Thursday, October 7, 2004
Knee injuries plague women's soccer
By Shannon Russell
Enquirer staff writer
Times have changed in women's soccer, but the sport's biggest injury offender has not.
Anterior cruciate ligament tears are so prevalent, Cincinnati Sportsmedicine and Orthopaedic Center president and director Dr. Frank Noyes said high school and college teams can expect one female player to suffer an ACL injury each season.
Female soccer players visiting Paul Brown Stadium Sunday for the U.S. Women's National Team's Fan Celebration Tour share two things in common: high-risk knees. And some parents, players and coaches believe that ACL injuries are striking younger players, thanks to year-round soccer and a highly competitive climate.
A decade ago, Noyes started Sportsmetrics, a program to prevent serious knee ligament injuries in female athletes. He said the injury rate among female soccer players under age 12 is "very, very low" per hour of play.
But he keeps seeing younger and younger patients.
"We're seeing ACL tears in young children, some 6 and 7, others 8 to 11. We're seeing younger kids because they are playing so young," Noyes said.
The ACL, located in a knee joint, stops the shin bone from sliding beneath the thigh bone. The ligaments crisscross to keep humans steady on their feet, but when an ACL tears - often from quickly changing direction, slowing down from running, or coming down from a jump - it unravels like a rope and does not repair
itself.
Soccer and basketball are the most dangerous sports for females' knees because of "sudden deceleration and cutting." Noyes said anatomical, hormonal and neuromuscular differences lead to serious knee injuries four to 10 times more often in female athletes than male athletes, and his six-week program utilizes strength, coordination and balance as preventive measures.
Whereas males' testosterone levels help develop strong muscles as they age, females "never develop the muscular strength per weight" as males do, and therefore are disadvantaged in high-intensity sports, Noyes said. Both genders try to harness balance and coordination as they start playing sports.
But too much playing and not enough conditioning could be wreaking havoc on girls' knees, said Wil Cagle, head coach and co-owner of the Cincinnati Ladyhawks and women's soccer coach for Cincinnati State.
After seeing ACL injuries continually strike players - this fall seven of his Surge players have some type of knee injury - Cagle said he wouldn't dispute the idea that they stem from a heightened youth club soccer environment. Cagle said the country in general has gotten "carried away" with its push to get kids involved in serious soccer so early.
"We've probably gone overboard in the other direction," Cagle said, "trying to formalize the experience instead of letting kids have fun."
Katrina Rice, a 32-year-old Fort Mitchell resident who is on crutches while awaiting surgery for a soccer-related ankle injury, burned off stress by playing soccer as a kid but now wonders if the sport is causing emotional and physical distress in today's youth.
The mother of four and former coach has seen kids' soccer leagues become feeder systems for club teams, and while the setup allows for opportunity to pursue different avenues in soccer, she said it also can leave depleted girls in its aftermath.
"There's so much pressure to coach select and play select. What does that say to kids? It's kind of sad," Rice said. "Growing up, we didn't have that kind of pressure, and it was kind of nice."
Punishing indoor turf and novice coaches who inadvertently cause harm by not knowing proper injury prevention often go with the club ball territory.
All things considered, Katie Petry, a Mount Lookout resident and former college player and youth soccer coach, thinks the ACL injury rate "has to be going up" among young girls.
Sooner or later, soccer probably will catch up to you, said Petry, who had total reconstructive surgery on her right knee in her 23rd year of playing soccer. Petry, 27, needed six months to recuperate.
The upswing is that ACL injuries today are more researched, easier to prevent and less likely to end careers. When Petry was growing up, knee injuries were "the kiss of death" because they sidelined players indefinitely, she said. She doesn't see a reason to quit soccer for her knees - ever.
"I doesn't matter if I blow it out four times. I'll reconstruct it every time," Petry said. "Six months and surgery isn't going to stop me from playing the sport I love."
Noyes said athletes have a 15 to 20 percent chance of re-injuring a torn ACL or suffering the injury in the other knee within three years of the first injury.
So preventing ACL tears is crucial at any age, and players need to correct potential injury-causing tendencies.
"Think of a cat. They jump down and right themselves, landing softly with great control," he said. "A lot of women land with a wiggle-wobble. That imbalance is what we're talking about."
USA vs. New Zealand
The U.S. Women's National Team's Fan Celebration Tour visits 10 cities this fall, just months after the team's 2-1 overtime win over Brazil in the Olympic gold-medal match. The team's stop in Cincinnati comes more than 11 years after its only previous visit to the city, a 7-0 victory over Canada in 1993.
