Are You At Risk for an ACL Injury?

At one time, it seemed that the majority of injuries or tears to the Anterior Cruciate Ligament (ACL) happened to professional athletes. In recent studies, however, it is estimated that there are nearly 200,000 ACL-related injuries annually in the United States (1). Unfortunately, females (particularly athletes) are up to 9.7 times more likely to have ACL injuries than males. The increased rate of ACL injuries in central New York athletes was so dramatic by 2007 that Syracuse-area orthopedic surgeons held a meeting with all New York State Division III High School Athletic Directors to address the need for ACL injury prevention programs for the spring of 2008.


There are a variety of non-contact ways to tear your ACL including (but not exclusive to):
  • Trying to slow down while running
  • Jumping and landing off balance
  • Leaping and landing on one foot
  • Quick change of direction
  • Jumping and landing with stiff legs/knees
Why do non-contact ACL injuries to occur?
Poor functional movement is the main cause for non-contact ACL injuries. Muscles of the hips and legs that are tight, weak and lack coordination produce abnormal stress on the joints they surround. During activity, joints can be limited in normal motion by stressed muscles and produce abnormal stress on the ligaments that hold the joint together. The ligaments are then unable to handle the stress load on the joint and tear.


Why is the ACL injury rate so high among young females?
Young women have a higher rate of ACL injuries for two main reasons:
  1. During adolescence, young women are begin to develop wider hips, producing greater biomechanical stresses in the knee joints
  2. Young women are less likely to have the muscle mass developed around the hips and legs to adequately control stress on the knee
Can ACL injuries be prevented?


There is no guaranteed way to prevent ACL injuries, however, the risk of an ACL injury can be reduced through physical assessment and functional screening. Physical assessment of joint and muscle function occurs during an anatomical screen where each joint range of motion, muscle group flexibility, and muscle group strength are assessed throughout the trunk, pelvis and legs. In comparison, a functional assessment looks at how well the muscles and joints work together during specific movements, keeping proper body alignment and minimizing stress on the body. If you would like to determine your own potential risk for ACL injury, here are 2 functional tests you can try at home:
  • SQUAT TEST:Stand in front of a mirror, hands on hips, feet shoulder width apart and toes pointing straight forward. Squat down slowly and try to get your thighs parallel to the floor. You could be at risk for ACL injury if: (1) your heels rise off the floor, (2) your knees go inward, (3) your hips shift to left or right, (4) you lose balance and step out of squat position.
  • SINGLE LEG STANCE BALANCE TEST: Stand and lift your right foot from the floor, bringing your right knee forward and up to about waist height. Try to balance on your left foot for 20 seconds. Try the same test on your right foot for 20 seconds. You could be at risk for ACL injury if: (1) you are unable to maintain balance for 20 seconds, (2) your arms, non stance leg or upper body wave around during test
If you have difficulty with any of these tests, you may want to find a ACL Injury Prevention program or Sports Performance program to evaluate what you have to work on to avoid injury. Mary Lou Corcoran Physical and Aquatic Therapy offers an Athletic screening program and ACL Injury prevention program. These programs are administered by physical therapists who evaluate an individual's risk for injury based on medical history, anatomical screen, functional screen, running analysis and sport position played (if appropriate). After the screen, problem areas are identified and an exercise program can be designed to address these areas. This program can not only reduce the risk of ACL or other injury, but can improve sports performance.
(1) Gammons M, Schwartz E. January 5, 2010 Anterior Cruciate Ligament Injury. Retrieved from Medscape website:
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