Why Are Girls So Susceptible to ACL Injuries?

If your daughter plays soccer or basketball, you know that ACL injuries are a hot topic. We explain what current research tells us about why girls are so prone to this knee injury.

Knee injuries are common among athletes who compete in soccer and basketball. Injury to the anterior cruciate ligament (ACL) has received a lot of attention lately because it is such a high-risk injury among female athletes. In general, girls are nearly three times more susceptible to ACL injuries than boys. For female athletes, the risk of ACL injury is even higher. Girls in competitive sports are four to eight times more likely to tear this ligament, depending on the sport that they play. Bottom line is that female ACL injuries are an area of concern.

Understanding ACL anatomy and injury

The ACL is located deep in the knee joint. It is one of the ligaments connecting the femur (thighbone) to the tibia (shinbone). The ACL functions to stabilize the tibia, keeping it from moving too far in front of the femur in the upper leg and controlling the tibia’s rotation. Typically, this ligament is injured during player actions that cause the knee to bend or rotate excessively, such as landing in the wrong position after a jump. Rough contact or a hit by another player can also cause ligament trauma.

The immediate symptom of ACL injury is knee instability, which has been described as a sensation that the knee is buckling or giving way.

Why are female ACL injuries so common?

Numerous research studies have been conducted to understand why females are more prone to this ligament injury. Researchers suggest that the following factors may play a role in female ACL injuries:

  • Girls and boys have different knee structures; the female knee structure may contribute to ACL vulnerability.
  • The size of the ACL may be smaller in girls.
  • The alignment of the knee with the lower leg may be different in girls.
  • Skill and conditioning deficits may make girls more vulnerable to injury.
  • Girls’ knees may not be as strong as boys’ knees.
  • Girls’ running and jumping techniques may increase their injury risk.

Although several of these factors may contribute to higher injury risk for female ACL injuries, studies point toward running and jumping techniques as the most significant cause. In response, training programs have been developed to help girls improve their form as they run, jump, and land during competition. Female athletes who participate in these training programs have significantly reduced their incidence of ACL injury.

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