On the rise?

Dr. Arnold Peterson is alarmed that he’s treating more knee injuries in athletes.

“The older I get and the longer I do this, it worries me,” said Peterson, a Spokane orthopedic surgeon. “I don’t think we have the problem under control.”

Athletes today are playing sports year-round and it exposes them to an increased risk of injury – namely knee injuries. More specifically, anterior cruciate ligament injuries that require reconstructive surgery. The ACL is the main ligament that stabilizes the knee.

“Sports, to some extent, are getting too serious,” said Dr. Russell VanDerwild, also a local surgeon. “Kids are specializing at such a young age. We’re not generating recreational lifetime athletes.”

VanDerwilde said about 200,000 ACL surgeries are performed every year in the U.S. Another study from a Dallas-based surgeon suggests that number is closer to 300,000.

“That’s an astounding number,” VanDerwilde said.

VanDerwilde said he’s done reconstructive surgery on 15 athletes this winter.

“You see the whole spectrum,” he said. “The youngest I’ve treated is 12.”

Dr. Michael Kody, an area surgeon, has noticed a spike in ACL injuries, especially among female athletes.

“It’s really almost epidemic proportions for female soccer and basketball players,” Kody said.

There’s been a rash of ACL injuries this winter in the Spokane area among varsity-level basketball players, and according to statistics, ACL injuries are on the rise across the country. One Philadelphia-based study suggests that knee injuries are up about 400 percent in the last decade.

There are plenty of theories to the why. Frequency of play seems to be a major contributor. As recent as 15 to 20 years ago, high school athletes weren’t playing as much out of season as they do today. The best basketball players in the region are playing 75 to 100 games a year. Year-round club and high school soccer athletes are playing as much or more.

Orthopedic surgeons believe there’s been a discernible uptick in ACL injuries.

“Doctors who treat kids have all been saying over and over that the numbers of ACL tears are going up dramatically,” Dr. J. Todd Lawrence, an orthopedic surgeon and pediatric sports medicine specialistist at the Children’s Hospital of Philadelphia, was quoted recently in a New York Times story.

“I think it’s primarily because kids are out there trying to emulate professional athletes,” Lawrence said. “You see these very young athletes playing sports at an extremely intense, competitive level. Kids didn’t play at that level 20 years ago. They didn’t play one sport year-round.”Overuse or overexposure in sports is also believed to take a toll on athletes, Lawrence suggests.

Studies suggest that athletes who play one sport are more apt to suffer ACL injuries than those who play two or more.

“Encourage kids to play multiple sports and not to do any one sport year-round, and especially not when they’re 5 or 6, or even 9 or 10. They’re kids,” Lawrence said.

VanDerwilde and Peterson, who treat Gonzaga University athletes, suggest plyometic jump training can help to avoid ACL injuries. Most physical therapists, the doctors say, can provide an organized jump program.

VanDerwilde said the jump training can’t be done alone. The athlete either needs to have a physical therapist present or paired off with another athlete who can watch and make sure the proper mechanics are being used.

After athletes rupture an ACL, they learn how to properly strengthen the surgically repaired knee and usually use the same rehab program to strengthen the other knee.

Athletes who have been injury free rarely attempt to strengthen the tissues around their knees, the local doctors say. One reason is the cost of going to a physical therapist.

“It’s hard to convince people to invest time and resources when they don’t have a problem,” VanDerwilde said.