ACL Injury - Prevention Opportunity Missed

ACL INJURY JOURNEY Mikelle Hauck and Louis Stack, Fitterfirst Inc.

The circle of life is a curious one! We start so innocent as babies excited to touch and learn anything. After a few months, then years, experience breeds many personalities from shyness to outgoing or free spirited to home bodies. As parents we hope for our kids to find a way to comfortably fit in with their peers on each child's own terms. Sports are often the ice breaker for young kids and their parents as well. This is Mikelle’s story from a young soccer player to a social media professional with something important to share!

Community Kids soccer is great fun for kids of any age! It is an introduction to team sports, exercise, and social interaction for the child and a moment of peace for their parents. Soccer for most children comes and goes like a great deal of phases throughout their early years. But for others, including myself, it became a passion. A passion that has an unknowingly detrimental outcome without the proper precautions.

At age eleven, I begged my parents to try higher level competitive soccer. I had been playing since 4 and I knew I had what it took to challenge myself more than your average child. Upon their approval, as a young female athlete, I felt empowered by the challenge. However, amongst the thrill of the game, there were hidden challenges I was yet to face.

In what now feels like chilling foreshadow for what was to come, that year a news crew came to film my new soccer team. They were doing a story on the strong correlation between young female soccer players and Anterior Cruciate Ligament (ACL) injuries.

Studies prove that ACL injuries are prominent in adolescent and young adult athletes. More specifically, research shows that female athletes are anywhere from 2-10 times more likely to sustain a non-contact ACL injury than their male counterparts.

A study performed by Myer, Chu, Brent, Hewett (2008) found that Neuromuscular Training can reduce ACL injuries in adolescent and mature female athletes. Neuromuscular ability is the ability for nerves to communicate with the muscles, sending signals to contract. The bodyrequires these muscle contractions in order to counteract force. An example of this would be when balancing on one foot, muscles are contracting to keep the body stable. According to Myer et al. (2008) “Targeted neuromuscular training, at or near the onset of puberty, may simultaneously improve lower extremity strength and power, reduce dangerous biomechanics related to ACL injury risk and improve single leg balance.”

At the time I was unaware of the importance of consistent Neuromuscular Training or a focused, thoughtful warmup and cool down. A few stretches pre-game and a quick, light jog post-game was all I practiced.

I will never forget the day the foreshadow from years past became my reality. I was rushing up to challenge for the ball, took a hard pivot and felt a dreaded “pop” in my knee. A flood of heat and pain quickly followed. At 22, I was unable to escape the statistic so many young female soccer players fall victim to.

Interestingly enough, I had no idea I had torn my ACL or that you can still perform daily tasks this way. I went on for nearly two years with a weak knee before attempting to play again in a Calgary women’s team. On my first day, feeling in my element, I sprinted toward the goal on my first breakaway, only to crumble to the ground at the “pop” of my knee. Again, feeling a flood of heat and pain.

The weakness in my knee persisted after 6-weeks of physiotherapy so I was determined to get a second opinion. It wasn’t until I pushed to get an MRI the answers finally unfolded into a proper diagnosis, a fully torn ACL and Meniscus. With the surgery date scheduled a plan was finally set in motion to put this roadblock behind me.

The estimated recovery time of an ACL injury is 9 months to a year. I knew I had a long rehabilitation road ahead of me. As I write this now, today marks 13 months of consistent stretching, strengthening, and balancing post operative surgery. A formed habit that can easily fall to the wayside and affect your overall recovery if not taken seriously.  However, with persistence and patiences I was recently able to complete my goal of running 100km this month. Accomplishing this goal was a celebration to show myself what my body is capable of and how far it has come.

Perhaps if injury prevention was more emphasized in my youth those habits would have been better established in my discipline. Therefore, more strictly integrated into my everyday life and in my warmup and cool down routine beyond adolescence. Ultimately helping prevent my ACL injury in my twenties.

Whether team sports becomes a passion for your child or is simply an introduction to life's big lessons, I encourage parents and their kids to incorporate simple daily movements into their lives to form habits focused on thoughtful warmup and cool down exercises during sports activities. One simple step is to include a balance board in your family's daily home life so that it is used often throughout the day, much like a toothbrush for oral hygiene or a seat belt for autosafety.  With the proper precautions we can reduce the number of children and young adults who become part of the dreaded static and instead enjoy greater mobility and a higher quality of life!

As American Educator Horace Mann once said “Habit is a cable; we weave a thread each day, and at last we cannot break it.”

Mikelle’s story is one I would like to hear less often. My first knee injury was at a Cowtown Saddle Company Stampede Party where I jumped off the roof of a Barn to go dancing because my friend did. Needless to say, there was beer involved. That knee injury was done for in 1979 at UWO Ski Team tryouts, playing soccer. I had a portion of my cartilage removed and managed to keep it strong with Fitterfirst products for 42 years. I finally had a knee replacement March 18, 2021 after significant COVID delays.

The trick to all of this is regardless of your age is to keep on moving with the best posture you can, everyday. The sooner you start the better. My family was lucky, as they all started using balance boards daily at the age of 3 years old. The more things you do each day the better. Many are so simple too!

Here are just a few ideas to get you started:

• Balance on one leg for 10 seconds while brushing your teeth. alternate your legs, keep your head up and look in the mirror.
• Learn to balance on one leg while putting your socks on, start beside your bed.
• While watering your plants, practice slow knee lifts with one leg, then the other,  as many as you can.
• Try sitting in a firm kitchen chair with arms crossed. Move from sitting to standing and back to sitting as many times as you are able to in 1 minute.  (10x poor, 14x OK, 17x good, 20x very good) Work to improve this number daily.

When should you start?  Yesterday was better, but now is good too.  Stand up and have a great active day.  Remember: “Balance is the Essence of Movement, Movement is the Essence of Life!”

Myer, G. D., Chu, D. A., Brent, J. L., & Hewett, T. E. (2008). Trunk and hip control neuromuscular training for the prevention of knee joint injury. Clinics in sports medicine, 27(3), 425–ix. https://doi.org/10.1016/j.csm.2008.02.006

Hornbeck, K., Peterson, A., (2012) Neuromuscular training program reduces knee injuries among adolescent female soccer players. The Journal of Pediatrics https://www.jpeds.com/article/S0022-3476(12)01011-6/fulltext