Why Female Athletes Are More Prone to ACL Injuries and What They Can Do About It

Nothing ends a sports season — or even a career — faster than an ACL injury. Your ACL, short for anterior cruciate ligament, is a major ligament in your knee that provides stability and support. Its job is to limit the amount of rotational movement in your knee and prevent your shinbone from moving too far forward.

When you injure your ACL, you either overstretch or tear this important ligament. The most common causes of these types of injuries include:

While both male and female athletes experience the same types of ACL injuries, they occur much more frequently in women. At Empire Physical Therapy & Athletic Rehabilitation PC, our experienced team of rehab specialists can help you understand why female athletes have a higher risk of ACL damage, and offer tips to keep you in top form.

ACL injuries and women

Female participation in high school sports has increased 900% since Title IX passed in 1972. This surge has not only resulted in more female athletes of all ages, but it has also led to high rates of ACL injuries — 20,000-80,000 ACL injuries among female high school athletes each year.

It’s pretty obvious that women and men have different builds, but is that to blame for more ACL injuries? Several factors could make these types of injuries more common in women, especially differences in anatomy and technique.


Men and women have two significant differences in their knee structure. First, the intercondylar notch, the groove where the ACL crosses the knee, is naturally smaller in women. Likewise, a woman’s ACL is also smaller in size. 

Women also tend to have a knee alignment that bends inward when landing after a jump. This knock-kneed position puts more strain on your ACL, especially if your knee buckles.


In addition to physical differences, female athletes often have different biomechanics when jumping, landing, and pivoting — activities that can cause an ACL injury. 

For example, most women naturally land on flat feet with straight knees after jumping, instead of on the balls of their feet with soft knees. Landing with straight legs and flat feet increases the pressure on your knees, increasing your chances of an ACL injury.

It’s also more common for women to run in a more upright position, which can add stress on the ACL and reduce control over knee joint rotation. Plus, female athletes are more likely to have imbalanced quadriceps and hamstring muscles. When you rely on your quadriceps instead of your hamstrings to stop or slow down, you put extra pressure on your knees and ACL.

Avoiding ACL injuries

While female athletes have a greater chance of suffering an ACL injury, they can take steps to keep it from happening. For example, our team can help identify potential issues with your biomechanics that increase your risk of injury. 

Then, we can develop a personalized training program to help you learn safer and more stable movements that reduce stress on your joints and ligaments. ACL physical therapy training programs often include:

In addition to helping you avoid ACL injuries, we can also help you recover if you’ve already sustained ligament damage. 

If you have an ACL injury or other sports injury, contact us at Empire Physical Therapy & Athletic Rehabilitation by calling 646-491-9141 or by requesting an appointment online today. You can also send us a message here on our website.

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