Anterior cruciate ligament injuries affect more sportswomen

2023-07-11 10:00:12

Ten thousand steps and more. The sad news fell at the end of May. Olympique Lyonnais striker Delphine Cascarino will miss the Women’s World Cup, which begins on July 20 in Australia and New Zealand. In question, a serious sprain of the knee, with in particular a partial rupture of an anterior cruciate ligament (ACL). Delphine Cascarino thus joins the long list of female victims of this injury in the world of high-level football. At the end of 2022, the German site Soccerdonna listed fifty-seven footballers playing in six of the best leagues in the world (including six in the French first division, D1 Arkema) affected by an ACL injury during the year. The knee is the most frequently injured area of ​​the body in women’s football (27%), ahead of the face and head (22%), concluded an analysis of the literature covering nearly five hundred articles, published in 2022 in review Research in Sports Medicine.

Front view of knee showing anterior cruciate ligament tear. (C) ELISE WALMSLEY-MACWHA / STOCKTREK IMAGES / BIOSPHOTO / (C) ELISE WALMSLEY-MACWHA / STOCKTREK IMAGES / BIOSPHOTO

Located inside the knee, the ACL has two major roles: it prevents the translation of the tibia forward and allows internal rotation to be controlled, underlines Professor Thomas Neri, orthopedic surgeon at the Saint-Etienne University Hospital. ” The surgical indication for reconstruction of this ligament is justified by a limited healing potential and by the need to restore its stabilizing functions, especially for sports with rotational constraints.he continues.

In fact, football is not the only discipline with a risk of knee sprain by reaching the anterior cruciate. The other so-called “contact-pivot” sports (rugby, basketball, handball, combat sports) or pivot sports (such as tennis, skiing, volleyball or even gymnastics), in which changes of direction are frequent, are also concerned. And sportswomen are much more often victims of it than their male counterparts: the risk is multiplied by two, even by five, according to sports and publications.

Increased risk in adolescence

“ACL injuries occur mainly during poorly controlled rapid movements, changes of direction, bad impulses or receptions”, explains Sébastien Ratel. The teacher-researcher in exercise physiology at the University of Clermont-Auvergne specifies that, in girls, the risk of these lesions increases in adolescence, linked to several factors. ” At puberty, girls’ pelvis widens, which can contribute to dynamic valgus (legs in X). They therefore tend to have the soles of their feet turned outwards, which can promote ligament damage when landing jumps., he explains. Other female risk factors have been identified: anatomical specificities, hyperlaxity (excessive elasticity of the ligaments), but also hormonal influence, with a greater frequency of these lesions in the first part of the menstrual cycle.

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