Dr. Burnham recently co-authored a research study and book chapter with Dr. Vonda Wright on female ACL injuries. Dr. Wright is an orthopaedic surgeon and renowned speaker who specializes sports medicine, knee injuries, fitness, and leadership. This article summarizes the most recent research on ACL injuries in female athletes.
Why are ACL Injuries More Common in Females?
The incidence of anterior cruciate ligament injuries is on the rise, especially in female athletes. There are a variety of known risk factors for female ACL injuries. Hormonal, anatomical, and neuromuscular characteristics all contribute. Examples include:
- Knee Bony Anatomy – Females are more likely to have an “A-shaped” notch that can impinge on the ACL. Also, females are more likely to have knee valgus, or “knock knees” that can put extra strain on the ACL and lead to female ACL injuries.
- Neuromuscular – female athletes may have more weakness of the hip and core musculature compared to their male counterparts, leading to a higher chance of risky knee conditions leading to knee injury.
- Hormonal – This is poorly understood. It is possible that decreased ligament compliance in the preovulatory phase could contribute to the higher tear rate. However, it is also likely that the increased tear rates seen during the preovulatory phase are due to changes in neuromuscular control and muscle contractility and not due to changes in the mechanical properties of the ACL.
Which Sports are Female ACL Injuries Likely to Happen?
ACL tears can occur during any sport and even an irregular step during regular activity. However, soccer and basketball athletes are at the highest risk.
It is important that ACL surgery is not done on a “one-size-fits-all” basis, but rather must be individualized for each patient. ACL rehabilitation programs should target the hip, core, and trunk neuromuscular control. A team approach including the surgeon, athletic trainer, physical therapist, coach, family, and patient is crucial for success.