Reasons for ACL Injury in the Female Athlete

July 11, 2011

A couple of weeks ago, I posted a research paper I wrote in college about ACL injuries and the Menstrual Cycle. In this article, I will explore a variety of reasons why researchers and clinicians believe females suffer ACL injuries at a rate 4-6 fold greater than their male counterparts.

One thing that must be recognized is the rate of athletic participation is so much greater now than it was in the past. Thus, we have seen a sharp increase in knee injuries in females simply because there are more of them participating in athletics. As you increase the participation numbers, it just makes sense that the injuries would also increase.

The anatomy and physiology of a female is different than that of a male. I think this is something people don’t always recognize. Of course, most know that a male and female have different genitalia and different reproductive systems. But for a lot of people that is where the differences end. This is just the beginning for the medical professional.

I will only briefly mention hormones in this post because that is what the research paper was all about. There is still question as to whether hormones are involved or not, but I believe they are to some degree. I’d suggest you read my research paper to gain more insight into this topic. It’s another condition and injury that female athletes appear to be more susceptible to based simply on their physiology involved in the menstrual cycle.

The female body has numerous bony structures that can differ from a male. At least two are common causes for ACL injury and are likely to predispose an athlete to injury although they are not strictly a female condition. The first one is the Q-angle in the hip. This is the angle at which the femur is connected to the pelvis. Most females have a larger Q-angle due to the fact that females are able to give birth and males are not! Their body has adapted to that ability by having wider hips and unfortunately the athletic aspect is not a priority for the human body. Another bony aspect that affects females is in the knee itself. In fact, it is the groove in which the ligament resides and that is the intercondylar groove in the knee is often smaller in females. This groove is sometimes shaped like a “V” instead of a “U” and due to this shape the ligament can be pinched easier leading to injury. Typically when a surgeon goes in to repair an ACL, he/she will also drill along that groove to create the “U” shape and eliminate the pinching possibility.

The next reason that is a common cause for ACL injury is probably the one that is most correctable. Females are said to be quad-dominant oftentimes and this is yet another factor in the ACL puzzle. This means these girls use their quads (those muscles on the front of the thigh) to restrain the tibia and prevent movement. Often female athletes have significant strength in their quadriceps muscles and lack strength in their hamstrings. This, combined with the early activation of the quads, leads to the girl pulling through the ACL essentially when they go to land, or cut, etc. The angle of pull from the quads, since they are on the front of the leg and attach to the tibia on the anterior side, pulls up through the ACL toward the patella. On the other hand, males typically use their hamstrings to restrain the tibia from the anterior translation. It takes considerable time, but females can be taught to use their hamstrings instead of their quadriceps and also they can build up the hamstring muscle to increase strength. This is why I say this is one area that is most correctable.

So that’s just a few reasons for female ACL injuries. I’m sure there’s plenty I’m missing and hopefully I can explore that at a later date. For now, I’m going to move on to another topic surrounding Anterior Cruciate Ligament injuries. Look for that article soon!

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2 Responses to “Reasons for ACL Injury in the Female Athlete”


  1. […] Reasons for ACL injuries in Female Athletes […]


  2. […] one that I really enjoyed writing. I intend to write more about this topic in the near future. “Reasons for ACL Injury in the Female Athlete” discussed some of the differences between male and female athletes which can lead to increased […]


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