37 GMT -5
Qualified clubs and experienced coaches know what they're doing and have had preventive injury programs in place or in some form for sometime now. Unfortunately it has not been possible for players to attend such programs regularly in the past year due to Covid restrictions. Even so, it's not enough. All coaches who push kids to their limits should know what they're doing. Fatigue and overtraining are major risk factors, and so is bad training. I wonder with some coaching "methods" sometimes ... I am not convinced that there is enough of the appropriate training going on. The BEST practice is to start the prevention programs 6 weeks prior to practice. So really the kids should be doing these in the summer before they get out into full preseason. Most clubs do some once practice starts. |
|
|
|
Post by oraclesfriend on Feb 12, 2021 21:57:07 GMT -5
It is really nothing new. Girls have always had a higher rate of ACL injuries than boys and girls soccer is one of the leading sports for ACL injuries. As pre-teens enter into puberty and grow taller and heavier, their risk of ACL injury increases – beginning at age 12 for girls, and age 14 for boys. Girls are at higher risk of ACL injury because after puberty, as their body size increases, girls do usually not develop more muscle power. In fact, female athletes between 15 and 20 years old account for the largest number of ACL injuries. At the high school level, girls soccer has the most ACL injuries, followed by boys football, girls basketball, girls gymnastics, and boys and girls lacrosse. Among high school and college athletes, females have two to six times higher ACL injury rates than males in similar sports. Compared with boys, girls are more likely to have surgery and less likely to return to sports after an ACL injury. This is all mostly true. Girls basketball has a higher rate of noncontact ACL tears than girls soccer especially per athlete exposure. Otherwise what you are saying is true. However there are other reasons for the increased tears with age despite size. It really is skeletal maturity that plays a role too. The growth plates close in the knee and then they get tears instead of fractures. Size and speed due matter too as it is greater force across the knee with change of direction. Part of the reason we did not hear about ACL tears in the 80's and early 90's was because they did not really know how to fix them. No one talked about it because athletes would just say they "blew out" their knee. The players did not know what ligament they tore. They just knew they could not play. Arthroscopic surgery did not become popular and readily available to patients until the early 90's and most of the surgeons were still new at the procedures. |
|
|
|
Post by baller84 on Feb 12, 2021 22:23:10 GMT -5
Qualified clubs and experienced coaches know what they're doing and have had preventive injury programs in place or in some form for sometime now. Unfortunately it has not been possible for players to attend such programs regularly in the past year due to Covid restrictions. Even so, it's not enough. All coaches who push kids to their limits should know what they're doing. Fatigue and overtraining are major risk factors, and so is bad training. I wonder with some coaching "methods" sometimes ... I am not convinced that there is enough of the appropriate training going on. The BEST practice is to start the prevention programs 6 weeks prior to practice. So really the kids should be doing these in the summer before they get out into full preseason. Most clubs do some once practice starts. This is a year round thing, they say that. Maybe your club doesn't have it but there are clubs who do, directly or indirectly through another entity (athletic club or gym business) with soccer specific programs. |
|
|
|
Post by oraclesfriend on Feb 13, 2021 7:47:48 GMT -5
I am not convinced that there is enough of the appropriate training going on. The BEST practice is to start the prevention programs 6 weeks prior to practice. So really the kids should be doing these in the summer before they get out into full preseason. Most clubs do some once practice starts. This is a year round thing, they say that. Maybe your club doesn't have it but there are clubs who do, directly or indirectly through another entity (athletic club or gym business) with soccer specific programs. I have been at two big 6 clubs neither of which do a program that I think is sufficient. First of all there was nothing in the summer at one. The other we moved to this summer had a good program written out but with covid the girls had to follow on their own without supervision which leads to technique errors that negate the benefit. Not sure that is their fault so we will see. The club before the one we are at now has a once weekly program for their teams that compete at higher levels. Unfortunately it starts after the season starts so no protective benefit could even start until it has been done for several weeks. Secondly if you are assigned the Monday slot you often have it cancelled because they give you that day off after you have a travel weekend. Again that negates the benefit. So 1/3 of the programs playing ECNL/DA (now GA) are getting a failing grade or an incomplete from me so far on ACL prevention in girls. Plus let us not forget that the top team girls are also not the only ones that tear their ACLs. The new program to us I don't know what they give/offer their lower teams, but the club we were at before offers nothing. That is a real shame. |
|
|
|
Post by rocko1989 on Feb 13, 2021 7:52:51 GMT -5
I remember an article in Sports Illustrated back in the 90s about a ton of women’s basketball players suffering this injury. vault.si.com/vault/1995/02/13/out-of-joint-womens-basketball-is-making-great-strides-but-it-is-suffering-an-epidemic-of-torn-knee-ligaments-along-the-wayWhen my daughter tore hers, the surgeon simply said it was from overuse. I will only speak for my daughter, she is a hard charger that really did not grasp how and when to back off a bit. That mindset is often what makes them good players. The drive to work hard every training session can certainly lead to overuse injuries. I suspect other players suffering the same injury have a similar mindset. She is now fortunate that her high school coach will listen to her when she says she needs to take her foot off the gas a bit in training. Many players at many high schools do not have that kind of relationship with their coach. Of course, some players might abuse that situation. As for the playing on turf portion of this topic, all I can say is our experience was this: our high school has grass, club has grass, and the field on which she suffered the injury was grass. Certainly turf could be a factor, and I bet someone somewhere will do a study on this someday. |
|
|
|
Post by soccer47 on Feb 21, 2021 22:42:59 GMT -5
I felt compelled to respond to this post since I have seen this injury many times, being that I was a female soccer player, athletic trainer and coach. There are many factors that play into this particular injury and if you are interested here is an article about all the possible factors. www.ncbi.nlm.nih.gov/pmc/articles/PMC4805849/ Something few ever mention are female hormones, there have been studies done to see where the female athlete was in her cycle at time of injury. Another factor not often mentioned...genetics (my husband tore his, his older sister tore hers and his younger sister tore both of hers) . These are two factors that no amount of prevention can really help with, but there are some factors such as muscular imbalance between athlete’s quads and hamstrings and athlete’s core strength that can be improved. While I do believe overuse injuries could be a potential problem in our year round “soccer season”, I don’t consider an ACL rupture a typical overuse injury. In college, we trained 2-a-days for 7-10 days, no one tore their ACLs but we had lots of tendonitis, muscle strains, stress fractures and shin splints. Most of our ACL tears came mid season. My freshman year it was a senior, non-contact at practice. My Jr, year it was the keeper, contact in a match. My Sr year, a sophomore, non-contact. The only year we didn’t have an ACL tear, we had a player break her jaw in a match...not your typical soccer injury. For those of you questioning the number of hours your daughters train during HS, in college we only got Mondays off per NCAA. Practice T-Th, game F, Sat practice, game Sunday. Every Tuesday we ran a fitness test at the start of practice, my senior year it was 120s EVERY Tuesday. We trained 2 hrs every weekday session, Saturday was a “recovery” session, but we all knew it depended on how we performed on Friday night and who we played on Sunday. Don’t even get me started on what our “off-season” looked like. This grueling schedule might have been why my freshman class started with 9 and only 5 of us played all 4 years. Although I played club at the highest level, high school “preseason” (week of conditioning before we could touch a ball) and Lundy camp was the closest thing to college preseason I ever experienced. I had club coaches that made us run fitness, but nothing close to what I did in college. As a coach, I incorporate ACL injury prevention in the warm up and even more on recovery days. I include plyometric training and body weight strength training, focusing on player’s form and body positioning, in private/small group sessions when I’m working on speed and agility with players. Unfortunately, the longer your daughters play the sport, the more likely she is to see a teammate suffer this traumatic injury. It’s a difficult surgery/recovery/rehabilitation, but I have seen athletes come back to play after tearing each ACL is sequential seasons, now that takes a special player/person. |
|
|
|
Post by oraclesfriend on Feb 21, 2021 22:59:48 GMT -5
I felt compelled to respond to this post since I have seen this injury many times, being that I was a female soccer player, athletic trainer and coach. There are many factors that play into this particular injury and if you are interested here is an article about all the possible factors. www.ncbi.nlm.nih.gov/pmc/articles/PMC4805849/ Something few ever mention are female hormones, there have been studies done to see where the female athlete was in her cycle at time of injury. Another factor not often mentioned...genetics (my husband tore his, his older sister tore hers and his younger sister tore both of hers) . These are two factors that no amount of prevention can really help with, but there are some factors such as muscular imbalance between athlete’s quads and hamstrings and athlete’s core strength that can be improved. While I do believe overuse injuries could be a potential problem in our year round “soccer season”, I don’t consider an ACL rupture a typical overuse injury. In college, we trained 2-a-days for 7-10 days, no one tore their ACLs but we had lots of tendonitis, muscle strains, stress fractures and shin splints. Most of our ACL tears came mid season. My freshman year it was a senior, non-contact at practice. My Jr, year it was the keeper, contact in a match. My Sr year, a sophomore, non-contact. The only year we didn’t have an ACL tear, we had a player break her jaw in a match...not your typical soccer injury. For those of you questioning the number of hours your daughters train during HS, in college we only got Mondays off per NCAA. Practice T-Th, game F, Sat practice, game Sunday. Every Tuesday we ran a fitness test at the start of practice, my senior year it was 120s EVERY Tuesday. We trained 2 hrs every weekday session, Saturday was a “recovery” session, but we all knew it depended on how we performed on Friday night and who we played on Sunday. Don’t even get me started on what our “off-season” looked like. This grueling schedule might have been why my freshman class started with 9 and only 5 of us played all 4 years. Although I played club at the highest level, high school “preseason” (week of conditioning before we could touch a ball) and Lundy camp was the closest thing to college preseason I ever experienced. I had club coaches that made us run fitness, but nothing close to what I did in college. As a coach, I incorporate ACL injury prevention in the warm up and even more on recovery days. I include plyometric training and body weight strength training, focusing on player’s form and body positioning, in private/small group sessions when I’m working on speed and agility with players. Unfortunately, the longer your daughters play the sport, the more likely she is to see a teammate suffer this traumatic injury. It’s a difficult surgery/recovery/rehabilitation, but I have seen athletes come back to play after tearing each ACL is sequential seasons, now that takes a special player/person. Genetics play a very strong factor. Very strong. The hormones where they are in their cycle has been very heavily debated in the medical community. That theory is currently thought to contribute very little (though new research could change that). Now the cycle issue is preventable with the current birth control pills. The overuse issue I used to dismiss, but there is more data that it is valid. It is not as much short term overuse (too many practices in one month or season or year) but thought to be over the long term (years of single sports participation). I am still not sold. I need more data. I do also think that overuse causing FATIGUE could be an issue. You mentioned the non-contact injuries in college happening mid-season. There are a few coaches saying that the college athletes should not be having twice weekly games especially Friday/Sunday. Not enough recovery time. That needs more data too. Kudos to you for adding the prevention program into your training. I wish all programs did that! |
|
