On March 24th, star women’s USC basketball player JuJu Watkins tore her ACL. This season-ending injury shook the sports world, as USC was expected to go into the final rounds of the NCAA tournament. Fans were also disappointed to be unable to see JuJu play against a fellow star, Paige Bueckers of UConn, in the Elite 8. USC ended up losing to UConn 78-64 without Watkins. Notably, Paige Bueckers also tore her ACL, causing her to miss the entirety of her 2022-23 basketball season. Despite her injury, Watkins still won Naismith Player of the Year.
ACL tears are an ongoing problem in women’s professional sports. An ACL tear is an injury to the ligament that connects the femur to the tibia in the knee. Women have 4 to 6 times the chance of tearing their ACL in sports, including cutting maneuvers, compared to men, and overall, girls are 8 times more likely to experience an ACL tear than boys. At least 88 professional women’s soccer players have torn their ACLs since 2021, including Leah Williamson (England) and Christen Press (USA). That is enough players to make up over four professional soccer teams. ACL tears are also too common in women’s professional basketball (Cameron Brink, WNBA) and volleyball (Grace Lopez, NCAA). The problem also extends to girls’ high school sports. As many as 80,000 female high school athletes experience ACL tears a year, mostly in basketball and soccer.
These injuries can be career-altering and take up to a year to recover. There is also an increased likelihood of tearing your ACL again after the first tear. Surgery to repair the ACL can cost tens of thousands of dollars and is necessary for recovery from a complete tear.
Female athletes’ increased risk for ACL tears is due to a combination of hormonal, anatomical, and biomechanical differences. Some of these differences, such as ACL size, knee anatomy, and hormonal fluctuations, cannot be modified. Women tend to have smaller ACLs than men, and the tissue is typically thinner. Women also have wider pelvises, which can influence the alignment of the knee and legs, putting more stress on the ACL. Additionally, hormones have been found to increase the stretchiness of ligaments like the ACL. All of these differences make it easier for the ACL to tear.
Other factors, such as landing techniques and hamstring and quadricep strength, can be modified to decrease risk. Ways to decrease the risk of ACL tears in female athletes include improving strength, flexibility, and balance, practicing proper landing techniques, neuromuscular training, and improving foot/orthotic support.
Despite these drastic differences in the number of injuries, only 6% of sports injury research focuses on women. Women have been performing at high levels in sports for decades, but society is just starting to recognize their skills and hard work. More research geared towards women’s sports-related injuries is critical for the growth of women’s sports and the health of players. It is important not to look at ACL tears in women from the perspective that it is “just something that happens to female athletes,” and instead, look at it as an issue with training and preparation.