Snap. Longtime soccer coach Bob Hogan knows the sound of an ACL tear. And he often has had to bear the frustration felt by a young player itching to get back on the field, yet forced to undergo surgery or months of rehabilitation. This season, Mr. Hogan, a coach of the nationally ranked Farmers Branch D'Feeters soccer club, hopes to avoid this scenario. His players have been taking part in an injury-prevention program designed to thwart knee injuries in young women who play soccer, the top sport for women.

"If we can prevent the injury, we've done a good thing," says Mr. Hogan, who has been a soccer coach for 28 years.

There is good reason for prevention training that gets to the root of this injury problem. Not only are more females playing sports these days, they are also hitting the field faster with more power than ever before -and getting hurt.

Female players are susceptible to ankle, head and other injuries - but knee problems stand out. Women and girls who play such sports as soccer, basketball or volleyball are two to eight times more likely to injure the knee's anterior cruciate ligament, or ACL, than are their male counterparts, according to recent research by the

University of North Carolina at Chapel Hill, published in the American Journal of Sports Medicine.

The local injury prevention program evaluates how young female athletes jump, land, cut and go after the ball, and teaches them new ways to perform these tasks to reduce the impact on the knee, says Stefani Wylie, a Dallas physical therapist who introduced the injury prevention program earlier this year to area soccer clubs.

The ACL is one of two ligaments that cross within the knee joint to prevent the shin bone (tibia) and thigh bone (femur) from slipping forward or backward out of the joint. Although ACL injuries are more than 70 percent sports- related, most happen when there is no direct physical contact with another athlete, note North Carolina researchers.

Experts aren't sure why female athletes are more prone to knee trouble, but theories are emerging. Biology is partly to blame, says Ms. Wylie, 28, a former Southern Methodist University and semiprofessional league player who has also coached youth soccer. A woman's wider hips put extra stress on her joints; female hormones may also weaken ligaments. Female athletes also tend to rely more heavily on their quadriceps muscles in the front of the thigh, rather than the hamstrings in the back, creating a power imbalance.

North Carolina researchers also found that women's lower extremities move differently from men's. Female players invite injury by keeping their legs straight, and tend to be more knock-kneed than men during the landing phase of a stop-jump task. When performing forward, vertical and backward jumps for the study, females also showed greater anterior shear force - forward slippage of the tibia - that might act to stretch, and ultimately tear, the ACL.
Retraining means practice sessions three times a week, for up to 20 minutes per session.

D'Feeters player Lynn Janick practices jumping, squatting and lunging drills, and balancing and stretching exercises designed by Ms. Wylie. The 17-year-old central midfielder is relearning basic moves she has done since she began kicking a soccer ball at age 4. The effort has made her a better player, she says. Her moves on the field feel softer and she is more comfortable going into a tackle without the fear of getting hurt.

"It's about confidence," says Ms. Janick, who also plays soccer for Lake Highlands High School. "You don't second-guess your decisions."
Ms. Janick, a senior who hopes to play college soccer, is just one of the players evaluated by Ms. Wylie and her partner, fellow physical therapist Keegan McConnell. The program evaluates teams, and players individually, for flexibility, strength and function - how they use their muscles - when they perform typical soccer moves.

Even a veteran such as Mr. Hogan, who has long witnessed knee problems in girls, was "amazed" that every player had three to four weak areas she could improve. The players receive individual prevention workout plans that include neuromuscular and plyometric training - jumping, bounding and hopping moves to improve strength and speed.

The program also uses drills and stretch bands for resistance training to teach the players how to jump and plant their feet correctly - two moves that can get you injured when done wrong.

Teaching young women to land with a lower center of gravity, bending at the hips and knees rather than with straight legs, is a great start to prevent injuries. Think of the "old ready position" in sports, says Dr. Donald T. Kirkendall, a UNC study co-author and assistant professor of orthopedics at UNC School of Medicine.

Ideally, Ms. Wylie and Mr. McConnell return to evaluate a team's progress in six months. The goal of the program is to get players to automatically avoid vulnerable moves on the field, says Ms. Wylie, who hopes to expand her injury prevention program to other sports.

As more coaches and parents grow concerned about injuries, prevention programs such as Ms. Wylie's are cropping up around the country. Early indications are that, if taught and practiced correctly, they can help to reduce injury in a game, says Dr. Kirkendall, a member of the sports medicine committee of the U.S. Soccer Federation.

Meanwhile, researchers will continue to look at risk for injuries, including fatigue, to find better ways to prevent them.

"One of the best ways to prevent an injury is to have the person be more fit," says Dr. Kirkendall. "But sports are inherently risky, and every sport has its Achilles heel."

For more information or to schedule training sessions, e-mail stefani@s-i-p-p.com or keegan@s-i-p-p.com.
Helen Bond is a Dallas free-lance writer.

A woman's anatomy = leg injuries

A woman's wider hips put extra stress on her joints.

Female hormones may weaken ligaments.

Female athletes tend to rely on their quadriceps muscles in the front of the thigh, rather than the hamstrings in the back.

Female players invite injury by keeping their legs straight and tend to be more knock-kneed than men during the landing phase of a stop-jump task.

When performing forward, vertical and backward jumps for a University of North Carolina study, females showed greater anterior shear force - forward slippage of the tibia - that could stretch or tear the ACL.
How the training program works

Evaluates how young female athletes jump, land, cut and go after the ball, and teaches them new ways to perform these tasks to reduce impact on the knee.

Evaluates teams and individual players for flexibility, strength and function - how they use their muscles - when they perform soccer moves.

Teaches players to practice jumping, squatting and lunging drills, and balancing and stretching exercises.

Provides individual prevention workout plans.

Uses drills and stretch bands for resistance training to teach players how to jump and plant their feet correctly. Girls should learn to land with a lower center of gravity, bending at the hips and knees rather than with straight legs.

The goal is to get players to avoid vulnerable moves on the field.