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Staying on the Court: Female Basketball Players and ACL Tears

Female basketball players are no joke.  Neither are anterior cruciate ligament (ACL) tears.

Ask anyone who has experienced an ACL tear and the story always sounds about the same: a sudden turn, twist or fall with a pop, excruciating pain and the immediate knowledge that their season of play is over. 

Well documented need-to-know facts about ACL tears are:

  • Female athletes are 4-5 times more likely to injure their ACLs than their male counterparts.
  • 70% of all ACL injuries happen through pivoting, cutting, sidestepping, out of control play or awkward landings.
  • ACL tears cost approximately $2 billion annually.

Research has shown there are physiological differences between women and men that lend women athletes to ACL tear more so than men:

  • The intercondylar notch, the groove in the femur through which the ACL passes, is naturally smaller in women than in men. Accordingly, the ACL itself is smaller in women, which makes it more prone to injury.
  • Women have a wider pelvis and more commonly have “knock-knee” alignment, meaning that their knees bend inward when they land from jumps.
  • On average, women have hyper extension in their joints more than men.

Other contributors to a woman’s propensity to tear her ACL:

  • Women often land flat-footed, instead of on the balls of their feet, after a jump. This improper landing puts pressure on the knee when the calf muscles should be absorbing the force.
  • Women tend to have an imbalanced quadriceps/hamstring ratio. A female athlete is more likely to rely on her quadriceps muscles to decelerate or change speed, putting more pressure on the knee.
  • Women run in a more upright position than men, adding stress to the ACL and resulting in less control over rotation of the knee joint.

So, what can women do to prevent ACL tears?  Lots, actually. 

Ask a coach, trainer or physical therapist for exercises that are specific to your position.  A center is three times more likely to tear an ACL because centers jump and land more than the guard.  Females who to shoot the ball from the perimeter are more likely to pivot and twist at the knee.  Guards also twist and pivot, making this position 78% more likely to ACL tear.  Guards also decelerate quickly and depend more heavily on the quads than the hamstring, putting the knee in danger of injury.    

Specific training has been proven to prevent ACL tears.  Some examples include: 

  • Specifically practice flexing the knee on landing
  • Strengthen hips and core   
  • Learn to lunge, squat and land correctly  
  • Proprioceptor training
  • Plyometrics

Learning how to prevent and protect from injury is as important as practicing before a game.  Train smarter for a better, safer basketball season.