Tuesday, May 19, 2009

ACL Injury: Contact vs. Non-Contact

An ACL injury happens frequently in sports such as soccer, gymnastics, skiing, football, etc. And female athletes may be 4-6 times more prone to an injury than male counterparts. Even though it happens more often in contact sports, about 75% 0f the injury happens without involving a contact with another player. It has gotten more attention because of the seriousness of the injury and many research articles regarding the issue have been published. As a result, we know more about how the injury happens, what factors are involved, who may be more prone, how to prevent it, etc.

Contact ACL Injury

A common mechanism of contact ACL injury involves falling down while being tackled in the knee or lower leg, which forces the knee into valgus motion (knee bending in). The foot usually is planted on the ground by a tackling athlete and it becomes difficult to control his lower legs and the body. It can also happen when an athlete is tackled in the front of the leg causing the knee to hyperextend.



Non-Contact ACL Injury

A non-contact ACL injury occurs more frequently than contact ACL injury. It is common in soccer, basketball, gymnastics, skiing, etc. Athletes may sustain this injury when they are try to stop and make a quick change in direction leaving the foot planted on the ground while the body is being twisted. Another mechanism of injury is landing and hyperextending the knee. It also happens when the knee collapses into valgus on landing. The athlete usually does not have a good control of the body when he/she gets hurt.



A contact ACL injury is harder to predict, however, a non-contact ACL injury can be prevented by implementing balance training, proprioception training, strengthening exercises, neuromuscular program, etc.

Saturday, May 2, 2009

Sports Medicine Myth: No Pain No Gain?!

There are many people (parents, coaches, etc) say that no pain no gain. But is it true? No so much when you are injured. Pain usually is a signal that there is something not right. You have pain when you twist your ankle because you just damaged (injured) a ligament in the ankle. When doing rehab and trying to come back from an injury, it is not a good idea to keep doing what causes pain.

Soreness is difference from pain. You get sore after lifting weights and doing training that you are not used to, etc. And it goes away in a day or two. It is ok to be sore as long as it goes away. It is a natural response of your body.

But sometimes, you may have to deal with some pain during physical therapy. Let's say you had an ACL reconstructed. The first thing you do is to reduce inflammation. Then, you try to regain lost range of motions. In this phase of rehab, you will be pushed and have some (a lot of) pain to get the range of motion back quickly. Rehabilitation is not pain-free. It sometimes is painful. It can be challenging what pain is ok and what pain is not ok.

So, is it ok to play through pain when you get hurt during practice? The best thing to do is to stop doing what you are doing and take a break. In youth sports, often times there is no health care professional on site to take a look at an injured athlete right away. So, when you are in doubt, the best thing is to not do what causes pain. You do not want to keep playing when injured not knowing what is wrong and make things worse.