Everyone has heard about the horror of a torn ACL (anterior cruciate ligament). They put you out of the game for months, they’re painful, and they necessitate surgery. According to the Department of Orthopaedic Surgery at the University of California, San Francisco, there are over 200,000 ACL injuries each year, with women most at risk. Now, experts with the American Academy of Pediatrics are urging doctors and other health-focused authorities to train young athletes how to reduce these risks.

The report, published in the journal Pediatrics, notes that ACL injuries have increased in athletes over 18 years old during the past 20 years, as more children are becoming active, especially girls. It urges doctors and school officials (physical education teachers and coaches) to engage in neuromuscular training with young athletes, which focuses on the proper way to bend, jump, land, and pivot on the knee. Practicing this could reduce the risk of an injury by as much as 63 percent, the American Academy of Orthopaedic Surgeons (AAOS) found last month.

Most people injure their ACLs — the ligament within the knee joint that helps with forward and backward motion — when they force the knee in a direction that it shouldn’t move in. These motions can include changing direction rapidly, stopping suddenly, landing from a jump in the wrong way, and less often, from direct contact to the knee, according to the AAOS. It’s especially important to protect the knee from these injuries because athletes who’ve already injured an ACL are at a six times greater risk of injuring it, or the one on the opposite knee, within two years of the first injury — not to mention the added risk of osteoarthritis in the knee later on.

The report’s authors were most adamant about young girls undergoing the training. Studies have shown that women are two to 10 times more likely to sustain an ACL injury than men. In part, this risk comes from an increasing amount of girls who are picking up sports, such as soccer, lacrosse, basketball, and gymnastics.

However, the unique shape of a woman’s body could add to this risk, as some tend to have knees that angle inward — known as knee valgus. Landing from a jump in the wrong position could force the knee further inward, injuring it. This, combined with the tendency for girls to land from a jump with their bodies tilted sideways, or on only one foot, could put more pressure on the knee, causing a worse injury, the AAOS said.

To avoid this problem, young female athletes should engage in exercises to strengthen the legs and improve stability, while also learning about the proper, safe ways to move. Such exercises include jumping and balance exercises (on a balance board). In as little as six weeks, one can start to see results, according to the AAOS.

Source: LaBella C, Hennrikus W, Hewett T. Anterior Cruciate Ligament Injuries: Diagnosis, Treatment, and Prevention. Pediatrics. 2014.