Few sports injuries are as devastating as an ACL tear. Specifically, because the anterior cruciate ligament (ACL) is one of the main stabilizing ligaments in the knee. When it tears, surgery is often required, and recovery can take 9 to 12 months—or longer. For a teenage athlete, that can mean missing an entire season, or even a full year of sports. Unfortunately, per hour of sport participation, ACL injuries occur much more often in female athletes than in their male counterparts.

Why Are Young Females at Higher Risk?

• Anatomy Plays a Role. Girls and women generally have wider hips than boys and men. This can create a greater inward angle at the knee during running, cutting, and landing, placing additional stress on the ACL.
• Hormonal Changes May Affect Ligaments. Hormonal fluctuations during adolescence can influence ligament strength and flexibility, potentially making the ACL more vulnerable during certain movements.
• Year-Round Sports Increase Stress. Today’s young athletes often play one sport nearly year-round. While specialization can improve skills, it can also increase repetitive stress on growing bodies and reduce recovery time. Sports such as soccer, basketball, and lacrosse place particularly high demands on the knee because of frequent jumping, pivoting, and sudden changes in direction.
• Cutting and Landing Style. On average female athletes cut from side to side differently than male athletes do. The pattern of cutting and landing changes the forces on the knee and can increase the risk of knee injury. Training programs with specific practice routines on how to cut and land have been shown to reduce the risk of ACL injury in female athletes.

The Good News: Many ACL Injuries Can Be Prevented

A recent study involving more than 2,500 youth soccer players found that teams using supervised injury-prevention training experienced fewer serious lower-extremity injuries, including ACL tears.

These programs typically include:

• Dynamic warm-up exercises
• Balance and coordination training
• Strength training
• Jumping and landing mechanics
• Agility drills
• Sport-specific movement training (to retrain the cutting and landing style)

The goal is simple: teach athletes how to move more efficiently and safely before an injury occurs.

What Parents and Coaches Should Know

Many young athletes spend hours practicing skills yet very little time learning how to protect their bodies.

A complete training program includes:

• Proper warm-ups before practices and games
• Strength training appropriate for age and development
• Balance and neuromuscular training
• Adequate rest and recovery
• Avoiding excessive single-sport specialization at a young age

In fact, young athletes who participate in multiple sports often develop more balanced strength, coordination, and movement patterns. Playing different sports throughout the year may help reduce repetitive stress on growing joints while promoting overall athletic development. These strategies not only help reduce injury risk but may also improve athletic performance.

The Bottom Line

ACL tears remain one of the most common serious injuries in youth sports, especially among teenage female athletes. While we cannot eliminate every injury, we can dramatically reduce risk through proper training, conditioning, and recovery.

For parents, coaches, and athletes, the message is clear: injury prevention should be treated as seriously as skill development. Spending just a few minutes each day on proven prevention exercises may help protect an athlete’s season—and potentially their future in sports.

For more information about ACL injury prevention, treatment options, and keeping young athletes healthy and active, explore The Knee & Shoulder Handbook by Dr. Alan Reznik.