I am not a surgical doctor, but I have dealt with knee injuries from experience and injury prevention through exercise most of my life. I worked as a physical education, health, strength, conditioning instructor and coach at small middle and high schools for over 41 years.
Injuries occur due to the anatomical make-up of the individual, biomechanics, hormones, muscle strength, training, footwear, age and sports participation of the individual. Flexibility is another factor. I had my students and players walk and jog a lap before they stretched. Some injuries are incidental, accidental, over-load and intentional. The most common injury I saw to the knee was the anterior cruciate ligament (ACL). The ACL is responsible for agility, especially quick side-to-side or lateral movements. The ACL is the weaker of the two anterior ligaments, the other being the Posterior Anterior Ligament.
A female has a wider pelvis, so that effects the knee alignment and can be more susceptible to injury. In comparison, a male’s pelvis is a bit narrow and can be better aligned with the knee joint. Movement patterns, like stop and go, twists and turns, also influence stress levels. Hormone fluctuations in estrogen levels in females can effect ligament laxity monthly. Being more flexible can also contribute to the instability of the knee joint. Less muscle mass in the legs hinders stability. Inadequate training, ignoring other muscles, not resting the previous muscles used or over-training, sleep, nutrition and hydrating are other factors. Selecting the right strength and conditioning methods are important, as well as resting, eating right and drinking plenty of water (not carbonated sugar drinks). Selecting the right type of athletic shoes is important-not for how pretty they are, or that a popular sports figure wears them, but for stability.
We age every second. Our body changes completely every seven years and so there are changes in the bones, muscles and joints through growth. Finally, the type of sport played (low impact to high impact) is maybe the biggest factor. I believe running cross country may be the safest, then volleyball and basketball. Football is the most risky scholastic-seasonal sports.
Injuries can happen because of overuse, lack of proper conditioning, imbalance of training or over training one area while ignoring other muscles and just plain ignorance. We can call them incidental, accidents or they can be intentional. I got hurt in football by someone chop blocking and I was already engaged with a receiver.
I pointed out this same behavior in a football game I coached recently to the officials on the field in the second quarter. By the fourth quarter, one of our players had a broken ankle. A good strength and conditioning program with fair play must be practiced and enforced in all sports contests for safety. In my experience, performance after an injury can be 80-90% after rehab, but never 100% again.
Progression is very important. Do not run a mile if you haven’t run at all. instead, run a quarter mile at first, then a half mile, building up to maybe two miles in two weeks, then maybe a half mile every other day. If you’re a good runner, your performance will dwindle drastically after 10 to 14 days of non-rigorous activity. These physical sports require running for endurance and possibly injury prevention. You can still play well in the fourth quarter if you’re in good physical shape.
Jim Phillips,
Shonto, Arizona
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