ACL injury prevention and female athletes

ACL tears are a common injury in sports like soccer, basketball, AFL and netball. Female athletes are at a higher rate of having ACL tears compared to their male counterparts, ranging from 2-3 times more likely in sports like soccer and basketball specifically. With participation of girls and women in sport increasing dramatically in the past 10 years, we seen a corresponding increase in the overall number of ACL tears and reconstructions. Considering this, there is limited research targeting female athletes in relation to ACL tears. Let’s look into this further. 

We’re going to focus on certain risk factors in this blog, if you’re wanting to learn more about the anatomy read more here 

What causes ACL injuries?

The most typical mechanism of injury is related to noncontact deceleration and twisting on a planted foot.

There are some contact related injuries, with knocks from other athletes creating awkward body positions and again twisting on a stationary leg, but these are less common.

Most often, however, the athlete is often moving on one leg when a dynamic change is required, causing the knee to twist inwards towards the opposite knee.

This stress creates tension on the ACL and can result in a tear, as well as bony bruising, fractures, meniscal tears and other ligament damage. Some studies believe it is particularly the deceleration component of defending in sports seen to be the most provocative.  

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 Why are women more prone to ACL injuries?

The most commonly discussed factors are: 

  • Neuromuscular. 
  • Core control 
  • Hormonal 
  • Anatomical  

Neuromuscular control and ACL injuries

The same article discusses the lack of control in the lower limb often extending to the core in women, which further increases potential injury rates.

It shows control through the lower spine is directly related to control on a single leg. This will directly relate to exercises which are needed for prevention but also rehabilitation. Core is an integral part of rehabilitation process after ACL reconstructions.  

Hormonal and anatomical differences in females.

There are discussions relating to hormonal and anatomical differences, but studies are inconclusive at present about them being further risk factors.

A lot of people discuss the differences in hip and knee angles between men and women, but research doesn’t deem them to be significant differences to result in the different percentages of ACL tears comparing men to women. So that’s at least one thing we don’t have to worry about! 

How do we prevent ACL injuries in women and girls ?

The most promising information from this particular study is that a lot of ACL tears are deemed preventable. By incorporating lower limb and core control exercises into sport specific training sessions, less tears and therefore reconstructions may be needed.

As mentioned prior, neuromuscular training is a large factor for rehabilitation for prevention; but with the research showing deceleration being a contributing movement, including this within rehabilitation is integral.  

If you’re wanting to learn more about the different types of exercises, read more in our blogs here.

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ACL rehabilitation and prevention and female athletes:

So what to do to prevent and ACL injury ? Well its very similar after having an ACL tear.

Increasing neuromuscular control and strength at the core and lower limb  are essential in rehabilitation after ACL reconstruction or injury. Just like ACL rehabilitation they form the corner stone of ACL injury prevention.

How to create an effective ACL prevention circuit.

Here are the basics steps of our rehabilitation which can form part of a prevention program: 

  1. – Improve general lower limb and core strength.  with squats, lunges, deadlifts and leg press machines, as well as some core exercises such as planks and side planks.  
  2. Incorporate single leg activities in an easy to control manner. Exercises such as step ups, arabesques, split squats.
  3. Slowly increase difficulty of single leg activities and introduce hopping/jumping and running tasks.  
  4. High level agility and sport specific movements. Particularly including sport specific tasks, deceleration training, unplanned movement skills and controlled landing from jumps. 

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Luckily, we also have some blogs discussing  and showing you the progression of rehab  exercises through the stages.  I’ve linked the 3 different phases of rehabilitation to the pictures underneath.

Click on the picture below to read more:

ACL and knee ligament injuries Pt 1
ACL and lower limb rehab Part 2:
ACL and lower limb rehab Part 3 : Return to running and sport.


If you’ve had a previous ACL reconstruction or tear, or are just recovering from one there’s always something we can do to get you started. Feel free to give us a call on 3351 5639 or book online here to start the preventative or rehabilitation approach. 

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