ACL tears are common and severe in sports, with females having a much higher risk than males. The anterior cruciate ligament (ACL) is one of the most common ligaments to be injured. The ACL is often stretched and/or torn during a sudden twisting motion (when the feet stay planted one way, but the knees turn the other way).

Several factors contribute to this increased vulnerability:

Anatomical Differences

Women have a wider pelvis and a larger Q-angle, which increases knee pressure and instability. They also have less muscle mass, particularly in the quadriceps, leading to weaker knee stabilization.

Biomechanical Factors

Women often land with a more upright posture and less knee and hip flexion, which increases stress on the ACL. Knee valgus (knees collapsing inward) also adds strain.

Hormonal Influences

Hormonal fluctuations, especially during the preovulatory phase when estrogen levels are high, increase ligament laxity, making the knee joint more prone to injury.

Prevention

To reduce ACL tear risk, women should focus on:

• Strengthening the VMO (Vastus Medialis Obliquus) to stabilize the knee.
• Strengthening the Gluteus Medius to stabilize the knee

• Hamstring training to balance the quadriceps and protect the ACL.
• Improving mobility in the hip and ankle joints for better alignment and stability.

Through targeted strength training and mobility exercises, ACL injury risk in females can be reduced, supporting long-term health and performance.