 There is evidence to suggest that women are more likely to injure their anterior cruciate ligament (ACL) than men. Female athletes participating in basketball, soccer, and volleyball are more likely to get an ACL injury compared to their male counterparts. Barry Boden, MD, reports that female athletes participating in basketball and soccer are two to eight times more likely to suffer an ACL injury compared to their male counterparts.
There are several possible reasons why this may be so. A West Point study suggested that the wider female pelvis makes women knock-kneed when they jump and land, straining the ligament. Men tend to land in a straighter position and have more hamstring strength, which bolsters the ligament. Also males bend their knees like hinges, while females often pivot theirs like a ball-and-socket joint. Others speculate that another risk factor may be the presence of estrogen , which may cause ligament loosening.
One solution may be to coach women in landing and positioning of the knee. Emphasis placed on landing on the balls of the feet with knees bent and chest over the knees can help prevent ACL injuries in women. Proper knee positioning to prevent inward buckling while running is also critical and may reduce the possibility of injury.
In a 1998 U.S. study of 1,200 indoor-soccer players, 400 girls who spent six weeks working on jumping without caving in at the knees and doing other stability and balance exercises saw their injury rate drop to that of untrained boys. "The untrained girls were five to six times more likely to blow out their knees," said Dr. Tim Hewett, University of Cincinnati sports medicine professor.
Dr. Boden suggests prevention exercises that emphasize proper knee positioning and landing. An example would be during soccer drills to have athletes jump over a soccer ball and training them to land on the balls of their feet. Balance training with the use of balance boards can also be helpful.
ACL injuries can be devastating emotionally and physically for an athlete. Healthcare costs of this knee injury are estimated at more than half a billion dollars annually. Prevention through coaching, proper positioning, and landing are highly recommended to address this problem.
References
"Common Knee Injury More Likely in Women" by Barry Boden, MD, in the Spring 2010 In Motion, a publication of the American Orthopaedic Society for Sports Medicine.
"Epidemic of Knee Injuries Afflicts Female Athletes" in the Ottawa Citizen, June 5, 2001. Found at the web site Girls at Play: Getting More Girls in the Game, April 30, 2010.
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