ACL Injuries In Female Athletes (Continued)

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Why women and girls are more prone to ACL injuries than men and boys defies easy explanation is also likely due to a number of anatomical and hormonal differences between men and women:

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1. Narrower intercondylar notch and smaller ACL: Not only does the intercondylar notch (the groove in the femur through which the ACL travels) tend to be smaller in women, but so is the ACL itself, leading it more prone to injury.

2. Wider pelvis: Women typically have a wider pelvis, which makes the thigh bones angle downward more sharply than in men. The greater the so-called "Q" angle, the more pressure is applied to the inside (medial aspect) of the knee, which can cause the ACL to tear.

3. More lax ligaments: Women's ligaments tend to have more "give" (laxity) than men's. Research has also shown that women's muscle tissue is more elastic than males. Excessive joint motion combined with increased flexibility may be a significant contributing factor in the higher rate of torn ACLs among women.

4. Slower reflex time: Research shows that the muscles stabilizing the knee may take a millisecond longer to respond in women than in men. Scientists suspect that this small difference in contraction time also leads to a higher rate of injury.

5. Greater Quadriceps/Hamstring Strength Ratio: Poor hamstring strength may contribute to ACL injuries in both sexes. If the hamstring cannot balance the power of the quadriceps (front thigh muscle), the imbalance can cause significant stress to the ACL, leading to injury.

6. Changes in estrogen levels. A recent study suggests that changes in estrogen levels during a woman's menstrual cycle may affect ACL strength, predisposing women to the higher injury rate.

There is good news

Several studies demonstrate that the rate of ACL injury among women can be significantly reduced by proper training and conditioning.

According to Dr. Thomas Haverbush, a Michigan orthopedic surgeon, a training program developed at the University of Vermont Medical School designed to prevent ACL injuries in skiers led to a 69% decrease in the number of knee injuries among ski patrol personnel and instructors who received the training compared with those who did not.

In the same article, Dr. Haverbush reported that a six week training program in Cincinnati in which athletes were trained to rely more on hamstring muscles than quadriceps in order to protect the knee could reduce the ratio of knee ligament injuries in female athletes as compared to men from five times higher to only one or two times higher.

How Your Daughter Can Reduce The Risk of ACL Injury

Experts say there are four ways to reduce the risk of ACL injury:

1. Proper leg muscle strength training and core training.

2. Proper neuromuscular (balance and speed) training.

3. Proper coaching on jumping and landing and avoiding any straight knee landing.

4. Proper footwear and orthotics if necessary.

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Article Updated: August 25, 2007

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