ACL injury in women is four times more likely to happen than it is for men. ACL injuries in women, especially female athletes, is becoming an epidemic. Sports that produce the most ACL injuries in women are basketball, volleyball, skiing, trail running, gymnastics, and soccer. The increase of ACL injuries in females is becoming a challenge for the sports medicine community as we work to protect their female athletes.

While there is not an exact reason why ACL injuries afflict women more than men; there is a clear anatomical difference between the knees of a man and a woman. Researchers believe this structural difference is the main cause for higher incidence of ACL injuries in women. Several theories include:

  • A wider pelvis in women: This results in a wider quadriceps angle. This is the angle at which the femur (upper leg bone) meets the tibia (lower leg bone). It is thought that this increased angle places more stress on a woman’s knee joint, which makes it less stable than a man’s knee joint.
  • A smaller intercondylar notch: This is the area in the knee that lies between the two ends of the thighbone. This particular space is larger and wider in men than it is in women, and may result in the ACL rubbing against the bone, and tearing.
  • Biomechanical alignment: As girls enter puberty and adolescence, the size and shape of their hips naturally change. This affects the alignment from the hips all the way down the lower extremities. Many variables can become risk factors for injury, including the ligaments that support these structures.
  • Muscle strength and muscle fatigue: When fatigue sets in, components within the knee joint, and surrounding structures must compensate for that weakness. This leads to tension and force of movement that is inevitably transferred to the ligaments, which puts them at risk for ligament injury.

While it is still not clear what exactly causes women to suffer more ACL injuries then men, the sports medicine community is becoming more aware, and are implementing ACL injury prevention programs for female athlete injuries. These programs combine strengthening, stretching, and proper knee support to help decrease the risks of future ACL injuries.