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Everyday Life & Health
Tamika Catchings. Chandi Jones. Shea Ralph. Tricia Payne.
Collegiate women's basketball players, all of whom suffered season-ending knee injuries this year. Caatchings, Jones and Ralph missed the end of the 2000-01 season and were unable to redshirt. Texas Christian's Payne injured her knee the first official day of practice in October. A senior, Payne will have to redshirt this 2001-02 season.
These women have proven themselves nationally as top basketball players. Catchings and Ralph were drafted into the WNBA on crutches. Jones was a top 10 NCAA scorer her freshman year despite missing the last 12 games of the season. Payne was voted the Most Valuable Player of the Western Athletic Conference Tournament in 2001.
They are all well-conditioned athletes with a great deal of talent and reconstructed knees. And they are not alone.
Oklahoma University lost center Jennifer Cunningham for the season and maybe forever when she sustained her fourth knee injury recently. Both of her knees have now given out twice. Stanford's Susan King is back on the court now after a knee injury sidelined the Cardinal for much of last season.
But what is most upsetting about these long-term knee injuries is the specific type of injury suffered: a torn anterior cruciate ligament. And it's more prevalent among female basketball players than male.
"There are several reasons why women are more likely to tear their ACLs," said Pam Waller, assistant athletic trainer in her third year at the University of Houston."One reason is women have wider hips, and their thighs angle in more, putting stress on the knee."
Waller explained that the knee is not "a" joint. It is actually two joints: the tibiofemoral joint and the pattellofermal joint. The joint most people refer to as the knee joint is the tibiofermal joint.
Connecting the tibia (shin) and the femur (thigh bone) in this joint are four major ligaments. The medial (inner) collateral (side) ligament and the lateral (outer) collateral ligament provide stability to the knee joint, preventing the femur and the tibia from sliding too far to the left or right.
The posterior cruciate ligament, which is attached to the posterior part of the tibial plateau (the back of the top of the tibia), crosses (cruciate) behind the anterior cruciate ligament to connect to the femur. The PCL keeps the femur from sliding forward off of the tibia.
The ACL is attached to the anterior part of the tibial plateau (the front of the top of the tibia) and connects to the back of the femur on the posteriolateral side of the intercondylar notch. The ACL keeps the tibia from sliding forward from underneath the femur. It also controls rotational movement or turning.
"It's a non-contact injury," Waller said. "Some players tear it while jumping, or landing, or pivoting. It's hard to prevent."
Of all the injuries in sports, the one injury that takes athletes out of competition for the longest.
"It takes about six months after surgery before their cleared (to play) with a brace. Their completely cleared after about a year," Waller said. "They can graft the hamstring tendon from the same leg, or the patellar tendon from the opposite knee, or an ACL from a cadaver. But that depends on the physician, the sport and the athlete."
Besides the typically greater degree of femoral anterversion (femur angles more toward inner leg), another factor is the weakness of the hamstring in relation to the quadriceps in women than in men, Waller said.
The quadricep is a group of muscles which make up the musculature of the thigh. Of the four muscles, the rectus femoris (front of thigh) is the main player in hip flexion and knee extension. The four muscles combine to make the quadriceps tendon, which covers the patella (kneecap).
The patella is also connected to the tibia via the patellar tendon. As the ACL's fuction is to keep the tibia from sliding forward, overdevelopment of the quadriceps and underdevelopment of the hamstrings may put strain on the ligament. If the player has tendinitis in a patellar tnedon, the doctor will not use that tendon because it won't be strong enough to handle the high stress role of the ACL.
The ACL is the most essential ligament in pivoting movements, and injury to it is the bane of many sports: football, men's basketball, soccer, volleyball and women's basketball.
"The most common women's sports are women's basketball and soccer," Waller said. "Sometimes you see it in volleyball."
Women, according to a research study by the NCAA, are three times as likely as men to injure their ACLs in basketball. Several studies and opinions have suggested why this is so in female athletes, but no one factor is credited as a sole cause.
"Another reason is the women's menstrual cycle," Waller said. "With the hormone levels constantly changing, it alters muscle response, ligament strength. It affects the whole body."
The intercondylar notch (a depression in the bottom of the femur) usually has a specific anterior view shape according to gender. It's described as more of an upside down "U" shape in men and more of an upside down "V" or an "A" shape in women. But, there are men with "V" shaped notches and women with "U" shaped notches with no more or less susceptibility to ACL injury for their respective genders.
"They're doing studies on the other factors more," Waller said.
Besides the prevalence of ACL injuries among female athletes, Waller said there are other commonalities which deserve study.
"Since I've been here (at UH), 90 percent (of ACL injuries) have been in the left knee," Waller said. "I don't know if all of the players were right-handed, but I believe most of them were."
With all of the studies to find the cause of the higher risk of ACL injury in women and to find new methods of surgical repair, there aren't many studies being made to find a way to reduce risk.
Waller said Dr. Walter Lowe, an orthopedic surgeon at Methodist Hospital in Houston, has developed a program called Sportmetrics.
"It's a series of jumps used to teach proper jumping techniques," Waller said.
Two players on the UH women's basketball team went through the program after they had surgery to reconstruct their ACLs. The program teaches participants how to land properly, with knees bent, gradually increasing the height of the jumps as they go through the program.
"Women tend to land with their legs straight," Waller said. "They say that program has proven to help reduce the risk of injury."
There are still many questions that need to be answered about the high risk of women basketball players to ACL injury, problems that may take many years to solve. Until then, doctors, trainers and athletes alike are looking for any way they can to reduce the risk until they can prevent the injury.
"If we knew that, we'd do it," Waller said.
© Copyright World Internet News 2006-07
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