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acl pain

Why Are ACL Injuries More Common In Females?

What is an ACL and why is it important?

Knee injuries account for about 40% of all sports injuries, with ACL (anterior cruciate ligament) injuries being one of the most common and impactful injuries. The ACL is one of the four major ligament of the knee and is one of the most injured. The ACL keeps the knee stabile by preventing excessive movement of the joint. It is a very important static stabilize. When an ACL injury occurs, the knee will often buckle and intense pain can be felt immediately.

ACL injuries occur from contact and noncontact sports but those who are most prone to ACL injuries are athletes who participate in high demand sports which require cutting, stepping, pivoting and jumping movements. Athletes who play sports like basketball, skiing, tennis, volleyball, football and soccer are at high risk of having an ACL injury. Studies have shown that females are significantly more likely to have an ACL injury than males who participate in the same sports.

Why do ACL injuries affect females more than males?

Females are more affected than males due to a range of anatomical, biomechanical and hormonal factors.  Female athletes who participate in pivoting and jumping sports are 8 times more likely to have ACL injury than males and are also three times more likely to have an ACL injury through noncontact mechanism.

Compared to men, females have, what is called a higher Q angle, which increases the tension of the ACL during certain movements. The Q angle is the measure of the angle of the femur in relation to the pelvis. As females tend to have a wider pelvis, this angle is increased, which can create a narrower compartment in the knee that houses the ACL. In addition this increasing variability of structures also affects the quadriceps muscle, which is an important dynamic stabilizer of the knee joint.

Women also tend to have a strength imbalance as they activate the quadriceps more than the hamstrings while accelerating or changing direction. Some women may also have weaker hip rotators (glutes) than their male counterparts. These anatomical differences can increase the risk of an ACL injury.

Recent studies have shown that hormonal imbalances, such as those found in high level female athletes can further place the female athlete at risk for not only ACL injury, but also stress fractures and other structural injuries.

What Can Be Done To Prevent ACL Injuries?

Given all of this information, it may seem too daunting for females to play sports – but that is absolutely not the case! There is nothing that should stop a female athlete from pursuing her passion and excelling at the highest level. However, certain precautions should be taken in an effort to lessen the chance of an ACL injury.

ACL Injury Prevention techniques include stretching and strengthening of the upper and lower leg muscles and have been shown to reduce the risk of injury substantially. Also, proper strength and endurance training should be maintained both during the season and in the offseason as well. Attention to proper sport mechanics is also vital to prevent aberrant movements that may play a role in developing an injury.


At The Orthopaedic & Sports Medicine (OSM) Center we utilize the collective skills of our exceptional providers to deliver the most complete musculoskeletal care available. From your first appointment, you are cared for by a team specifically built based on the best treatment for your condition. If surgery is necessary, you will be paired with an OSM surgeon who has the expertise and experience in your specific condition. Our surgeons use the latest minimally invasive techniques where appropriate to ensure fast recovery.  Contact us today to schedule a consult.