Less Knee Injuries = Improved Athletic Performance for Female Adolescent Athletes

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Dr. Cynthia R. LaBella, MD

Dr. Cynthia R.  LaBella, MD, kicked-off the second year of the Women’s Health Research Monthly Forum, on September 22, 2009, by presenting her research on knee injuries in female adolescent athletes to an audience of over 150 professionals from the Northwestern community.  Dr. Labella is the Medical Director of the Institute for Sports Medicine at Children’s Memorial Hospital and Assistant Professor of Pediatrics at Northwestern University’s Feinberg School of Medicine.

The basis for Dr. LaBella’s research is that adolescent females are the fastest growing population participating in sports, but in turn are more frequently injured compared to boys and pre-pubescent girls.  The most common sites of injury for adolescent girls are the knee and ankle.  In particular, girls are 4 to 6 times more likely than boys to tear the anterior cruciate ligament (ACL).

Hormonal, anatomic, and neuromuscular control differences exist between boys and girls. These differences, have been studied, to determine why girls are at a greater risk of ACL injuries.  Hormonally, estrogen increases ligament laxity, yet this data has not been correlated with an increased risk of ACL injury.  Anatomically, females have a wider pelvis, smaller femur notch sizes, more knocked knees (genu valgum) and more inward twisting of the thigh bones (femoral anteversion), but, like the hormone data, this also has not been correlated with an increased risk of ACL injuries.

Dr. LaBella’s research focuses on the development and evaluation of neuromuscular training tasks to prevent knee injuries in adolescent girls.  Neuromuscular control is defined as muscle strength, nerve and muscle firing patterns, and the mechanics of landing and pivoting.  The neuromuscular sex differences associated with the knee appear at puberty when males begin producing increased amounts of testosterone; prior to puberty neuromuscular differences are not observed.  Research indicates that quadricep dominance, leg dominance, and ligament dominance are the significant differences between males and females that lead to a greater risk of ACL injuries in girls.

Dr. LaBella and her team of researchers at  Children’s Memorial Hospital developed and published a neuromuscular training program that included the elements of high-intensityprogressive plyometrics, proper technique feedback to athletes, and strength training.  This training program was implemented in 46 Chicago urban public high schools to study knee injuries considering the variables of race, coach compliance and injury rates. It was concluded that coaches can be trained to integrate the neuromuscular exercises into their practices.  In addition, these exercises can reduce lower extremity injuries in female soccer and basketball athletes.  This is a significant finding especially for populations who have limited access to medical care.

faurot-150wNow that Dr. LaBella has uncovered that neuromuscular exercises can prevent knee injuries, the challenge is to disseminate her findings to more high school coaches so the information can positively impact the ever-growing population of adolescent female athletes.  Dr. LaBella shared that approaching high school coaches with the notion that they will enhance the athletic performance of their athletes rather than stressing the prevention of  injuries is more convincing, and leads to better coach compliance with.respect to conducting the  neuromuscular exercises with their female athletes.  A non-ACL injured, healthy female athlete can spend more time on the field/court practicing their skills that will only contribute to a more successful team and season.

For more information about Dr. Cynthia LaBella and the Institute for Sports Medicine, please visit, http://www.childrensmemorial.org/depts/sportsmedicine/bios.aspx.

8 Comments

  1. Ellen Faurot
    Posted September 23, 2009 at 3:50 pm | Permalink

    Very interesting article—having torn my ACL in my early 30′s I think this is very important research—love the photo of the soccer player.

  2. Dennis Faurot
    Posted September 23, 2009 at 5:27 pm | Permalink

    Thank you for the information. I think that better conditioning will help to prevent injury. I belive that I have read an article by Dr. Labella earlier this year.
    Thanks for the information Ms. Faurot

  3. Warren Potash
    Posted September 24, 2009 at 10:59 am | Permalink

    As a fitness therapist who has trained more than 600 adolescent female athletes using Balance, Neuromuscular control, and Proprioception as a foundation for improving adolescent female athletes for 14+ years, I hope that Dr LaBella’s research reaches coaches and athletes so more young ladies can have FUN playing their sport(s).

  4. Knee Pain Info
    Posted April 18, 2010 at 12:25 pm | Permalink

    I’m glad medical professionals are using these forums to share their expertise. This information reaches men and women who might never get any medical attention otherwise. The preventative measure that Dr. LaBella shared are great to keep young atheletes healthy so they can be successful in their lives after collegete and high school level sports.

  5. kitesurfing lessons
    Posted April 21, 2010 at 7:44 am | Permalink

    Very intresting post. Similar injuries are gained when kitesurfing. I have seen alot of this in the past 5 years of teaching and taking lessons.

  6. world cup 2010
    Posted May 26, 2010 at 1:10 pm | Permalink

    thank you for this great information, I realy like it .

  7. Roger Garcia
    Posted July 8, 2010 at 3:06 pm | Permalink

    This kind of info really helps understand problems faster. Thanks for the great info.

  8. Jumper's Knee Sufferer
    Posted June 26, 2011 at 11:30 pm | Permalink

    As a sufferer of jumper’s knee, I would agree to say less injuries definitely would improve athletic performance (even though I am a male).

    I believe the key to preventing these injuries, is to strengthen their quads and legs, which i highly doubt young athletes do.

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