The Truth About Female ACL Injuries

STACK Expert Rick Scarpulla says ACL injuries among female athletes are reaching epidemic proportions and it's time to do something about it.

Torn ACL

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Female athletes are up to six times more likely to sustain an ACL injury than their male counterparts. As female sport participation continues to explode, it's safe to say ACL injuries are becoming an epidemic.

To see what I'm talking about, all you need to do is watch a girls soccer game. You're guaranteed to see some athletes wearing braces or showing scars on their knees.

Crazy thing is, I've had girls come to me complaining of knee pain at 12 and 13 years old. Knees are supposed to last a lifetime, yet these kids haven't even made it to high school and they're already having problems.

Many studies and opinions point to why this occurs. We need to understand the causes, but we also must address the problem. Quite frankly, not enough is being done.

After years of experience helping female athletes fend of ACL injuries, I believe it all comes down to biomechanical and strength issues.

The Primary Culprits

If you do something wrong in life, there will eventually be a backlash. The same principle applies to poor jumping or running technique if nothing is done about it. Let's say your knees collapse inward when you land following a jump, yet you make no effort to correct it—or you're simply unaware that it's an issue. Every time you jump, you put stress on your ACL. This causes inflammation and irritation, which only gets worse as you continue to play your sport.

Technique is often blamed for poor biomechanics. However, the primary cause is usually either muscle imbalance or lack of strength.

I blame this on the poor information constantly fed to female athletes through the media. Many girls believe they should never pick up heavy weights or a barbell, because they'll get big and bulky like boys. So, you see workouts that only use body weight or tiny five-pound dumbbells.

Avoiding lifting weights leads to serious weaknesses in the big hip and leg muscles that stabilize and protect your knees. Plus, it limits your exposure to ACL-prevention exercises, which are usually integral to good strength and conditioning programs.

To make matters worse, female athletes—especially soccer players—are often quad dominant, meaning their quads are much stronger than their hamstrings. This is a serious issue, because the hamstrings relieve stress on the ACL as the knee bends.

What You Need To Do

Some coaches do nothing to help athletes prevent ACL injuries. They just hope nothing happens or simply accept that it's part of the game. This is totally unacceptable.

You can't completely eliminate ACL injuries. But you can certainly improve your chance of staying healthy.

Strength Training

The number one preventative exercise is the Box Squat. It differs from a conventional Squat in that you're positioned in a wider stance and move down and back to better recruit your glutes and hamstrings.

You don't need to go super heavy or do a crazy number of reps—just do them correctly. You can find a complete video demonstration here.

You should also incorporate inner and outer thigh machine exercises into your workouts. These will not only improve your looks, they will also stabilize your knees so they stay in line with your hips and ankles.


You're not born with an innate ability to run or jump with perfect form. It takes years of practice and instruction from a good coach to do things properly. The best thing you can do is find a qualified coach who can help you learn how to move. It may be difficult at first, but your muscles will learn the proper mechanics with repeated practice. Eventually, it will become second nature.

Take a Break

Take at least one season off from your sport. Your parents or coach may encourage you to play all year, but this gives you no time to recover and focus on getting stronger and commit to preventing injuries

If you have any questions, contact me at, and I will be happy to give you more information.

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