Risk Factors & Prevention Tips For Anterior Cruciate Ligament (ACL)

Authored by: Jason Arnett

Football season is officially upon us, and it’s not all cheese fries and buffalo wings! While we sit around the living room with our closest friends enjoying these delicacies, our favorite players (and fantasy draft teams) are at risk for serious injuries throughout the season. One such injury and a complete game changer is an ACL injury.


The anterior cruciate ligament is one of 4 knee ligaments that connect the upper leg bone (femur) with the lower leg bone (tibia). The ACL stabilizes knee movement by:

  • Preventing the lower leg bone from sliding forward or turning inward when the leg is straight
  • Preventing the knee from being stretched or straightened beyond its normal limits (hyperextension)
  • Supporting the knee ligaments that keep the knee from bending sideways

ACL injuries are primarily non-contact and occur in sports that involve cutting, pivoting, jumping or landing. Given that football requires heavy bursts of sprinting and dodging, these athletes are especially at risk. Athletes will often feel a tear or hear a ‘pop’ when they’ve injured their ACL, accompanied by small fractures or bone bruises at the top of the tibia. Pain, swelling, and loss of normal function are typical symptoms of an ACL injury.  Women are actually a greater risk for ACL tears then men for the following reasons:

  • Hip and Knee Angle: females have a greater Q-angle (the angle of the knee to the hip position) which has been shown to cause excessive shear and rotation at the knee joint.
  • Ligament Size: Females have a smaller notch size (where the ACL attaches to the bone) which is speculated to therefore contain a smaller ACL. The decreased material in the ligament may make it vulnerable to rupture
  • Estrogen Level: Fluctuations/surges in the female hormone estrogen are thought to soften the ligaments, making the ACL vulnerable to injury.
  • Muscular Strength: Males have greater muscular development than their female counterparts – less muscular support leaves the knee more vulnerable to injury.

VSI Physical Therapy is the only leading physical therapy in the Virginia area that offers an ACL Injury Prevention Training program specifically proven to decrease ACL injuries in female athletes. To learn more about this and our other specialty services, contact us today!

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