Medical Monday: ACL injuries: Why are they more common in female athletes?

Posted at 7:05 PM, Apr 17, 2017
and last updated 2017-04-17 20:05:45-04

Dr. Schock is an orthopedic surgeon with BayCare Clinic. He joined us on Wisconsin Tonight to talk about ACL injuries. 

The anterior cruciate ligament, more commonly known as your ACL, is one of four main ligaments within the knee that connects the femur to the tibia. The ACL runs diagonally in the middle of the knee and provides stability. It is one of the most commonly injured ligaments of the knee.

An ACL injury occurs when the ACL ligament tears. This is most common in non-contact events when decelerating, suddenly stopping, twisting, or jumping. Many people will hear or feel a “pop” in the knee when the injury occurs. Symptoms usually include severe pain or inability to continue activity, swelling, and inability to put weight on the joint. There are more than 200,000 cases of ACL injuries in the United States each year, according the Department of Orthopaedic Surgery.

The chance of tearing your ACL is higher for people who participate in high-risk sports, such as basketball, football, skiing, or soccer. The risk for this injury increases in girls between 12 to 13 years old and in boys 14 to 15 years old. Other risk factors for ACL injuries include loose knees and joints, smaller sized ACL, and being a female.

Various studies, such as one conducted by the Orthopaedic Specialists of North Carolina, show that women are four to eight times more likely to tear their ACL than men. Their studies suggest multiple reasons for the higher female risk factor:

* Females’ knees being more “turned in” when they land

* The ACL in women is smaller than in men

* Having more lax ligaments which causes women’s ligaments to “give” more than men’s

* Having a wider pelvis which creates more pressure on the inside of the knee

* Landing in a flat-footed position, as opposed to landing on the balls of their feet

* Poor hamstring strength

One theory also suggests that changes in estrogen levels could affect ACL strength.

Follow these tips courtesy of Johns Hopkins Medicine:

* Maintain a center of strength: Strengthen your muscles but don’t strain them. Work on building up your core muscles in your legs, hips, and torso.

* Stretch for symmetry: Studies have shown that even a 15% imbalance between the left and right side of your body can increase your risk for injury. Stretching one side more than the other can create an imbalance.

* Activate the right muscles during exercises: Women tend to have less hamstring strength than men, which leads to an inability to control the knee if it gives out while moving.

* Eat a well-balanced diet: Not eating enough can cause fatigue. If an athlete is tired or worn out, she may concentrate less on her form. Female athletes should focus on drinking plenty of water and eating a well-balanced diet.

More information Visit or call BayCare Clinic Orthopedics & Sports Medicine at 877-229-2273.