ANTERIOR CRUCIATE LIGAMENT

DIFFERENCES IN THE CONFIGURATION OF THE ANTERIOR CRUCIATE LIGAMENT BETWEEN MEN AND WOMEN

If you are a person who likes football, basketball, rugby, football or any sport where physical contact during play is inevitable or it is necessary to make sudden decelerations throughout the game you probably know about the ligament Crossed.

The anterior cruciate ligament is one of the main components of knee stability and often tends to be injured. The problem with this injury is undoubtedly recovery, which becomes quite tedious due to a number of factors. But do you know if sex is one of these factors? Discover the differences in the configuration of the anterior cruciate ligament in men and women and its relation to the lesion of the same.

ANTERIOR CRUCIATE LIGAMENT

Anterior cruciate ligament: a little anatomy to locate and understand

The elements that give stability to the joints are the ligaments. They are arranged in a certain way in the joint to avoid movements that the joint should not perform.

In the case of the knee are 4 ligaments whose only function is to keep it stable: the collateral ligaments and the cruciate ligaments. Here is an image with the graphic representation of the different structures of the knee joint:

On the collateral ligaments, we will not explain too much because they are not the central theme of the article: these are located one on each side of the knee (i.e. an internal collateral ligament and an external collateral ligament).

On the other hand, we will speak in depth of the cruciate ligaments, within the joint capsule of the knee. The cruciate ligaments are 2 structures that are very deep in the knee joint. The cruciate ligaments are 2: one that is located in the anterior part and one that is located in the back.

The posterior cruciate ligament extends between the posterior intercondylar area of the tibia and the medial condyle of the femur. The anterior cruciate ligament, on the other hand, extends between the posterolateral part of the femur and the anteromedial part of the tibia.

Once we understand where each one is, we need to understand what task each has, that is, what movement they must avoid as it may arise. The posterior cruciate ligament should prevent the sliding movement of the tibia on the femur backward, a movement that occurs for example during the descent of the stairs.

The anterior cruciate ligament should do the opposite: avoid the sliding movement of the tibia on the femur forward. The funny thing about this last action is that it is a movement that hardly occurs during the activities of daily living. That is to say: there are no activities that we do every day that requires the action of this ligament. But in the case of the sport specifically, his injury is quite frequent.

ANTERIOR CRUCIATE LIGAMENT

How is the anterior cruciate ligament injured?

When the ligament fails to prevent the movement that it avoids itself, its tear occurs, which can be total or partial. The tearing of the anterior cruciate ligament usually occurs in the following cases:

  • Abrupt deceleration (that is when we are running and suddenly we break, as it happens when very frequently in football).
  • Sudden hyperextension of the knee.
  • Direct trauma to the knee.

The problem of a rehabilitation of cruciate ligaments is its location. The cruciate ligaments are located within the joint capsule of the knee as mentioned above. This area does not receive blood supply but receives the necessary nutrients from the surrounding liquid: the synovial fluid.

It is in the blood and not in the synovial fluid where the cells that repair the tissues travel so that when the ligament injury occurs, it is difficult to repair. Note: this does not mean that recovery is impossible, but care must be taken in rehabilitating it.

There are a number of guidelines that must be followed verbatim in order to have a successful recovery, and yet many people follow the guidelines and sometimes there are some disorders in the knee.

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How to recognize an anterior cruciate ligament injury?

Basically to recognize the lesion of the anterior cruciate ligament one has to take into account the symptoms and a special test.

Symptoms occurring during an anterior cruciate ligament injury include:

  • A click on the knee followed by intense pain. The pain is aggravated when trying to support the injured lower limb on the ground to walk.
  • Inflammation of the knee.
  • Feeling of instability (people who injure the ligament often say “I feel my knee go alone”).

As for the special test to verify the anterior cruciate ligament injury we have the previous drawer test. This test should be done by an expert and consists of pulling the person’s leg toward the therapist while the person is lying on his back with his knee bent at 90 degrees and his foot resting on the supporting surface.

When performing this maneuver and if the anterior cruciate ligament is injured the upper part of the tibia protrudes, as if we were opening the drawer of a bureau.

ANTERIOR CRUCIATE LIGAMENT

What does sex have to do with the anterior cruciate ligament injury?

The participation of women in sport is increasing. The differences in sports, at least in the genre, have been shortened, to the point where there is no sport in which women cannot participate and excel.

With the increasing participation of women in sports, injuries also increase. But what if we said that there is something that makes gender a risk factor for an injury? As this happens in the anterior cruciate ligament, gender is a factor to take into account in their injuries.

It has been determined that anterior cruciate ligament injury is much more frequent in women than in men. The anterior cruciate ligament is injured 2 to 9 times more in women than in men when gender injuries are analyzed in competitions and sports activities. This has led to the investigation of why injuries occur more in women than in men, and this is what has been demonstrated:

There are certain gestures that women perform differently from men

 It was found that women perform the gesture of cutting and landing on the floor other than men: the knee placed in femoral adduction, femoral internal rotation and external tibial rotation during the additional movement to a high load in valgus puts the ligament in a tension Excessive and makes it prone to tearing.

The anterior cruciate ligament of women is different from that of men

When we analyzed the shape of the ligament we realize that in men the ligament is longer, has a greater cross-sectional area and greater volume.

ANTERIOR CRUCIATE LIGAMENT

The physiological laxity of the ligament

The anterior cruciate ligament is much laxer than in men, however, if the ligament force is overshadowed by joint movement, as in women, this ligament is broken. In addition, women during the menstrual cycle secrete certain and certain hormones that make the ligaments of the body more lax.

There are muscular imbalances that make ligament rupture more prone

Women tend to be much stronger in quadriceps than in hamstrings. This imbalance of forces causes the tibia to move excessively forward, injuring the ligament.

Activation (non-imbalance) of certain muscles exposed to anterior cruciate ligament injury

In men the activation of lower limb muscles occurs proportionally, avoiding valgus loads that can prevent injury, unlike what happens in women, where the activation of the quadriceps is greater than the activation of the Rest of the muscles.

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What to do to avoid anterior cruciate ligament injury in women?

Having said all this we can only think of what to do. How to avoid these injuries that can harm a person’s sporting career? Very simple: prevention through the identification of risk factors.

Treatment of a sprained knee

Are you looking for what to do after a knee sprain? For in the following video we will explain the steps that you must follow for a successful recovery of the sprain or rupture of the ligaments of the knee.

There are factors on which you can not directly influence, as they are not susceptible to change (that is, no matter what we do we cannot reverse it). This happens with the morphology of the anterior cruciate ligament and with the physiological laxity: they are questions that belong to the nature of the gender and nothing can be done about it. However, we can focus on the factors that can be influenced, such as the realization of movement in different ways, imbalances, and muscle activations. On these factors, it is essential that the physiotherapist intervene.

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