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ACL Injury Risk: What Every Female Athlete Needs to Know

Anterior cruciate ligament (ACL) tears are a common sports-related injury, but data show ACL tears and strains don’t affect men and women equally. While many ACL injuries seem to be associated with male-dominated sports like football, women are far more affected by these kinds of knee injuries.

At Pacific Sports and Spine, our team is dedicated to providing state-of-the-art treatment for ACL tears in both female and male athletes with a patient-centered approach that supports fast, complete healing and recovery. 

Here’s why ACL injuries are more common in women and what we can do to treat — and prevent — ACL strains and tears.

ACL injuries: The basics

The ACL is one of four main ligaments that maintain knee integrity and support while helping your knee move the way it’s supposed to. Crossing in the middle of the knee joint, the ACL connects the femur and the shinbone, supporting normal back-and-forth movement of the joint.

ACL injuries tend to happen with sports requiring fast stops, jumping, or quick changes in direction (pivoting). These movements put an uneven or excessive strain on the ligament, causing it to tear either partially or completely.

ACL injuries in women

Researchers aren’t sure why ACL injuries tend to happen more frequently in women than in men, but they believe it’s probably due to a combination of factors.


The ACL passes through a groove called the intercondylar notch. In women, this groove tends to be narrower, and the ACL itself tends to be smaller, factors that could lead to an increased risk of injury.

Partly due to anatomical differences in pelvic alignment, women’s knees are oriented slightly differently from men’s knees. That means they absorb impacts differently when women run, jump, or land, which could put uneven stress on the knee joint. 

Finally, women tend to have smaller muscles and less muscle mass compared with men, and tendons and ligaments may be smaller or thinner, as well. These factors contribute to a lower level of support for the knee when it’s under physical stress.


Differences in the way women perform sports can influence the impact on ligaments and the knee joint itself. 

For instance, women may be more likely to depend on their quadriceps when changing speed, putting more pressure on the knee joint. The wider pelvis in women also results in changes in movement that can place additional strain on the knee joints.


Estrogen may also play a role. While this hormone tends to improve muscle function in women, research shows it may have the opposite effect on ligaments and tendons, decreasing stiffness and altering the way ligaments provide support. 

Preventing ACL injuries

Despite these differences, there are some things women can do to reduce the risk of ACL injuries.

Warm up

Warming up delivers oxygen-rich blood to your muscles and connective tissues, preparing them for physical activity. You can get the most from your warmup routine by tailoring it to your activity, focusing on the muscles and joints you’ll be using most during play.

Balance your training

Most people have a dominant leg, and that leg tends to be stronger. When warming up, working out, or practicing, balance the load and activity by using both legs, so you can avoid strain caused by uneven loads.

Listen to your body

Pay attention to what your body is telling you during sports and other physical activity. If you start to feel fatigued or you notice any type of change in your legs or knees, stop for the day and give your legs a rest. Continuing to play when you’re tired or in pain can quickly lead to significant injuries.

Treat knee pain promptly

Pain, clicking, stiffness, or any other knee symptom is a sign that something’s wrong. If you have symptoms that don’t completely resolve with a little rest, it’s definitely time to schedule a visit so we can treat any underlying problem before it becomes more serious.

ACL injuries can limit your activity, but fortunately, we can treat most injuries conservatively. To find out what’s causing your knee symptoms or to learn more about ACL injury treatment, book an appointment today with our team at Pacific Sports and Spine in Eugene or Roseburg, Oregon.

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