here’s another article i found interesting. i’ll just include one part but provide the link. i wonder if bradford has narrow notches. i wonder in general how strong his ligaments are. he’s had three severe ligament injuries already in 5 years.
http://www.txsportsmed.com/acl.php
Are certain athletes predisposed to the injury?
Dr. Souryal: My study was the first to describe the link between bony anatomy and ACL tears and to describe the way of measuring it. We found that a certain segment of the population has a bone structure that predisposes them to an ACL tear. The ACL and posterior cruciate ligament (PCL) live in a tunnel at the end of your thigh bone. If that tunnel is very narrow (which you can detect by X-ray), then there’s no room for the ACL to maneuver in cutting activity, and those people are at 26 times more risk of tearing an ACL.
In 1992, we took X-rays of 1,000 high school athletes’ knees and followed them for the next two years. Whenever a player went down with an ACL injury, we looked at his notch. And it was phenomenal: The kids who were blowing out their ACLs all had those narrow notches. We stopped the study early because the numbers were so dramatic. I’m sure that there are a lot of factors that go into ACL injuries — the notch is just one of them — and the biggest question right now is, what lives inside the narrow notch? Does a small ACL live in a narrow notch and tears because it’s never had the room to grow properly? Or does a normal-sized ACL live in the small notch and ruptures because it doesn’t have the room? We don’t have answers because we’re not doing surgery on uninjured people and measuring their ACLs.
As a next phase, we’re waiting for MRIs to get a bit clearer to allow us to measure the normal ACLs in the notches. Maybe in the next couple of years, we’ll be able to answer the question. If it is a normal-sized ACL in the notch, then maybe we can go in there surgically and widen the notch, and perhaps save that person from an ACL rupture. But if it’s an underdeveloped ACL in that narrow notch, you can widen the notch all day long and you’re not going to fix it. Once we get this question answered, maybe we can do something about people with the predisposition.
In ’92, we found that girls have proportionally narrower notches than boys. Does that have anything to do with the fact that ACL injuries are epidemic among females? I don’t know, but I certainly do think that it’s one factor. Other factors have to do with muscle development and neuromuscular coordination, because the boys are encouraged to be active athletically almost from birth. They may develop better neuromuscular coordination and therefore are somewhat protected as they get into high school and college. Girls are not necessarily directed into athletics early in life, and as they become more athletically active in their teens, they may not have the neuromuscular coordination that boys have. The bottom line is that nobody knows for sure. But there’s definitely a higher incidence of ACL ruptures in female athletes than in male athletes.
