SAGINAW, MI (WNEM) -
With competitive club teams in almost every sport, year-round play is status quo for young athletes.
But with the promise of championships and scholarships comes the greater chance of injury - and it's a price more and more young athletes are paying.
Rachel Clements, 16, is among that group.
"I ran at least once a day; I would work out at Seung Ni usually twice a day, and every night I would have basketball or rugby practice," said Rachel.
It's that type of high-intensity sports training that landed her in physical therapy rehabbing a torn ACL. That's the anterior cruciate ligament. Its job is to keep the thigh and shin bones in line and when it's torn, it leads to major instability.
Rachel knew right away on the rugby field something bad had happened.
"My knee just cracked," she said. "It just felt like I got shot. I just fell to the ground and started screaming."
Now, one month out of surgery, she's back on her feet but still months away from returning to the field.
In the past decade there's been a 400 percent increase in ACL tears. Girls and women are two to eight times more likely to suffer an ACL injury. The question is why.
Dr. Danielle Duncan with Saginaw Valley Bone & Joint says there's no one answer.
"It's a combination of hormonal differences, body morphology differences, muscular development differences and also, to some extent, neuromuscular training," said Duncan.
And whether it's a boy or girl, certain sports like soccer, basketball, volleyball and football - with their stopping and twisting motions - are the main ACL enemies.
"It's a bad injury. It can be a devastating injury for an active young person. If they want to return to sport they typically have to have a surgical reconstruction of the ligament," said Duncan.
That means six to 12 months on the sidelines. "Time off" can be just what the doctor ordered, though often times Duncan says it should have come sooner.
"Most of these injuries are not contact injuries; these happen because of your own poor mechanics, and your ability to react to the stress of your body moving through space and landing," she said. "So if you're exhausted, you are much more vulnerable."
Duncan continued, "Currently there's a big focus on neuro-muscular training. What that involves is exercises flexibility training, balance training, strengthening and agility, and the specifics can vary from program to program but that's what you're looking for.
"You're looking to enhance certain things like always keeping your knee centered over your feet, not letting your knees way behind your feet or way forward from your feet or way to the side. Making sure your core is tight and conditioned."
Once the initial healing is complete, rehabbing an ACL is a lot like preventing a tear. The focus isn't just on the knee.
"You got to work on the core," said Pam Kutchuk, a physical therapist with St. Mary's Spine & Rehabilitation Center. "You have to make sure you have a strong core to make sure you can maintain good foundation, and then you're going to work on the mechanics of the lower extremity as well.
"Because if you don't have good foot and ankle mechanics, you're going to have issue at the knee. If you have issues at the knee, you're going to have problems at the hip. So we make sure we address the entire kinetic chain."
Rachel doesn't mind putting in the work now, as long as it gets her back to doing what she loves most.
"I just want to be able to run and play sports," she said.
According to the Orthopedic Society for Sports Medicine there are 150,000 ACL tears in the United States every year - a $500 million healthcare cost.
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