Beware – Female Athletes Significantly More Prone To ACL Tears Of The Knee!

The anterior cruciate ligament is the major stabilizing ligament of the knee joint.  It is one of the most common sports related injuries that leads to athletes losing significant time on the field and can be career altering.  One in 3000 athletes will experience an ACL tear in general according to the Orthopedic Specialists of North Carolina.

There are two types of ACL tears that occur in athletes, contact and non-contact injuries.  Contact injuries lead to tear as the result of collision or impact, while non-contact ACL tears are the result of simple plant and pivot.  It is the latter, the non-contact ACL tear, that female athletes experience at a rate 5 times greater than males.

I am fortunate to have a great resource on this topic, friend, childhood lacrosse buddy, lacrosse podcast co-host, and trainer to the stars Steve Jordan (SteveJordanFitness.com).  According to Steve, there are key reasons why females are structurally at greater risk for ACL injury:

  1. Females’ knees are more  “turned in” (toward the midline of the body).
  2. Females’ knees are less bent when jumping and landing.
  3. Females jump and run with the soles of the feet in a more rigid position and directed away from the body’s center of gravity.

Much of these differences, according to Steve, is the result of unique anatomical difference in the pelvic cradle of females that is designed to facilitate child bearing.

In light of these findings, we not only have a better understanding of the answer to the question of why female athletes are so much more predisposed to ACL tears, but also have the ability to prescribe a solution. Even more exciting, the solution is not some new, outlandish, complicated, surgical procedure requiring months of recovery, but a comprehensive preventative rehabilitation program that can be performed by any athlete.

In the lacrosse club that I preside over in my community, we are fortunate to have a girls coach that is a physical therapist by trade, whose main role is to warm our girls up and coordinate conditioning sessions designed to prevent ACL tears and other injuries.  I believe it is in the best interests of any female athletic organization to have similar expertise in the management of injury prevention programs.  Whether it be a physical therapist or a highly educated and experienced athletic trainer like Steve Jordan to integrate into an organization for this purpose, it is a worthy and justified investment that will prove priceless in keeping the girls safe.

Dr. Roger Welton is a practicing veterinarian and well regarded media personality through a number of topics and platforms.  In addition to being passionate about integrative veterinary medicine for which he is a nationally renowned expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.

New Girl’s/Women’s Lacrosse Helmets Remain Controversial

New Cascade LX Women's and Girls Lacrosse HelmetThere has been a lot of controversy surrounding the requirement of helmets in girls and women’s lacrosse.  Proponents for protective gear opine that girls must have head protection from injury caused by collision with other players, as well as stick and ball contact to the head.  Opponents to the head gear requirement feel that head gear would serve nothing more than to provide a false sense of security for players and actually have the net result of more head injuries.

Further inflaming opponents to head gear is that there is no minimum standard for female lacrosse head gear as there is for male lacrosse players that have had helmet mandates for several decades.  This lack of standardization leads to very significant disparities in the various products available for states that have a head gear requirement.  It is noteworthy that the governing body of the sport of lacrosse nationally, US Lacrosse, has been one of the most ardent critics of head gear mandates for girls and women’s lacrosse players.

Women's-Girls Game Breaker Lacrosse Helmet/Protective Head GearIn my home state of Florida, for example, a head gear requirement went into effect 2 seasons ago as mandated by the Florida High School Athletic Association, the governing body of high school athletics state wide.  While it is too early to tell what impact this has had on head injury statistics, the lack of any standard for head gear could not be more obvious.  Pictured here is the Game Breakers rugby style helmet worn by some programs.

However, once girls became aware that simply putting “something” on their head would suffice to satisfy the FHSAA head gear requirement, the majority have gone with this minimal head band type of protective gear made by Storelli.  Storelli Lacrosse Protective Head Band For Women and GirlsThese are but a couple of the variations available in the lacrosse market even at this time when Cascade has teamed up with US Lacrosse to provide a helmet that satisfies minimum head gear requirements (more on this below).  This lack of standardization has essentially made a joke of the head gear requirement, as, regardless of the choice of protective head gear, lacrosse officials have no guidelines as to whether a particular head gear item is acceptable or not.

I am all for efforts to make the sport of lacrosse safer, but to impose protective gear requirements with no standards for what that protective gear should provide makes no sense.  This most certainly not one of FHSAA’s finest moments, and that is an opinion shared by the vast majority of girls lacrosse coaches across the state.

At least finally there is a standard that US Lacrosse has signed onto with the help of helmet manufacturer Cascade.  They have produced the Cascade LX girls and women’s lacrosse helmet  (picture at the top of the page) in accordance with ASTM f3137, the first minimum lady lacrosse helmet standard the fulfills the ultimate goal of girl’s and women’s lacrosse helmets: to reduce the impact forces associate with stick and ball contact to the head.

Still, while US Lacrosse approved of this helmet as the standard, they still do not deem protective head gear in girls and women’s lacrosse with the jury still very much out on the ultimate impact helmets will have on head injuries in the female game.  US Lacrosse is simply saying that for those who buy in on the the concept of protective head gear for girls and women, this is the standard.

On the other hand, state regulating bodies such as Florida’s FHSAA will continue to have their own mandates that may disagree with US Lacrosse.  Clearly, there is a precedence for state regulating bodies to detour from US Lacrosse stances and recommendations.  It is not clear where the requirement goes from here.

With US Lacrosse having a strong track record of best practices and safety, with strong research departments that further support their credibility, my opinion stands with theirs; that is, that head gear should be optional with the science still strongly lacking in support of increased safety for girls playing with protective head gear.  In fact, there is credible evidence to the contrary, that head gear may create a false sens of security that encourages more contact an subsequent risk for serious injury.

As such, with the youth lacrosse club I preside over, not under the FHSAA mandate for require protective gear, the requirement use of head gear remains optional.

Dr. Roger Welton was a 4 year starter for Montclair State University and was selected as a First Team All Knickerbocker Conference Midfielder in 1995, 1996. He is the founder of the Viera-Suntree Lacrosse Club and Space Coast Elite Lacrosse Club in Brevard County, Florida.