Q. I am a 17 year old who injured my knee playing basketball 4 months ago. I felt a “pop” and had major swelling. X-rays were normal and I was told it was just a sprain. It began to feel better but when I tried to play, it feels unstable and sometimes buckles. Are there exercises that can help prevent this feeling?

A. It sounds to me as though you have suffered an anterior cruciate ligament tear (ACL). You have most of the classic signs and symptoms. This is a serious injury and unfortunately exercises alone will not solve this problem for you. I would recommend that you see an orthopaedic surgeon or sports medicine specialist who can usually, on physical exam, determine if your important anterior cruciate ligament was indeed torn. An MRI may also be suggested to see if there are any other problems in your knee since tearing your ACL often results in other damage to the knee (i.e. torn cartilage or meniscus and/or joint surface injuries).

If your ACL was indeed torn, you would probably be best served with reconstructive surgery to replace that ligament with a new one. Young female athletes are experiencing and epidemic of ACL injuries and we are just beginning to understand why. There is a variety of reasons and there are good prevention programs that every female athlete should be involved with. Female athletes are approximately five times more likely than their male counterparts to tear their ACL’s because of the following: female athletes land differently from jumps; knee anatomy is somewhat different both in alignment and also internal architecture; hormonal issues resulting in ligament weakness at certain times during the menstrual cycle; strength and training issues, and females being more “loose-jointed”.

I believe that it is critically important for both healthy uninjured females, and those who have had ACL injuries and reconstructions, to be on preventive strengthening and agility programs to reduce the incidence of ACL tears. I believe that preventive strength and coordination really works. I have treated high level dancers from all over the country for many many years. Even though dancers are the most “loose-jointed” female athletes around I rarely see ACL problems in dancers. This is because they are trained very early to jump and land properly and most dancers have tremendous strength, flexibility balance and agility all of which go a long way to prevent serious knee injuries. All athletes can take a lesson from dancers in this regard.

One great ACL prevention program for athletes is the “PEP” program developed by the Santa Monica Orthopaedic and Sports Medicine Group in Santa Monica, California.