ACL Injuries in Female Athletes

ACL Injuries in Female Athletes

Over the last decade, torn and ruptured anterior cruciate ligament (ACL) in female athletes have increased at an alarming rate. Anterior cruciate ligament injuries in female athletes are common due to anatomical differences between men and women. Preparing yourself before beginning any athletic activity can help reduce your chances of getting injured.

Injuries in Female Athletes

Consistently, it has been found that a higher prevalence of ACL injuries occurs in female athletes over their male counterparts. Women are 2.4 to 9.7 times more likely to suffer from ACL injury when compared to men of similar competition and training levels.
Women involved in sports that require landing from a jump, rapid directional changes, and cutting, such as basketball, soccer, gymnastics, skiing, and gymnastics, are particularly vulnerable. Reports state that women basketball players are 5 to 7 times more likely to have ACL injuries than men, and those female soccer players are injured more than twice as often as men (American Council on Exercise, 2009). On average, women rupture their ACL ligaments five years earlier than men. In addition, most females with torn ACLs are between the ages of 15 and 25.
The interplay of different factors may account for the gender difference in ACL injury rates, and the cause is still unclear. However, possible explanations have been proposed and reviewed. The suggested reasons are anatomic differences, joint laxity, range of motion, hormonal secretion, and training techniques are proposed factors that predispose women to ACL injuries.
Two different factors can influence an injury. The first is intrinsic factors. Intrinsic factors are internal factors within the body that can increase the risk of injury.

5 Intrinsic factors that Lead to ACL Injuries in Female Athletes

#1 – The Pelvis

The female pelvis is wider than the male pelvis. A wider pelvis causes a more forward tilted femur near the hips as the shin bone is angled toward the knee, resulting in knock-knees, which in turn place significant stress on the ACL.
Injuries in Female Athletes

#2 – Narrow Notch

Females have a narrower intercondylar notch through which the ACL passes. It has been suggested that cutting and jumping movements with little femoral notches may weaken the ACL.

#3 – Smaller ACL 

Women have smaller anterior cruciate ligament sizes, making them more vulnerable to fraying.

#4 – Hormones

Generally, women have more significant knee laxity, which may be influenced by the hormones secreted in large amounts by the females. Receptors for estrogen and progesterone have been identified in the ACL; thus, hormonal fluctuations occurring during the menstrual cycle may influence the structure of the ACL. It was found that women are more susceptible to ACL tears during the ovulatory phase (days 5 through 12 of the menstrual cycle), when the estrogen and progesterone levels are high, increasing the laxity and susceptibility of the ligament to overstretching.

#5 Weaker Leg Strength

Women have lesser muscle strength and slower muscle reaction times than men. Solid and fast-reacting hamstrings are vital to keeping the ACL intact during abrupt direction changes. In addition, women tend to recruit or use their front thigh muscles or quadriceps, increasing the risk of ACL injuries. The hamstrings protect the ACL by decreasing the stress applied to the knee as the lower leg moves forward. The quadriceps pull the shin bone forward, placing additional pressure on the ACL.
This is part 1 of this article. In part 2, I will go through extrinsic factors that lead to more female ACL injuries.

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Rick Kaselj, MS

P.S. – As a side note, this was my 150th post to  Very cool!

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