My daughter passed her high school freshman physical exam with flying colors. Yet a month later she was red-shirted with a knee injury. It happened during a basketball game. Why wasn't this weak spot found during the exam?

It's well-known that female athletes are at increased risk for knee injuries. This is especially true for anterior cruciate ligament (ACL) tears in the knee. The reason for this isn't clear yet. Researchers have found a few key factors.

According to a study at the Cincinnati Children's Sports Medicine Biodynamics Center, growth spurts may be one of these risk factors. When bones grow fast, muscles may not be able to adapt fast enough. Muscle contraction and coordination gets off kilter. The result is an unstable knee. There are altered forces during activities like jumping and landing.

Measuring neuromuscular control isn't part of the standard sports physical exam. At best the doctor may measure joint motion and test for ligament laxity.

Right now there's no practical way to screen for athletes at risk for ACL injury. As more studies are done, doctors, athletic trainers, and physical therapists may find an accurate and reliable screening test.

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