Major Injuries in Female Athletes Part 1 – The ACL

The most common cause of prolonged absence from sport is anterior cruciate ligament (ACL) injuries. Although ACL injuries occur in males and female, the incidence within female athletes is much higher.

The ACL is an important ligament within the knee and controls rotational movement. Most ACL tears occur when a person is landing from a jump, pivoting or decelerating suddenly. These non-contact ACL injuries generally occur because of insufficient control around the hip, knee and ankle. ACL tears rarely occur in isolation and there is often associated injury to other structures in the knee.

Lower limb injuries are the most common type of injury in running sports. In these sporting populations muscular injuries are more likely in male athletes, whereas female athletes have a higher incidence of ligament injuries. Possible reasons for higher levels of ACL injuries in females are that:

  1. Females have a wider pelvis creating greater angles of stress between the knee and the hip.
  2. Females tend to have a higher level of flexibility and ligament laxity then male (this is especially true at certain times of the month due to hormone changes).

This results in the joints having the ability to move through a greater range of motion, placing the ligaments under more stress. The muscles around these joints need to be strong enough to control this range of motion during rapid activities and changes in direction.

Looking at this hypothesis, do females need to have more muscular control then males to prevent serious ligament injuries; the answer is most likely yes!

We are now living in an era of injury prevention not just injury management. Basic conditioning programmes such as the FIFA 11+ has been implemented into warmup routines in many different sports. Research is showing that training and improvement of muscle control and joint proprioception is reducing the incidence of ligament injuries most notable ACL injuries in female athletes.

Catherine Simpson MISCP MSc. Sports Medicine


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