The ACL Epidemic
Despite the short hiatus we had in sports due to COVID, the athletic world continues to get faster, stronger, and more competitive with every year that goes by. This is great for all of us as we continue to be dazzled and amazed at what athletes can do every single game that is played. As a result of that, physical human achievement records get broken every single year, with no stopping in sight. However, a record that no one wants to see broken is the amount of Anterior Cruciate Ligament (ACL) tears that occur every year in America.
ACL Tears on the Rise
The current injury porous state of the NFL is a prime example of how lack of preparation is causing our most elite athletes to be taken out for the season. ACL tears and their costly reconstructions continue to be on the rise in youth sports across America with over 150,000 tears per year. ACL tears have been steadily increasing ~2.3% percent every year over the last 20 years (Beck, 2017) Why is this the case? What are we doing wrong? And what can we do to help?
Credit:https://simplifaster.com/articles/nfl-acl-tears-trends-data/
Shifting the State of Medicine
The United States as a whole tends to be a reactive nation that makes knee jerk decisions following a negative outcome especially in the case of medicine.
When you find out that you have high blood pressure (HTN),oftentimes you are prescribed blood pressure medications which happen to be the same medications you hear about countless times on TV. Why aren’t there commercials telling people to exercise and eat better instead of taking medication for high blood pressure? I cannot say I have ever seen an anti-high blood pressure commercial in my entire life, but I have seen hundreds of HTN medication commercials. Why is that the case? Possibly because it is more profitable to the medical/pharmaceutical world when you do take these pills or doctor visits.
Also, society itself doesn’t want to put in the extra effort until something becomes a “real” problem. Well I can tell you that even if you do not have a diagnosis, it’s a real problem and it starts way before you become “at risk”.
A good quote to live by from one of my PT professors Dr. Robert Marsico is “An ounce of prevention is worth a pound of treatment”. And, in regard to ACLs this couldn’t be more true.
Me back in my competitive soccer days.
Modern Athlete Mentality
I get it. As a former athlete, anything that was done besides actually playing soccer was viewed as a punishment. Run for better conditioning…punishment. Weight room for strengthening and injury prevention…punishment. Going to the athletic trainers to do rehab exercises to get back on the field sooner after an injury…. you guessed it; it’s viewed as a punishment for some. That needs to change. Instead of viewing them as punishments, we need to view them as ways to make us better athletes by becoming stronger, increasing endurance, and helping us become more resilient. This is the mentality shift we need in America today.
I still to this day, even in 2020, hear athletes say all they do year-round is play one sport and rarely ever do anything in strength and conditioning. At this point, that’s baffling. The research is out there that we need to vary things with different sports and formal strength & conditioning programs and prevention programs.
The classic mentality of practice makes perfect and the 10,000-hour rule to becoming an expert in anything has its perks but definitely has its flaws. Thinking all one needs to do to be the best at their sport is play/practice just their sport is ill-advised. It would be better to say practicing multiple different performance components themed around your sport makes perfection.
What Can Be Done?
Parents, I get it. Who has the time or the money on top of your kids sports to invest into programs outside of athletics?
Consider this: the cost of ACL reconstruction is anywhere from $30,000 to $50,000 (even with insurance you can expect to pay $1,000-10,000 for just the surgery) cost of rehab 2-3x week (average for post-op ACLs) is $90 to $300/week, time for therapy 1-2 hours, 1-3x per week for 6-9 months. There you have it: that is a lot of money and a lot of time spent on something that is extremely difficult to watch through especially in the beginning. To watch your child go from dominating on the field to needing help for basic tasks such as lifting their leg and getting in and out of the car is tough. Let alone the amount of discomfort that comes with complex surgery and the early rehab.
There is another way! In our next blog we will detail specific things you can do to guard yourself against ACL injuries, as well as general strategies that top athletes utilize!
Until next time,
Dr. Jeremy Boyd aka The Decent Doctor
References:
ARUNDALE A.J.H., BIZZINI M., GIORDANO A. et al., Exercise- Based knee and anterior cruciaiate ligament injury preven- tion, J, Orthop, Sports Phys, Ther., 2018, 48 (9), A1–A43.
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Milewski MD, Skaggs DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop 2014;34:129–33.
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Myer GD, Ford KR, Di Stasi SL, et al. High knee abduction moments are common risk factors for pa- tellofemoral pain (PFP) and anterior cruciate liga- ment (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury? Br J Sports Med 2014.
Rugg C, Kadoor A, Feeley BT, Pandya NK. The effects of playing multiple high school sports on National Basketball Association players’ propensity for injury and athletic performance. Am J Sports Med. 2018;46(2):402–408pmid:29135275
Smucny M, Parikh SN, and Pandya NK. Consequences of single sport specialization in the pediatric and adolescent athlete. Orthop Clin North Am 46: 249-258, 2015
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