The incidence of anterior cruciate ligament (ACL) injury among female basketball players is very high. Unfortunately, the ACL rupture is very often even in young age. Understanding the risk factors and mechanisms of basketball related ACL disruptions is very important for developing prevention strategies in order to reduce the number of these severe events. Although the internal risk factors (anatomic, hormonal, biomechanical and neuromuscular) have important impact on the occurrence of ACL injuries in female athletes, we should not neglect the role of external risk factors with the special emphasise on frequency, intensity ant type of training sessions. Striving for better sports results usually leads to both participation in professional level of competition in very young age and an increased number of intensive trainings, with little or no rest during the season. All of these can lead to overtraining syndrome which could provoke intrinsic factors and result in ACL tear.
Objectives To evaluate the impact of playing senior-level basketball in young age and the influence of frequency and intensity of training on the incidence of ACL injury in female basketball players.
Methods A total of 104 female basketball players were included in the study (age 28.56 ± 8.8). The questionnaire regarding: the age of the ACL injury (if occurred), involvement in senior/professional level of basketball at younger age, hours/week of training two years before the ACL injury (or in last two years if injury did not occur), and days of continuous rest during the competitive season, was filled by all participants. The logistic regression method was used in order to calculate the odds ratio confidence interval (O. R.). Exposure variables were coded as 1 for those exposed to senior level of competition in younger age, to more than 10 hours of training per week, and less of 15 days of continuous rest during the season.
Results 41 out of 104 athletes reported ACL injury at the age of 18.55 ± 3.22. Those involved in professional level of training and competition had an odds of ACL injury about 9.5 times greater than those who trained and competed only for their age (O. R. 9.5035; low 2.9892, high 30.214, p = 0.0001). The ones exposed to more than 10 hours of training per week and had less than 15 days of continuous rest during the season had an odds of ACL injury about 7.33 and 2.2 times greater than those with less training hours and more rest during the competitive season, respectively (O. R. 7.3374; low 2.5985, high 20.719, p = 0.0002 and O. R. 2.1987; low 0.7; high 6.9062, p = 0.1773).
Conclusion Only optimal training and level of competition, adapted to both chronological and biological age of female athletes, with enough time for rest and recovery, can lead to reduced risk of ACL injury. It is important not to provoke internal risk factors by high frequency and intensity of training, since what is in the genotype, does not have to be expressed in the phenotype, if those who work with young female athletes are enough educated and careful.