Teen Trouble: ACL injuries on the rise for girls

Teen Trouble: ACL injuries on the rise for girls


By Greg Bach

Female teen soccer players who lace up the spikes for year-round games and training are at great risk for sustaining ACL injuries that will land them on the operating table.

And likely lead to arthritis and potentially other knee problems later in life.

“We’re seeing a lot more ACL injuries in the Under 17 population than we used to see 10 years ago,” says Dr. Lyle Cain, renowned orthopaedic surgeon and sports medicine specialist at the Andrews Sports Medicine and Orthopaedic Center in Birmingham, Ala. “Girls are about seven times more likely to tear their ACL in soccer than boys are. It’s a pretty astounding number.”

The injury risk has climbed substantially, in large part due to sports specialization, as more young athletes are dialing in on one sport.  

“Preventing overuse is a big thing,” Cain says. “So what we recommend through the American Sports Medicine Institute in Birmingham is we have done studies of different sports that show that you probably need about four months off for each sport during a year. So if you are a single sport athlete you need to have about a four-month rest period and recovery period in a given year.”

Here's what else you need to know regarding ACL injuries and keeping your young athletes safe and in the game:

SPORTINGKID LIVE: How important is it for kids to play multiple sports as a means to help prevent so many of the injuries you see in your office?

CAIN: We would prefer from a medical standpoint for people to play multiple sports and kind of cross-train and use different joints. But if you are a single sport specialist – say a baseball only player, or only basketball or soccer – you need to make sure that you take enough time off to let your body rest. That takes three or four months. Unfortunately, the way that youth sports have progressed over the last 20 years, most youth sports athletes who are elite play year-round and they don’t take any time off, and I think that really takes a toll on their body.

SPORTINGKID LIVE: What are the long-term ramifications for a young athlete who suffers an ACL injury and undergoes surgery?

CAIN: The bottom line is once you have had an ACL tear the knee is never the same. Surgical techniques are able to return the athlete to sports most times and return athletes to normal function in terms of their activities and their abilities. But it really sets up a progression that often leads to arthritis in the knee. In youth athletes it can cause injuries to the growth of the knee and cause the knee to not grow properly. It can also cause cartilage damage, which can affect the knee from a function standpoint. I think the younger you tear your ACL the more likely you are to have arthritis and problems later in life.

SPORTINGKID LIVE: What would be your suggestions for parents of a young athlete who is returning from an ACL injury?

CAIN: There are criteria we use for return to play in terms of muscle strength and function and return of normal mechanics. But ultimately, all of those athletes tend to get some changes and some arthritis in their knees, so as a parent I would be very protective of my child after an ACL tear. I’d let them return to sports, but I would be very protective about their exposures in terms of number of events, how much they run, how much they cut, and how long they play during the season. I would be very selective about how much trauma their knee takes during their adolescence and young adulthood. I think you have to be very careful once an ACL has torn to kind of change your mindset in terms of what you are looking at in sports.

SPORTINGKID LIVE: What’s the key message you would want volunteer coaches and parents to keep in mind?

CAIN: I think the key message is that parents and coaches, and really the community, needs to know that young athletes are not supposed to be treated like professional athletes. They should be treated like young athletes. They should be out there having fun and enjoying the game and enjoying the experience and enjoying the team and learning from the game. But they shouldn’t be training and playing year-round in such a way that they would if they were professionals. I think parents and kids, and even coaches, sometimes get off on a tangent where they feel like they are developing a kid into an elite athlete. The more talented someone is you have to be super careful because they are going to get overused and oftentimes use up their potential before they ever get to the elite level.

Dr. Lyle Cain ACL Injuries Safety Injury Prevention Specialization Soccer

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