ACL Injury in Teen-Aged Athlets

ACL Injury in Teen-Aged Athlets Blog  ACL Injury

The anterior cruciate ligament in the knee is prone to injury in people who play sports. Teen-aged girls are especially prone to ACL injuries because the growth of their neuromuscular system does not always match pace with the increased growth throughout the rest of the body.

The difference between growth in the body and growth in the neuromuscular system causes subtle changes in the gait, and the way body moves. These natural changes leave the athlete more prone to injuries of the leg, knee and hip, but especially ACL injury.

Leg Dominance is a common problem when the muscles in the legs grow faster than the ligaments in the knees. When this happens ACL injury occurs because the ligaments are unable to absorb and support the level of shock produced by the legs.

Quadriceps Dominance occurs when there is an imbalance between the quadriceps muscle and the hamstring muscle. This imbalance tends to cause the athlete to bend the knees to far and put undue pressure on the ACL.

Ligament Dominance is when the athlete absorbs most of the shock of running, jumping, turning and other high impact actives with the ligaments in the knee, instead of with the muscles of the lower leg. Oftentimes, it’s the ACL which absorbs this impact, and that leads to injury.

Landing with the knees fully extended also contributes to injury. When an athlete lands with an improper bend in the knees the tibia is pushed forward by the contractions in the quadriceps. This pressure on the tibia contributes to ligament damage in the knee.

We offer comprehensive training that teaches the teen-aged athlete how to avoid injury to the ACL. Our training uses Computer Assisted Rehabilitation Environment (C.A.R.E.N) to identify the risk factors that typically lead to ACL injury. Then, we use force plate technology, and pressure gait analysis to understand, and teach the athlete how to avoid future damage to the ACL.

Once an injury has occurred, appropriate treatment is vital to recovery. NYDN Rehab offers effective screening for ACL injury. We then use C.A.R.E.N, to develop a solid recovery plan that retrains the foot, leg and athlete to prevent further injury.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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