ACL Injuries Are Increasing. Female Athletes Face the Greatest Risk.

The Economist June 26th 2021 pp72|Science & technology|Anterior cruciate ligament injuries|”Wounded knees” “ACL injuries are a growing problem-and one that particularly affects women”



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Summary provided by 2244


ACL injuries affect 2M people annually and are “among the most immobilizing injuries someone can sustain.” The ACL is one of four ligaments that hold the knee together. Surgery and rehabilitation likely requires six-to-nine months and the cost annually is estimated as “billions of dollars.” About 20% will reinjure and 75% may “develop arthritis of the knee 15-20 years later.” In general ACL injuries have tripled for those under 18 years of age and women are afflicted “far more often than men-as much as eight times more.”


Why more ACL injuries and why are women at greater risk?


Explanation for the rise in ACL injury is attributed to early specialization in a competitive sport that puts focused strain on the ACL and the increase of the deployment of less-forgiving artificial turf in sports like soccer and gridiron football. Females are believed to be more affected due to female body shapes, movement patterns and even differences in risk during the normal menstrual cycle. Evidence from studies suggests that as estrogen levels rise early in the cycle and peak at ovulation women are at greater risk for ACL injuries than after ovulation when estrogen levels fall. It’s unclear why the ACL versus other ligaments is more often impacted as they all reportedly have receptors for estrogen.


What to do?


First the vast majority of athletes are unaware of preventative measures. These measures include how to move more safely. “Straightforward exercise classes in balance and agility have been found to reduce ACL tears by 50%. Delaying sports specialization is also recommended to avoid repeated and focused stress. Finally, as it pertains to female athletes there’s now an APP called FitrWoman that “monitors a user’s cycle and tells her on which days it may be risky to train intensely.”