Why ACL Injuries Are More Common in Women

Find out why being female is a big risk factor—and what you can do to protect your precious knees.

| March 8th, 2013
Why ACL Injuries Are More Common in Women

The knee. Although its only job is to bend and straighten the leg, it requires a vast collection of bones, muscles, tendons and cartilage to pull off this simple feat. And because it’s designed to stick to such a rigid path of movement, any little tweak puts all of those moving parts at risk for injury.

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The anterior cruciate ligament (ACL) is an especially delicate piece of hardware. The ligament, which runs through the center of the knee and ensures that the thigh tracks properly with the shin bones, is highly susceptible to rips and tears.

ACLs attached to female knees are particularly prone to injury. Robert Marx, M.D., a professor of orthopedic surgery at the Hospital for Special Surgery and Weill Cornell Medical Center in New York City, notes that women are approximately two to six times more likely to tear the ACL than men. That’s why, despite the fact that fewer women are active in high-risk sports such as soccer, basketball and hockey, they account for half of the 200,000 ACL surgeries performed in the U.S. each year.

Dr. Marx also points out that it’s not just female team players who put their ACLs in harm’s way. “Any activity that involves sudden stops, jumping and pivoting ups the chances of ACL injury,” he states. “Skiing, boot camps and kickboxing classes can all lead to ACL injuries.”

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So why are women getting the shaft? There are several reasons. For one, women have wider hips, which places greater pressure on the inside of the knee. Marx says that some research indicates that estrogen and other female hormones may create a laxity, or looseness, in the joints that renders their knees less stable. Many women also love high heels, much to the detriment of the ACL. High heels throw the body into a forward position creating undue pressure on the knees and forcing the ACL to work overtime.

Now for the good news. Trashing your ACL is not inevitable even if you’re a woman who’s super active in a high-risk activity. One American Journal of Sports Medicine study found that performing a regular regimen of knee exercises that bolster the knee’s strength, stability and biomechanics of the joint reduced ACL injuries in women by more than 40 percent.

Ready to protect your precious knees? This four-move “healthy knee” program is taken from Marx’s new book, “The ACL Solution: Prevention and Recovery for Sports' Most Devastating Knee Injury.” Do one to three sets of each exercise, eight to 15 repetitions per set. Use it as a warm up to any workout at least three times a week and despite your gender, your benders will be ready to rock.

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