Australian rules football, rugby union, rugby league, netball, soccer, and skiing are all sports synonymous with winter time in Australia. What you may not know is that these sports are also the most frequently associated with anterior cruciate ligament (ACL) ruptures within Australia (Janssen et al, 2011).
What is the anterior cruciate ligament (ACL)?
The ACL is one of the four major ligaments in the knee responsible for stabilising the joint. The anterior cruciate is arguably the most important of these ligaments and, if injured, is certainly the hardest to recover from. An ACL rupture (complete tear) is one of the most-feared athletic injuries, as it generally requires surgery and a 7-9 month recovery period.
Prevalence of ACL injuries in Australia
A recent study conducted by Zbrojkiewicz, Vertullo, and Grayson (2018) looked at the rates of ACL reconstruction for young Australians between 2000-2015. As the winter sports season has just kicked off, it is important to be aware of their findings and how they may impact you.
The above study found that Australia has the highest incidence of ACL reconstructions worldwide, with the most at-risk population being males aged between 20-24 and females aged between 15-19.
However, incidence is increasing most rapidly in children aged between 5-14. This means more and more younger athletes are succumbing to ACL injury. Studies have suggested the reason for this could be a combination of earlier sport specialisation (less variety), longer sporting seasons, more intense training, higher levels of competition, and less time for free play (Werner et al, 2016).
The negative impacts of ACL rupture include inability to participate in sport, risks associated with surgery, financial burden and prolonged rehabilitation period. Individuals who rupture their ACL are also at increased risk of developing osteoarthritis – and at a much younger age. This can result in an increase in the prevalence of pain and disability in a younger population, causing an increase in the burden of health within Australia.
So, with overall rates of ACL reconstruction on the up, younger people becoming increasingly affected, and consequences of ACL rupture pretty significant, what can you do about it? What can you do to give yourself the best chance possible of preventing injury?
Preventing ACL injuries
Studies have shown that neuromuscular agility and proprioception training can reduce the risk of ACL rupture by up to approximately 80% (Sadoghi et al, 2012). These are highly specialised exercise programs which train athletes in how to move (i.e., run, jump, land, change direction, etc.) in the safest manner possible.
Your physiotherapist can help you assess any individual deficits and devise a training program incorporating these principles to address any specific needs. If you have any questions or are after more information regarding ACL rupture and reconstruction, please do not hesitate to contact your physiotherapist.
References
- Zbrojkiewicz, D., Vertullo, C., Grayson, J. E. (2018). Increasing rates of anterior cruciate ligament reconstruction in young Australians, 2000-2015. Medical Journal of Australia, 20: 1-5
- Janssen, K., Orchard, J. W., Driscoll, T. R., Van Mechelen, W. (2011). High incidence and costs for anterior cruciate ligament reconstructions performed in Australia from 2003-2004 to 2007-2008: time for an anterior cruciate ligament register by Scandinavian model? Scandinavian Journal of Medicine & Science in Sport,22: 495-501.
- Werner, B. C., Yang, S., Looney, A. M., Gwathmey Jr, F. W. (2016). Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injury and Reconstruction. Journal of Pediatric Orthopaedics, 36 (5): 447-452
- Sadoghi, P., Von Keudell, A., Vavken, P. (2012). Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs. The Journal of Bone and Joint Surgery, 94: 1-8