In The News
Sutter Medical Center, Sacramento
 Franklin High School basketball player Kim Manlangit rehabs her surgically repaired right knee. |
So much hinges on knees
By Sam McManis
smcmanis@sacbee.com
Published: Sunday, Mar. 15, 2009 - 12:00 am | Page 2L
Last Modified: Sunday, Mar. 15, 2009 - 9:35 am
Just 17, so young to be so gimpy-kneed, Kim Manlangit gave that typical teenage eye roll when her father, Oscar, spoke up.
Her concerned dad had the temerity, after all, to suggest the mere possibility that she might consider the wisdom of even thinking about giving up basketball.
Parents. Sheesh.
"That's not really an option," Manlangit says, turning away from her dad and smiling. "He knows how much I love basketball."
Manlangit, a junior point guard at Franklin High School in Elk Grove, is one of the better players in the Sacramento area. She's also one of the more frequently injured – a living, breathing and limping poster child for what some call a plague of anterior cruciate ligament (ACL) knee injuries afflicting women athletes.
Two years ago, as a freshman, Manlangit tore her left ACL – a structurally vital bit of tissue that binds the femur to the tibia – in practice. And in December, just six games into her junior year, she tried a crossover dribble during a game in Woodland and crumpled to the floor. This time, she shredded her right ACL. Both injuries required reconstructive surgery to graft new ligaments.
No surprise, then, that Oscar Manlangit is apprehensive about the aggressive rehabilitation plan Kim hopes will get her game-ready for the start of the Amateur Athletic Union basketball season in June.
"It scares me every time I see her play," he says.
There is ample reason for concern, if not alarm.
Recent studies suggest that women who play sports involving quick cutting, jumping and bursts of speed – such as soccer and basketball – are five to eight times more likely than men to tear an ACL.
Look no further than former Sacramento High basketball star Vicki Baugh, now playing at the University of Tennessee. Two weeks ago she underwent ACL surgery for the second time.
"It's a devastating injury," says orthopedic surgeon Dr. David B. Coward of Sacramento Knee & Sports Medicine. "You talk to those girls and it's six months out of their lives and potentially having accelerating knee problems well into their future. It's a real big issue in the field."
A consensus has yet to be reached on the reason for the higher degree of ACL ruptures in women athletes, though theories abound.
Among them:
• Anatomical differences: Starting at puberty, women's hips become wider, causing stress on the joints.
• Strength differences: Women develop a greater fat-to-lean-muscle-mass ratio than men. They also typically have stronger quadriceps muscles than men, creating an imbalance.
• Mechanical differences: While men tend to flex their knees to absorb shock when landing from a jump or cut, women are more likely to land straight-legged. They also run more upright.
• Hormonal differences: Higher estrogen levels may soften the ligaments, making them more susceptible to rupture.
"There's no one thing, in and of itself, that predicts ACL tears," says Sacramento orthopedic surgeon Dr. Stephen Howell. "It may well include variables we aren't even measuring. But there is a difference and you've got to think of the consequences when you're young and have an injury like that."
More and more, orthopedists are seeing women enter examination rooms asking to be patched up and sent back out there.
And the phenomenon is not confined to high school and college athletes. It's also 40-something women like Kelly McNabb of Rocklin, a fanatical recreational softball player. It's active late middle-aged women like Auburn's Karen Lawlor, 59, and an avid cyclist, and Carla Bolton, 56, a Humboldt County sheriff's deputy and dedicated skier.
By far the bulk of the cases, however, involve younger women in competitive sports.
One example of a promising career nearly shelved is Redding native Megan Rapinoe, the top scorer on the University of Portland's 2005 NCAA championship soccer team. Rapinoe ruptured her left ACL after scoring 10 goals in the first 11 games of the 2006 season. She returned in time for the 2007 season, but shredded the ligament again, this time in practice.
Back to top.