08.26.2008
ACL injuries to female athletes
Eric Steele, MD

The recent Olympics in China illustrate the growing involvement of millions of girls and young women in organized sports. Unfortunately, as the number of female athletes has grown, so has the number of injuries to female athletes. One common and serious injury is tearing of an important knee ligament called the anterior cruciate ligament, or ACL.

Most of us think of professional football players and basketball players when we think of ACL injuries, but in fact, female athletes are particularly prone to these injuries because of issues unique to female anatomy and physiology. In fact, female athletes have a rate of ACL injury 4-8 times higher than male athletes. The way women run and jump, and their relatively smaller thigh muscle mass related to strain on their ACLs, may make them more prone to ACL tears, according to sports medicine experts.

An ACL injury is a devastating sports injury, one that is certainly a season-ender and can be a sports career-ender. Repair of an ACL that is completely torn usually requires surgery or the knee will not be stable. Complete recovery, which requires an aggressive physical therapy program after surgery, can take 6-12 months. Partial tears of the ACL usually do not require surgery, but can force extended limitations on sports participation.

Sports medicine experts are looking for ways to reduce the risk of ACL injuries to female athletes. Some are encouraging players to land differently after jumping – with knees bent a little and in a broad stance, instead of in a narrow stance with knees locked. Athletes who have recurring episodes of knee pain and swelling after games should consider that they may be causing themselves minor ACL injuries and consider seeing a physician, sports trainer, or physical therapist about how to prevent a more serious injury. Good muscle tone and strength of an athletes thigh muscles – both those in front and those in back – is probably important.

Some female athletes are perhaps fearful that exercises to strengthen thigh muscles will cause them to “bulk up” their thighs. That generally does not happen unless the athlete undertakes a very aggressive weight training program with large weights. Exercises can increase strength considerably without causing substantial increases in muscle size.