• Frédéric Van Burm, MSc.Ost.Med., DO.

Another ACL-alert: alarming rates of 'preventable' knee injuries in youth and speculations o

According to a study (Magowan) ACL injuries are more common in women than in men playing soccer or sports with a high dose of starting, shifting and turning activities (eg.handball, basketball and racketsports..)

Female athletes suffering a 'preventable' ACL injury outnumber their male counterparts 3 to 1.

Despite these male friendlier scientific stats, Australian newspaper the Sydney Herald brings the exemplary case of young soccer player John Roumeliotis: his career was almost over before it began.

At 18 years John had already torn his Anterior Cruciate Ligament (ACL) for the third time. That third time, he hadn't even returned to playing when he snapped his ACL again, just jumping. And this only two days before his return-on-the-field was scheduled in his 'comeback game'.

In his interview the young player stated that he thought it was 'game over', but that he hoped for a miracle to happen that would bring him back playing in the Australian Football League one day.

Despite millions spend on football injury prevention by FIFA and their self-selected and sponsored Centres of Excellence (Ekstrand, Bahr, Walden, Hagglund e.a 2002, 2007), similar sporting heartbreaks continue to occur in any league, worldwide.

The most recent FIFA studies still state: "Injury numbers remained equally high during international competitions over the last 10 years. Moreover, another study states: "We don't understand the mechanisms behind certain injuries or how to prevent it, or even how the body works" (Bahr).

The ability to understand how the body works (pathophysiology) or how to get the most out of an individual without getting injured (non-contact), is the coordinated work of many experts together: field experts like periodisation training experts, clinical experts like (holistic) medicine experts, osteopaths, chiropractors, lab experts like biologists, biochemists, physiologists and rehab room specialists like physiotherapists, eventually overviewed by...sport scientists.

Innovative knee research has revealed that Australia is amongst those countries with the highest rates of ACL reconstruction in the world. A study led by Vertullo calculated that there were almost 200 000 ACL reconstructions in the 15 years to 2015!

Surprisingly, ACL patients are also getting younger and younger, some as young as seven or eight. The Vertullo research showed the biggest increase is found in children aged 5 to 14!

It remains unclear what causes this growing ACL litany.

Besides being a country where a lot of people participate in sports, one can only speculate that high injury rates could be caused by

- a lack of free, deliberate play in youngsters ? (> deliberate play enabling their structures to grow stronger like advocated by many movement scientists)

- a lack of proper nutritional knowhow at younger age ? (>do parents have to learn more about modern/adapted ketogenic eating habits ?)

- a sitting overdose in between consecutive and too organized sporting events, in a generation glued to computergames, TV-playstations, smartphones? (> they also notice that UEFA Champions league is sponsored by ... Sony Playstation...for the players!)

- too early specialization as individual athlete ? (> do we all stimulate alternative/deliberate activities at least to the age of 13-14. enough? )

- a maintained scientific ignorance for the athlete as a whole ? (> Do academy scientists incorporate holistic medicine hypotheses in future research?)

- growing overall lifestyle discrepancies compared to our evolutionary traits ? (> do we have to read more about novel evolutionairy medicine strategies?)

Another research of La Trobe University in Melbourne (Webster) has also identified a trend of repeat injuries (re-injuries) in younger people who undergo a ACL reconstruction: more than 30 % re-occurrence in a sample of 128 operations.

To conclude, the final lines of the Herald article is that the national cost of prevention (eg.devices with an warming-up App, cost 3 000 000 $) will be far less than the annual cost of operative reconstruction (142 000 000 $).

However, prevention of crippling ACL episodes has to go far beyond...warming-up strategies.

If what you always do does not work, do something else.

Questions on what we can do for you as a young athlete suffering from an ACL (re)injury?

Send us an e-mail. Or call: +32 496 52 21 14.

Zuiderlaan, 20, B-9000 Gent, Belgium.

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