Sports Medicine Research: In the Lab & In the Field: Know Your Genetics Before You Hit the Slopes (Sports Med Res)


Wednesday, May 28, 2014

Know Your Genetics Before You Hit the Slopes

The correlation between anterior cruciate ligament injury in elite Alpine skiers and their parents

Westin M, Reeds-Lundqvist S, and Werner S. Knee Surg Sports Traumatol Arthrosc. 2014. April 2014.

Take Home Message: Elite-level alpine skiers with a family history of ACL injury are more likely to sustain an ACL injury themselves compared with skiers without a family history of an ACL injury. 

Despite the anterior cruciate ligament (ACL) injury being one of the most common injuries, few studies have examined possible risk factors for ACL injuries in alpine skiers. One possible risk factor may be genetics. If we can identify key risk factors for ACL injuries in this athletic population then we could develop more effective screening and training regiments to reduce the risk of ACL injury. Therefore, Westin and colleagues completed a survey study to assess whether there is a relationship between ACL injuries in Alpine ski students at the elite level and ACL injuries in their parents. Researchers invited 593 skiers who studied at Swedish ski high schools between 2006 and 2012 to participate in the current study. All participants completed a questionnaire that asked about the skiers’ personal and family history of ACL injuries. Overall, data from 418 skiers were available for analysis; among whom 65 skiers reported an ACL injury. The number of ACL injured parents was higher among ACL injured skiers (29%) compared with skiers without an ACL injury (18%). Hence, “an elite alpine skier is almost twice more likely to sustain an ACL injury if he (or she) has a parent with an ACL injury when compared to an elite alpine skier without a family history of ACL injury.”

The results of this study are of interest because it suggests there may be a genetic factor in sustaining an ACL injury among elite skiers. However, we need to keep in mind that this study did not identify a specific gene and it was not able to rule out that the link between parents and their children could be something other than genetics (e.g., environmental, skiing techniques). If we can get a better understanding of the link between ACL injuries in parents and their children then clinicians may be able to develop better screening tools and training regiments for elite alpine skiers at risk for an ACL injury. It would be valuable to clinicians for further research to be conducted on other sports to understand if this interaction is truly based on genetics or unique to alpine skiers. Ultimately, this data helps clinicians better understand one of the many factors which contribute to an ACL injury.

Questions for Discussion: How heavily do you weigh an athlete’s reported family history of ACL injuries prior to participation? After looking at the presented data, do you feel this finding is applicable to you in your current setting?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

Related Posts:
Comparing Screening Methods for ACL Injury Risk

Westin, M., Reeds-Lundqvist, S., & Werner, S. (2014). The correlation between anterior cruciate ligament injury in elite alpine skiers and their parents Knee Surgery, Sports Traumatology, Arthroscopy DOI: 10.1007/s00167-014-2974-9


Melissa DiFabio said...

This is a very interesting study, especially to me as an athletic trainer having had ACL injuries on both knees from skiing. There is a great amount of research on structural and biomechanical reasons to ACL injury, but this may be the first time I've noticed anything about genetics playing a role. It is something that makes sense, but seems very difficult to confirm. The common mechanism of ACL injury in skiiers of being in the "backseat" position seems to be more of a commonality to skiiers than families, which makes it hard to believe that genetics caused the injury. It would be interesting to see how these skiiers with parents who have had ACL injury were taught to ski; perhaps if it was the parents their children may have learned the fundamentals from them and skiied in a manner similar, potentially predisposing them to similar injuries as their parents. Additionally, it would be interesting to see the correlation of elite skiiers and parents with ACL injuries and recreational skiiers and thier parents - is it more common in racers than the recreational athlete? I am very interesting in reading more on this topic and look forward to further research!

Jeffrey Driban said...

Hi Melissa: Thanks for the comment. It's important to remember that genetics didn't cause the person to tear their ACL but rather it increased their susceptibility to tear their ACL in a given situation. For example, genetics could influence how much collagen is in the ACL and hence influence how much excess load is required to tear the ACL. Similarly, genetics could influence the size of the ligament or its location or maybe even the individual's neuoromuscular control. I agree with you that it would be interesting to see these findings replicated among other athletic populations such as recreational skier.

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