Reasons Why ACL Injuries are Common in Females and How to Prevent Them

Why ACL Injuries are Common in Females

Women participate in sports as much as men. A participant can experience different injuries during sporting activities. Knee injuries are the most common for many athletes. At one point, we have witnessed a player falling on the ground to grab his or her knee while groaning in pain. We wonder what could have gone wrong and if they will be okay. The injury sustained could be short or long term depending on the extent of the damage. The pain usually results from a torn anterior ligament in the knee area. Players who experience such injuries cannot play until they get well, and that could be for an extended period. At times, a player will drop to the ground in pain without being touched.

How does it happen? Two out of three injuries occur without the athlete being pushed or shoved. The pain results from a wrong landing after a jump or step.

Research indicates that anterior cruciate ligament (ACL) injuries occur six times more in females as compared to men. What causes a higher injury incidence in women?

Lower knee or limb locus – this is also referred to as knock knees. Females tend to have a lower limb position when landing. This can affect the hip region too. The position is different in males thus increasing the incidence in females.

Inappropriate muscle activation arrangements – the activation pattern in women is different from men. The pattern for females includes calf, hamstring, and quad. The incorrect activation in females increases the incidence of injury.

Wide pelvis – Females have a wider pelvis compared to men. This inclines the angle of the thigh bones sharply downward as compared to men. The angle formed exerts pressure in the interior knee area resulting to injury.

Increased ligaments laxity – the ligaments laxity is higher in females than in males. Females also have more elastic tissues than men. This causes extreme joint motion and amplified flexibility contributing to the injury.

Delayed reflex time – studies indicate a slower muscle response to stabilize the knees in females also contributes to the injuries. The difference in contraction time increases the chances of injury.

Variations in estrogen levels – studies have proven that estrogen level changes in women during menstrual cycle raise the likelihood of injury.

How Do You Prevent The Occurrence Of ACL Injuries?

The preventative programs will include the following components to prevent the injury

• Acquiring optimal position- upholding the optimal position is acquired by avoiding the valgus locus. This will aid in landing correctly.

• Reducing landing forces- an athlete should achieve a straight spine, proper posture, place the shoulders back, and jump straight. This will aid in acquiring a soft and balanced landing.

• Tend to muscle imbalances- there are different forms of imbalance in females compared to males. For instance, females have fragile hamstrings than quads. You can focus on strengthening your weak areas to reduce chances of injury.

• Proper conditioning- this principle is useful in preventing various sporting injuries. It emphasizes on the training of athletes. The training should be conducted all year round instead of particular seasons. Regular exercise is also known to reduce injury incidence in both males and females.

• Working on your balance and speed will also help in reducing the incidence of the injury.

• Proper orthotics and footwear- the level of grip of the shoes of an athlete should be within optimal range. This will reduce rotational friction that causes resistance by optimizing transition injury. Reduced friction also boosts the peak performance in stopping and cutting.

Studies indicate that the cases of ACL injuries have reduced in females because of the effectiveness of the prevention techniques applied. Proper training will also help in reducing the cases. The chances of trained females experiencing injuries are only 1.3x higher than in males. Untrained females have a 3.6x higher incidence than the trained ones. Besides, the rate of injuries in untrained females is higher than men by 4.8x. We can deduce that female athletes should often train aside from other preventative measures to reduce the chances of injury. Select an effective program that will help you to prevent injuries and also work on your recovery. This will boost your overall performance.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
Request Telehealth Request Telehealth Request in office visit Book now