Knee Injuries in Student Athletes- the Professional Opinion of Chariho Athletic Trainer Morgan Gilli

By: Eva Simmons

Morgan Gillis graduated with a Bachelor of Science from the University of New Hampshire in 2016. Her major was athletic training and she became a certified athletic trainer in June 2016. From there, she went to the University of Florida as a graduate assistant and earned her Master's in Applied Physiology and Kinesiology in 2018. While at UF, she worked at two local high schools as their head athletic trainer. Next, she worked at Brown University primarily with their women's rugby, M&W track and field, and M&W fencing teams. From July 2019 until October 2021, she worked as an assistant athletic trainer at Colgate University, primarily with women's soccer and lacrosse. She came to Chariho in October 2021. Her current position is contracted through University Orthopedics. She works 30 hours a week at Chariho and 10 hours a week in the UOI clinic in their durable medical equipment department.

1. How common are knee injuries among student athletes at Chariho? What are the most common knee injuries you see in your student athletes?

• Knee injuries are relatively common among student-athletes at Chariho. I would say ankle injuries are the most common, followed by knee injuries. The most common knee injuries I see at Chariho appear to be chronic from overuse or muscle weakness and there are some acute injuries that happen from contact or improper landing at practice or games. The most common chronic injuries I see are patellar tendinitis, patellar femoral pain syndrome, MCL sprain/tear, and meniscus tear.

2. What sports do you typically see with the most knee injuries? Are specific groups of athletes more susceptible to knee injuries than others?

• Sports with a lot of pivoting, change of direction, deceleration, and awkward landings typically yield the most knee injuries. This happens particularly in soccer, football, and basketball. Female athletes are more susceptible to knee injuries. ACL injuries occur 4x greater in females than males. The Q angle is the angle formed between the quadriceps muscle and patellar tendon, which is greater in females and can be a contributing risk factor. There is a higher incidence of ACL tears occur during a female menstrual cycle. Other risk factors include hamstring flexibility, muscle imbalance, foot pronation, BMI, and overtraining.

3. Why do you think knee injuries are so common?

• The knee supports a great deal of body weight, therefore a lot of stress is imposed on the knees. It is also a complex structure so improper landing mechanics, deceleration, and contact can impose unintended forces on the knee.

4. What preventative measures for knee injuries do you encourage your athletes to take?

• There are specific ACL prevention programs that can be utilized, such as, the FIFA 11+, PEP, and sportsmetrics. However, there is not a one size fits all approach and it’s important to take a multifaceted approach. It’s important to implement core strengthening to stabilize the body and help the pelvis, hips, and back to work together. Strengthening the hip and glute muscles, as well as stretching and maintaining some level of flexibility is helpful to prevent knee injury. I always tell my athletes to be aware of proper form and technique. Don’t rush through any exercises or even drills at practice. It’s very important to focus on proper landing mechanics in sports that require jumping. The knee can experience what is called a knee valgus where the knee moves inwards and that position makes one more susceptible to injury. A clinical tool to assess landing mechanics is called the landing error scoring system. There isn’t a lot of evidence supporting preventative knee bracing, so I don’t want my athletes to have a false sense of security when wearing a brace. The best course of action is to keep muscles flexible and strong. Another way to prevent injuries is to avoid overtraining, take appropriate rest days, fuel your body with proper nutrition and hydration, and get plenty of sleep.

5. Other than obvious physical effects, what other effects do you think injuries in general have on student athletes (mental, social, and emotional effects)?

• Injuries take an enormous toll on a student-athlete’s mental health. Emotionally, student-athletes can feel withdrawn from teammates, fear of reinjury, fear of losing playing time, sadness, loss of motivation, frustration, feeling disengaged. This can affect student-athletes relationships with family and friends, schoolwork, and in severe cases can sometimes result in depression and anxiety. There can also be added stressors such as missing practices or school time for doctor’s appointments or physical therapy. Further stressors could involve financial constraints or parents/guardians who are not present in the athlete’s life. Injuries affect everyone differently and that’s okay. There is no one size fits all response.