As female soccer players between the ages of 12 and 19, Hailey Turner and Madison McKoin are part of the group of individuals most susceptible to ACL injuires.

Young women compete in almost every sport that their male counterparts do, and while many are equally as physically fit for their chosen sport, they face an increased chance for injury that can impact their athletic future.

Female athletes between the ages of 12 and 19 are four to eight times more susceptible than male athletes to tear their anterior cruciate ligament (ACL). The enhanced risk is due to several physical and biological factors; however specific exercises and conditioning can help reduce that chance of injury.

The ACL is one of four major ligaments that stabilize the knee. It also protects the knee’s “shock absorbers” from injury when an athlete jumps, lands, cuts or pivots.

Some of the factors that make female athletes more prone to ACL injuries can be determined by which muscles they use, how they use their muscles, standing positions, balance and strength, as well as changes in their bodies during puberty. Ligaments and tendons can be more extensible when estrogen levels are higher. Some athletes demonstrate weakness in their core muscles and hip stabilizers which can make it difficult to land correctly to prevent injury.

ACL tears are usually evident by a “pop” at the time of injury, followed by immediate swelling, pain and instability at the joint. Young women who play basketball, soccer and gymnastics are at greater risk of injury than those who play other sports.

ACL injuries aren’t necessarily the result of a collision, but rather from landing or pivoting incorrectly. A year-round strengthening and conditioning program that concentrates on specific muscle groups and landing mechanics can help prevent injuries. Points to focus on include:

• Maintain a center of strength. Build and maintain strength in core muscles, but don’t overstress those muscles to the point of straining them. Developing strong hamstrings is crucial for female athletes. Conditioned muscles are less likely to undergo injury.

• Focus on balance. Even a slight imbalance from one side to the other puts a female athlete at greater risk for injury. Focus on maintaining a good center of gravity when stretching, jumping, landing and turning.

• Build the right muscles. It is important to build strong hamstrings and hip stabilizers to help female athletes control the knee, reducing a young woman’s chance of injuring her ACL.

Physical therapist Beth Milligan leads Kalayna King in a Romanian dead lift to practice balance.

Young athletes who tear their ACL face a long and extensive journey to recovery. This includes surgery along with six to nine months of physical therapy before returning to the game.

Long-term consequences of an ACL injury include potential limitations in the athlete’s ability to play sports, as well as pain that may continue after sports are finished.

Prior to returning to play, female athletes who have undergone surgery should be evaluated by their physical therapist to compare the strength and flexibility of both legs to ensure readiness to return to their sport. This reduces the temptation by the athlete to return to their sport too soon and risk another injury.

Many athletes now participate in sports throughout the year, so proper rest and downtime are crucial for performance. A good off-season strength and agility program can help decrease the chance for injury. Female athletes who consistently work to build their core and improve lower body strength and technique increase their ability to withstand the physical stress the sport has on their body throughout the year.

It’s important, too, that coaches watch for correct technique during warm-ups and practice, so they can help their young athletes create the correct habits. Every coach knows “You play like you practice,” so good habits are critical.

Karsen Roach goes for a shot over Kalayna King as they both focus on balance and landing properly.

Beth Milligan is a physical therapist at the Conway Regional Therapy Center Scherman Heights location. She has worked in sports medicine for the majority of her career and loves working with athletes of all ages. Beth enjoys spending time with her family and friends and is active in her community. She loves to hike and enjoys sports of all kinds.