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Tackling ACL injuries among teen footballers

Muhammad Najmudin Akmal Kamal Akmal

It was hardly two minutes into play in a recent Youth Cup match against Kedah when Mokhtar Dahari Academy (AMD) Under-16 footballer Muhammad Najmudin Akmal Kamal Akmal fell awkwardly.

The pain was excruciating as he held on to his knee. His mother Ramlah Amir, who was informed of the news, was already bracing for the worst.

Several tests later, it was confirmed that Najmudin, who turned 16 on Jan 11, had torn his anterior cruciate ligament (ACL).

“The whole family was devastated,” said Ramlah, a junior executive at Bursa Malaysia.

“Najmudin, however, was upbeat, saying he will overcome this obstacle and return stronger.”

It wasn’t easy seeing her third child undergo surgery. And Ramlah wondered if it was a result of Najmudin and his team mates being pushed beyond their limits.

After all, the AMD boys play against opponents who are three years older. The Youth Cup is a league for Under-19 teams, with the AMD outfit the odd ones out.

Outgoing AMD technical director Lim Teong Kim was quoted recently as saying Najmudin’s situation is the result of impatience in developing players and not using them appropriately in the youth league.

He pointed out the energy of the Under-16 lads was obviously not on par with that of their Under-19 peers.

Despite the odds, AMD impressed many with their second placing in Group B. Eventual winners Terengganu FC IV topped Group B before defeating PKNS FC in the two-leg final. The east coast side edged PKNS 1-0 in the second leg on Saturday. The first leg was goalless.

ACL injuries are increasing among young athletes as revealed by Dr Louise Shaw of the Royal Melbourne Hospital in Victoria, Australia last year.

Dr Louise, a research fellow at Australian Centre for Research into Injury in Sport and its Prevention at Federation University in Ballarat, and her colleague Caroline Finch, studied the data of youngsters aged five to 14 who were hospitalised for ACL injuries between 2005 and 2015.

Of the 320 injuries, more than half were boys and sports activities accounted for 57 per cent of the injuries. They recorded that the rate of ACL injuries went from 2.74 injuries per 100,000 youngsters in 2005 to 6.79 per cent per 100,000 a decade later.

Shaw and her colleague pointed out: “Greater demands being placed on youth athletes through increased training, younger sports specialisation and emphasis on year-round competitive play have led to an increase in the diagnosis of sports-specific knee injuries.”

Pediatricians in the US have also reported increases in ACL tears in children and teenagers, according to the same Reuters report. Dr. Frank Cordasco, a sports medicine orthopaedic surgeon at the Hospital for Special Surgery in New York, had in 2014 described the rise of knee injuries in teens “an epidemic“.

“I’ve heard of young footballers having ACL injuries. Najmudin is only 16. He is too young to be floored by such an injury.”

“I don’t quite understand why Under-16 boys are playing against elder boys. Their opponents are physically bigger and stronger. And these Under-16 boys are expected to defeat their opponents and win matches. The same players are fielded week in week out.

“When this happened, I was cursing myself. It has crossed my mind several times to ask him to stop playing football and concentrate on his studies. But I can’t stop his passion,” Ramlah said.

She added raising four children alone was no easy feat as her husband passed away after a massive stroke three years ago. But she is placated by Najmudin’s determination.

“Even the doctor is confident Najmudin will bounce back sooner than expected as his muscles are strong but I can’t bear to see something like this happen to him again,” she said.

Ramlah hopes more attention would be placed on the welfare and well-being of young athletes.

“I don’t want to see any other child go through this. Children his age should be having fun, not undergoing ACL surgery. Najmudin may be fine in the next six months or sooner but we will never know the implications of his injury when he gets older,” she added.