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The Scarlet & Black

Column: Women and ACL tears

The best way to describe what I did to my knee two weeks ago is that I fell over. I fell over in a stunningly uncoordinated attempt to field a routine line drive in an indoor softball practice. I looked down and watched my knee do something I knew in my heart a knee should not and then rolled around on the floor in agony for a little while.

This directly followed a conversation I had with the climbers, who I had warned not to sit behind us because we weren’t very good at fielding balls (yuk yuk yuk). And then I took myself out for the season.

I won’t burden you with too much knee anatomy, as it is both boring and confusing, but suffice it to say that there are four ligaments whose job it is to keep the knee from moving out of place. The Anterior Cruciate Ligament (ACL) is in charge of preventing the shin bone from rotating away from the thigh bone and is the most commonly torn ligament.

Ligaments are a pretty good argument against intelligent design, as they don’t get any blood and can’t heal themselves. The same goes for the majority of the cartilage in the knee, called the meniscus. Only the outer edge of the meniscus is vascularized, so if a person, hypothetically, decided to tear their meniscus in the same dazzling display of unathleticism they would need surgery on that too.

While they won’t be fixed without surgery, both ACL and meniscus tears, in theory, can be left alone if the injured party doesn’t mind having his/her knee come completely undone on occasion. If the torn pieces aren’t mucking up the inside of the knee they can sort of be ignored as long as the injured party braces the shit out of that knee and doesn’t attempt gymnastics.

If the meniscus is lodged in the knee joint, however, it has got to go. It gets in the way of walking, and bending and straightening the knee becomes a little dicey. The options for dealing with a torn meniscus are repair or removal. Since only the outer sliver gets any blood, only the tears are right along the outside of the cartilage can be repaired. Anything else has to be hacked off, dooming the former athlete to an arthritic future.

Seeing as I have had this done on both knees, all that is left to do is pick out which type of booze I want to drink my sorrows away with. But the good news is I will have bitter, drunk company. I will join a growing community of prematurely arthritic previously active women.

There has been a lot of buzz in the media about women and ACL tears. According to Education week, a newspaper focused on topics in education, Female athletes are something like eight times more likely to tear their ACL than males, which just makes it all the more obvious that girls are fragile creatures and shouldn’t be allowed out of the kitchen.

Several theories have emerged as to why girls have such crappy ligaments. One is that during women’s menstrual cycles their ligaments get more flexible and are thus more likely to tear. This is not as true of women who are on the pill, as their hormone levels are more stable and less prone to wild fluctuation than women whose birthing is not controlled.

Another difference between guys and gals is the alignment of their muscles, bones and ligaments. All the baby room in ladies’ pelvis’ means that they have a larger “Q-angle” between their hips and their knees than their male counterparts. And for some reason means they are more likely to tear important ligaments.

Lastly, Wikipedia tells me that womenfolk have underdeveloped hamstring muscles in relation to their quadriceps muscles, and their quads still aren’t very strong. This results in men controlling their knee stability with their quads, and thus putting more stress on the ligaments. What all this boils down to is that women need to be really vigilant when it comes to knee safety, and build up lots of leg muscle to protect the ligaments. Crutches aren’t sexy—trust me, I’ve tried.

But there may be hope for me in the future. Bone marrow stem cells injected into knee joints have shown a remarkable ability to re-grow cartilage tissue in goats and dogs. With any luck by the time I have retired to the porch to yell at kids to get off my lawn some of those sweet little suckers will be available to me.

In the meantime, though, I’m stalking up on Johnny Walker and rocking chairs. Bite me, cruel world.

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