For Female Athletes, ACL Injuries Take a Toll

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For Women in Sports, A.C.L. Injuries Take Toll Log in to see what Log In With Facebook your friends are By JERÉ LONGMAN sharing on nytimes.com. Privacy Policy | What’s Published: March 26, 2011 This? RECOMMEND PHILADELPHIA — This is not the homecoming that What’s Popular Now Caroline Doty wanted, surgical scars having formed a vague TWITTER William In Mural of T on her left knee, her contribution to Connecticut this SIGN IN TO E-MAIL Cronon and Maine’s season limited to charting plays from the bench instead of the American Workers, PRINT Thought Police Governor leading the team at point guard. SINGLE Dreamed He Saw Jong- PAGE il Enlarge This Image Three times Doty has torn the REPRINTS anterior cruciate ligament in her SHARE left knee, an injury that has Ads by Google what's this? afflicted sports like basketball Buying call options $8.50 Options & $0.15/Contract-How and soccer, where women are up Much More Do You Pay to Trade? OptionsHouse.com to five times more likely than Covered call men to have their careers interrupted for reasons Learn to Trade Options Successfully from Motley Fool's Options Expert! Jessica Hill/Associated Press that are believed to be anatomical, biomechanical www.Fool.com/Options UConn's Caroline Doty, and hormonal. Write Safe Covered Calls center, has torn the A.C.L. in Covered Calls, Safe & Conservative her left knee three times. Subscribers up 7% in last 2 months “I’m hanging in there, but it’s tough watching,” said galtstock.com Doty, 21, a junior at UConn and former basketball Related Sang Lucci and soccer star at Germantown Academy in Fort Easy Approach To Options Trading! Vandersloot Leads Gonzaga to Options Trading Made Simple and Fun Washington, Pa. www.sanglucci.com First Trip to Round of 8 (March 27, 2011) 3 Profit-Boosting Secrets On Sunday, UConn (34-1) will face its Big East rival Insider Options Trading Free Report On UConn’s Bench, a Little Secrets of an Option Trading Master Georgetown (24-10) for the third time this season www.cabot.net Size in Reserve (March 26, 2011) in the semifinals of the Philadelphia Region. A year Triple Peak Jackets New authentic baseball styles ago, Doty was a starter as the Huskies won a second Low prices, sizes to 4X. consecutive N.C.A.A. title. Now, she can only watch. www.sportsk.com

Track your picks “I told her the other day, ‘If we had you, we’d be TimesLimited E-Mail and follow Nate undefeated,’ ” Coach Geno Auriemma said, referring Silver’s 538 Sign up to receive exclusive products and experiences featuring NYTimes.com's forecast to the end of UConn’s record 90-game winning premier advertisers. throughout the streak last December at Stanford. N.C.A.A. tournament. You can win an iPad. Doty was expected to run the team, providing an Men's Bracket MOST E-MAILED RECOMMENDED FOR YOU Women's Bracket outside shooting threat, feeding Maya Moore, 1. U.S. Group Stirs Debate on Being ‘Pro- tutoring the freshman point guard Bria Hartley. Israel’ Instead, Doty has rehabilitated the knee she injured Stay on top of all last summer and has faced daily reminders why the 2. THE TEXAS TRIBUNE the news, on and acronym A.C.L. has become a four-letter word in A Search in the Senate to Avert House’s off the court, on Cuts The Times's women’s college basketball. college sports 3. Yemen’s Leader in Talks on Exit but Still blog. Shea Ralph, a UConn assistant and former star, has Defiant Go to The Quad Blog five times torn the ligament that stabilizes the knee Log in to discover more articles and controls its pivoting. Michala Johnson, a based on what you‘ve read. Men freshman forward, tore an A.C.L. twice in high PRESENTED BY Schedule and Results A.P. and Coaches Poll school, the peak years of vulnerability, experts said. Standings Statistics “A.C.L. injury rates sadly are staying the same What’s This? | Don’t Show across the country,” Dr. Thomas Trojian, a UConn What’s This? | Don’t Show Women team physician, wrote in an e-mail. Schedule and Results A.P. and Coaches Poll Standings A number of possible risk factors have been Statistics identified in women: wider hips; ligament laxity at Enlarge This Image certain stages of the menstrual cycle; the smaller size of the notch through which the ligament connects to the femur in the upper leg; a tendency to land straight-legged and knock-kneed; core instability; a greater imbalance than men in the comparative strength of the hamstring to the quadriceps, or thigh muscle.

Bob Child/Associated Press An improved surgical technique, called double Shea Ralph, a UConn bundling, uses two tendon grafts instead of one to assistant and former star, has torn knee ligaments five resemble the normal A.C.L. There is a better times. (though not definitive) understanding today of what causes the ligament to tear, increased attention being paid to preventive techniques and a more consistent return by athletes to previous levels of activity. Ads by Google what's this? Yet players who tear the ligament seem to be significantly more vulnerable to tearing it again in the same knee or the other one. And researchers have found True® Exercise Bike troubling rates of osteoarthritis 10 to 15 years after an A.C.L. is torn. Professional Grade Exercise Bikes. Choose from Recumbent or Upright! “This is more than a sports medicine problem,” said Dr. Edward Wojtys, the www.truefitness.com director of sports medicine at the University of Michigan. “It’s becoming a public health problem.”

A number of coaches and trainers have criticized youth development in sports, where far more attention is paid to winning and athletic skills than to injury prevention. Auriemma and other coaches also wonder whether girls are reinforcing poor biomechanical behavior by specializing in a sport too soon.

Jenny Moshak, the trainer for women’s basketball at Tennessee, said: “If we want to turn this situation from an epidemic to something else, we really need to hit the youth sports when they are in their motor-development phases. The habits they come in with are very difficult to change.”

Doty first tore her A.C.L. while playing soccer as a high school senior in the fall of 2007; when a teammate passed her the ball, she turned, and an opponent slid into her knee. On Jan. 27, 2009, during her freshman season at UConn, Doty drove for a layup against Syracuse and landed awkwardly, a typical way that women tear the ligament, often without making contact with another player.

Last August, while practicing one-on-one moves, Doty drove for a left-handed layup and felt her left knee shift when she landed. The A.C.L. was 80 percent torn, she said, and a third operation was required.

A cadaver tendon had been used for the second operation, Doty said, “and my body never really took it in; it never really healed, wasn’t really strong.” A graft from the patellar tendon in her right knee was used for the third operation, she said.

Some studies indicate that cadaver tendons used to reconstruct the knees of young, active athletes are up to four times more likely to fail than tendons grafted from their own bodies, said Trojian. The reason, in part, is that athletes often feel better more quickly after a cadaver graft and are more likely to return to full activity before their bodies and the graft have reached full strength, Trojian said.

After that third operation in late summer, Doty spent three months regaining range of motion in the knee, strength and neuromuscular control. At four months, she began running.

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A version of this article appeared in print on March 27, 2011, on page SP2 of the New York edition.

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