ACL Injury in Women’s Sports - From Causes to Surgery

ACL injuries are one of the most common and debilitating injuries in sports, particularly among female athletes. Whether it's soccer, basketball, or skiing, women face a higher risk of suffering from an ACL tear than men. These injuries can sideline athletes for months and, in some cases, lead to long-term complications if not managed appropriately. At Ortho South, we understand the unique challenges women face when it comes to ACL injuries, and we're here to explore the causes, prevention strategies, and treatment options to help female athletes get back to their best.

What’s the ACL and Why Is It Important?

The Anterior Cruciate Ligament (ACL) is one of the main ligaments in your knee. It’s what helps stabilize your knee and control movements like pivoting, jumping, and sudden stops. If you tear or injure your ACL, it can seriously affect your ability to play sports, especially those that involve cutting and jumping, like soccer or basketball.

Why Are Women More Prone to ACL Injuries?

If you’ve ever wondered why ACL injuries are more common in female athletes, it comes down to a mix of anatomy, muscle strength, and even hormones. Let's break it down.

Anatomy Plays a Big Role

Here’s how:

• Wider Pelvis – Women have a naturally wider pelvis compared to men, which changes the alignment of the knee joint. This can put more strain on the ACL, making it easier to tear.

• Larger Q-Angle: The Q-angle is the angle between your quadriceps and patellar tendon. Women generally have a larger Q-angle, which can lead to knee instability, increasing the risk of ACL injury.

• Smaller Intercondylar Notch: This is the space through which the ACL passes. Women typically have a smaller notch, which may make the ACL more likely to get injured, especially during intense movements.

Physical Factors and Technique Differences

Because men and women have different anatomy, we use our bodies in different ways. Here’s how that affects your ACL:

• Muscle Strength – Women tend to have less muscle mass around the knee, particularly in the quads and hamstrings. This means the knee has less support, which puts extra stress on the ACL during quick movements like jumps or pivots.

• Hormonal Influences – Fluctuating hormones, particularly estrogen, can affect ligament flexibility. Studies have shown that increased estrogen levels can make ligaments, including the ACL, more lax (loose), making them more prone to injury.

• Landing and Movement Mechanics – Women often have different landing mechanics compared to men. For example, female athletes are more likely to land with their knees inward (called “valgus collapse”), which increases the stress on the ACL. This is especially common in sports like soccer or basketball, where quick direction changes are frequent.

How to Prevent ACL Injuries in Female Athletes

Prevention is everything. If you’ve experienced an ACL injury before, you know how tough the recovery process can be. But there are things you can do to lower your risk and protect your knees:

• Strength Training – Focus on building strength in your quads, hamstrings, and hips. Exercises like squats, lunges, and leg presses help stabilize the knee and reduce stress on the ACL.

• Neuromuscular Training – This kind of training improves your body’s awareness and balance, helping you land and move more safely. Programs like FIFA 11+ are designed to reduce the risk of ACL injuries by improving jumping and landing mechanics.

• Proper Landing Techniques – Landing correctly is one of the easiest ways to protect your ACL. Training to land with your knees aligned with your toes, rather than letting them collapse inward, can make a big difference in preventing injury.

• Stretching and Flexibility – Maintaining flexibility in the muscles around your knee—especially the hamstrings and hip flexors—can reduce the strain on your ACL. Stretching is a simple but effective way to prevent injury.

What Happens If You Do Tear Your ACL?

If you’ve torn your ACL or think you might have, the first thing you should do is get it checked out by a specialist. Here’s the rundown on treatment options:

Non-Surgical Treatment

If the tear is mild or you’re not an athlete, you might be able to recover without surgery. Rest, ice, and physical therapy can help you heal and regain strength. Your doctor might also recommend a knee brace or crutches to give your knee more support during recovery.

But if you're an athlete or you have a more severe tear, surgery might be the best option.

ACL Surgery: What to Expect

For more serious injuries, ACL reconstruction surgery is often needed. During this procedure, the torn ligament is replaced with a graft (commonly from your own quariceps, hamstring, or patellar tendon). While recovery from ACL surgery takes time, it's possible to return to sports—though it takes dedication to your rehab plan.

For female athletes, recovery is generally similar to male athletes, but it can be affected by factors like muscle strength and post-surgery rehab. Don’t rush it—rehab is key to making a full recovery and getting back to your sport safely.

ACL Treatment in British Columbia

If you’re a female athlete concerned about ACL injuries or dealing with the aftermath of an injury, don’t wait to seek help. At Ortho South, our dedicated orthopaedic team in British Columbia and Alberta can guide you through prevention to treatment, and recovery. Contact us today to learn more about how we can help you get back to doing what you love.