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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003E?Anterior cruciate ligament (ACL) injuries in athletes are common, especially among females, who are at a 2- to 10-times greater risk than males. The causes are multifactorial but can be avoided with proper training. This article discusss the mechanics of ACL injuries in terms of neuromuscular, anatomical, biomechanical, hormonal, and growth and development risk factors. The study of these form the groundwork for a prevention program developed at The Ohio State University Medical Center.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EAnterior cruciate ligament (ACL) injuries in athletes are common, especially among females, who are at a 2- to 10-times greater risk than males. The causes are multifactorial but can be avoided with proper training. Timothy E. Hewett, PhD, The Ohio State University Medical Center, Columbus, Ohio, USA, discussed the mechanics of ACL injuries in terms of neuromuscular, anatomical, biomechanical, hormonal, and growth and development risk factors. The study of these form the groundwork for a prevention program developed at The Ohio State University Medical Center.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EFemale athletes have a greater risk of ACL because of increased dynamic valgus and high abduction loads during landing. Other biomechanical and neuromuscular risk factors identified include dynamic trunk instability, proprioception, history of low back pain, and greater knee joint laxity [Myer GD et al. \u003Cem\u003EAm J Sports Med\u003C\/em\u003E 2008; Zazulak BT et al. \u003Cem\u003EAm J Sports Med\u003C\/em\u003E 2007; Hewett TE et al. \u003Cem\u003EAm J Sports Med\u003C\/em\u003E 2005].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EFor those at high risk for a first ACL rupture, studies have shown a body-knee connection to injury where there is uncontrolled trunk or core motion coupled with knee abduction. To make female athletes less vulnerable to ACL tear, Dr. Hewett recommended training that addresses the mechanisms leading to knee abduction: not allowing the knee to cave in and training to increase hamstring and quadriceps recruitment, single-leg balance and symmetry, and dynamic core stability. This training identifies the neuromuscular imbalances\u2014ligament, quadriceps, leg, and trunk dominance\u2014that make the knee vulnerable to ACL injury.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EFemales diverge in ACL injury rates from males at \u223c 12 years, the time that the majority of females begin puberty. ACL injuries peak in females at age 16. During females\u0027 adolescent growth spurt, their landing motion patterns are considerably different from those of males. Female athletes display greater total medial motion of the knees and a greater maximum lower extremity valgus angle than do male athletes on landing. Flexor torque decreases, and there is an increase in dynamic valgus angulation of the knees after maturation [Hewett TE et al. \u003Cem\u003EJ Bone Joint Surg Am\u003C\/em\u003E 2004].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn a study that examined longitudinal risk factors of ACL in females during maturity, incremental increases in height, body mass index, and anterior knee laxity were associated with decreased hip abduction and knee flexor strength and increased knee abduction loads after each year of growth. These changes increased the risk of ACL injury [Myer DG et al. \u003Cem\u003EJ Athl Train\u003C\/em\u003E 2009]. In females, increased body mass and height of the center of mass, without matching increases in hip and knee strength, may underlie increased knee abduction loads. Peak height velocity and high load coincide in females but not males.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ECombined biomechanical and epidemiologic studies and video analysis provide evidence that sex-specific mechanisms of ACL injury may occur, with women sustaining injuries by a predominantly valgus collapse mechanism. ACL injury preventive programs should focus on the reduction of high-risk valgus, the reduction of loads, and the stability of sagittal-plane movements.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/28.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoxde\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}