While most back-to-school preparations involve backpacks, pencils and other school supplies, for student athletes, they also should include core strengthening and dynamic warmups, especially for females who play soccer and basketball, according to a sports medicine expert at Baylor College of Medicine.

“Among NCAA athletes, the two highest risk patient groups for anterior cruciate ligament (ACL) tears are female soccer and basketball players. There are anatomical and neuromuscular factors that put these athletes at particular risk,” said Dr. Theodore Shybut, sports medicine expert and assistant professor of orthopedic surgery at Baylor.

Studies have reported that female athletes are 2 to 10 times more likely to have ACL tears than male athletes.

According to Shybut, when female athletes cut and pivot during sports such as soccer and basketball, they tend to have greater trunk motion, which produces higher rotational forces at the knee.

“What happens is her body is moving one way and the foot plants to change direction but the body keeps moving laterally, causing torque around the knee that causes it to buckle inward, twist and overload the ACL,” said Shybut.

He also notes that when female athletes land from jumps, they tend to be more quadriceps dominant as opposed to more balanced between the quadriceps and the hamstrings, so they land with their knees in a more extended position, which also can result in giving way at the knee.

“The hamstrings are dynamic stabilizers of the ACL so they pull in a way that braces the knee against anterior cruciate instability,” said Shybut.

Neuromuscular training and accompanying core strengthening can help female athletes prevent ACL injuries. For example, jump training to learn to land with their knees in a more flexed position that engages the hamstrings and core strengthening to decrease trunk motion during cutting can be helpful.

Shybut also notes that functional movement screens, usually done by athletic trainers, could help identify problems and determine specific corrective exercises to strengthen the core and improve neuromuscular coordination.

“Improving the way they control their trunks when they’re landing and cutting and learning to keep their bodies centered over the knee can help decrease their injury risk,” he said.

Shybut also notes that for similar reasons, ankle sprains are also more common in women.

He suggests taking advantage of resources such as the American Orthopaedic Society for Sports Medicine’s STOP Sports Injuries website (http://www.stopsportsinjuries.org/) to learn more about sports injury prevention.