WHY Do We See More ACL Injuries in FEMALE Athletes? 


WHY Do We See More ACL Injuries in FEMALE Athletes?

Emily R. Pappas, M.S.

Its FACT that women have a higher incidence and prevalence of ACL Ruptures compared to Male Athletes.

The question is WHY and WHAT can we do about it?

Female Athletes MAY have a DIFFERENT Hip Structure

Compared to their male counterparts, Female athletes MAY have a different hip structure that affects their movement mechanics at their lower limbs. However, understand that EVERY FEMALE IS DIFFERENT. And having wider hips DO NOT MAKE US innately incapable of sport! Rather, it may just imply we need to enhance our neuromuscular control of our lower limb (through strength training!)


Certain Hormones Released During Menstruation MAY Cause A Weakness in Ligaments

During menstruation, female athletes have higher levels of certain hormones that make ligaments more ELASTIC.  This increase in elasticity MAY make them more prone to injury (especially if they aren’t that strong, to begin with!)  Again, every female and her menstrual cycle and corresponding hormones are UNIQUE to her.   If there is a chance these hormones lead to increased laxity, females MUST increase their tendon and ligament strength (and the only way to do this is through strength training!)

Female Athletes MAY have a weakness in their Pelvic Stability

Pelvic what?? Simply, women have more “discontinuations” or weak points in their pelvic floor muscles compared to men.  Remember, the pelvis is QUEEN when it comes to how our lower body moves.  Weaker pelvic muscles affect our mechanics during lower body dominant movements such as sprinting, decelerating, jumping,….

Once again….EVERY FEMALE IS UNIQUE.  Being female does not make us innately weaker than males.  Rather, it just means there are certain areas we need to strengthen in order to improve our capacity to kick butt on the field!

Female Athletes Have Different Muscle Firing Patterns

Compared to their male counterparts, the AVERAGE (remember there are outliers) female athlete has stronger quadricep muscles in relation to their hamstring muscles.  During movements such as deceleration, female quadricep muscles fire FIRST to try to slow down, while males fire their hammies first!  Why is this a problem? When quads work first as you slow down, you have a greater translation or MOVEMENT of the lower limb.  AKA more stress on that ACL!




Our muscles fire according to strength.  The body will recruit the STRONGER muscle first to perform certain movements.  For women, stronger hammies = greater chances we use them FIRST when we decelerate (instead of our quads). 

How can we strengthen them????

Hinge: Romanian Deadlifts, Single leg RDLs, Deadlifts, ….

Squat: Goblet Squats, Back Squats, Split Squats, Single leg Squats…

Lunges: Reverse Lunges **

**bonus because reverse lunges FORCE you to use your hamstrings first in order to complete the movement!

Reverse Lunges FOR THE WIN!!!

Reverse Lunges FOR THE WIN!!!


Being Female doesn’t make us WEAKER Athletes,  it just means we have to TRAIN for those DIFFERENCES!!