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This was me five months ago.
This was me two days later.
This was me 3 months ago.
And well, this is me now. To give you
some context, 5 months ago, my family
and I went on a skiing trip. I've been
skiing since I was 6 years old. And so
naturally, I assumed this trip would be
no different to the others. Except it
wasn't. It was shorter. On day two, I
lost control of my skis on dangerous
terrain and was hurtled halfway down the
mountain.
I was then carried down by ski patrol
and taken to the nearest hospital where
I was then told that I had torn my ACL
miniscus, fractured my tibia and thumb,
and had partially torn my MCL and LCL.
At first, I wasn't upset or annoyed at
all. That came later. I was simply
naive.
Initially, I had no idea how difficult,
how long the recovery process would be.
that I would have to miss school for
physio, that I wouldn't be able to take
public transport, put my own shoes on,
or even take a shower.
In fact, I realized that I knew nothing
about ACL injuries, and I started to
wonder,
why did no one warn me?
Why wasn't I told that this could
happen? Today, we're going to question
three central issues around ACL
injuries.
How can we start rethinking ACL
research? Why do we only train for
performance and not prevention? And is
recovery more science or story?
Now, some of you might be thinking,
"This doesn't apply to me. I barely make
it up a flight of stairs and haven't
played sports since school."
Well, it does because ACL injuries don't
only occur in athletes. ACL injuries can
happen to anyone any time. Now, some
people are certainly more susceptible to
ACL injuries than others, but we'll get
on to that later. So, don't zone out
because I am certainly no athlete and I
was just on a ski holiday.
I conducted a survey here at Francis
Holland where I asked students in year
12 what they thought an ACL was and
turns out only 20% of students got it
right. The ACL is the anterior cruciate
ligament, i.e. a ligament in your knee.
Now, I didn't just pick our age group
because they were the easiest for me to
reach and badger to complete my survey,
but rather because our age group has one
of the highest ACL incidence rates
globally. As well as this, teens are 29
times more likely to have ACL surgery
today versus 20 years ago. And I found
it worrying that only 20% of us knew
what an ACL was, let alone the impact it
could have.
Women are three to six times more likely
to rupture their ACL than men.
Most would argue that this is probably
related to the menstrual cycle. People
love to blame the fluctuation in female
hormones. Even when the Australian Rules
Football League noticed their players
were experiencing high ACL injury rates,
their default response was to only
investigate its association with the
menstrual cycle. Now, I don't want to
disregard the fluctuation in female
hormones and what that might have on ACL
in incidence rates and ligament laxity,
but I'd argue that reducing women's
injury risks to biological factors only
causes us to disregard the root cause of
ACL injuries, which is likely to be
strongly influenced by gendered
environmental disparities.
For example, we can categorize the risk
factors for ACL injuries into two
groups, intrinsic and exttrinsic.
Typical intrinsic and sexbased
biological factors include anatomy,
hormones, and genetics, while exttrinsic
factors include weather conditions, and
playing surfaces.
What I have noticed is that the majority
of ACL literature focuses on these
intrinsic factors with minimal
recognition towards external,
environmental or social factors despite
how closely linked they are.
For example,
muscular strength is an intrinsic factor
which impacts ACR incidence rates.
Labeling it as intrinsic suggests it's
unaffected by any external factors or
social factors, which simply isn't the
case. As environments like the gym and
prevention training programs are still
heavily gendered in ways that discourage
and disadvantage female participation.
We must question how gender norms about
girls body participation in sports and
funding influence girls attitudes
towards sports, body movements and
attitudes towards prevention training
and how this impacts injury risk.
Moving on to prevention versus
performance.
Studies show that when women
participated in dedicated prevention
training, they experienced a significant
67% decrease in non-cont ACL injuries.
The issue here is that despite how
effective these prevention training
programs clearly proved to be, they
still suffered from low levels of
commitment once this structure and
supervision disappeared, which I believe
is unfortunately due to the
misconception that stretching and
warming up is time consuming and
requires a lot of commitment. Similarly,
in schools, for example, at a
recreational level, prevention training
might include stretching or warming up
before a PE lesson. We've all done it,
but the question is, do we know why we
do it? Do we know why it's so important?
And would we implement this practice
into our lives beyond school?
Power Up to Play is an exceptional
charity that showcases not only the
importance of warming up, but why we do
it and are at the forefront of knee
injury prevention training programs in
adolescence specifically.
For example, feel free to join in. I
know we've been sitting for a while, but
don't worry, I won't be offended if you
don't. This stretch, although it looks
silly, is strengthening important
muscles and reinforcing strong body
positions.
And I know that despite this
presentation, you might still think that
stretching and warming up is still
tedious. But I promise you that it is
worth it. And if there is one thing that
I could have changed about that day 5
months ago, it would have been to just
take five 10 minutes to warm up to
prevent a year of recovery and a
lifetime of worrying about early onset
osteoarthritis.
To conduct effective prevention training
and reduce ACL injury rates, we need to
consider that both biological and social
factors are at play.
As I previously mentioned, strength
training is another form of prevention
training. The issue here is that women
still participate in strength training
at a much lower rate than men, which is
unfortunately due to the gender norms
about how a woman's body is supposed to
look and the stereotype that
weightlifting is for men.
To conduct effective prevention
training, as I said, we need to begin
conducting a more holistic approach and
tackle the gender norms baked into
women's sports.
Now, let's talk about my recovery.
Despite the fact I'm only five months
into a 12-month recovery program, I
think I've learned a lot. And I think
I've developed a lot as a person in ways
I didn't think I would. To give you a
very surface level example, I have
become very oddly appreciative of the
small things like being able to walk
quickly if you're running late
somewhere.
As they say, recovery is all about
finding the positives, which are
definitely hard to find at first, but
they do exist. For example, I didn't
have to get on the tube at rush hour
every morning for 4 months. I'm cycling
now, and in a couple months, I'll be
running. So, to answer my question,
recovery is definitely more of a mental
game than a physical game. Of course,
your knee hurts and you need to do your
physio. But when you start focusing more
on your mentality, suddenly physio
becomes a break from school work and you
realize that the pain is just temporary.
Injuries break you down, sure, but I
think injuries also rebuild you stronger
and smarter. And in my case, a story to
tell at TEDex. Thank you.
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