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Beyond the Score: Research shows female athletes more prone to ACL injuries, but why?

Beyond the Score: Female athletes more prone to ACL injuries, but why?
Posted at 4:50 PM, Apr 30, 2024

GREEN BAY — Studies have shown female athletes are up to 8 times more likely to tear the ACL than their male counterparts. In our latest edition of Youth Sports: Beyond the Score, NBC 26 investigated the reasons why.

"Honestly it's devastating,” said Hortonville head coach AC Clouthier.

Clouthier is talking about female players specifically tearing their ACL's.

"I've had five knee surgeries myself, so I know what it's like sitting out entire seasons and wanting to be a part of it and a part of the game,” he said.

Hortonville senior Kallie Peppler tore her ACL going up for a layup two seasons ago and like me, she wanted to know why so many female basketball players tear that ligament

"I really have no idea,” Peppler said.” I've been asking (that) question so many times cause it is so much, like so many girls who play basketball it has happened to but every time I see someone go up for a layup it's like, 'ooh.' "

To get some answers, NBC 26 talked to orthopedic surgeons from around Green Bay who specialize in ACL injuries.

"When the knee is in a certain position when you land or when you pivot, increased stress can be put on the ACL and it can tear,” said Dr. Michael Parman, an orthopedic surgeon at OSMS in Green Bay.

"Pivoting, cutting, jumping sports seem to have higher incidents compared to other sports, but basketball is certainly a sport I see a lot of injuries in,” said Dr. Kevin Shepet, an orthopedic surgeon with Bellin Health.

Doctor Shepet shared some startling statistics.

"We do know that it's about 4 and half times more likely in a female than in a male, but certainly it's a problem in the sports medicine world,” said Dr. Shepet.

Research from a University of Connecticut study has shown some sports make every athlete more susceptible to non-contact ACL injuries but that females are injured at a much higher rate.

"Basketball there's certainly a lot of quick changes in direction. Same thing with soccer. Whenever you plant your foot and pivoting your bodyweight around that leg, that's when we get enough torque within the knee to rupture that ACL,” said Dr. Parman.

The biggest reason for that, doctors say, is because girls are anatomically different than their male peers. Such as, the angle of the lower legs going through the knee. The size of the ACL ligament and surrounding bone.

"On average females are more quadricep dominant compared to males and that's been theorized to be one of the many reasons for increased rate of injury,” according to Dr. Shepet.

More research needs to be done according to the doctors, but some studies have also shown a female athlete's menstrual cycle could play a role in these injuries.

"There have been certain studies that show that during a specific phase of the menstrual cycle, specifically the ovulatory phase, changes of hormone levels can actually increase ligamentous laxity which in theory could increase the risk of rupturing your ACL during that specific time,” Dr. Parman said. "The female body is meant to have some ligamentous laxity especially during the birth process. That's why these hormones increase ligamentous laxity and when the joint is loose. So when the ligament is loose and it's not quite as stable, that's when you have the increase of torque when you're torquing around your knee, you could potentially sustain that injury."

Local high school trainer Marissa Haug knows all too well what female athletes go through.

"I think it's just a big body change for these females, especially at their age,” Haug said. “They just have to make sure they're taking care of their bodies, nutrition is a huge thing."

To be clear, according to studies, the menstruation cycle could be one of the many various factors that lead to ACL tears -- which aren't 100% preventable, but there are ways to reduce the risk.

"There are certain injury prevention programs that work on core muscle exercises. Working on landing mechanics so that when you land you're not twisting your knee and pivoting improperly, and building up good muscle control in your lower extremities to prevent ACL ruptures,” Dr. Parman said.

A big reason for ACL tears is overuse for boys and girls according to the doctors we talked to, as too many athletes focus on one sport.

"The recommendation is always to get adequate rest, to take time off from all sports to give your body a chance to heal and recover, and to get adequate nutrition and adequate rest to prevent injury,” said Dr. Parman.

Trainers like Scotty Smith of Synergy Sports Performance say that doesn't mean athletes have to stop working out.

"You know, maybe today your recovery is a yoga session. Maybe come in and have a massage, or it's a small bike ride, but it's not going back out and playing volleyball or basketball or whatever it may be,” Smith said.