Hearing a loud pop, feeling their knee give out, and having intense pain surround their knee, the athlete walks off the field with assistance. Within a few hours, the athlete is hopelessly sitting on a couch with a swollen knee, fearing the worst.

About 75 percent of all torn ACLs happen without contact, while the other 25 percent is due to contact with the knee. Young women, like Rachel Wille, junior, are up to eight times more likely to tear their ACL (a ligament in the knee that crosses from the underside of the femur to the top of the tibia) than young men.

“The most common way to tear the ACL is usually in a weight bearing position, so your foot is planted, and you have some kind of twisting rotation, where the foot stays planted and doesn’t give. Usually people think you have to be hit for that kind of injury, but it is usually a non-contact injury,” Linda Mass, NovaCare physical therapist, said. “Women are more likely to tear their ACL because of their body structure. Their hips are wider, which can cause their knees to point inward, but a lot of it has to do with being weaker. Also, everyone tends to focus on one sport all year round now, there is no cross training, and that hurts kids’ development of overall muscle.”

Wille tore her ACL during a soccer game, but went home thinking she just popped her knee. She laid down for a while, but then returned to walking the next day with a limp. Wille went to get an MRI and within a week, she was told she tore her ACL.

This past October, after her surgery to reconstruct her ACL, her doctor said her recovery time will be six to nine months. Similar to most athletes who tear their ACL, Wille has been going to therapy two times a week and cannot participate in any sports.

“After the surgery, usually patients here come two to three times for three to four months. They focus on areas such as strength, stability, balance, and eventually can do specific exercises designed for their sport. For example, for basketball we would focus on jumping drills, for soccer we would focus on more planting type of drills, lots of plyometrics,” Mass said. “At four months, high school athletes are usually back to doing normal activities. As far as returning to play, it really depends what the sport is. Also if you tear your meniscus (C-shaped disc that cushions your knee) along with your ACL, it can take longer to recover.”

While thinking of her long recovery, Wille said she looks back on the day she got injured and said she was shocked and never even considered that she might have torn her ACL during that soccer game.

“I think athletes, especially girls, should learn about how to prevent knee injuries,” Wille said. “Sports like soccer and basketball involve planting, twisting, and jumping, and athletes should know the correct form so they don’t end up injured.”

In order to prevent knee injuries, all athletes should address deficits in the strength and coordination of the stabilizing muscles around the knee joint and emphasize correct posture and landing. All the exercises explained in this article are from Santa Monica Sports Medicine Research Foundation’s Prevent Injury and Enhance Performance Program (PEP).

“I think every soccer, basketball, or any other sport with constant pivoting and jumping, team should throw [this program] into their practices because it is an easy warm up,” Mass said. “When my kids played at Ela [soccer club], I went in to teach the trainers this type of warm up. I think it is really a good program to incorporate into training.”

PHOTOS TO DISPLAY EXERCISES

Strengthening

1. Walking Lunges- 1 minute

• lunge forward, keeping a 90 degree angle, alternate legs
• do not let knees go over ankles, control the motion
• strengthens quadriceps

1. Russian Hamstring- 1 minute

• kneel on the ground, have partner hold ankles
• use hips to lean forward, keep a straight back
• strengthens the back of the thigh

1. Single toes raises- 1 minute, 30 seconds each leg

• stand up on one leg and slowly rise up on toes
• keep a slight bend in the knee
• strengthens calves

Plyometrics

1. Lateral, Forward/Backward, and Single Leg Hops- 1 minute each

• hop over a cone for 30 second intervals
• increases strength and control

1. Vertical jumps with headers- 30 seconds

• stand and push off jumping, landing on balls of the feet
• slight bend in knees, land softly
• improves vertical jump

1. Scissors Jump- 30 seconds (or 20 times)

• lunge forward with one leg in front, push off with front foot and propel opposite foot forward into a lunge
• keep the front knee from going over the front ankle
• increases power and strength of vertical jump

Stretching- Done at end of the warm up

1.  Calf Stretch- 30 seconds each leg

• stand with one leg in front, and opposite leg straight, perpendicular to the ground
• keep knee slightly bent

2.  Quadricep Stretch- 30 seconds each leg

• bend leg back, grab the front of the ankle with same side hand, bring the heel to the buttock
• stand straight up, be balanced

3.  Figure Four Hamstring Stretch- 30 seconds each leg

• right leg in front, left knee bent, left foot resting on the right inner thigh
• do not round the back, switch legs

5.  Inner Thigh Stretch- 30 seconds each side

• sit down, legs spread apart, lower the body to the center, to the right with right arm, and then to the left with left arm
• slowly lower the body to the floor

6.  Hip Flexor Stretch- 30 seconds each leg

• lunge forward with one leg, drop the other leg to the ground, place hands on top of lunging leg

lean forward with the hips, hips should be aligned with shoulders