More and more athletic women and girls are injuring their knees, and females are participating in more sports than ever before like basketball, soccer and volleyball. Girls are competing in sports at a younger age and continuing to play well beyond their school years. Just look around and you will see more and more women playing competitive sports on adult coed and women’s teams into their forties and beyond.
ACL Injuries In Women: Cause and Prevention
The sheer number of female athletes means that more will get injured. There is growing evidence that women are 10 times more likely to suffer a knee injury such as an ACL (anterior cruciate ligament) tear than men playing the same sport. There are approximately 22,000 ACL injuries in female athletes each year from high school and collegiate sports. One out of 10 girls that compete collegiately in any sport will tear their ACL prior to graduation. The good news is that this injury is often preventable, and there are a few things that can be done to decrease the risk.
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One reason for this increased risk of serious knee injuries among female athletes is the difference in alignment of the leg in women. The female pelvis is usually broader than the male pelvis, which creates a more “knock-kneed” alignment of the knee (valgus). This alignment is thought to put more stress on the ACL during twisting activities like cutting or changing direction.
A second reason is the area of the knee where the ACL resides (called “the notch” because it is a cave or notch in the femur bone). The notch tends to be narrower in females than in males. The bone can actually cut through the ligament if the knee hyperextends, so a notch with more room is less likely to do this. Also, estrogen seems to be associated with increased knee looseness (“laxity”), but it is not yet known if this predisposes toward tearing the ACL.
The third reason sports medicine professionals believe that ACL tears are more frequent in women is due to differences in strength and balance, termed “proprioception”. Some of this is thought to be that as children, boys have tended to be more physically active than girls. Of course, this is now changing.
The good news is that this can be changed as teens and adults via “proprioception” programs that involve plyometrics, and agility drills. Maximizing your speed and agility improves your sports performance, plus it lowers your risk of serious knee injury.
While all athletes in agility sports such as soccer, basketball, etc. have a risk of tearing their ACL, this risk is higher in females. Some of the risk factors cannot be changed, but some can! So take advantage of agility training programs (whether you are male or female) to minimize your risk.
About Dr. Michael Simpson 
Michael R. Simpson, DO, specializes in family medicine and primary care sports medicine. Dr. Simpson is board certified in family medicine and sports medicine, and is a fellow of the American Academy of Family Physicians. He is a member of the American Osteopathic Association, American College of Sports Medicine and the American Medical Society of Sports Medicine. Prior to medical school, Dr. Simpson earned a master’s degree in exercise science from the University of South Carolina in Columbia, S.C.