Preventing ACL Injuries in Women

In general, musculoskeletal injuries are sport specific rather than gender specific. Injuries to the anterior cruciate ligament (ACL), for example occur frequently in soccer, basketball and volleyball. However, data collected since 1995 suggest the ACL injury patterns are different for men and women who participate in the same sport. The incidence of ACL injury among women basketball players is at least twice that for men, and female soccer players are four times more likely to suffer an ACL tear than their male counterparts. Both women and men incur ACL injuries in non-contact situations. Nearly 60 percent of ACL injuries in female basketball players occur during landing from a jump.

The ACL is located inside the knee joint and stabilizes the joint by preventing the shinbone (tibia) from sliding forwards beneath the thighbone (femur). A hard twist or excessive pressure on the ACL can tear it, so that the knee gives out and can no longer support the body during athletic competition. If the ACL is injured it must be accurately diagnosed and treated to prevent further damage to other structures within the knee joint.

Risk Factors for ACL Injuries in Women

Studies have identified several risk factors that contribute to a higher incidence of ACL injuries among women athletes. Based on these studies, training methods that could reduce the risk of injury are now being developed.

• Safer jumping skills—women do not bend their knees as much as men do when landing from a jump. This increases the pressure on the knee joint. The knee is exposed to higher forces per pound of body weight. Learning to land safely is a skill that can and should be taught early.
• Cutting maneuvers—women also turn and pivot in a more erect position, which also strains the ACL. Learning to crouch and bend at the knees and hips can reduce the stress on the ACL. These maneuvers are motor skills that can be learned, practiced and improved, just like a golf swing or tennis stroke.
• The hamstring muscles in the back of the thigh work with the quadriceps muscles in the front of the thigh to bend or straighten the leg. As one set contracts (shortens) the other relaxes (stretches). Muscles that are being stretched produce more force than muscles that are contracting. Many female athletes use their quadriceps when they are changing direction rapidly. This can put enough force on the shinbone to tear the ACL if the knee isn’t bent enough. By strengthening and using the hamstrings rather than the quadriceps, a female athlete could reduce her risk of an ACL injury.
• Women can take three steps to reduce their risk of ACL injury: 1) Training and conditioning should be year round. Skill drills and strength and flexibility exercises will enhance balance and coordination so you will be ready when the season starts. 2) Make strengthening exercises for the hamstrings and quadriceps a regular part of your conditioning program. 3) Practice proper landing technique (from a jump) and learn to do cutting maneuvers in a crouched posture with a slight bend at the knee and hip.

Treatment for ACL Injuries

If an ACL injury does occur, it can often be successfully treated. Both operative and nonoperative treatment options are available. Nonoperative treatment can sometimes be used if the athlete is willing to reduce her athletic participation. An athlete who wished to return to sports that involve jumping, cutting, and pivoting will probably need surgery to reconstruct the ligament followed by extensive rehabilitation and reconditioning.

Prevention, performance and treatment. If these are important to you, contact the specialists at Saint Vincent Sports Medicine at 814-866-3466.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.