Over the past few years, a significant number of women’s soccer and lacrosse student athletes at the University have suffered knee injuries—specifically ligament tears. Ligaments in the knee, most notably the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL), are absolutely critical to an athlete’s success. These ligaments stabilize the knee, allowing athletes to make all sorts of complex cuts and leaps. The frequency of these tears speaks not only to the physical demands of the sport, but also to the negative effects not doing rehabilitation exercises can have on student health.

The ACL is known as the ligament you really don’t want to tear; it requires extensive reconstruction surgery, a grueling rehab process, and lots of time for the body and knee to get on the same page, as they once were. At the University, over the past few years, many athletes have been sidelined for their injuries.

Those who have torn their ACLs playing soccer and lacrosse experienced a mix of contact and non-contact tears. Former soccer player Kinsey Yost ’19 noted that, in spite of the frequency of tears, each one is an injury specific to the athlete.

“I think that every tear is individual, and sometimes it is contact, a weird fall, a mis-plant, an errant follow through—you can’t really see it coming,” Yost said. “I planted and hyperextended my knee, and I didn’t think that I had torn it in the moment so I was able to jog off the field.”

Soccer player Nicole Brodkowitz ’20 also explained how she got injured.

“We were playing Trinity and I went in for a tackle and the girl kicked through my knee and basically blew out my entire knee,” Brodkowitz wrote in a message to The Argus. “I tore a bunch of ligaments including my ACL and my bones smashed together in the collision. I did have to have surgery to repair my knee.”

Meanwhile, in lacrosse, the “dodge” move, an attempt to evade a defender by skillfully maneuvering around them, has produced an unfortunate amount of ACL tears.

“I tore my ACL and meniscus,” Emma Richards ’20 said. “I tore it doing a 1v1 in practice where I planted my right leg when going for a dodge and my cleat got stuck in the turf and I twisted and heard a pop and immediately knew it was torn.”

Kat Cucullo ’21, another lacrosse player, highlighted an injury during her first year of college.

“I tore my ACL playing in a game my freshman season when I went to dodge off of my right knee, but my right leg got caught beneath me as I was cutting with the ball,” Cucullo said.

So why have so many women athletes at the University suffered from season-ending ACL tears?

Experts have tried to explain this question over the years, but there has not been an overall consensus as to exactly why women are two to four times more likely to injure their ACLs than men.

To help understand this statistic, doctors point towards anatomy and biomechanics. Anatomically, most people participating in women’s sports have wider hips than those participating in men’s sports. This can affect an athlete’s knees, causing them to move inward and putting stress on the ACL. Also, for those participating in women’s sports, the proportionally smaller groove at the bottom of the femur bone could theoretically restrict ACLs in movement.

Biomechanically, the collapse of knees inward while landing a jump, or the lack of hamstring strength, can also cause ACL tears, which disproportionately affect those participating in women’s sports.

Once injured, calculated decisions have to be made. It can often take months before any medical action is taken. When you attend an academically rigorous university like Wesleyan, life can’t just stop because you need surgery. Cucullo spoke to this issue, noting the difficulty of prioritizing the injury while in college.

“I tore my ACL in March but waited until May to get the surgery so that I could recover fully at home and not be completely immobile while on campus,” Cucullo said. “Because the first two weeks out of surgery are very painful and you can’t really do much except for lie down and ice all day.”

Yost noted a similar dilemma.

“I tore it at the beginning of September and ended up waiting until the beginning of December to have surgery since there wasn’t any additional damage,” Yost said.

And what comes after surgery? Rehab.

“The rehab process was definitely exhausting, physically and emotionally,” Brodkowitz wrote. “Physically it was difficult because it was extremely painful (especially in the beginning stages). However, I would say it was more mentally challenging because I wanted to get back to where I was, but the whole recovery was extremely long.”

One of the most painful factors of the ACL rehab process is the amount of time required to recover and get back to full strength. This can be difficult for full-time students, who ultimately may have trouble juggling student demands and rehabilitation.

“Its’s crazy how we take for granted being able to bend our knees on a daily basis when after ACL surgery it is such a battle,” Richards said. “It is also an extremely long process. Nine to 11 months is a really long time to be on the sidelines and it takes everything in your power not to just check out. Keeping yourself accountable in doing your exercises when you can’t even really see the goal at the end of the road is extremely tough.”

Yost, who was a senior when she tore her ACL, echoed the sentiment.

“For me, the hardest part of the rehab process was staying consistent towards the end of rehab,” Yost said. “In the beginning there are so many personal goals you hit so quickly that you can see yourself getting better and stronger, the hardest part is going from the 80 percent back to 100 percent back.”

Richards, who is currently going through the recovery process, pointed out how big of an impact tearing a small ligament can make.

“My injury has made me so much stronger, accountable, and more determined,” Richards said. “I work hard because I want to be able to come back from this injury stronger than before to be strong for my team and to show girls that even with this injury, there is hope and there is success later on.”

Across the board, women athletes who have torn their ACLs agree that the recovery and rehab processes are not direct paths to getting back on the field.

“The recovery was also filled with so many ups and downs,” Brodkowitz said. “The recovery was not linear at all, so it was frustrating when rehab would be going really well one day and then the next day, I would feel like I hadn’t made any progress. I vividly remember going to Cheshire, Connecticut, three times a week for a couple of hours at a time to work with my physical therapist. I think I spent more time there than in the library that semester.”

The recovery period can be more than just physically taxing—it can also take a toll on emotional and mental health.

“Physically, it was difficult to reteach my body to move in certain ways and the inability to do certain things for so long takes a toll when it comes time to do them,” Cucullo said. “Also, generally getting back into shape is extra hard when coming back from an injury where you need surgery because you’re physically inactive for such a long time in recovery. Emotionally, it was very hard to trust my knee to do certain moves because of the nature of my tear, where there was no external contact, so the tear seemed like my body failing me in a way it hadn’t in my athletic career.”

Women’s soccer and lacrosse athletes agree that tearing ACLs is common in their respective sports. So, what solutions should be offered to confront this mini-epidemic?

It ultimately comes down to muscle strengthening and pre-habilitation.

“Females are more prone to tearing their ACLs, but I also don’t think the average female athlete does enough pre-hab to help prevent an ACL tear,” Brodkowitz wrote.

Cucullo points out other factors that, if acknowledged, could possibly help prevent ACL tears in women.

“I think all injuries also have multiple reasons behind them: I pulled my left groin at the beginning of my freshman season and consequently was overcompensating with my right leg, which was the knee I ended up tearing,” Cucullo said. “I also think the way females tear their ACLs is dependent on the sport, because my two older sisters tore both of their ACLs in soccer through contact only, while the three ACL tears on our [lacrosse] team last year all were non-contact.”

Yost added that individuals can work to make sure they protect their bodies from injury.

“What I think is most important is that each athlete trains their body so that they are their strongest for when it does come,” Yost said. “It is important to lift and strengthen the muscles that support the knee, and I think that there can always be more pre-hab exercise for female athletes, let alone any athlete.”

Sports that demand quick cuts and complex movements, while playing through contact, need training regiments that don’t just get athletes in shape but also prepare their major joints for high-level function. This is not a knock on any team’s current strength training program. It is just an important point to be shared among teams. Consensus lies in confrontation—confronting the issue of women’s knee injuries on Wesleyan’s campus will benefit athletes.

 

Ben Owen can be reached at bowen@wesleyan.edu.