by Reagan Sellers
“Looks like you’re going to be out for a year.” Hearing those words for the first time as a
freshman in high school it seemed like my whole world was falling apart. Needing surgery. Not
being able to play sports for 9 months. Not being able to walk unassisted for a month or 2. The
pain I was feeling. Nothing about tearing an ACL is fun. After getting through months and
months of rehabilitative therapy and passing my clearing test, I was finally able to return to the
field and participate in activities that I missed out on for so long. But only a year later, I tore the
opposite ACL while playing in the district championship for my high school soccer team. This
time, I knew ahead of time what I was getting into and how to keep the rehabilitation process as
smooth and as fast as possible, but the timing couldn’t be worse. As it was Junior year, I was in
the middle of my recruiting process for collegiate soccer and this injury basically put an
immediate halt to that. I couldn’t attend prospect camps or visit colleges, and I only had one full
season of stats and highlights to send to college coaches as a result of my recurring injury.
ACL tears typically occur when an individual is changing direction quickly and the
sudden force from pivoting or twisting causes the ligament lying inside of the knee to rupture
(6). These tears, especially in female athletes, are becoming more and more prevalent each and
every year. There are between 100,000 and 200,000 ACL ruptures per year in the United States
alone, with between 20,000 and 80,000 of them being high school female athletes (1). Women
are also five times more likely to rupture an ACL as compared to their male counterparts (2).
There are quite a few differences between male and female makeups that cause this significant difference in the number of injuries between genders. Anatomically, women have less muscle
surrounding their knee joint which can cause instability and end in a tear if stretched or twisted
beyond its capability (5). Also, females have much higher levels of estrogen than males do and
estrogen has been linked to greater laxity in ligaments (5). This laxity, or looseness, of ligaments,
creates instability in the joint because it is not being held together as tightly and makes
women much more prone to injury than their male counterparts.
This is not a new issue. With the implementation of Title IX creating more opportunities
for women to play collegiate sports in 1972, injury rates of female athletes have skyrocketed,
with ACL tears being one of the main ones (7). Many organizations, in compliance with
orthopedic doctors and surgeons, have created preventative programs that aim to build strength
in the muscles surrounding the knee and teach proper cutting methods and techniques to lessen
the occurrence of ACL tears. When the muscles surrounding the ACL are strong, they prevent
the knee from contorting into a position that would put it at risk of a ligament tear. On the other
hand, teaching proper cutting methods and techniques allows athletes to learn the correct form to
avoid incorrectly cutting and putting themselves at a high risk of injury. A typical program
begins with a dynamic warm-up and then adds a strengthening portion, a balance/proprioception
portion, and ends in plyometrics (3). The dynamic warm-up is essential to warm up muscles and
get the body ready for the following exercises. The strengthening portion aims to strengthen the
muscles surrounding the knee to make it a stronger joint as well as all lower-body muscles for
power. The balance portion keeps the knee in the correct alignment while the plyometrics part
encourages practicing the correct cutting techniques during athletic movements. On top of the recommended exercises, they include both goals and any precautions that need to be taken in
order to avoid injury. There are many different programs available that can be specific in nature
to many athletes and sports, but almost all of them follow this same layout.
Here is what you can do to help, right now! Head to https://preventinjuries.org/programs/
and read about the different programs they offer for injury prevention and how they aim to
personalize them to each and every athlete that requires one. By clicking the Injury Prevention
Programs tab at the top of the page you can then scroll down to the Subscription programs tab
which opens up the specified programs available. Click on the ACL Injury Prevention tab which
takes you to the page that has all of the details on the prevention programs they offer for ACLs.
They have options for athletes with or without previous ACL injuries as well as for those
currently in rehabilitation following reconstructive surgery. After reading and researching on that
page, you can then click the Donate button in the top right-hand corner and proceed to scroll
down to where the donate box is located on that page. Preventinjuries.org is a nonprofit
organization and they need your help to be able to educate and supply athletes with programs
that will help to keep them injury-free.
2 The female ACL: Why is it more prone to injury?. (2016). Journal of Orthopedics, 13(2), A1–A4. doi: 10.1016/S0972-978X(16)00023-4
3 Geary, M. ACL prevention program. South Shore Orthopedics, Spine and Sports Therapy, 1-6.
5 Macmillan, C. (2020). Are ACL tears really more common in women? Yale Medicine.
6 Cosgarea, A. (2022). ACL tears in female athletes: Q&A with a sports medicine expert. John
7 Carlton, G. (2021). How title IX impacts women’s equality in college athletics. Best Colleges.
What do you think?