Preventing Repeat ACL Tears in Soccer Athletes: A Crucial Consideration

Abstract

Likelihood of a Second ACL Tear in Soccer Athletes Introduction While analyzing the likelihood of a second ACL tear in soccer athletes, it is imperative to note that as much as these athletes continue to engage in soccer-related activities, they have no control over re-occurrence of an injury as this happens as an accident. Then what is an ACL and what is an ACL injury? A knee has ligament on each side (collateral ligaments) and two deep ligaments crossing each other in the inside part of the knee known as anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Both ACL and PCL attach on one side to the end of thighbone and on the other to the top of shinbone thus during activity ACL control how far forward the tibia can slide to the femur. In case of too much motion, ACL tears due to sudden pivoting or cutting maneuver during soccer activities and chances of re-occurrence of such injuries remains relatively high even after treatment especially on female athletes as long as they remain exposed to such sporting activities most especially in football, basketball and soccer as explained in three literatures from credible scholars on this topic. Literature Review Background An injury is an injury and the likelihood of a second tear in case of exposures to triggers that caused the first injury remains a reality. In order to understand the likelihood of a second ACL tear in soccer athletes, it is wise to understand the structure of a knee to ascertain whether any injury on it can re-occur in case of continued sporting. A knee is a hinge joint held together by four ligaments that hold the bones together and help control joint motion and movement. The collateral ligaments are on each side of the knee while anterior cruciate ligament and posterior cruciate ligament cross each other deep inside the knee. During sporting activity, ACL controls how far the tibia can slide forward relative to femur to ensure that there is no much forward movements or too much motion as can cause discomfort leading to destruction on other knee structures (Della Villa et al., 2021). Unfortunately, as much as ACL tries to control unnecessary forward slides, it become exposed to tear and injuries incase of sudden pivoting or cutting maneuver as athlete engages in vigorous sporting activities. During injury, the victim may experience a pop or snap feeling/sound resulting to immediate kneel swelling with extent of swelling varying based on first aid experienced. Since ACL injury stops the athlete from engaging in sporting activity immediately after the injury due to pain experienced, the severity of pain determines the most effective treatment to address such injuries ranging from rest and rehabilitative exercises to surgery (Brophy et al., 2012). Therapies help athlete regain strength and stability while surgeries help replace the torn ligament giving the athlete a chance to re-enter the sporting arena and engage in the same activities exposing such an athlete to a second ACL injury in the course of vigorous engagements. In their article “Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared with Their Athletic peers?” Allen among other scholars confirmed that 28% of all female soccer players and 34% of those players that returned to soccer experienced a second ACL tear. Using cohort study design, Allen et al. (2016) reviewed medical records at a single institution for female patients previously injured during competitive athletic event and treated with ACL reconstruction between 1998 and 2013. Clinical outcomes were obtained after following the patients for 68.8 months citing that soccer players matched 1:1 to non-soccer athletes for age, activity level and graft type. What does this imply? In a total of 180 female ACLR patients (90 soccer and 90 non-soccer players), soccer players sustained more second ACL injuries (11% vs. 1%) including both graft failures and contra-lateral ACL tears (17% vs. 4%) as compared to non-soccer athletes. Out of the 67 patients (13-27 years) that returned to soccer activities treatment, more had graft tears compared to those that did not return to sporting but not the case with contralateral ACL second tear. Older age proved a significant risk factor for ACL graft tear but not for contralateral ACL injury. Basically, the study confirms high likelihood of a second ACL tear on soccer athlete thus the need for athlete to remain vigilant and cautious to avoid such experiences. Unlike Allen et al. (2021) that analyzes the likelihood of second ACL tear from the female soccer athletes’ point of view, Della Villa and colleagues argue the same topic through a close analysis of 118...