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Concussions in youth sports are increasingly considered a public health crisis. As a result, there are multiple public health efforts aimed at combating the effects of youth concussions. These initiatives range from modifying individual safety behaviors such as underreporting concussions to changing the rules of sports to reduce exposure to potentially harmful head impacts.

National guidelines

In 2015, the U.S. Soccer Federation issued guidelines that children 10 years or under are not allowed to head the ball in practice or games. Players 11 to 13 are only allowed to head the ball during practice, not games.

That same year, the American Academy of Pediatrics released a policy statement about football after its national conference that includes seven recommendations, from proper enforcement of game rules by officials and coaches to delaying the age at which tackling is introduced. (See the National Football League website for the entire list of recommendations.)

In March 2019, USA Hockey updated its concussion management program and its return-to-play forms for the 2019-2020 season. To learn more about the changes, how they’ll be implemented and how they’ll enhance the youth hockey experience, see USA Hockey’s website.

HEADS UP initiative

The Centers for Disease Control and Prevention developed a program called the HEADS UP Concussion in Youth Sports initiative to ensure the health and safety of young athletes. The initiative provides information and training around concussions for coaches, parents, and athletes alike. The HEADS UP initiative provides critical details related to preventing, recognizing, and responding to a concussion.

Many Minnesota youth sports associations, such as the Minnesota Youth Soccer Association, require their coaches to complete the HEADS UP free online course.

Welia Health, prevention and treatment

Welia Health’s Sports Medicine specialists work with young athletes, local coaches, and high school athletic departments to prevent injuries including concussions.

In the event that a concussion is suspected, our team is experienced in concussion management. A comprehensive assessment includes memory testing, cognitive function, balance, and a vestibular assessment (commonly known as VOMS). In addition, an advanced, scientifically validated computerized concussion management system called ImPACT® (Immediate Post-Concussion Assessment and Cognitive Testing) is also offered.

An Anterior Cruciate Ligament (ACL) tear is a dreaded season-ending injury. The recovery is long and challenging. Any athlete participating in high-intensity contact sports has the potential to sprain, tear or even rupture the ACL, a flexible band of tissue that runs diagonally in the middle of the knee and provides the knee the stability it needs to rotate.

Female athletes are between two and 10 times more likely than male athletes to tear their ACL. There isn’t one specific reason this is the case, and it has been a source of great debate. Orthopedic experts are starting to agree that differences in how a woman’s body is structured (anatomy) and how it moves (biomechanics) both contribute to women’s increased risk of ACL injury.

Anatomical Factors: There are anatomical differences between men and women that might cause women to have more ACL injuries for several reasons. They include:

Pelvis width
Q-angle or the angle at which the femur meets the tibia
Size of the ACL
Size of the intercondylar notch (where the ACL crosses the knee joint)

Women also have more elastic ligaments than men do, and this greater flexibility makes the ACL more prone to being stretched and twisted.

Technical or biomechanical factors: Some orthopedic researchers believe that the most conclusive evidence shows that ACL injury rates are most influenced by biomechanical differences between men and women. Some of these include:

Landing position: When landing from a jump, women tend to land with their knees straight, which transfers the force of impact to the knee joint. Because they tend to land with their knees bent, men tend to absorb more of the energy.
Flat-footed landings: When they jump, women also tend to land with the soles of their feet instead of on the balls of their feet. By landing flat-footed, the knee has to absorb most of the shock.
Quadricep vs. hamstring strength: Because women tend to have stronger quadriceps than hamstrings, female athletes tend to rely on their quads for movement. The knee compensates for this by putting added stress on the ACL.
Running upright: Women tend to run in a more upright position than men do, giving them less control over how the knee rotates.

Lowering the risk of ACL injuries

The Welia Health team can help female athletes lower their risk of ACL injuries. Preventing ACL injuries is most effective with a comprehensive approach. To lower a female’s risk of an ACL injury, it’s important to:

Increase leg muscle strength and core muscle strength
Improve or learn proper jumping and landing techniques
Improve balance and speed
Wear proper footwear specific to the sport

The most effective methods to reduce ACL injury risk is to strengthen the muscles that support the knee, including the quadriceps, hamstrings, hip adductors, and gluteus muscles and to do plyometric training. Plyometric training involves various jumping techniques, lateral bounding and lunges, sprinting and resistance training and helps to build strength, speed, agility and coordination.

Athletes will also want to consider an evidence-based, sport-specific training program. These programs will not only help athletes lower their risk of injury but will also improve their performance.

What to do when you experience an ACL injury

Even with proper prevention programs, injuries can occur. If you suspect an ACL injury, contact Welia Health’s orthopedics department. Early treatment is critical to reducing pain and swelling and to recovering quickly.