Female Athletes at a Greater Risk for this Unfortunate Injury

By Amanda Gannon-Welligee Coach

For those that regularly tune into my blog posts, you know I try to keep the science lessons down to a minimum. I intend to do the same while discussing a topic that deserves some attention given its large incidence rate in the world of sports and physical activity.

Female athletes and anterior cruciate ligament (ACL) tears or sprains appear to go hand in hand. Although it is not an extreme rarity for men, the likelihood of an ACL injury for women is four to six times greater than for their male counterparts.

30 seconds to explain the role of the ACL. GO!

The ACL runs diagonally through the middle of the knee. The role is to provide stability for the knee by preventing forward sliding of the tibia (lower leg bone) on the femur (upper leg bone) as well as rotational stability. This is why we more often see ACL injuries during a non-contact movement such as landing from a jump or pivoting to the side, however, they can also occur during a collision.

Both men and women run, jump, pivot, land, etc. So why are women at a higher risk? There are several theories, some of which I will highlight here before discussing how an exercise program can help.

First of all, many women have an imbalance in the strength ratio between the quadricep muscle (front of thigh) and the hamstring (back of thigh). When the quadricep muscle dominates a movement, the instability of the knee puts a larger strain on the ACL to balance out the fighting forces, often giving under the pressure. Men are noted to use the hamstring in equal parts, especially during movements requiring a change of speed such as decelerating from a sprint, offering more protection for the knee.

Lesser core strength and stability found in female athletes also makes controlling the center of mass much more difficult, causing other areas of the body to absorb more force than desirable.

There are also structural differences between men and women that may lead women to a higher risk of ACL injury. Some research argues that the smaller size of the ligament itself and bony structure in which the ligament sits in the leg predisposes women to a higher injury rate. Also, wider-set hips angle the bones of the leg downward more sharply, creating a higher force on the inside of the knee. When a female lands in this type of alignment, especially when coupled with a sideways tilt of the upper body, the knee may buckle inward and the ACL will be put into a faulty position. Similarly, landing flat-footed instead of on the balls of the feet will disable the calf muscles from absorbing some of the force, causing the knee to buckle inward and follow the same dangerous pattern.

Another theory focuses on the reaction time of females verse males. Females are seen to have a slightly slower reflex reaction in the knee, potentially leading to a higher risk of injury.

So how can your program help fight the risk against this unfortunate injury? Proper strength training that equally targets each muscle group, specifically the quadriceps, hamstrings, and the core, will eliminate imbalances that predispose the knee to unstable forces. Learning how to jump and land with proper knee alignment and building a stable core during plyometric exercises will also be of benefit. A well-rounded program will always include a focus on single leg work (think single leg deadlifts and squats) as training on a single leg improves stabilization of the knee and builds the strength to control and support body weight on a single side. In addition, performing drills that require balance and speed for increased reflex time will play a role in correcting the common issues seen in women that suffer ACL injuries.

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Originally published at www.welligee.com on July 8, 2015.

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