ON A TEAR; ACL INJURIES ARE ON THE RISE FOR WOMEN.

Byline: Susan Stocum Associated Press

Shelley Sheetz had been injury-free for years, in high school, as an All-American point guard at Colorado and during a season in Europe.

Then, in her 17th game for the Colorado Xplosion of the new American Basketball League, her luck ended with a sickening snap.

``I positioned for the rebound ... and when I jumped my knee just popped,'' she said. ``I screamed. I said a bad word.''

Sheetz became one of a growing number of women athletes to tear an anterior cruciate ligament - the thigh-shin connector and main stabilizer in the knee. And in a trend that researchers don't fully understand, women are sustaining ACL injuries at a greater rate than men.

``Women are or may be more susceptible to a serious knee injury in certain sports,'' said Dr. Ted Schlegel of the Steadman Hawkins Clinic in Denver. ``With time, as we learn more about it, we will be able to make significant inroads into that injury rate.''

According to a study of injuries in NCAA basketball from 1989-1993, women tore an ACL at a rate four times greater than that of men. In soccer, the other sport in the study, the women's rate was more than double.

In a study by the National Athletic Trainers Association, there were eight ACL surgeries among 125 high school girls' basketball teams in 1995-96 and just four surgeries among 131 boys' teams.

``You have to ask the question: Is the difference a gender difference or is it a sport-related gender difference?'' said John Powell, director of the NATA study. ``We don't know enough to be able to make a statement.''

While researchers trying to determine why there is such a disparity don't have all the answers, they do have some of them.

Because a woman has a wider pelvis than a man, the angle at which the thigh bone connects to a calf bone is greater. The greater the angle, the less stable the knee joint.

Researchers also believe that the same hormones that allow a woman's hips and ligaments to relax during childbirth might cause ACL weaknesses.

One theory that generates the most debate is also the one that could be the easiest to correct.

``In basketball, a female has a tendency to land straight-legged and on one leg, as opposed to a lot of the male basketball players who have been taught to land on both legs,'' Schlegel said. ``If we can do some of those things to teach athletes to maybe change some of the ways they're participating now, maybe we can reduce the incidence of injuries.''

Dr. Elizabeth Arendt of the Department of Orthopedic Surgery at the University of Minnesota doubts that's the only answer because the injuries are happening at every skill level - from high school players to Olympians.

``That's what's so puzzling about this injury,'' said Arendt, co-author of the study on the NCAA injuries. ``It's happening in skilled athletes who are doing the same things they've done a thousand times before. Only this one time something goes awry.''

One reason the ACL is taking center stage is the recent growth in women's athletics, including the two new pro basketball leagues: the ABL, which began play last fall, and the WNBA, which begins its first season June 21.

Putting all women - or all players - in knee braces is not the answer to cutting down on injuries, Schlegel said.

``The knee is not a simple hinge. It flexes, rolls and rotates,'' he said. ``That's why it's so difficult to design a brace that can simulate knee motion and protect those ligaments as it goes through that range of motion.''

With advances in surgery, athletes have a better than 90 percent success rate to return to the same level as before the injury, Schlegel said. In the past, a torn ACL would often end a career.

Kris Horner, a star high school basketball player at Mason City in Iowa, tore her ACL in practice in January during her senior season.

``I did a two-foot jump-stop - a move I do every day,'' she said. ``My feet stopped. The rest of my body just kept going.''

CAPTION(S):

2 Photos

Photo: (1) Shelly Sheetz, right, of the new ABL Colorado Xplosion, tore her anterior cruciate ligament.

(2) Jennifer Ocif, a graduate student at the Univeristy of Iowa, is conducting a study on herself to understand why women athletes have a greater number of ACL injuries than men.

Associated Press