The ACL stands for the anterior cruciate ligament. It connects your thigh bone, the femur, to one of your shin bones, the tibia. It’s crucial for controlling rotations in your leg.
In soccer, there are a lot of quick cuts and changes of direction, which are the main movements that normally lead to an ACL tear. There doesn’t even need to be contact for the ligament to completely tear, which is terrifying. Commonly, athletes hear a “pop” when they tear their ACL. For those who only tear their ACL, it takes about 6 months to return to regular activity and another month or two to return to competitive activity. Even if the recovery runs smoothly, athletes still have a 25% rate of re-tearing. This fear of re-tearing can often lead to people going into tackles with a weaker mindset, which can make things even worse.
So why are women four times more likely to tear their ACL than men? There are a few reasons. Women have wider hips than men, which causes their knees to turn inward during movements like cutting and jumping. In many women, the ACL tissue is thinner altogether, which means it takes less force to tear it. It’s also important to note that women’s landing technique is different from men in many cases. Often, women land with straight knees, rather than engaging their core and bending their knees. This increases the tension in the ACL because the muscles around it don’t absorb the shock as much as they should. Women are also more likely to tear their ACL during ovulation because their estrogen levels peak. When this happens, the ligaments become looser and less stable, leading to a higher risk of injury.
While hormonal differences can rarely be altered, there are ways to be mechanically cautious during physical activity. It’s important that female athletes have a proper warm-up before activity that strengthens and balances the muscles around the ligament so that they’re less prone to injury. It’s also necessary to practice good landing and cutting techniques to further prevent injury even more.
Sources:
McDaniel, L. W., Rasche, A., Gaudet, L., & Jackson, A. (2010). Reducing the risk of ACL injury in female athletes. Contemporary Issues in Education Research, 3(3), 15–20. https://eric.ed.gov/?id=EJ1072598
Northwestern Medicine. (2023, November). Why women have more ACL injuries than men. Northwestern Medicine. https://www.nm.org/healthbeat/healthy-tips/Why-Women-Have-More-ACL-Injuries-Than-Men
This is really interesting! I did not know women are more likely to tear their ACL compared to men. It's interesting to see when a slight or partial ACL tear happens and how the muscles around it try to help the knee as well. I know that individuals who don't get it untreated can increase their risk of long term join damage which is also not the best. I wonder if it's a mix of rehabilitation and other surgical factors that can play a role in the re-tear process of an ACL.
ReplyDeleteI think this gender gap is fascinating, and I hope it's one we can work to close! I especially found the re-tear rate significant, as I found a study that mentioned once one ACL reconstruction is done, the contralateral (opposite) ACL is more likely to tear. There didn't seem to be a clear line of reasoning as to why, I would guess maybe compensation as someone is likely to favor their "good" knee when returning to sport. https://pubmed.ncbi.nlm.nih.gov/24753238/
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