Q: I am a 35-year-old woman who recently had surgery to repair a torn ACL in my left knee. In doing research on the Internet, I noticed that females seem to be more at-risk for this injury than males competing in the same type of activity. Why is this?

A: This question has an answer with many theories and ideas, some farfetched, others physiologically proven. What does seem to be true is that females are indeed more prone to ACL injury during similar activity.
There are two things that are main contributors to this: muscle imbalances and a greater Q-angle.

The Q-angle is a rough angle created by the upper leg bone (femur) and the slope down and in to the knee joint. Most females have a greater Q-angle than males due to wider hips to allow a child’s birth. This creates stress at the knee and may lead to an increase in discomfort and possible injury.

The other contributor, muscle imbalance, is very common and easy to adjust with proper exercise. Many athletes and active people have strong quadriceps and weak hamstrings. Why? Most of us don’t spend the time necessary to properly balance our leg strength and so we rely exclusively on activities of daily living (i.e., walking, jogging, getting in/out of cars, seats, couches, stair climbing, etc.). All of those exercises tend to put any emphasis on the front part of your leg, or your quad. You still need to train the backside, or the hamstring.
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Q: I have been working out for several years now, and in that time span I have endured surgery to correct biceps tendonitis. I have noticed that the muscles of my left side (surgery side) are slightly smaller than my right side. Will this ever return to normal?

A: It’s actually very common to have a slight muscular differences or asymmetry with your dominant side prevailing, especially if you are involved (or were previously involved) in an occupation or activity that was single-arm dominant (i.e., tennis, painting, carpentry). While this is true for many of us, since you did have surgery this type of trauma also compounds the amount of asymmetry.

I do have a couple of recommendations for helping your right side catch up to your left side. When you train your upper body, try using as many multi-joint dumbbell movements as possible. For example, instead of completing a regular lat pull down, try using single arm attachments to complete the same movement isolated to each arm. Focus on slow and controlled actions until failure of the weaker side. If completing exercises that focus on one side at a time, i.e. the dumbbell curl or row, always begin with the affected, or left side. If you complete only eight repetitions with good form on your left, stop at eight on your right even if you could do more.

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