Stanford Medicine Children’s Health orthopedists seeing a rise in ACL injuries among young girls

*Young, athletic girls like Aminah Carter, 8, are being treated for sports injuries typically associated with adults and professional athletes

“As a parent, you encourage your child to participate in a diverse range of activities,” said Sarah Ahmed. “Rarely do you consider an injury like a torn ACL. I thought that was something for adults and professional athletes.”

Instead, it’s the reality facing Sarah’s daughter, eight-year-old Aminah Carter of Fresno, Calif. The dancer, gymnast and athlete is about seven months into recovery from her torn anterior cruciate ligament, which runs diagonally in the middle of the knee and provides stability. Her ACL surgery was performed by Charles, Chan, MD, orthopedic surgeon at Lucile Packard Children’s Hospital Stanford and Stanford Medicine Children’s Health.

Mom said she thinks it may have started with a collision on the school playground. “Last May, I got a call that Aminah had collided with another child and she needed to go to urgent care,” Sarah recalled. “However, they ended up clearing her and said she was fine.”

Then, a few days later Aminah was in a soccer tourney when she fell to the ground screaming in pain. She couldn’t even get up. “I knew something was very wrong,” said mom. “Local pediatric ortho specialists were not available to see her and in my opinion, we needed an MRI.”

Online research found the Children’s Orthopedic Center and Sports Medicine Program at Stanford Medicine Children’s Health. After an MRI and consultation with Chan, they found that the ACL of her right knee had torn, and would need to be surgically reconstructed.

“Because Aminah is very young and still growing, standard adult techniques for ACL reconstruction can’t be utilized,” notes Chan. “So we use a technique where we reconstruct her ACL by passing it through the knee and secured to the bone without ever drilling through or near the growth plates of her leg where she is still growing from.”

Chan noted that it’s only in the last couple of decades that surgeons would even perform ACL surgery on a still-growing child. “They’d brace it and recommend holding off on agility sports for a few years,” said Chan, clinical assistant professor of orthopaedic surgery at the Stanford University School of Medicine. “But there are techniques now that won’t inhibit growth.” This is good news, especially with a three-fold increase in the number of youths participating in organized sports since 1995.

Currently, Aminah is participating in physical therapy twice a week. She strictly adheres to the doctors’ orders of very limited physical activity in order to ensure the success of the repair.

“After the reconstructed ACL has fully matured  and she has passed physical therapy, she can then return to all her activities prior to the injury,” said Chan. “From my perspective, recognizing that Aminah is not just a smaller version of an adult athlete with an ACL tear is the first step in ensuring that the reconstruction is long-lasting. Both her surgical reconstruction and post-operative physical therapy plan need to take this into consideration.”

Aminah had another unexpected health issue in September, 2015. She was diagnosed with Type 1 diabetes, which Sarah said is presenting a whole new set of challenges and adaptations. After such a challenging year in her daughter’s health, Ahmed says that introducing physical activity again will be a welcome return to “normal” childhood.

“The schedule may not ever be as intense as it was pre-surgery,” said mom. “We’re taking one thing at a time and paying close attention to all aspects of her health before returning to normal activities. We are hopeful to receive clearance to return to dance. But if we have to wait a little bit longer for the ACL to heal, Aminah understands.”

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