The Rise of ACL Injuries in Youth Athletics

Concussion prevention should not be the only prevalent topic in regard to injuries affecting youth and adolescent athletic participants. The number of young athletes damaging the anterior cruciate ligament (ACL) has increased significantly over the last 15 years. Parents, coaches, and youth athletic organizations must take steps to correct this problem.

Of the four ligaments which connect the bones of the knee and provide stabilization during movement, the ACL carries the biggest workload. Orthopedic surgeons nationwide have seen as much as a 400 percent increase in ACL injuries over the past decade. These medical professionals point out today’s youth athlete is subject to an increased amount of participation hours compared to similarly aged athletes of earlier generations.

Example: Consider the athletic participation by the average high school soccer player. Children as young as four begin their organized soccer experience. There are fall and spring seasons, as well as indoor soccer sessions. In theory, the body of a 16-year-old may have been subject to 36 soccer seasons during the 12 year span. The same can be said of other ‘year round’ sports such as volleyball and basketball. Children playing baseball or softball are involved in seasons running from early spring through late summer, and those same players will then participate in fall leagues lasting one to two additional months.

For decades, many youth athletes would participate in shorter seasons which allowed them to play two or three different sports during the year. Athletic organizations are now pressuring prepubescent and adolescent athletes to specialize in a single sport at an earlier age. The age of specialization has created an increase in repetitive, or ‘overuse,’ injuries to youth participants. Whereas a change in sports meant a change in how an athlete’s body was being used, the single-sport athlete now uses the same muscle groups continuously throughout the year.

Some doctors worry the way children are now being trained for a sport is too harsh for the undeveloped body. Many youth coaches use the same training approach as is used with professional athletes. A child’s body is not fully developed and injuries to such areas as the ACL come into play. Teaching the proper fundamentals to young athletes does not have to include training sessions geared for an adult’s body.

The American Academy of Orthopaedic Surgeons believes more studies are necessary to improve the knowledge of injuries occurring to youth athletes. An increase in proper conditioning can reduce the injury numbers. In the case of older children and adolescents, strength training programs need to focus on muscle efficiency and strength. This differs tremendously from adult-oriented bulk strength training.

Just because youth athletes play multiple sports does not guarantee a lesser chance of an ACL or other serious-type injury. Rest also plays a huge part into recovery time for a child’s body. Consider placing the child on a less competitive league, or one which has a lesser amount of games for the season. There is also nothing wrong with a child taking a break from a sport. Giving up fall baseball or indoor soccer may lead to an overall healthier environment for a youth athlete.

This research coupled with “over-use” injuries that are growing, it is important to be an advocate for your child when selecting programs, teams, coaches, and camps.