ACL injuries are a common problem among athletes and active individuals. Research evidence shows that women are more to have ACL injuries. Don’t you want to know why this happens to women? The ACL is a ligament in the knee that helps stabilize the joint. Its injury may cause severe pain, a loss of function and mobility, and long-term health problems. Various elements, including hormonal changes, muscle imbalances, and variations in the anatomy of the knee and lower limbs, cause the increased risk of ACL injury. The causes, risk factors, and potential remedies for ACL injuries in women will all be covered in this overview.

ACL injuries are common in men and women. Still, research has shown that women are more prone to them. It is a major ligament in the knee that helps to stabilize the joint.

Causes 

to an ACL injury and that not all ACL injuries can be attributed to a single cause[1][2]. Some common causes of ACL injuries include:

  • ACL injuries can occur during sudden changes in direction, such as cutting, pivoting, or landing from a jump.
  • ACL injuries can also occur due to direct contact with an opponent or object, such as a collision or tackle.
  • Repetitive stress on the knee can cause tiny ACL tears over time, eventually leading to a complete tear.
  • Poor knee joint mechanics or alignment can put extra pressure on the ACL and increase the risk of injury.
  • The knee may be pushed beyond its normal range of motion, causing the ACL to stretch or tear.
  • The knee may be forced into a very bent position, causing the ACL to stretch or tear.
  • A direct impact on the knee, such as a collision or fall, can cause ACL injuries.
  • Repetitive stress on the knee, such as from playing sports, can lead to an ACL injury.
  • Poor knee joint mechanics or alignment can strain the ACL and increase the risk of injury.
  • Poor landing techniques, such as landing with a straight leg or landing outside the foot, can increase the risk of ACL injury.
  • A muscle imbalance between the quadriceps and hamstrings can increase the risk of ACL injury.
  • Hormonal changes, such as those that occur during the menstrual cycle, can affect the laxity of ligaments and make them more susceptible to injury.
  • A wider pelvis may be anatomically predisposed to an ACL injury in some people. ।t is a smaller knee notch or increased ligament laxity.
  • Young athletes are at higher risk for ACL injury because their bones are still developing, and their muscles aren’t as strong yet.

women are at a higher risk of suffering from ACL injuries

There are several reasons women are at a higher risk of suffering from ACL injuries than men[3][4]. Some of the main reasons include the following:

  1. Hormonal changes: The laxity (looseness) of ligaments can be impacted by hormonal changes, such as those occurring during the menstrual cycle, making them more prone to injury.
  2. Muscle imbalances: Women tend to have more quadriceps muscle mass than hamstring muscle mass, which can contribute to muscle imbalances that increase the risk of ACL injury.
  3. Anatomical differences: Women have a wider pelvis and a smaller notch in the knee, which can affect how the knee joint functions and increase the risk of ACL injury.
  4. Movement patterns: During jumping and cutting, women are more likely to land with their knees in a valgus position knocked knee, increasing the risk of an ACL injury.
  5. Participation in high-demand sports: Compared to men, women who play high-demand sports like soccer, basketball, and volleyball are more likely to sustain an ACL injury.
  6. Previous injury: Women who have had an ACL injury are also at a higher risk of re-injury or developing osteoarthritis later in life.
  1. Ligament strength: Studies have shown that the ligaments in women’s knees tend to be weaker than those in men’s knees, which increases the risk of injury.
  2. Hormonal influence: Some studies have suggested that estrogen, a hormone in higher levels in women, may affect the strength and stability of the knee ligaments, increasing the risk of injury.
  3. Training and conditioning: women might be less inclined to participate in strength and conditioning regimens that specifically target the muscles in the knee and lower limbs. Which could result in muscle imbalances and raise the risk of injury.

Why are men a lesser risk of it

Men are generally considered to be at a lower risk of suffering from ACL injuries compared to women[5][6], and there are several reasons for this:

  • Muscle mass: Men tend to have more muscle mass in the legs, particularly in the hamstring muscles, which help to stabilize the knee joint and protect the ACL.
  • Hormones: Men have lower levels of estrogen. This hormone can affect the laxity (looseness) of ligaments and make them more susceptible to injury.
  • Movement patterns: Men tend to land with their knees in a more extended position during jumping and cutting movements, which can help to protect the ACL.
  • Skeletal structure: Men have a narrower pelvis and a more significant notch in the knee, which can affect how the knee joint functions and reduce the risk of ACL injury.
  • Biomechanics: Men tend to have different biomechanics during physical activities than women, which can reduce the risk of ACL injury.
  • Testosterone: Men have higher testosterone levels, which can affect muscle mass and strength and help protect the knee joint.
  • Connective tissue: Men have more muscular connective tissue around the knee joint, making the ligaments more resistant to injury.
  • Core stability: Men tend to have more core stability than women, which can affect knee alignment and reduce the risk of ACL injury.
  • Rehabilitation: Men may require different rehabilitation protocols and have a shorter recovery time after an ACL injury, which must be considered during the treatment.

Potential Remedies

Several potential remedies can help to reduce the risk of ACL injury in both men and women. Some of these include:

  • Strength training and conditioning: Regular strength training and conditioning programs that target the knee and lower limb muscles can help reduce the risk of ACL injury. This includes squats, lunges, leg presses, and exercises targeting the core and hip muscles.
  • Physical therapy: Physical therapy can help to improve flexibility, strength, and movement patterns, which can reduce the risk of ACL injury.
  • Proper warm-up and cool-down techniques: Engaging in a good warm-up and cool-down routine before and after physical activity can help to reduce the risk of ACL injury.
  • Landing technique: Improving the landing technique during jumping and cutting movements can help to reduce the risk of ACL injury.
  • Sport-specific training: Engaging in sport-specific exercise that focuses on the sport’s movements and demands can help reduce the risk of ACL injury.
  • Plyometric exercises: Plyometric exercises involving jumping and landing can help improve muscle power and reduce the risk of ACL injury.
  • Core stability: Improving core stability can help to reduce the risk of ACL injury.
  • Wear appropriate shoes: Wearing proper shoes that provide good support and cushioning can help to reduce the risk of ACL injury.

ACL injuries are common knee injuries in both men and women. However, research suggests that women are at a higher risk of ACL injury than men, while men are at a lower risk of this type of injury. Injuries to the ACL can bring on by various factors, including trauma, overuse, poor biomechanics, improper landing techniques, muscle imbalances, hormonal changes, and anatomical predispositions. Understanding the risk factors and causes of ACL injuries is critical to help with prevention and recovery. It’s essential to consult with an orthopedic specialist for an accurate diagnosis and treatment plan if you suspect an ACL injury. Additionally, engaging in preventive measures such as strength training and conditioning, physical therapy, proper warm-up and cool-down techniques, and seeking professional guidance to improve landing techniques and core stability can help reduce the risk of ACL injury.

Reference

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https://pubmed.ncbi.nlm.nih.gov/8600737

2. Bell DG, Jacobs I.: Electro-mechanical response times and rate of force development in males and females. Med Sci Sports Exerc18: 31–36, 1986

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3. Clarke KS, Buckley WE: Women’s injuries in collegiate sports. A preliminary comparative overview of three seasons. Am J Sports Med8: 187–191, 1980

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4. Engström B., Johansson C., Törnkvist H.: Soccer injuries among elite female players. Am J Sports Med19: 372–375, 1991

https://pubmed.ncbi.nlm.nih.gov/1897651/

5. Gray J., Taunton JE, McKenzie DC, et al: A survey of injuries to the anterior cruciate ligament of the knee in female basketball players. Int J Sports Med6: 314–316, 1985

https://pubmed.ncbi.nlm.nih.gov/4077357/

6. Gwinn DE, Wilckens JH, McDevitt ER, et al: The relative incidence of anterior cruciate ligament injury in men and women at the United States Naval Academy. Am J Sports Med28: 98–102, 2000

https://www.webofscience.com/wos/woscc/full-record/WOS:000084857600017?SID=EUW1ED0D449Bc1pqOLV4cKnLfgl84

7. Harner CD, Paulos LE, Greenwald AE, et al: Detailed analysis of patients with bilateral anterior cruciate ligament injuries. Am J Sports Med22: 37–43, 1994

https://journals.sagepub.com/doi/10.1177/036354659402200107

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