ACL Tear Reduction - Why is this Injury More Common in Female Athlete's?

It’s a sight no parent ever wants to see – their young, promising athlete suddenly going down on the field or court for no apparent reason. Unfortunately, athletes who compete in high demand sports such as soccer, football and basketball are at the highest risk of injuring their anterior cruciate ligament - especially an injury involving no external contact at all - this can range from planting and cutting mishaps, to pivoting and sudden deceleration (i.e., inward rotation of the tibia).


There are over 200,000 ACL tears every year in the United States every year and female athletes are nine times more likely to suffer this injury than their male counterparts. Unfortunately this is trending upwards, too – girls were six times more likely to tear their ACL only a couple of years ago.

We in the fitness world are at a cross-roads. We need to stand up and accept that the way we approach training young female athletes is not perfect. We need to accept that there are undeniable differences that need to be addressed when we build our performance programs. Simply getting them to jump higher or lift more in the hope of by-passing a functional short-comings is just plain ridiculous.  As a fitness professional it goads me that we are risking our young female athletes futures by going for short term (and short-sighted) gains at the expense of long-term development. 

Anatomy 101

The ACL, or Anterior Cruciate Ligament, is one of the major ligaments (tissue that fastens bone to bone) of the knee. Its primary jobs are to prevent excessive anterior (forward) movement within the joint and assist in limiting rotational movement of the tibia.


So what’s the difference between female and male anatomy that causes this increased risk for injury?

  • Female anatomy: Referred to as the “Q” angle, females have wider hips relative to the rest of the skeleton which creates a valgus angle at the knee.                                        

  • Smaller ACL

  • Dynamic neuromuscular differences: Females move differently than males – meaning they fire their muscles differently.

  • Muscular imbalances and weakness: Particularly in the hamstrings, glutes, core and postural muscles.

The good news is that we can, at the very least, affect the muscular and neuromuscular deficits. At Nexus Performance we adhere to the following with our female athletes:

  • Proper warm-up

  • A well balanced strength training and sport preparation program

  • Balance and Proprioception training

  • Rest/Recovery

A well balanced program to reduce the risk of an ACL tear involves teaching girls as young as 10 years of age to first control their limbs - and therefore their joints - in a safe, but still fun, environment.