The number-one risk factor for tearing the anterior cruciate ligament (ACL) in the knee is being female. This is not because there are structural differences between knee joints in men and women but because the muscles surrounding the knee joints are likely to be looser and weaker in girls and women. While that doesn’t mean that every female athlete and fitness buff will tear their ACL, it is something to be very aware of as a female athlete—or parent of a girl who plays sports.
At Northwest Extremity Specialists, we treat ACL tears in both female and male patients, but we also offer rehabilitation and prevention strategies that are unique to our female patients.
Ligaments That Support and Control the Knee Joint
The knee joint is held together by ligaments that connect the fibula to the femur on the outside of the knee (lateral collateral ligament) and the tibia to the femur on the inside of the knee (medial collateral ligament). The cruciate ligaments are found inside the knee joint and control the back and forward motion of the knee. The posterior cruciate ligament (PCL) is at the back of the knee and keeps the shinbone from moving too far back. It is stronger than the ACL and is injured far less often.
The ACL attaches the tibia to the patella and prevents the femur from sliding backward on the tibia and the tibia from sliding forward on the femur. It also plays the very important role of providing rotational stability to the knee. This means that it bears the difficult burden of holding the knee in place as a person makes rapid side-to-side motions, lands after a jump, or comes to an abrupt stop.
How Girls and Women Tear Their ACLs
Clearly, both female and male athletes make these motions when running or playing a sport. However, women tend to have more looseness and a wider range of motion in their knee joints than men. They also have less muscle mass surrounding the knee. These factors contribute to a joint that is less stable and more likely to overstretch the ligaments. Technique also plays a part. When landing a jump, for example, female athletes tend to collapse their knees inward, not bending them to cushion the impact as much as male athletes.
Female athletes who ski or play soccer, basketball, field hockey, volleyball, tennis, or lacrosse are at the greatest risk of tearing their ACL because these sports require cutting, pivoting, and sudden deceleration, all of which put tremendous strain on the knee.
Treatment and Prevention of ACL Injuries in Girls
ACL tears are often accompanied by a popping sound and the feeling of the knee giving out. Most coaches and athletic trainers are aware of the symptoms of an ACL tear and should refer the athlete for a medical exam and MRI as soon as possible. If the ACL has only been sprained, rest and physical therapy will be recommended. For torn ACLs, however, the only fix is reconstruction surgery. For young athletes, this is usually the best course of action to ensure continued participation in sports.
An athlete who has torn an ACL is at high risk of reinjuring the knee or injuring the other knee. It is important that they follow up with physical therapy to learn how to be active while protecting their knees. Effective follow-up includes:
- Learning new techniques. If improper landing or pivoting technique caused the original injury, it’s important to be trained in proper technique, or the same injury is likely to happen again.
- Strengthening supporting muscle groups. Targeting the muscles surrounding the knees for strengthening exercises—as well as the core and other leg muscles—will take some of the pressure off of the ligaments in the knees.
- Balancing strength and flexibility. The ideal is muscles that are neither too tight nor too loose. Working on finding the balance between the two is key.
- Avoiding fatigue. When an athlete becomes tired, they are sloppier about form and technique. Building endurance through off-field conditioning and getting adequate sleep are important to avoiding re-injury.
Female athletes recovering from ACL surgery can get support in these efforts in any one of our clinics throughout the Portland area.
Discuss ACL Surgery With Our Team
If you or your daughter has an ACL injury, the skilled orthopedic surgeons at Northwest Extremity Specialists can evaluate the injury to ensure that we are providing the best possible treatment options and follow-up care. Call us today at 503-245-2420 to make an appointment in the Portland-area office closest to you.
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