ACL injuries with female athletes

Why is the risk of this injury so high?

by Joe Eisenmann, PhD

Injury to the anterior cruciate ligament (ACL) of the knee is common among young female athletes. Compared to males, female athletes have a 3.5-fold increased risk of ACL injury. Sports with highest rates of ACL injury are girls’ soccer and basketball.

A main reason for a higher likelihood in these sports deals with the fact that about 70-80 percent of ACL injuries are from non-contact positions such as quick stops, cutting and lateral movements, in addition to unanticipated movements.

There are several risk factors for ACL injury and these include: previous injury; poor hip, knee, and foot mechanics; lack of postural balance; muscle imbalance in legs (greater quad and less hamstring activation); poor deceleration (slowing down) technique.

If we want to avoid ACL injury then we need to control the risk factors. The injury rate can be reduced with appropriate training. Like all properly designed training programs, all facets of athletic movement should be emphasized including: strength, power, mobility, flexibility, conditioning, balance, agility, plyometrics, etc.

It is very important when executing these programs that the athlete is educated on proper biomechanics of jumping, landing, falling, deceleration, and changing direction.

Unfortunately, few coaches spend adequate time on this critical matter. In fact, less than 20 percent of coaches have implemented ACL Injury Prevention Programs.

No matter how good the ACL injury prevention program, there will always be a risk of ACL injury. When ACL injury does occur, it is important to follow the correct steps in the recovery process. 1. Surgically or non-surgically repair the injury 2. Follow a rehabilitation program 3. Obtain release from medical care 4. Train the body to return back to at least the same level of competition.

Unfortunately, the last step in the recovery process is often neglected or skipped. Many athletes are released from their rehabilitation program and prematurely return to their sport before their body and mind are fully prepared for higher intensity activity. Bridging the gap between rehab and returning to sport can be achieved by implementing a systematic strength and condition program focused on decreasing the ACL risk factors.

Dr. Joe Eisenmann, PhD is a professor of pediatric exercise medicine..