ACL Injuries in Women

Ernesto Luciano-Perez, MD, of Virginia Orthopaedic & Spine Specialists

Ernesto Luciano-Perez, MD, Medical Director of Bon Secours Sports Medicine

As the number of female athletes has increased over the past decade, so have the incidence of anterior cruciate ligament, or ACL, injuries in women. It is now a well accepted fact that women are 6 to 10 times more prone to ruptures of the ACL.

These injuries occur even in the absence of contact, high-risk sports, including basketball, gymnastics, field hockey, cheerleading, lacrosse, skiing and soccer, which make athletes vulnerable to injury from pivoting and jumping.

The implications of the rise in injured female athletes are quite serious as 50% of these patients are likely to develop osteoarthritis within two decades of the initial injury.

The causes of ACL injuries have been identified as multi-factorial and include both anatomical and hormonal situations. Multiple studies have also identified decreasing neuromuscular control of the lower extremity as a contributing cause of ACL tears. These studies form the basis for the recent development of trunk and core-based rehabilitation programs to decrease the risk of injury to the ACL. Physicians and therapists are working together on rehabilitation programs that have proven effective in increasing the power of the lower extremities and trunk within six weeks of training. This increased focus on leg and abdominal strength specifically helps to reduce impact forces upon landing and cutting and decreases the likelihood of an ACL injury.

Prevention is key. As the number of ACL injuries per year approach 300,000, the cost of treatments for female varsity players alone is close to one billion dollars a year. In our sports medicine department we are working closely with physical therapists in developing rehabilitation programs that emphasize prevention.

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