Female Athletes More Vulnerable To ACL Tears

Blame it on Title IX. Soccer, basketball and volley ball–These are sports that require quick turns and abrupt landings. Girls who play these sports are up to eight times more likely than boys to rupture the anterior cruciate ligament of their knee, according to Joe Miller, writing for the Charlotte Observer.

In 1971 before the passage of Title IX–the law that mandated equal opportunities for males and females in sports that receive federal funding–approximately 290, 000 females participated in high school athletics. After Title IX, by 2010, that number had soared 100 fold to nearly 3.2 million. And so had the number of injuries to female knees.

Miller quotes William Garrett, M.D., an orthopedic surgeon and team physician for Duke University, saying,

When I see the women making sudden stops on hard floors, or the gymnasts make a landing on the floor exercises–I cringe every time.

The reason is the fact that the anterior cruciate ligament, one of four major ligaments in the knee has, since the 1970’s, proven to be a ticking time bomb for post-pubescent female athletes.

Why are female athletes more vulnerable to these types of injuries? Doctors speculate that it may relate to biological differences. Since the higher risk does not occur in women until puberty, estrogen may play a key part. Males see an increase in testosterone around this time, girls see an increase in estrogen, which may make tendons such as the ACL more relaxed, and thus more susceptible to injury.

Miller reports on an area of study that looked at the anatomical differences between boys and post-puberty girls. According to James Fleischli, M.D., with the OrthoCarolina Research Institute in Charlotte, females at this age are more apt than boys to be knock-kneed, to have weaker hip muscles and to have dominant quadriceps vs. hamstrings. This causes girls to stand more upright, with knees extended when they land or make sudden turns, which may stress the ACL.

Researchers at the Sports Medicine Research Laboratory at UNC-Chapel Hill have developed a regimen of exercises designed to help prevent ACL injuries. When a tear occurs, treatment typically requires surgery to replace the torn ligament, then months of rehabilitation to restore strength and range of motion. Overall recovery, with rehabilitation, can take seven to nine months, or even up to a year.