In Sports, a Painful Demographic

ACL injury rates higher for females in soccer, basketball, lacrosse


Described as a nightmare for athletes, a torn ACL is exceptionally painful and slow to heal. Though this injury strikes down athletes of all demographics, certain groups may be more prone to it.

A new study found that the rate of anterior cruciate ligament (ACL) injuries in high school athletes was notably higher in females, especially those playing soccer, basketball or lacrosse.

For those unfamiliar with the knee’s anatomy, the ACL runs diagonally in the middle of the knee and prevents the shinbone from slipping in front of the thighbone.

Though researchers at the Children’s Hospital of Philadelphia found a sizable risk of ACL injuries among both genders and found that most ACL injuries occur in males, they also found that the overall rate of injury per exposure was higher in females. The highest injury risks for high school females were seen in soccer (1.1 percent), basketball (0.9 percent) and lacrosse (0.5 percent).

Lead study author Alex L. Gornitzky said, in a press release, “It has been well-established that the risk for ACL tear per athletic exposure is higher in female athletes compared to males."

Gornitzky, a fourth-year medical student at the University of Pennsylvania's Perelman School of Medicine, added that "As participation rates in high school athletics continues to rise significantly, it has become increasingly important to establish up-to-date, individualized injury information for high school athletes and their families, who represent a large proportion of patients visiting pediatric orthopedic and sports medicine clinics."

A 2008 article published by the National Institutes of Health presented a few theories on why young female athletes may suffer ACL injuries at a higher-than-average rate. One possible explanation is that women have more of a “knock-knee” alignment and that women’s knees tend to bend inward when they land. Another theory is that women are “ligament-dominated” versus “muscle-dominated.” These theories have yet to be verified.

As far as high school athletes — especially females — are concerned, knowing “sport-specific, seasonal risk,” is important for “evidenced-based parent-athlete decision-making, accurate physician counseling, and targeted injury-reduction programs for the most at-risk sports,” according to the press release.

This study was presented Oct. 24 at the American Academy of Pediatrics National Conference and Exhibition in Washington, DC. Research presented at conferences may not have been peer-reviewed.

Information on funding sources and conflicts of interest was not available at the time of publication.