Girls and ACL tears
John Hunt Udall, MD, is a pediatric orthopedic surgeon specializing in sports injuries at Cardon Children's Medical Center. For more information on this topic, call (480) 412-KIDS.
Question: My teenage daughter is an avid soccer player, but I'm concerned she might injure one of her knees, especially because I've heard that girls have more ACL tears than boys. Is this true, and if so, is there something she can do to prevent an injury?
Answer: The anterior cruciate ligament (ACL) is one of four major ligaments in the knee, and acts as the main stabilizer to prevent shifting and twisting of the bones around the knee. Without the ACL, the knee is less stable and more prone to injury.
Females do experience more ACL tears than males - as much as twice as often - but the reasons are not entirely understood. Researchers believe a number of factors might influence these statistics, including differences between male and female adolescents in muscle strength in the knee, hormones, and bone anatomy.
One proven way to help prevent ACL injuries is to start a formal prevention program that focuses on strength, balance, using correct techniques when landing from jumps and other maneuvers, and related skills.
Most ACL injuries are due to non-contact events, meaning they are not caused by one athlete colliding with another; the injury often results from an awkward landing, a pivoting motion of the knee while the foot is planted, or hyperextension of the knee.
Tears to the ACL require surgical reconstruction of the ligament, and recovery takes an average of six months before the athlete can return to sports. A prevention program helps to train the muscles around the knee to provide better stability, and while such a program cannot eliminate all ACL injuries, it has been shown to reduce the incidence of ACL tears.