Health and Wellness

The Dreaded ACL Tear (Part 1) – Prevention Strategies

Posted by Anup Shah, M.D. on Oct 10, 2015, 8:30:00 AM

Anterior cruciate ligament (ACL) injuries are a common knee injury and approximately 150,000 ACL reconstructions are thought to be performed yearly in the United States. While this knee injury can be devastating, there are exercises that can be done to help decrease the risk of injury. Whether you’re a 30-year-old mom looking to start an exercise program, a Division I college football player or an 18-year-old girl on your high school’s volley ball team, the best way to prevent ACL injuries is recognizing potential weaknesses and then working on them so that they don’t lead to trouble. 


Women Have Higher Risk


Are you a young female athlete? If so, some studies have shown you may have a higher risk for ACL tears. The good news is that if you’re aware of the things that lead to ACL tears, there are exercises that can help decrease the risk of injury.  What seems to put young female athletes at a higher risk for knee injury is:

  • Alignment of the lower extremitie
  • Quad muscle weakness
  • Poor jumping mechanics


First, imagine a line from your hip to your knee to your ankle. In men, this line is typically straighter than it is in women, who generally have wider pelvises. Orthopedic surgeons believe this greater angle in women could potentially put them at a higher risk for ACL injury because it puts greater stress on the knee.

While quad muscle weakness could cause an ACL tear in anyone, it seems to happen in higher instances with young female athletes because they typically start out with less muscle mass than men.

Like quad strength, good jumping mechanics are vital to prevent injury in any athlete; however, because of alignment differences in women and men that we discussed earlier, the landing impact in women can be harder on the joints.

Strengthen Your Muscles

A lack of quad strength does not lead to ACL tears in only young female athletes. Anybody who is planning to start an active lifestyle needs to consider the muscle strength it will take to carry out that lifestyle safely.

If you’re a weekend warrior who hasn’t played sports in a while, it may not be a good idea to go from total inactivity on Saturdays to playing competitive basketball or beach volleyball every week. If you are planning on changing your lifestyle to include more activity, that’s great! Just make sure you do all of the preliminary work first to ensure that you can carry out this new healthy lifestyle for a long time. To prevent potential ACL tears, this plan should include not only implementing a healthy diet to help eliminate stress on your joints, but also getting into the gym and doing some strengthening exercises for your legs – especially your quads.

Basically, be smart. Before you jump into a strenuous exercise regimen or an intense sports situation, focus on strength and training in order to prepare your body for the changes you’re about to make.

Learn Good Mechanics

When most people think of ACL injuries, they envision high-impact collisions in sports like football, but the truth is, many ACL injuries are the result of non-contact situations.  If you’re involved in a sport where you’re jumping, twisting, pivoting and landing, it is essential to practice good mechanics; otherwise, you might find yourself sitting out a season.

The ideal way to land out of a jump is with your knees parallel. This lessens the impact on your knee and helps prevent some of the twisting motion that notoriously causes ACL tears. Again, everyone should practice good jumping mechanics, but jumping and landing is something that female athletes need to remain mindful about. Because of the higher angle that occurs between the hip, knee and ankle in women, oftentimes on landing, women’s knees tend to bend inward, putting them at a higher risk for injury. The more muscle tone someone has, the easier it will be to perform these mechanics correctly. 

In Part 2, I’ll identify the tell-tale signs of an ACL tear, what to do if you suspect your ACL is torn and treatment options. 



Dr. Anup Shah is an orthopedic surgeon with Kelsey-Seybold specializing in shoulder and knee injuries. 

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