As mentioned previously (here and here), knee injuries are frequent in sport. They vary by sport, age group and as demonstrated here, by gender. Swenson et al 2012 collected data from the National High School Sports-Related Injury Surveillance System. They analysed 5 academic years of high school athletes (2005/6-2010/11) and looked at over 20 sports.

5,116 knee injuries occurred in that time period but consider that athletes were exposed to activity (training, conditioning or game play) over 17 million times during that time period. The overall rate of knee injury was 2.98 per 10,000.

Findings include that knee injuries were 3.5 times more likely in a game than in practice. Knee injuries were highest in American football 6.29, followed by girls’ soccer 4.53 and girls’ gymnastics 4.23 (all per 10,000). High school girls had a 1.52 rate of knee injury compared to high school boys and 2.38 times the rate of ACL injuries compared to boys- evidence that as early as our teen years, q-angle play a role in injury.

The MCL was the most common structure injuries making up 36.1% of reported injuries over 5 years. The patellar tendon (29.5%), ACL (25.4%), meniscus (23.0%), LCL (7.9%) and PCL (2.4%) making up the rest.

We can clearly see that the pattern of knee injuries varies by sport, level of contact and gender. This information should be used in adapting the ACL prevention program (discussed here) to the sport (and where possible to the athlete). If American football players and women’s soccer are the two most common sources of high school knee injuries, increasing strength through strength training, plyometrics and proper body mechanics will help decrease the rate of injury. Of course the origin of the injury will be different and as such different modifications will need to be made. It is likely American football injuries are associated with tackles while running, causing a shearing and compressive/rotational load on the knee joint. Women’s soccer is more likely to have a rotational component both given the nature of the game and the associated q-angles.

One can see how this plays a role in the early stages of pre-hab. Begin to look for more specific knee injury prevention programs- they are on the horizon.