Why are women at greater risk of ACL injuries?

Women are anything between 4 and 6 times more likely to rupture their ACL (anterior cruciate ligament). The ACL is a major stabiliser of the knee, preventing anterior displacement of the lower leg and reducing the rotational forces on the knee. Most commonly injuries occur without contact in a twisting movement with football and skiing being some of the highest incidence.

It has recently been expressed that there could be potential that women’s periods and hormone changes during this time have a knock on effect and could increase the risk of ACL injuries. Currently it is known that the ACL has hormone receptors for estrogen and progesterone, and it has been thought that hormone concentration could play a role in ACL injuries.

Whilst further investigations are being carried out to understand whether females undergoing their periods need to modify their training loads to reduce the risk of ligament and specifically ACL injuries, there have already been many studies which have shown how effective neuromuscular training (NMT) is in reducing ACL injuries, in fact so much that they have been shown to reduce the effect by 8 fold.

There is potential that women need to spend more time working on NMT as they have higher risk factors, their Q angles are much greater than mens – this is the angle drawn from the outer hips to the inner knee, because women have wider hips for child birth they generally have larger Q angles therefore placing greater stress on the ACL.

NMT