Female Athlete ACL Injury: Mechanisms, Screening and Prevention

Thank you for visiting my Capstone site!!

 

  My Story:

I have loved sports from as far back as I can remember. There is actually home video of me rolling a ball back and forth to my father before I could even sit independently! I participated in sports including tennis, gymnastics, basketball, volleyball, softball, taekwondo, and many others from the time I was about five years old. As I grew older, I focused on volleyball and softball throughout my high school career and loved every minute of competition, every scrape,and every drop of sweat. At Appalachian State University I decided to give up highly competitive sports, focus on my studies and spend my time in the outdoors and playing club/intramural sports to “feed” my addiction. Throughout my athletic career, I heard about and witnessed many of my teammates and peers fall to injury, especially the infamous ACL knee  injury. I was lucky to have somehow avoided any serious injuries throughout  my competitive years, but fell victim to a complete ACL tear my senior year of college. This may have been a sort of blessing in disguise since  at that time I was not quite sure I wanted to be a physical therapist. However, throughout my rehab process I knew this was the field that was right for me. Additionally, since that time and throughout my physical therapy school career at UNC, I had always wondered why I and so many of my female peers had fallen to this injury and what, if anything I could do about it. I soon discovered the trend I personally saw was true: Females athletes are between 2-8 times more likely to suffer an ACL injury compared to males!  The Capstone project gave me the opportunity to discover in depth, the mechanisms of ACL injury and current prevention programs in female athlete population. In addition, I was able to share the information I learned and propose an evidence supported intervention program at the high school where I  spent countless hours training, competing and graduated from in hopes of saving some of the female athletes from the devastating physical and emotional injury so many girls have endured.

Products:

I dove deep into researching my idea in our evidence based practice II class this past fall.  During that class I produced an evidence table and research paper regarding female specific ACL injury mechanisms and intervention programs geared towards reducing incidence of female athlete ACL injury.

For the Capstone project specifically, I created a comprehensive, coach-friendly powerpoint presentation that addressed basic anatomy of the knee joint, mechanisms of female ACL injury and described the non-modifiable and modifiable risk factors for female ACL injury. The presentation was on the 11th of April where the audience included the athletic trainer, strength coach and four women’s sport coaches. However, a few of the athletes attended as well when they heard about the presentation.

Included in the presentation was evidence supporting intervention programs that have been used to reduce the incidence of ACL injury in female athletes. I decided to focus on and propose to implement the Prevent injury, Enhance Performance (PEP) program. I chose this program not only because it’s effectiveness in reducing the incidence of female ACL injury was supported by the evidence, but because it is a time efficient, easy to administer alternative warm-up program that could be easily implemented into almost any high school sport routine. Each audience member received a copy of the PEP program in their handout packet.  The handout included:

• PEP program outline/sequence: This is the 1 page sequence of the PEP program the coaches can refer to once they are familiar with how to perform each activity in the program
• PEP program exercise descriptions: This is the PEP program in sequence with a specific description of how to perform each activity, what to look for regarding correct form, and proposed elapsed time.

I also surprised the audience with a short and fun pop quiz to encourage participation and to assess their understanding of some of the main elements of the presentation.

To conclude the presentation session I administered an  anonymous satisfaction survey to gain feedback including how clear the presentation and handout materials were. Additionally I was interested in knowing how useful the coaches thought the presentation and proposed intervention program was and how much of a potential there was of the coaches using the alternative warm-up program in the future.

                                                                       Results:

The feedback on the anonymous satisfaction surveys were extremely positive! The average scores regarding the usefulness of the elements presented and how likely the coaches are to use the proposed intervention program were above a 9.5 out of 10. All of the participants agreed the presentation was presented clearly. The audience remarked the most useful information presented were the specific mechanisms of female ACL injury and the intervention program (PEP program) itself. As a whole, the coaches felt very confident (at least 4/5 on all items) administering all of the components of the intervention program. Face-to-face conversations after the presentation revealed a current warm-up program utilized by most of the teams with some similar elements, but good intention from all of the coaches in utilizing the presented intervention program in the future. I was very pleased with the receptiveness of the coaches and the audience, as well as great personal fulfilling  feeling of giving back to a place where I had so many learning, athletic and positive experiences.

Thank you(s):

Thank you for your interest in my Capstone!  I look forward to your comments, questions and feedback!

I would like to thank all of the UNC physcial therapy faculty for their support and dedication throughout the past 3 years!

Special Thanks:

I would like to especially thank my committee members, Alan Tomczykowski and Stacey Churchill for their help, advice, time and special interest in my project.

Also, I would like to give a special thanks to Mike Gross and Kmac for their time, support, guidance and effort throughout the Capstone process!

Ashley C. Tortorici