Girls Can

by Laura Ramus, P.T., A.T.C.

Prevention of ACL injury depends on identifying possible risk factors that may contribute to an athlete's susceptibility to knee injury. Many different factors have been investigated in the search for predictors of NONcontact Anterior Cruciate Ligament injuries.

Three factors in particular have garnered considerable attention from medical professionals and researchers.

1) Static Postural Malaignments with special focus on:

    1. Excessive Foot Pronation (flat foot position)
    2. Knee Recurvatum (knock knee)
    3. Tibial External Torsion (Lower leg rotation)

2) Lower Extremity Strength (specifically the quadricep, hamstring and gluteal muscles)

3) Neuromuscular control (dynamic balance and sport specific movements)


Many theories have been proposed as to why female athletes participating in sports involving running, cutting and jumping maneuvers incur a disproportionate number of noncontact ACL injuries. One theory is based on Postural Malalignments. Ideal posture is a state of muscular and skeletal balance that protects the supporting structures of the body against injury. Faulty alignment detracts from the efficiency of movement, which in turn results in higher levels of energy consumption and mechanical stress, which then contributes to injury of the musculoskeletal system. In circumstances of faulty Postural Alignments, it is theorized that the joints are already in positions that have a preloading effect on ligaments, subjecting them to complete structural failure when placed under tension produced by sport that would normally be well below critical stress limits.


Flat Feet

Investigators have found that ACL - injured athletes have a greater tendency toward a FLAT Foot position. Stand with bare feet and no socks. What does your arch look like?

flat foot

"Pronated Position"

normal arch


If you have FLAT feet or HIGH ARCH Feet, it is advised to seek a medical professional to be evaluated for orthotic therapy.


Calf Muscle Tightness

Good calf muscle flexibility is essential for normal foot and ankle biomechanics.

Laura Ramus demonstrating proper squat technique

"Can you do this?"

improper squat

Or, do you look like this?
Tight calf muscles
Unable to squat all the way down
without heels coming up or losing balance


General Physiological Joint Laxity

Women tend to exhibit greater muscle and ligament elasticity. It is theorized because of this extra elasticity muscle reactive contractions take longer to generate because they must "take up the slack" before maximal contraction can be obtained.

Do you exhibit Physiologic Joint laxity?

left leg demonstrates Normal zero

Left Leg demonstrates
Normal Zero "0" degree
Right Leg demonstrates
Knee Straightening

this photo shows excessive laxity

Excessive knee extension

normal thumb


excessive laxity


Here's another indicator for normal joint laxity, or excessive joint laxity.

excessive laxity
Excessive Laxity

normal elbow extension

Normal Laxity

  • If you demonstrate Flat feet, Excessive joint laxity or both, please contact a sports medicine specialist for testing.


Interested in a personal evalation for you, or your daughter?

We have many parents and student athletes contact us, requesting a personal evaluation. Athletes cover the entire range - from injury free, to post rehabilatation, with doctor's release - all age groups- junior high, high school or college aged female athletes.

First of all - yes, we do these , and there is a way to schedule one for you! (exception is if you are post-op and still in rehabilitation and your doctor has not yet released you to play. If these circumstances describe your condition, you must have a doctor's release and be post rehab, prior to evaluation.) One of our greatest joys is to receive notes from girls, who've gone through the evaluation, and a few years later after a successful high school program, letting us know how much they appreciated learning the adjustments to help prevent injuries and better their performance. This makes it all the more worthwhile for us, to help our youth realize their dreams!

However, until such time that the GirlsCanJump testing and evaluation is licensed in your area, your only option for now is to travel to the Detroit, Michigan area after arranging for an appointment through GirlsCanJump, Inc.

If you are a parent, and would like a personal evaluation for your daughter by the GirlsCanJump program, here's the way :
   • Personal evaulation by Laura Ramus, P.T., A.T.C. in Royal Oak, Michigan, or
   • Send a video for evalation.

Proceeds go to cover expenses, and anything in addition goes to the GirlsCanJump program to support outreach programs throughout the United States.

You can order either option below - thank you.

Personal services now available

  • Complete Screening Programs now available:
    1. 2 hour "in person" evaluation with concentration on Posture, Muscle imbalances in flexibility and strength, Balance and Sport Specific motion analysis, including jumping. Location = Royal Oak Michigan
    2. Fee = $ 250.00

       Visa Mastercard Discover American Express eCheck


    3. Video analysis of sport specific motions, including jumping and cutting maneuvers. Identification of the presence of the most common predisposing factors leading to knee injury.

      Format : VHS or DVD video of the player to be analyzed mailed to Laura Ramus, P.T., A.T.C. Should include 30-45 minutes of the athlete playing their specific sport. Also helpful is separate footage of the athlete jumping up and down and side to side (film from sides and front angles. Game and practice footage should be from several different games / and or practices. Player to be evaluated must be clearly identified.

      Fee = $ 125.00

       Visa Mastercard Discover American Express eCheck

      Procedure for videotape consultation. Order online, or by mail. If ordering by credit card online, print your order form and mail it together with videotapes(s) or DVD(s), clearly identifying which is your daughter or athlete being evaluated. Mail videotapes to:

      Laura Ramus Community Service and Women's Basketball
      Copyright © 2001-2005, All Rights Reserved, GirlsCanJump, Inc.