This is a summary of an article by Emily R. Pappas. Click here to read the full article complete with referenced medical studies.

“Fact #1: Female athletes experience ACL tears at a higher rate compared to male athletes.
In fact, some studies have shown that females are at a 2-5x higher risk of experiencing ACL tears compared to their male counterparts.

Fact #2: ACL injuries cost athletes big money.
An estimated 38,000 ACL injuries occur in girls’ and women’s athletics in the US annually at an estimated cost of $17,000. At the national level, surgery and rehabilitation costs associated with female ACL injuries total approximately $646 million per year.

Fact #3: 80% of ACL injuries are non-contact, typically [occurring] during deceleration, lateral pivoting, or landing tasks. ”
It is known that female bodies are structurally and physiologically different from males and there have been theories about how these differences contribute to a higher rate of ACL injuries in females. The author debunks some of the myths about Q-angles and knee valgus, ACL size and the effect of hormones. She puts forth another theory based on neuromuscular development during puberty.

“During puberty, males experience both a growth and “neuromuscular” spurt , where the acute rise in testosterone allows males to increase muscle mass relative to their anatomical growth. For females, without the acute rise in testosterone (an anabolic hormone), there is no automatic increase in muscle mass relative to their increase in peak height. This means a larger skeleton with less muscle and coordination to move that skeleton with “efficiency”.

The author suggests that the best methods for avoiding an ACL injury in females is to train them in a way that reduces their risk.

“Research has demonstrated neuromuscular training (NMT) modalities can reduce the risk of ACL injuries by about 50% in female athletes. Historically, this training includes: strength training, plyometrics, balance exercises, and stretching.

Unfortunately, there is a LOT of variability in these training tools. So which is most effective? In a review of the NMT modalities the most effective programs included the following three things:

  • Lower body strength training
  • Landing stabilization exercises
  • The program was provided by a coach or instructor

Meanwhile, the programs including balance, core strengthening, stretching or agility had no added benefit compared to programs without these modalities.”

In summary (and in line with our training modalities at Driven), “strength training helps females develop lean tissue and strength. A strong, lean-tissue focused athlete has a LOWER chance of injuring her ACL compared to an athlete with a less muscular body composition.”