Comments: Female athletes are more prone (as compared against their male counterparts) to ACL tearing for a number of reasons, and many of these reasons are still being researched. Factors that have been implicated include more inwards-angled knees (due to the childbirth-enabling wider pelvis), more lax joints to begin with (especially knees that hyperextend grotesquely), vertibular-system-firmware attributes, the monthly hormonal cycle with its ligament-weakening estrogen spikes, a narrow intercondylar notch, proportionally weak hamstrings, and tendencies to land jumps with inadequate knee flexion. The author quote study findings that the likelihood of ACL injury is four times greater in females than in males, and also notes that a greater percentage of women’s injuries tend to be noncontact (i.e. planting-and-twisting of the knee). This finding is consistent with other studies that suggest jumping activities are a major source of ACL injuries in female athletes.

Brody also discusses some of the research that has been done in the realm of female-athlete ACL-injury prevention, and that has spawned a number of injury-prevention training programs (such as Cincinnati Sportsmetrics). For example, instead of planting and cutting in order to change directions, an accelerated rounded-turn technique can be used. This guards against ACL-risky sudden deceleration and allows the athlete to continue accelerating through the turn instead of abruptly stopping and changing direction. Also helpful are learning bent-knee landings, especially given that females often tend to land with knees straight, thus ruinously hyperextending the knee. Another very helpful technique is to make a three-step stop when decelerating, as opposed to the standard single-step stop. This prevents sudden deceleration with a straight knee, another major cause of ACL devastation. (Griffis, one of the authors quoted here by Brody, found that these three techniques alone cut female-athlete ACL injuries by 89 percent.) This eminently readable, easy-to-understand and highly thought-provoking chapter is a must-read for any female athlete or parent of a female athlete. There are numerous interrelated factors germane to the four-fold greater incidence of ACL injuries in female athletes, and this article provides penetrating insight into these factors and their inherently complex nature. Knee-injury-prevention training can easily be incorporated into standard coaching regimens, but the training must go beyond standard strength-and-endurance exercises and canned sets of sports drills.