How teen girl soccer players can sidestep knee woes

NEW YORK Fri Jan 22, 2010 4:33pm EST

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NEW YORK (Reuters Health) - A simple training program requiring no special equipment and little extra time can sharply reduce knee injuries in soccer-playing teen girls, Swedish researchers report.

What's more, the injuries that did occur among girls assigned to special training were much less severe than those among the girls who didn't take part in the training program, Dr. Liisa Byberg and colleagues from Uppsala University found.

Due to a combination of anatomic, hormonal and other gender-related differences, Byberg and her team write in the Archives of Internal Medicine, female soccer players are many times more likely than males to injure their anterior cruciate ligament (ACL), which is key to maintaining the stability of the knee. These injuries can have lasting consequences, the researchers add, including osteoarthritis.

The researchers developed a 20- to 25-minute series of exercises focused on preventing such injuries by building strength, balance, core stability and awareness of the best way to execute movements that can stress the knees, such as landing from a jump. Because many of the exercises can be incorporated into standard pre-practice warm-ups, Byberg noted, including them in a team's practice regimen need not require extra time.

The "HarmoKnee" program also includes a seminar on knee injury prevention for the athlete's, their parents, and coaches. "The thought behind this is that the girls can feel support from all areas," Byberg noted.

This is important, she added, because talented teen female soccer players in Sweden are often asked to play on adult teams, which can put them at greater risk of injuries. Thus, she said, feeling supported should help girls to feel confident saying "no thanks" to such requests.

To evaluate the program, Byberg and her colleagues assigned 777 13- to 19-year-old soccer players on 48 different teams in one Swedish county to receive the intervention; another 729 girls on 49 teams in a different county acted as the control group. Teams in the intervention group were instructed to do the exercises twice a week during pre-season training, and once a week during the regular season.

From February through October 2007, there were three knee injuries among athletes on teams in the intervention group, and none of these injuries involved the ACL. In the control group, there were 13 knee injuries, five involving the ACL.

This translated to a 77 percent lower knee injury risk among the athletes in the special training group compared to the control athletes. And while all three of the athletes in the intervention group had returned to unrestricted play six months after their injury, just four of the 13 players in the control group had.

Among the 48 teams in the intervention group, 45 reported doing the exercises at least 75 percent of the time. A key aspect of the program, Byberg said, is that athletes should focus on doing the exercises correctly, rather than repeating them multiple times.

Coaches from the US, Germany and other countries have contacted Byberg's team to learn about implementing the program, she noted. Anyone interested in finding out more, she added, can go to www.harmoknee.com.

SOURCE: Archives of Internal Medicine, January 11, 2010.

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