2 surprising reasons women are at risk for knee injury

You feel it. Sometimes you even hear it. You’re running, jumping, playing hard. Suddenly, there’s a “pop.” The next thing you know, you’re feeling like someone’s pulled the rug out from under your feet.

You may have torn the anterior cruciate ligament (ACL) in your knee. This significant sports injury can end your season, and put you on the road to surgery and extensive rehabilitation. Many people don’t realize that this injury affects women in some sports far more than men.

What accounts for this gender disparity? Researchers have taken a careful look at athletes’ bodies in motion. What they have learned may help you avoid an ACL injury, and may even help you to use your body more efficiently in sports.

Anatomy of the knee

There are four main ligaments in the knee. These ligaments tether the tibia (shin bone) to the femur at the point where the bones come together at the joint. The ACL is a vital stabilizer of the knee, functioning to keep the tibia from sliding forward under the femur. It also helps to limit extreme rotation.

“Cutting” and “planting” are the moves most frequently associated with ACL injuries. Cutting involves taking a hard, quick step to accelerate in another direction. Planting is landing firmly on your feet from a jump or step. Although neither of these moves involves contact with another person, they comprise 70 percent of all ACL injuries.

Both cutting and planting may strain the ACL. When you initiate a cut or land from a jump the ability of your ACL to resist certain rotational and bending movements may be compromised. If you plant incorrectly, you may overwhelm the ACL’s ability to restrain the movement of the joint the way it is designed to do.

But since all sports use cutting and planting extensively, why are female athletes particularly at risk?

Why women are more at risk

A number of factors can contribute to injury risk. They include:

1. The particular way different athletes perform and land from a jump.
   When executing a jump-stop maneuver, women have a tendency to activate the quadriceps (front of the thigh) first, while men use their hamstrings (back of the thigh) first. This can affect the amount of strain applied to the knee ligaments. Athletes who land from a jump with their knees wider apart appear to have a decreased risk of ACL injury. Women have a greater tendency to land with their knees closer together.
2. Fatigue can also be hazardous.
   Tired athletes are more likely to land with poor mechanics (knees closer together). This is especially true when the fatigued athlete has to make a last minute decision and perform an unexpected movement.

What can you do to reduce your risk of injury?

Training programs supervised by sports health professionals can help improve leg strength and jump-landing techniques.

Proper training has been shown to decrease ACL injury rates in volleyball, basketball and soccer. The techniques that improve ACL safety, can also enhance performance, increase vertical jump, improve acceleration, and enhance the ability to change direction.

Nothing can prevent ACL injuries altogether. But exploring potential causes and maximizing prevention strategies are key to stopping the “pop” and its frustrating consequences.

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