Is Your Daughter’s ACL At Risk?


Thanks to Title IX, the number of girls participating in high school sports grew from roughly 300,000 to an estimated 3 million from 1972 to 2006, an increase of almost 1,000%! While there are still plenty of hurdles to cross for female athletes, the fact that more and more girls are playing softball, basketball, soccer, lacrosse, and even typically male-dominated sports like football the future is looking bright. Popular female athletes like the Williams sisters (tennis), Lindsey Vonn (skiing), Michelle Wie (golf), Kerry Walsh (beach volleyball), Hope Solo (soccer), and Gabby Douglas (gymnastics) are inspiring even more girls to take up youth sports. But with a few generations of female athletes to study, researchers have noticed a disturbing trend when comparing injury rates between young male and female athletes, especially when it comes to lower body injuries like a torn ACL.Is Your Daughter’s ACL At Risk?

In the United States, 20,000 to 80,000 high school female athletes suffer from ACL injuries each year, with most injuries happening in soccer and basketball. And studies reveal that female athletes are four to six times more likely than boys to suffer an ACL injury. Even more interesting is that most torn ACLs aren’t torn by contact with another player, like two soccer players colliding when both going after a loose ball. Over two-thirds of ACL injuries are caused by:

  • Stopping instantly
  • Quick, cutting movements
  • Sudden change in direction
  • Landing wrong after a jump

Looking at those causes you can understand why soccer and basketball, which involve quite a bit of directional changes, cause so many torn ACLs among female athletes.

While we can’t say for sure why girls are more likely than their male counterparts to suffer from a torn ACL, here are some of the prevailing theories:

1. Malalignment

Women’s feet tend to roll inward (pronate), are flatter, and the force on their kneecaps is aggrevated by the fact that a wider pelvis (thanks to hormones and puberty) makes the thigh bones angle downward more sharply than in their male counterparts. These “knock knees” put a lot of extra stress on the ACL, making it more vulnerable to damage.

2. Lax Ligaments

Female athletes tend to be naturally more flexible than male athletes, partially because their ligaments are more lax (have more “give”). Knees are dependent on ligaments for stability and with lax ligaments the knees turn to the ACL for extra support. The intense pressure that sports puts on knees can sometimes be too much for the small ACL to handle.  

3. Quadriceps versus Hamstrings

Compared to male athletes, female athletes tend to have weaker hamstrings. If the hamstring cannot properly balance the strength of their quadriceps the imbalance puts serious stress to the ACL.

While girls can play sports just as good (if not better) than their male counterparts, there is no denying that men and women start to develop differently once they hit puberty. How their bodies change naturally is somehow contributing to the high amount of torn ACLs among female athletes. The best way to prevent ACL injuries is for young athletes to stretch and strengthen their leg muscles, especially the quadriceps and hamstrings. It’s also especially important that female basketball players practice jumping and landing correctly.