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The ACL provides stability in the knee and is important in stabilizing the tibia and connecting it to the femur. The ACL also plays a role in the rotation of the knee and allows the stability to make sudden turns or pivots, said Dr. James Slauterbeck, associate professor in the orthopedics department at Texas Tech University Health Sciences Center.
"There are tremendous forces exerted on the knee, especially in running and cutting activities," Slauterbeck said. "If the ligaments are loose, they often can't handle those forces, and they tear."
Women tear their ACLs three to 10 times more frequently than men, he said. Researchers aren't sure why.
"There are both intrinsic and extrinsic possibilities," Slauterbeck said. "Intrinsic causes are those within the body such as the size or strength of the ligament, the size of the athlete's body, neuromuscular problems and hormones. Extrinsic causes are those that are external such as coaching or training differences."
He said neuromuscular problems play a role in making women more susceptible to ACL tears.
"There are definite differences in the way male and female athletes are getting messages from their brains to their muscles," he said. "For example, when a male steps off a box, he keeps his knees apart. When a girl steps off a box, her knees come together. Also, girls' knees are more wobbly, both from side to side and front to back. That wobbliness that occurs puts the ligament at risk.
"We're working to develop screening and training programs," Slauterbeck said. "We've found that we can actually train girls to change the firing patterns of their muscles. But, the main part is to take the wobble out of their knees through a combination of jumping and landing exercise and strength training. However, these must be done with careful supervision. If done incorrectly, these exercises could actually make a female athlete prone to an ACL tear. These must be done with medical supervision."
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