Why Women May Experience More ACL Injuries

Noyes Knee Institute Signature

Published On

Sep 27, 2017


Patient Education

Knee injuries are one of the most common types of sports injuries, with women tending to injure their knees more often and more seriously than men. Of these injuries, damage to the ACL, or the anterior cruciate ligament, is particularly prevalent. There are a few potential reasons why women are more likely to injure their ACLs than men.

Symptoms of ACL Problems

The feeling of a pop in the knee area, pain that’s severe enough to make you unable to continue what you were doing, swelling that occurs within hours, and instability when trying to bear weight on the injured leg can signal an ACL issue, especially if there’s a loss of motion as well. Consult a doctor right away if you suspect an ACL injury.

Movement Patterns Used During Play

Women are more likely to perform movements that can injure the ACL, such as jumping, cutting, quick changes in direction, planting, and stopping suddenly, in a riskier way than men. Women tend to land with knees buckled inward and their landing leg mostly straight, tilt their trunk sideways, and have most of their weight on one leg than men, causing more instability in the knee.

Hormone Levels

Another factor that can play a part in the risk of ACL injury is a woman’s hormone levels, as these injuries are most common after puberty. Some research has shown that women taking birth control pills are less likely to become injured while playing sports, and the theory is that these pills help keep estrogen levels low and consistent, as high levels of this hormone may cause the ligaments to be weaker than normal.

Muscle Strength

Women often have weaker hamstring muscles, which can lead to a higher risk of ACL tears because the hamstrings help stabilize the knee. They tend to rely more on their stronger quadriceps for slowing down and stopping, unlike men, who use the hamstrings. Using the quadriceps for this purpose tends to make the knee more likely to overextend, increasing the risk of ACL injuries. Strengthening the hamstrings may help with this problem.

Other Potential Factors

Some people also think that the type of footwear worn – sneakers vs. cleats – and the type of surface a sport is played on – artificial turf vs. grass – may make a difference in the risk of knee injuries. Differences in anatomy, including the angle formed by the quads and the patella tendon and the length of the ACL, are sometimes cited as well, but the evidence is still preliminary as to whether these affect injury rates.

Preventative Steps

Female athletes may lower their risk of ACL injuries by participating in an ACL strengthening program. These programs typically include a warm-up to help improve core strength, landing techniques, plyometrics, and agility. Some include balance training as well. Players practice proper techniques, such as keeping the leg in a straight line over the foot when jumping and keeping the upper body mostly still over the hips when turning on one foot.

Potential Benefits of ACL Training

With a risk of knee injury four to six times that of men, women can benefit significantly from programs to help limit ACL injuries. In one study, the FIFA 11+ program helped decrease ACL injuries by between 30 and 50 percent. These injuries can keep people from participating in their sport for months, if not longer. Once a person has had an ACL injury, they have a higher risk of injuring their ACL again in the future.

If you think you may have injured your knee, the professionals at Noyes Knee Institute can help diagnose and treat the problem.