Female athletes in sports like basketball face a shocking 2–8× higher risk of ACL tears compared to male counterparts due to factors like anatomical differences, hormonal effects, and muscle imbalance. Experts highlight strategies — including neuromuscular training and targeted prevention — that can dramatically reduce injury risk, writes Ennio Muh at Van Nuys High School in California.
Simply put, biological, anatomical, and hormonal differences contribute to significantly higher anterior cruciate ligament injuries among female athletes. Prevention through training and awareness is both necessary and effective.
As Ennio explains (and we can confirm), research consistently shows female athletes are 2 to 8 times more likely than male athletes to suffer an ACL tear in pivot-heavy sports like basketball and soccer. Women typically have wider pelvises, a greater Q‑angle at the knee, and smaller ligament cross‑sectional anatomy, all of which increase knee stress during landing and cutting.
In addition, female athletes are often more quadriceps‑dominant and rely less on hamstring engagement, which destabilizes the ACL during abrupt movements.
Finally, the hormone relaxin, which is present in higher levels in women, binds to receptors in female ACLs, increasing collagen breakdown and ligament laxity, particularly during menstrual cycle peaks, and correlating with a higher injury risk.
The good news is that preventive measures work. Structured neuromuscular training programs (strengthening hamstrings, improving landing technique, balance) have demonstrated injury risk reductions of up to 80% in female athletes.
