Preventing ACL Tears: 4 Tips for Girls and Women

While there is still much to learn in women’s sports medicine research, we already know that women are more susceptible to certain injuries than men. 

“It is very common for women — four to eight times more common than it is for men — to tear their ACL,” says sports medicine expert and orthopaedic surgeon Miho Tanaka, M.D., director of the Women’s Sports Medicine Program at Johns Hopkins Medicine. “But we also know that 70 percent of ACL injuries occur without collisions, meaning there are things women and girls can do to help prevent this type of injury from occurring.”

Noncontact ACL tears and injuries often occur when an athlete goes to pivot or change direction quickly. The knee gives way and the muscles aren’t there to support it, causing the ligament to tear. However, notes Tanaka, “data show that doing the right exercises can actually help prevent certain knee ligament injuries — like ACL tears — by strengthening the right muscles.”

A female athlete herself and former collegiate triple jumper, Tanaka shares the following four tips to help keep women from experiencing an ACL tear:

1. Maintain a center of strength.

You want to strengthen your muscles, not strain them. Many athletes try to push themselves to their physical limits while working out — run one more minute, do one more rep, lift just 5 more pounds — but doing so can actually cause strained muscles and lead to injury. Instead, Tanaka suggests concentrating on building and maintaining strength across the board during your workouts.

“Having a strong foundation and strength in the muscles that you use in your sport or activity is what will help prevent injury,” she says. For women specifically, this includes building your core muscles and hamstrings — the muscles that run up the back of your thigh — which help prevent against ACL injuries.

2. Stretch for symmetry.

Having balance between the left and right sides of your body is very important in preventing sports injuries. “Studies have shown that even 15 percent side-to-side differences in flexibility and strength can increase a female athlete’s risk for injury, so it’s important for them to pay attention to any imbalances while stretching,” warns Tanaka. “This imbalance can cause the body’s center of gravity to shift while landing from a jump and places girls at risk for knee injury. Sometimes athletes think that stretching is boring and don’t pay attention while doing this, but subtle things, such as stretching the right side less than the left, can add up and create an imbalance.”

3. Activate the right muscles during exercises.

“Exercises that build the hamstring are very important for women participating in sports and physical activities to help prevent ACL injuries,” says Tanaka. In general, women tend to have less hamstring strength than men, which leads to an inability to control the knee if it gives out during movement. When doing landing drills, like jumping squats, for example, women need to get down low enough in their squat to activate their hamstrings and build that strength.

4. Eat a well-balanced diet.

“Nutrition does not equal dieting,” warns Tanaka. “Generally women don’t eat enough and end up calorically deficient and/or dehydrated, which leads to fatigue.” When athletes are tired and feel worn out, they tend to stop concentrating on their form. That’s when an injury is likely to happen. Instead, women should concentrate on drinking enough water and eating a well-balanced diet, including fruits, vegetables, low-fat proteins and whole grains. 

More Facts About ACL Tears

A torn ACL can be a career-ending injury. Studies have shown that once an athlete has torn his or her ACL, the chance of re-tearing it is six times greater. Additionally, once a female athlete has torn her ACL, she becomes 16 times more likely to tear her ACL in the other knee. This is why it is especially important for female athletes to follow the right steps to prevent an ACL injury from happening.

Young athletes that tear their ACL can suffer irreversable damage to his or her body. As the skeleton and body continue to develop in young athletes, it is important to address ACL injury management in young athletes. 

Dr. Lyle Micheli, the Director of Sports Medicing at Boston Children's Hospital and Clinical Professor of Orthopedic Surgery at Harvard Medical School has performed countless ACL reconstructions. For more information about the skeletally immature young athlete and ACL injury prevention, tune into this podcast from the Clinical Journal of Sport Medicine.