Unveiling the ACL Risk in Female Soccer Athletes

The high turnover in ACL soccer injuries has been a hot topic for quite some time. With female athletes as young as ten years of age undergoing surgery, it is more important now than ever we find ways to reduce the risk of injury. ACL tears typically happen with movements that involve pivoting and quick changes of direction. Most injuries to the ACL are non-contact related injuries. With sports such as soccer that place a high demand on change of direction, athletes are at higher risk of injury. For female athletes, there is an increased risk due to anatomical, biological, and environmental differences when compared to males. Here are three potential contributing factors to ACL injuries in females.

Q-Angle

Over the years, many have attributed the higher risk of injury in women to anatomical and biological differences. One of the speculated contributing differences in anatomy is the Q-angle. The Q-angle is the angle formed between the imaginary line connecting the ASIS to the center of the patella and a proximal projection of the line running from the tibial tubercle to the patella's center (red line). Compared to their male counterpart, females show an inherent smaller femoral notch and wider Q-angle relative to body weight. An excessive Q angle indicates correlates to added biomechanical stress during activity. This can be a risk factor for ACL injuries as well as patellar femoral pain.

ACL laxity.

Some suggest there is a hormonal effect contributing to increased non-contact ACL injuries in Women. Estradiol, progesterone, and relaxin are the predominant hormones to be studied relating to ACL laxity. These hormonal fluctuations throughout the cycle have shown the ovulation phase to be the one with significant increases in non-contact injury in teenagers. It is theorized that the increase in Estrogen decreases ligament stiffness and affects injury rates.

Training Environment

Resistance training and increased muscle mass positively impact the prevention of ACL injuries. Unfortunately, there are well-documented lower resistance training participation rates among girls when compared to men. Higher participation in males can be due to the predominance of male coaches in the strength field and potentially the societal pressure of femininity on young female athletes. Because "having muscle" isn't always viewed as feminine, many young athletes might shy away from the training space, therefore missing out on potential strengthening mechanisms for injury prevention.

As female athletes, protecting our bodies is crucial to sustaining our passion for the sports we love. Understanding the unique risks associated with ACL injuries empowers us to take proactive steps. Let's shift the narrative. By prioritizing participation in specialized strength and conditioning programs tailored to enhance our agility, strength, and stability, we invest in our long-term athletic journey. Together, let's stride confidently towards injury prevention, peak performance, and the continued pursuit of our athletic dreams. Join us in embracing strength and conditioning programs to fortify our bodies and unleash our full potential on the field.