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The ACL Epidemic in Female Athletes and What You Need to Know

Updated: Apr 23



This subject has always been a passion of mine (still is to this day) and I did my Master's paper on ACL Injury Prevention Programs for Preventing ACL tears in Females Athletes back in 2006. There is not lack of research on this problem that has grown to epidemic proportions and honestly I feel things are getting worse vs. better. There are a number of reasons for this in my opinion, but I wanted to start Part 1 of this series by sharing some of the data that is currently available that I feel all coaches, parents and female athletes should be aware.

What The Does The Data Show?

Knee injuries are the most common cause of permanent disability in female high school athletes accounting for up to 91% of season-ending injuries and 94% of injuries requiring surgery. In the United States as many as 80,000 high school fem


ale athletes experience ACL injuries each year, with most in soccer and basketball. Female athletes have a 4-6x increased risk of ACL injuries compared to males in similar cutting sports and overall, girls are 8 times more likely to suffer an ACL injury than boys.

Why Are Female Athletes More At Risk?

At the age of 14 years, girls have 5 times higher r


ates of ACL tears than boys. The incidence of ACL tears in females peaks at the age of 16. The reasons for females being more at risk for ACL injury have been extensively studied. The increased risk for injury appears to be associated with many factors including a narrower intercondylar femoral notch and smaller ACL, an increase in natural ligament laxity, slower reflex time, an imbalance secondary to a greater quadriceps strength and hamstring weakness, fluctuation in estrogen levels and the tendency for females to altered lower extremity biomechanical patterns that inc


reases their risk of ACL tears.. Seventy percent (70%) of ACL injuries in females are non-contact and primarily involve one of two mechanisms: running and cutting sharply with an erect posture or landing with minimal knee bend on one leg. Both mechanisms result in the knee being forced inward into valgus with rotation as the athlete’s center of gravity is tilted laterally outside of their feet or their plant foot gets too far outside of their base of support.

Where Are We Going Wrong With Reducing Risk?

I wanted to share with you what I would con


sider my top 4 areas we often miss the boat, though there are others.

  1. Lack of Quality Programming. Female athletes sadly don't get the focus they deserve when it comes to strength and conditioning programs and injury reduction (especially at the middle and high school levels. This lack of quality programming often makes their risk worse and doesn't address the true needs of the female athlete looking to reduce their risk of having an ACL tear.

  2. No Formal Assessment or Evaluation Process. This is probably the biggest issue I see over and over when I work with female athletes coming back from an ACL tear or other injury. They have never been taken through a thorough assessment or evaluation process, that when done by a professional who understands functional biomechanics would have caught their biomechanical inefficiencies, muscular imbalances and areas for their unique focus that would drastically reduce their risk.

  3. Poor Biomechanics. Female athletes unfortunately often lack some of the foundational biomechanics that when taught to them properly could drastically reduce their risk of tearing their ACL. This includes things such as: Deceleration Mechanics, Cutting & Changes of Direction, Jumping & Landing, etc.

  4. Muscular Imbalances. Female athletes often display muscular imbalances and recruitment patterns that place them at greater risk then their male counterparts. Female athletes are often quad dominant and often lack posterior chain strength that is essential to proper deceleration mechanics, where most ACL injuries happen.

I hope you enjoyed this first part and gained some knowledge regarding some of the areas we need to be focusing on when training and coaching female athletes to help reduce their risk of being a part of this epidemic.

In the next parts I will be sharing some videos to expand upon the ACL epidemic, which has always been a passion of mine to help right this ship, because sadly we are headed in the wrong direction and the numbers prove it. Yours in Success, Coach Jeff


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