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Adolescent girl athletes are as much as eight times more likely to injure their knee's anterior cruciate ligament (ACL) than their male counterparts, according to a recent study led by Morgan Stanley Children's Hospital of NewYork-Presbyterian and Columbia University Medical Center. Published in the American Journal of Sports Medicine, the study looks at the reasons why the knee injury disproportionately affects mature girls. The study's author, Dr. Christopher S. Ahmad, also addresses how to prevent and treat the condition.

"With more girls competing in soccer, basketball, gymnastics and volleyball – sports requiring maneuvers such as jumping and landing, or quick stops and turns – more cases of ACL injuries are being seen," says Dr. Ahmad, director of the Center for Pediatric and Adolescent Sports Medicine at Morgan Stanley Children's Hospital and assistant professor of orthopaedic surgery at Columbia University College of Physicians and Surgeons.

The study posits two primary reasons for girls' increased susceptibility to ACL injuries. First, adolescent girls tend to develop increased quadriceps strength, while not increasing hamstring strength. With very strong quads overpowering the hamstrings, an imbalance occurs, leading to undue stress on the ACL. Second, girls become skeletally mature earlier during puberty, and they tend to perform their sports activities in a more upright position that adds stress to the ACL.

The study followed 53 female and 70 male recreational soccer players, aged 10 to 18. Greater knee laxity – one indication of risk for ACL injury – was found among mature girls (8.85 mm), especially when compared to mature boys (7.33 mm). Previous research has shown that estrogen may contribute to laxity and weakened ACLs. None of the study participants had evidence of damage to their ACLs. The study also found mature girls had significantly greater quadriceps-to-hamstring ratio (2.06) when compared to immature girls (1.74), immature boys (1.58) and mature boys (1.48).

Dr. Ahmad suggests tips for girls on how to prevent ACL injuries, including making them more aware of their upright position during activities like landing from a jump and training them to assume a more flexed stance. He also suggests strengthening of hamstring, hip and core muscles.

"When an injury takes place, the child's knee and surrounding areas should be iced and elevated to prevent inflammation," says Dr. Ahmad. "With any persisting pain or lack of mobility, parents should consult with their physician."

For more information, patients may call 866-NYP-NEWS.

Center for Pediatric and Adolescent Sports Medicine at Morgan Stanley Children's Hospital

The Center for Pediatric and Adolescent Sports Medicine at the Morgan Stanley Children's Hospital offers comprehensive care to children and teens who have an injury or condition affecting sports performance, exercise or activity. In growing children, injuries to bones, muscles, ligaments, tendons and joints often differ significantly from conditions more commonly seen with older patients. Special training and experience in pediatric sports medicine allow specialists to appropriately treat the unique sports-related medical needs of children and teens. In addition to ACL, the Center treats injuries including shoulder dislocation, elbow injury and less common injuries.

Morgan Stanley Children's Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top six children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics – including the most complex neonatal and critical care, and all areas of pediatric subspecialties – in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children's Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians & Surgeons, the College of Dental Medicine, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions.