TODAY   |  February 28, 2012

What’s behind the rise in teen knee injuries?

Sports medicine specialist Jordan Metzl tells TODAY’s Matt Lauer why knee injuries have increased nearly fourfold over the past 10 years, especially among young women, and offers tips for prevention.

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This content comes from Closed Captioning that was broadcast along with this program.

>> dramatic rise in knee surgery with tweens and teenagers. first, this is "today" on nbc.

>>> we're back with a dramatic rise in knee surgery among young athletes. more than 40 million kids participate in organized sports every year in this country. doctors say more and more they are treating young patients who suffer grown-up injuries. at 15 years old kyra klein has experienced two sports injuries severe enough to sideline an athlete twice her age.

>> it is a little frustrating to sit on the sidelines and watch everyone play. but really when you're injured that makes you more motivated and want to get back to sports more.

>> her first injury came during a fast break on the basketball court when she was 11.

>> next thing you know she turned, buckled, jumps, does it all at the same time and doesn't get up.

>> she tore her acl leading to months of physical therapy and knee surgery. once she turned 12. after healing, the same injury struck a year later at basketball tryouts, but this time in kyra 's other knee.

>> the first thing that went through my mind was how frustrated i was because i wouldn't be able to play for a few months and that would put me behind the other girls.

>> the acl is a ligament connecting the thigh bone to the shin, helping to stabilize the knee. it's most commonly injured during sports with sudden stops and changes of direction.

>> she looks young, too.

>> over a ten-year period surgeons at children's hospital of philadelphia have seen a 400% increase in youth acl injuries.

>> the adult terms, acl , cartilage, dislocation were terms reserved for adults. now we're seeing them in kids.

>> doctors suspect the injuries are showing up in athletes as they undergo intense training to specialize in individual sports . women are up to eight times as likely to injure their acls than men.

>> they land differently. there can be different strength issues and hip rotation, how they land a little bit more knock-kneed relative to the male counterparts. kyra 's injuries meant lots of physical therapy but she says being able to compete has been worth the trouble.

>> it's always in my head that i could reinjure myself. i really think all of the confidence i have developed by returning to sports really overpowers that. i'm confident that the amount i play now is appropriate. i'm doing what i should be doing.

>> dr. jordan metzel is with the hospital for special surgery in new york city or home away from home, as i call it. nice to see you.

>> and you.

>> a 400% increase in these injuries in this age group over ten years. that's dramatic.

>> shocking to hear. basically we are seeing more girls playing sports . with title ix we see more girls playing and they are much more likely to tear the acl than boys.

>> i mentioned as young people specialize more in individual sports , my immediate reaction is sports are more competitive. kids, schools, parents are driving the athletes harder. you're not necessarily sure about that.

>> i'm not sure that's the case. i don't think it's the sports . i think it's girls being exposed to sports like soccer and basketball where they are likely to land in an awkward position.

>> if a young athlete suffers an injury like this at 11, 12, 13, what's their long-term prognosis?

>> it's a tough issue. whether or not they have surgery, their risk of developing arthritis 15 years down the road just from tearing the acl is 35% to 40%. we are seeing people at 35, 40 years old with arthritic knees because they tore their acl as a teen.

>> has surgery come so far they can be 100% in their later teens and young 20s?

>> sure. surgery gets you back on the field. it's a great surgery to get people back to activity but the risk is arthritis later in life.

>> you say the trick is preventing injuries. how do you do that?

>> first, identify who is at risk for suffering the injury. girls are about six times more likely than boys. it's interesting. after puberty, her hips widen and the angle between the hips, knees and feet changes. i brought a picture to show you what it looks like. when a girl lands and we have two here. the girl in the yellow shirt is landing in an at-risk position. her knee is coming to the middle. the girl in the pink is not. the risk is landing in that position. we screen kids likely to land like that.

>> there are exercises you have identified that can help strengthen that area and prevent it. the first is a plyometric jump squat.

>> we want to build muscles around the back, butt and legs. what she's doing is getting the knees and hips low, the glute down low. she's building strength to prevent landing in that position.

>> you don't have to get high off the ground. you don't want to land awkwardly.

>> four sets of 15 every other day.

>> the next is a single leg squat.

>> all you need is a chair. just like this person in the picture and she's sitting down, standing right back up. three sets of 10, so 15 sets of jump squats. as she strengthens the muscles, the risk goes down.

>> as athletes get younger we have to pay attention to details and do more in terms of prevention.

>> we are doing a great job encouraging them to play sports . we want to prevent the injuries that happen.

>> doctor, good to see you. thank you very much.