Introduction
The knee injury prevention screening program is an annual screening program for Anterior Cruciate Ligament (ACL) and other knee injury prevention in school based sports. The current focus is on female student athletes participating in basketball. This is largely because of the greater incidence of non-contact injury that occurs in girl's basketball nation wide.
What Is The Program?
This program was instituted as a joint effort of the Mountain Home Junior High School and the BRMC Rehab department. It began in 2003 in an attempt to reduce and prevent knee injuries among female student athletes. The major focus of the program is to reduce severe ligament injuries, such as ACL tears. Participants are screened for weaknesses and tightness that could contribute to a variety of ailments, the most debilitating of which is the ACL injury. Prior to instituting this program, there were 15 ACL tears in the female basketball population from 1986 to 2006. This represents 7% of the approximately 200 athletes. During that timeframe, 11 of the 15 occurred from 1996 - 2006 coinciding with an increase in the intensity of the sport of girl's basketball nationwide. Since the implementation of this program in 2003, only 1 ACL injury has occurred out of 87 female basketball participants or 1% of the total population. This lone injury occurred in an athlete who was found to be positive for indicators for increased risk of injury, but did not participate in the recommended prevention part of the program.
Why Are Females More Prone To Injury?
There are several reasons why females are more likely to injure their ACL during sports. In no particular order, here is a list of the most common issues that contribute to the likelihood of injury:
Skeletal changes related to the pelvis and its position and width.
Altered Femur to Tibia alignment and position.
Hormonal changes related to monthly cycle.
Intercondylar notch (area ACL exits inside knee) shape and angle.
Decreased muscle strength and or imbalance in lower body.
Greater tendency for excessive foot pronation from ligament laxity.
Several of these items cannot be altered because of gender, normal physiological function and or heredity. Those that can be modified have been the areas of focus for prevention.
What Is Being Done To Decrease The Risk Of injury?
A program has been instituted to include stretching and conditioning by the coaching staff to minimize the potential of injury related to muscular control. In addition, the students are monitored by the coaching staff to insure adequate rest is given to prevent excessive fatigue. Screening evaluations are performed by a Physical Therapist looking for muscle weakness, muscle tightness, and excessive pronation (flat feet). Based on the findings of these screenings, participants are categorized as either at severe, moderate or mild risk for injury. Those with moderate and severe risk categories are then recommended to consider custom orthotic correction. This information is presented to the student and their family through the coaching staff or directly from the therapist. In addition, specific corrective exercise recommendations for muscular deficits are also provided by the Physical Therapist at no charge to the student or family.
What Is A Foot Orthotic?
A foot orthotic is a device worn in the shoe that has been molded to the shape of the foot. A plaster cast mold of the foot is made and the device is then fabricated at an orthotic fabrication laboratory to the specifications of the Physical Therapist. The orthotic has correction built into the device to control foot and knee mechanics. This customized device is designed to be comfortable and provides the greatest amount of support needed. Products that are not custom made have no ability to correct deviations from normal, are not durable, and seldom provide assistance. The way the orthotic helps is by controlling the excessive foot movement that can occur with excessive pronation during activity. This movement translates into how much stress occurs at the knee and sometimes even in the hip or the low back.
How Are They Acquired and What Do They Cost?
A Doctor's order is needed for an appointment with the therapist for evaluation and casting. There are evaluation and casting charges for this visit, which are usually covered by most insurance providers. In addition, there is the cost of the manufacture of the orthotics. This cost must be paid by the client to the orthotic manufacturer at the time the orthotics order is placed. This up front cost is approximately $150 and does not include the cost of the evaluation and casting.
What If My Child Out Grows Them, or they Breakdown?
For a nominal fee, the manufacturer allows one outgrowth replacement pair with each order per child by age 17. To get a new pair, the old pair must be returned and the extended warranty must be purchased ($50.00 for 2 years). This is also to insure that the manufacturer retains the casts. The warranty includes loss, breakage and recovering of the top covers. Each pair of orthotics comes with a 120-day free modification and correction warranty. This warranty does not cover any addition of materials to the devices after fabrication is complete. The average pair of orthotics will last 3-5 years with recovering of soft materials as needed if no outgrowth occurs.
Disclaimer
This program is designed to screen young student athletes for issues that are related to sports and specifically ACL injury in hopes of preventing injury. It is not intended to render a diagnosis or replace the consideration of a physician or evaluation for a previously made diagnosis or injury. It is intended solely as a prevention program provided free of charge to students involved in sports. BRMC and its employees, and Mountain Home School Systems and its staff assume no liability for injury sustained with or without recommendations made or products provided.