Women Are More Likely To Tear Their ACL
Orthopedic surgeons have long known that female athletes rupture their ACL or anterior cruciate ligament more often than men. The ACL, one of the primary ligaments in the knee, helps stabilize the knee and leg bones.
Now a team of researchers at Yale University has published an article in this month’s issue of the Journal of the American Academy of Orthopedic Surgeons suggesting that women are three times more likely to suffer from this injury – and the reason may be the unique difference in anatomy between male and female athletes.
Female Anatomy vs. Male Anatomy
The lead author of the article, Dr. Karen Sutton, assistant professor of orthopaedics and rehabilitation at Yale, suggests that the quadriceps angle or “Q angle,” which is where the upper and lower leg bones meet, is larger and angled downward more sharply in women than in men. That’s because women have wider pelvic structure than men. Where is the quadriceps? It’s the large muscle in the front of the thigh.
Because of this unique structure, women may experience a “greater stress and pull of the knee muscles” during strenuous activity like running, soccer, basketball, volleyball and similar sports, says Dr. Sutton.
Women have ACL tears not from a direct blow to the knee, but from a hard landing after a jump, or stopping and turning abruptly when using techniques like pivoting and cutting. Female athletes also tend to land in a more upright position, rather than bending their knees like men do. They also land more frequently with a slight inner rotation of the knee, which puts stress on the ligaments.
Researchers not involved in the Yale study have also suggested that the difference in injury rate between men and women may be due to muscle strength – women tend to have weaker hamstring muscles in the back of the thigh relative to their quadriceps muscle in the front, a structural difference than can compromise knee stability.
In addition, women’s ligaments are known to be more flexible or “lax” than men’s, which could make the tissue more susceptible to tearing. However, Yale researchers found “no conclusive link between female hormones, the menstrual cycle and increased risk of ACL injury.”
Prevention Tips
Prevention is the key when it comes to ACL tears. Dr. Sutton recommends that women undergo fitness conditioning routines that improve core strength and increase knee stability by building up the gluteal, quadriceps and hamstring muscles. Female athletes should also be taught the correct way to jump and land, pivot and turn to prevent injury, she says.
Other prevention tips include an adequate warm-up to stretch the various muscles, including hip flexors, and crosss-training to avoid overuse injuries.
An ACL tear can be a painful injury that may require reconstructive surgery, followed by physical therapy for a full recovery and return to the game. For more information about how the ACL is reconstructed, go to http://www.kaganortho.com/learn-more/.