It’s Time For A Change From The Black Swan Occurrence For Non-Contact Female Knee Injuries

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By Warren J. Potash, Sports Performance Coach

girljogYogi Berra said: “You can observe a lot by watching.” I have had a front row seat as a parent of a two sport athlete, and as a trainer of primarily female teen athletes. And, as an avid fan of all sports and a former basketball player, I have watched a lot in the past 30+ years and I have observed a lot.

One of my strengths is being able to form a solid foundation of safe and age-appropriate exercise guidelines for all female (and male) athletes. Sadly, I continue – in 2014 – to see too many injuries occurring to female athletes that can be minimized if youth sports organizations and their volunteer coaches would implement single leg balance exercises for all of their participants prior to, and continuing through their teenage years as an integral part of having these athletes play their sport(s).

All female athletes experience challenges at puberty that contribute to what researchers describe as an “epidemic” of ACL [knee] injuries. They need to prepare their bodies; i.e., training to play sports as I wrote in my book: They’re Not Boys – Safely Training the Adolescent Female Athlete [2012].

The word epidemic has been used by several leading orthopedic surgeons/researchers for decades to explain their frustration with the explosion of female sports injuries that can be minimized (sports injury is an inherent risk for those who play sports) with single leg balance exercises as part of a total training program that provides functional and sport-specific training.

FACT: Single leg balance exercises with strength training will go a long way to helping female athletes. I know this based on all the value added research (more than 300 evidence-based research papers) over the past decades that support this claim. Even better validation is the more than 600 teen female athletes I have trained since 1995 using this foundation of single leg balance. Remarkably, not one female (or male) athlete has ever had an ACL injury after completing my training program; i.e., every sport and cheering.

As Tim Hewett Ph D, a leading researcher for helping female athletes said: “I was only a page or two into the prologue, when I realized that a non-contact ACL injury is, by Taleb’s definition, a “Black Swan.”

A Black Swan (Nassim Nicholas Taleb) “is a metaphor that describes an event that comes as a surprise, has a major effect, and is often inappropriately rationalized after the fact with the benefit of hindsight. The “black swan theory” refers only to unexpected events of large magnitude and consequence and their dominant role in history.”

jumpingropeYes, non-contact ACL injuries are this consequential since Title IX was enacted more than 40 years ago. FACT: Female youth sport participation has exploded since Title IX. Myth: The increase in female injury rates is only due to this explosion. FALSE!! Apples to apples comparisons over the decades show the ratio of female ACL injuries is much higher by a factor of a 3-8 times higher rate than male ACL injuries. Even worse is that a vast majority of male athletes are hit while the females are non-contact; i.e., the knee just gives out.

Q angle, quadriceps dominance, and many more challenges occur at puberty and place every female athlete at risk for knee injuries. Long term consequence is OA [osteoarthritis] in the joint affected for 70%+ of all female athletes injured. Future moms should not have to deal with OA in their late twenties and beyond.

Will single leg balance exercises prevent all knee injuries? No, of course not!! But, there is no downside to safe and age-appropriate training to play sports. Training will help every female to become the best she can be and if injured, the athlete will return to play quicker than an untrained athlete.

So, all parents must understand the status quo for four plus [4+] decades now must change. You need to demand that every sports organization implement single leg balance exercise with strength training for every female athlete. Yes, it’s REALLY IMPORTANT that all female athletes train to play sports.

We need to be smarter and insist that the leaders of youth sports organizations mandate that all volunteer and paid coaches learn how to safely train all of their athletes to play their sport featuring single leg balance exercises – not several minutes before practice – and implement this training year round (everywhere there are trainers who can help implement this training). Train to play sports must become the norm for all female athletes now. IT’S TIME FOR A CHANGE NOW!!

– Mr. Potash has successfully trained more than 600 teen (and older) female athletes to play every sport since 1995 with much success. His BNP Training Program is an integrated approach that also provides quality information on eating for daily energy and sports nutrition, strategic thinking skills, how to concentrate between the lines, and more. He is also the creator and co-author of Your Lower Back (1993) and author of They’re Not Boys – Safely Training the Adolescent Female Athlete (2012). Quality information for helping all female athletes can be found online at