courtesy Detroit Free Press - ©2001 Detroit Free Press

Something tore in Laura Farhat's right knee during a volleyball game 3 years ago.

Now she has given up basketball and soccer. Tennis, which she loves, hurts. Volleyball is a strain. Even kneeling is painful.

Laura is 15.

"The girls in sports these days are extremely competitive, and they push and push and play even when they're hurt," says Patricia Farhat of Royal Oak, Laura's mother. "I wish they would train the coaches better in preventative exercises."

If you are a female who plays sports or you have a daughter who does, you should do one thing before sports start next month: Learn to protect the knees.

"Some of the things we are doing with our female athletes are making them even more prone to injury," warns Dr. Edward Wojtys (VOY-tis), director of sports medicine at the University of Michigan and professor of orthopedic surgery. "If you ask trainers why they use a particular exercise, they usually can't give you a reason."

For the past decade, athletic trainers and sports medicine experts have watched in horror and scrambled to find solutions to knee injuries among female athletes, particularly tears of the anterior cruciate ligament (ACL). The ropy ACL connects the thigh bone to the shin bone behind the kneecap.

Female athletes who play pivot sports -- basketball, soccer and volleyball -- have a rate of ACL injuries 2 to 8 times higher than male athletes, depending on the sport. A sudden twist can rip the ACL, destabilize the knee, require surgery or lead to cartilage damage, arthritis and other lifelong problems.

That risk is unacceptably high, says Wojtys. Players and parents must demand changes.

"For years, we have trained girls just like boys. We thought if leg curls and leg extensions are good for boys, they're good for girls," he says. "That's not true."

New research at U-M shows that Division 1 college female athletes who play pivot sports have weaker knee muscles than women who don't play pivot sports. Wojtys suspects something in their training is at fault.

"If they can't get improvement, then what is going to do it?" he asks. "It's really worrisome."

Laura Farhat may need knee surgery this fall if physical therapy does not help the pain. Her mother, who sees Laura's sports career fading at the tender age of 15, never considered that athletics could actually be a threat. Now she wonders about the sports training the girls got -- or did not get.

"Now I even wonder about all those suicides (running relays) the coach had them doing," she says. "It seems like the best athletes are the ones most likely to get hurt."

High number of injuries

An estimated 20,000 high school girls and 10,000 college- age women have serious knee injuries each year. But that number can be lower. How? Although they bicker over training details, experts have known for a few years that a combination of functional weight training, plyometrics (jump training) and reflex training can cut the risk to female athletes.

The trick is getting out the word -- and getting it down to the middle school and high school level, where it is needed most.

"Not enough people know these things or know how to train with them," says Laura Ramus, head athletic trainer for the WNBA's Detroit Shock and an authority on knee injuries. "We need to get this information out to coaches to teach girls to play sports in a lower position. You need to reach the girls when they are 11, 12 and 13 because that's when they are developing those neural pathways. I get Olympic and professional athletes who are demonstrating the same incorrect biomechanics as high school players.

"If you play straight up and down, which is how a lot of girls play, you will risk your ACL. But you need to be strong to play low."

Staying injury-free

They leap to the side. They pivot. They jump.

The Detroit Shock is not tops in the standings, but the team is tops in one category: For the past two seasons, not one player has torn her ACL.

Luck? Hardly. The Shock uses a training program Ramus designed to reduce knee injuries.

It employs weight training that involves nothing more than dumbbells and players' own body weight and plyometrics (jump training.) Ramus teaches proper jump technique and retrains the brain in jump mechanics to build power and improve performance.

In Ramus' first year with the Shock, 1998, star Korie Hlede tore an ACL. In 1999, player Rachel Sporn was injured. But last year, Ramus put players on her program. No Shock player has had an ACL injury since. That's contrary to the experience of other WNBA teams like the New York Liberty, which lost Rebecca Lobo most of two seasons to two ACL tears, and the Houston Comets, which this year lost the WNBA's biggest star, Sheryl Swoopes, after she tore an ACL in preseason.

What's Ramus' biggest success with the Shock?

"I've been able to change Dominick Canty's jump; she was an ACL waiting to happen," Ramus says. "She came up with a 34-inch vertical jump, but her biomechanics needed changing. Over a year's time, she is now jumping higher and jumping correctly."

The pros, scared by the devastation of fellow players, are willing to take drastic steps to change their playing style. "But for the junior high or high school kids, sometimes they feel invincible," Ramus says. "If I can't get them to buy into the injury aspect, I tell them I'll make them jump higher, 1 or 2 inches. That works."

Ramus' Girls Can Jump program is a streamlined variation of a pioneering program developed by Cincinnati Sportsmedicine called Sportsmetrics. Detroit Country Day, Grosse Pointe North, East Detroit and Marian high schools plan to try Ramus' program this fall.

But changing decades of ingrained training techniques by coaches and trainers is a slow process. All the experts' knowledge has not trickled down to the school gyms of the United States.

If that makes you nervous, understand this: