Houston Methodist. Leading Medicine

Knee News

Female Athletes Beware!

Ladies and gentlemen, listen up! But especially lady athletes: research now shows that women are more likely to injure the anterior cruciate ligament (ACL) than men. In fact women are two to six times more likely to tear the ACL compared to men. This applies to all sports and activities. Basketball and soccer players have the greatest risk.

Researchers are trying to sort out the details. Is it skill level? A lack of muscle strength? Joint laxity? Alignment problems? This study looks at two things: (1) the amount of damage in the knee cartilage at the time of ACL tear, and (2) the mechanism of injury.

Researchers included athletes from all levels (high school to amateur) and all sports. Over 1,000 patients filled out a form with information about age, sex, weight, height, sport, and competition level. How the injury occurred was also included. The researchers narrowed the field down to 221 athletes (men and women). This is the first study to report differences between men and women for meniscal tears that occur at the time of ACL tear and to report sport and level of play.

The researchers found that female high school athletes playing soccer had fewer tears of the meniscus. Female basketball players had fewer injuries to the medial femoral condyle (inside edge on the bottom of the thigh bone). Comparing amateur athletes was much harder. Fewer differences were noted. Most notably there were fewer lateral (outside edge) meniscal tears in women basketball players.

The reason for these differences in high school female athletes is unclear. The authors think there must be some type of difference in mechanism. Perhaps it is from a greater outward angle of the knee in men, or it might be that there is less force because women are lighter and shorter than male athletes in the same sport.

There are lots of other factors to study, including the size of the cartilage, firing of muscles, and differences in force from muscle contraction. More research is needed before a final answer is determined.


Dana P. Piasecki, et al. Intraarticular Injuries Associated with Anterior Cruciate Ligament Tear: Findings at Ligament Reconstruction in High School and Recreational Athletes: An Analysis of Sex-Based Differences. In The American Journal of Sports Medicine. June/July 2003. Vol. 31. No. 4. Pp. 601-605.

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