2014 Winter Olympics: Alpine Skiing and ACL tears
EVENT: ALPINE SKIING
Also known as downhill skiing, this encompasses 5 events that include the Downhill, Super-G, Slalom, Giant Slalom and Super Combined. Competitors use skis with fixed-heel bindings as opposed to those in Nordic skiing, such as cross-country, ski jumping and Telemark, which use free-heel bindings. At some spots on a downhill course, skiers can reach blistering speeds of 85-90 miles per hour which, if a fall occurs, increases the risk of an ACL Tear.
CONDITION: ANTERIOR CRUCIATE LIGAMENT (ACL) TEAR
What is it? The anterior cruciate ligament (ACL) is one of four stabilizing ligaments in the knee that helps to stabilize the knee and prevents excessive forward motion of the tibia (the larger bone below the knee joint) in relation to the femur (the thigh bone). ACL tears are often a result of trauma occurring during rough play in sports. They can also occur during falls, motor vehicle accidents or at work. “Non-contact” ACL tears also can occur during pivoting, cutting or landing from a jump and have been shown to be more common in females.
What are the symptoms? At the time of injury, patients often will describe immediate pain in the knee accompanied by a popping sensation and giving out. Additionally patients will often experience swelling in the knee and note that their knee feels more “unstable”. In some cases, patients will not experience these dramatic symptoms and will only note that their knee “doesn’t feel right” after a recent trauma to the knee. Physicians can usually diagnose an ACL tear on physical examination by looking for signs of instability when stressing the ACL. Often an MRI will also be obtained to determine if the ligament is torn and to look for any other injuries in the knee.
What is the treatment? The definitive treatment for an ACL tear is surgery and currently there are many widely accepted means of repair both in surgical technique and in the type of tissue graft used to replace the torn ACL. However, not all patients with an ACL tear need to have it repaired. Patients who are involved in a sport or work activity that requires a functional ACL or those that experience significant knee instability should have surgical repair. Those that have no significant instability and whose activities don’t require a functioning ACL usually can get by with just physical therapy with or without bracing for support.
How can it be prevented? ACL injury prevention is currently one of the “hot topics” in Sports Medicine. Numerous, nationally-recognized programs are currently available that focus on all athletes but pay significant attention to female athletes given their higher risk of “non contact” ACL tears. At their core, these programs focus primarily on exercise drills that require power, strength, agility and balance which work to improve neuromuscular conditioning and the reactions of leg muscles to repetitive starting, stopping, cutting and pivoting.
Random useless trivia about Alpine Skiing: The only two skiers to ever win Gold medals in 3 Alpine skiing events in one Olympics were Jean-Claude Killy in Grenoble, France (1968) and Toni Sailer in Cortina d’Ampezzo, Italy (1956).
