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Are Girls Different than Boys with Recovery and Prevention of Sport Injuries?

Amanda Vick, PT, DPT, OCS

SPORTS Physical Therapist

Board Certified Orthopedic Specialist

Cook Children’s Health System

Sports Symposium

July 21, 2016

Objectives:

Discuss the female athlete history and interesting facts

Assess injuries in specific sports

Assess ACL risk factors and screening tools

Review areas to maintain a healthy female athlete

Why talk about the female athlete now?

Women and the Olympics1900 Golf

1928 Gymnastics

1984 Marathon

2012 All sports 9

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Dr. Dudley Allen Sargent

1881 Founded Sargent School of Physical Training in Cambridge

Believed exercise over drugs

Allowed women to be educated

Hired the first female physical education professor, DelphineHanna 3

First female to run the Boston Marathon

1967: K. V. Switzer

Equality in Sports

Title IX

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What this means is…

Increased female participation

Increased

training

Increased

injuries 4

Interesting facts:

4-6 times more likely to sustain a non contact ACL injury

Within 7 years after an ACL injury, 65% of individuals no longer play soccer (landing error)

At least 2/3 of ACL tears are noncontact

ACL ruptures within 40 milliseconds after initial ground contact 7

Hormones and birth control

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Common injuries of gymnasts:

Stress fractures

Wrist pain

Spine (spondylolysis

/-listhesis)

Foot/ankle sprain 4

Common injuries of dancers:

Foot injuries

Stress fractures 4

Common injuries of volleyball players:

Jumper’s knee

Ankle sprain

Lower rate of ACL tears 4

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Common injuries of cheerleaders:

Catastrophic injuries

-brain/head injury

-neck injury

-heat stroke

-electrolyte imbalance 4

Common injuries of soccer players:

ACL

ACL

ACL 4

ACL risk factors

Modifiable Trunk/leg alignment

with sports

Muscle imbalance

Poor training

Shoe wear

Equipment/surface

Non-modifiable Hormones?

Bone structure

Ligament laxity 1

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Performance improvement = Injury prevention 1

Body control

Landing mechanics• Trunk/hip flexion

• Soft bent knees

• Backward weight shift

• Toes and knees forward • No knee kissing

• Hamstring recruitment

• Core activation 6

Body control

Valgus collapse (knee kissing)• Weakness in lateral hip muscles

• Poor training

• Lack of awareness 6

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Body control

Hamstring recruitment

Backwards weight shift 6

Body control

Trunk/core strength and awareness 6

Quick screens: LESS

Landing Error Scoring system (LESS)• Field assessment for potentially high risk

movement patterns (errors)

• 30 cm box drop and immediate jump and land

• Scores based on body position

• Scores of a 5 or more are at greater risk 8

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Quick Screens: LESS 8

Quick Screens: Tuck Jump Assessment 3

Prevention programs

Sportsmetric (1999 and 2012)

• Individualized program 3x/wk X 6 wks

• Ages 14-18 with a variety of sports

PEP (Prevent injury and enhance performance)

• Warm up in season 3x/wk X 12 wks

• Ages 14-18 included soccer only

KIPP (Knee injury prevention program)• Warm up in season 3.3x/wk X 13 wks

• High school age included soccer and basketball 7

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Sportsmetrics

http://sportsmetrics.org/ 7

Injury prevention

Diet

Sleep

Overtraining

Psychosocial

Menstrual cycle

Substance abuse 5

References

Brophy, R. H., Silvers, H. J., & Mandelbaum, B. R. (2010). Anterior cruciateligament injuries: etiology and prevention. Sports Medicine And Arthroscopy Review, 18(1), 2-11. 1

www.bu.edu/sargent 2

Coloradoinmotion.com/acl-injury-prevention 3

Colvin, A. C., & Lynn, A. (2010). Sports-related injuries in the young female athlete.The Mount Sinai journal of medicine, New York, 77(3), 307-314. 4

Elliot, D. L., Goldberg, L., & Kuehl, K. S. (2010). Young women's anterior cruciateligament injuries: an expanded model and prevention paradigm. Sports medicine (Auckland, N.Z.), 40(5), 367-376. 5

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References

Myer, G. D., Ford, K. R., Khoury, J., Succop, P., & Hewett, T. E. (2011). Biomechanics laboratory-based prediction algorithm to identify female athletes with high knee loads that increase risk of ACL injury. British journal of sports medicine, 45(4), 245-252. 6

Noyes, F. R., & Barber-Westin, S. (2014). Neuromuscular retraining intervention programs: do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes? Arthroscopy: The Journal Of Arthroscopic & Related Surgery: Official Publication Of The Arthroscopy Association Of North America And The International Arthroscopy Association, 30(2), 245-255. 7

Padua, D. A., DiStefano, L. J., Beutler, A. I., de la Motte, S.,J., DiStefano, M. J., & Marshall, S. W. (2015). The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury-Prevention Program in Elite-Youth Soccer Athletes.Journal Of Athletic Training, 50(6), 589-595. 8

WWW.titlexi.info 9