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Parent’s Guide: ACL Injuries

POSTED BY: Florida Hospital

ACL injuries in children are among the fastest growing injuries being reported to doctors today. What was an unheard-of injury in children in the 1970s is now a serious problem with today’s youth. To find out more we reached out to our own Dr. Sean Keyes for answers.

What’s Causing ACL Injuries in Children

“ACL injuries in kids are growing due in part to increased single sport specialization at too young an age,” Dr. Keyes says. “Kids used to play multiple sports but are focusing on just one, which is causing an overdevelopment of muscle groups while neglecting other ones.”
This in response to today’s increasingly competitive sports arena and societal pressures.  Some reasonings behind this are to gain an athletic advantage or increase a chance at scholarships. Whatever the reason, this is detrimental to the overall development of the child. Evidence shows that 80 percent of Division 1 college athletes played multiple sports.
“Children don’t have the body awareness or body control that adults have, and early specialization hinders their ability to develop these normally,” Dr. Keyes explains. “Children shouldn’t specialize in one sport until late adolescence or high school.  If you do choose to play one sport year-round it is recommended to take one season off per year to allow the body to recover and prevent overuse.”
Attending your child’s sports games aren’t just a great way to show love and support for your child but also an opportunity to watch them for fatigue and overuse which can lead to injury. If you see your child fatiguing, be sure to tell the coach that they need a break. Children will often push themselves or feel pressured to push beyond their limits.  It’s everyone’s responsibility to watch for injury and speak up when they see it.

ACL Injury Effects and Treatment

“Currently there is not a reliable way to repair an ACL when it’s torn. There is some research being done that could change that, but we’re still years away from knowing it’s success.  Our options right now for ACL tears is to either treat them without surgery including physical therapy, bracing and changing sports or to reconstruct the ACL which means we replace it with an entirely different ligament that functions to stabilize the knee,” says Dr. Keyes.
“It wasn’t long ago, doctors wouldn’t even bother to try to reconstruct an ACL injury in children. Kids are still growing and to perform the surgery you need to drill holes in the bones and put in a new ligament, but the growth plate is right there which makes the surgery extremely complicated. There are few people around the country, myself included, with specialized training to address ACL tears in growing children. The recovery time from an ACL reconstruction is about 9 months with intensive physical therapy,” explains Dr. Keyes.
“An ACL injury can be a devastating injury for kids. 50 percent of people who suffer an ACL injury will develop some form of arthritis within 10 years. We can't think of this as an isolated injury to just one ligament. The force required to tear an ACL is immense and also may also damage the surrounding bone, cartilage, and meniscus” says Dr. Keyes.
An ACL tear is a physical injury but there is a psychological component, as well.  The psychologic aspect of recovering from an ACL injury is often underappreciated until returning to sports.  There will be some component of apprehension, anxiety and fear of another injury when returning to sports.  It is important that kids returning to sports after an ACL injury first start practicing, drilling, and scrimmaging in a safe environment outside of a competitive game. 

Other Preventative Measures

Be sure to wear proper setting-specific footwear. If your child is playing on turf, make sure they have turf cleats and not grass cleats as the turf doesn’t give the way grass does. That additional amount of traction can lead to injury.
If you’re concerned that your child may sustain a life-changing injury through sports, we recommend they attend a Sportsmetrics ACL tear prevention clinic at the RDV Sportsplex. For more information or to speak with a specialist please visit our website or call 407-303-8080.