Rise in ACL Injuries in Young Female Athletes

Stephanie Specht's picture
By Stephanie Specht on August 31, 2017

ACL injuries are being recognized more frequently in athletes across the United States, especially in female athletes. 

According to the American Orthopaedic Society for Sports Medicine, the rate of ACL ruptures is two to eight times higher in female athletes than in male athletes.

Why? I sat down with Ashley Simpson, manager of athletic trainers for Carilion Clinic’s Sports Medicine program, to find out more about this common, yet complex, injury and what you can do to help your budding athlete.

Living: First off, what is an ACL?

Simpson: The ACL, or anterior cruciate ligament, is one of four main ligaments in the knee. It also acts as the primary stabilizer, so when your child is cutting and changing direction as she heads toward the soccer goal, the ACL is in play working to stabilize her knee.

Living: What causes ACL injuries?

Simpson: Most ACL injuries occur from sports that require a good bit of cutting, quick changes of direction, jumping and quick acceleration and deceleration.

The most common sports in which we see ACL tears include soccer, basketball, football and tennis. 

Living: Why are girls more susceptible to ACL injuries than boys?  

Simpson: It has a lot to do with growth and puberty. As boys enter puberty, they see an increase in testosterone, which helps them build more lean muscle; whereas, girls see an increase in estrogen.

The increase in estrogen results in more flexible or lax ligaments and an increase in body fat with little lean muscle gains.

This trifecta means that the joints are less stable and more vulnerable to injury. In addition, females naturally have wider hips that can predispose some to a more knock-kneed disposition.

Living: Is there way to identify if a young female athlete is at risk for an ACL injury?

Simpson: If you have access to an athletic trainer through your child’s sports team, work with your trainer to pinpoint any weaknesses or poor form that could increase the risk of injury.

There is also a test called the two-legged jump test. Ask your child to jump off a stable box or a stair and focus on landing with her hips, knees and ankles in line with each other.

If your child’s knees buckle inward or look knock-kneed it could be a sign of muscle imbalance, which could mean that she is at an increased risk for an ACL tear.

Living: Can you do anything to prevent an ACL injury?

Simpson: The best thing a young female athlete can do is to focus on neuromuscular training. Work with your child’s athletic trainer or coach to develop strength exercises that target the core, hip, pelvis and thigh muscles.

This can also include adding in balance and stability exercises that increase the ability of all of the muscles surrounding the hip, knee and ankle joints to work in unison.

Young athletes, male or female, also need to learn how to jump, land, cut and accelerate and decelerate safely. And, I always encourage young athletes to stay fit year-round to keep their muscles, joints and ligaments strong and ready for sports.

Check out the video below from Safe Kids Worldwide to see seven exercises Ali Krieger of USA Women’s Soccer performs to help prevent ACL injuries.

If your athlete is injured on or off the field, contact Carilion Clinic Sports Medicine for more information. We also offer Saturday Sports Injury Clinics now through November in Roanoke, Blacksburg and Lexington to help your athlete get back in the game.
Carillon Clinic's Sports Medicine program includes nine full-time athletic trainers who cover high school sports in the New River Valley and in Roanoke, Franklin and Rockbridge counties, as well as full-time athletic trainer for Virginia Tech's Corps of Cadets program and the Roanoke Railyard Dawgs hockey team. Athletic trainers help prevent injuries, act as first-line medical coverage if there is an injury and provide return-to-play care for injured athletes.