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ACL Injuries, why they’re more common in females and can we help prevent them?

Posted on by Josh Richling
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We are leaders in our profession, locally owned and operated by physical therapists who forge relationships with patients, and advocate for their care. All of our clinics have board-certified specialists on staff, meaning you get the highest level of care to maximize your recovery, and get you back to your game. We will listen, evaluate your symptoms, and create a personalized physical therapy program to meet your needs and improve your function, strength, and mobility.

ACL Injuries, why they’re more common in females and can we help prevent them?

We’ve all seen it, whether it was in person or on TV, an athlete falls to the floor grabbing her leg in pain. The gym goes silent. The same thing is going through everyone’s mind, what happened? Are they going to be ok? Is their season over?

After everything is done it’s found she has torn her anterior cruciate ligament (ACL) in her knee and she will be out for the season. But she didn’t even get touched, how did this happen? Two out of every three ACL injuries are from non-contact incidences, meaning the athlete wasn’t pushed, shoved or even landed on by another athlete. She most likely took a wrong step or landed incorrectly after jumping.

Females are 6 times more likely to have an ACL injury compared to males and 1 out of every 100 high school or college female athletes will have a knee ligament injury. Research has shown females have higher incidence of injury for several reasons:
Lower limb/knee position: females tend to have valgus knee position (knock knees) while landing; which is related to the hip as well. These movements are different from males (see image below)
acl pic 1

Improper muscle activation patterns: females activate muscles (quad, hamstring and calf) in a different order compared to males

Is there anything we can do to help prevent this? YES!

Three major components are focused on when dealing with preventative programs for ACL injury:
Decrease landing forces: The athlete should demonstrate proper posture, erect spine, shoulders back; jump straight up; soft landing; stay balanced

Fix muscle imbalances: females tend to have weaker hamstrings compared to quads
Maintain optimal position: avoid valgus position by landing correctly (see image below)

Proper landing(left image)
Improper landing/ valgus(Right image)

acl use this pic 2

Research has proven these methods to be effective in decreasing the likelihood of an ACL injury. Untrained females have 3.6x higher incidence of injury compared to trained females. Untrained females have a 4.8x higher incidence of injury compared to males. Trained females only have 1.3x higher incidence than males.

All Makovicka Physical Therapists are educated in proper landing techniques and ACL prevention. Don’t hesitate to contact us with any questions or concerns you have concerning this matter. We would rather spend time with you preventing an ACL injury and making you a better athlete than spending several months with you rehabbing after ACL surgery!