Understanding the “ACL Pandemic” in Women’s Sports

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Understanding the “ACL Pandemic” in Women’s Sports

Kashish Patel 
September 2025

In recent terms, the “ACL Pandemic” refers to a surge of anterior cruciate ligament injuries striking female athletes two to eight times more often than men. These injuries are especially evident in sports that require jumping or pivoting, such as soccer, basketball, lacrosse, and skiing[1].

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What is an ACL Injury?

An injury in the ACL occurs when the ACL, which is a strong band of tissue connecting the thighbone to the shinbone in the knee, is stretched, partially torn, or completely ruptured. There are different levels to ACL injuries. 

  • Grade I: Mild injury with minor tears.
  • Grade II: The ligament is loose and considered a moderate injury with a partial tear.
  • Grade III: A severe injury with a complete tear of the ligament, and the knee joint is unstable[2].

The ACL’s role is important for keeping the knee stable. When injured, it often causes a “popping” sound or sensation, which is followed by pain, swelling, and instability. ACL injuries can require months of rehabilitation or surgical reconstruction to restore strength and function[2].

Why are women more at risk? 

Women are at a greater risk for ACL injuries because of biological and even systematic differences. Women often have a wider pelvis and Q-angle than men, which indicates that the line from the hip to the knee slopes inward sharply. This adds additional stress to the ligament during quick movements[3].

It has been studied that hormonal fluctuations may also affect ligament laxity, making the ACL looser and more vulnerable to tears during menstruation. Research has shown that during the ovulatory phase, when estrogen levels are elevated, the ACL is less able to handle the intense forces of sudden movement. Hormonal effects reduce joint stability and alter muscle activation, making knee injuries more likely to occur[4]. 

Alex Morgan’s Story

Alex Morgan suffered a torn ACL during her senior year of high school, an injury which forced her to sit out for an extended period. She needed surgery, which would entail months of recovery and physical therapy. While this process usually takes about a year, she was able to return back on the field in around 5 months. 

She talks about how this personal experience has shaped the way that she perceived major injuries, especially in female athletes. She went on to win Olympic gold and a World Cup with the U.S. Women’s National Team, but she continues to carry the lessons from her injury. (5)

References

[1] Are ACL tears really more common in women? > news > yale medicine. (n.d.-a). https://www.yalemedicine.org/news/sports-injuries-gender 

[2] Northwestern Medicine. (n.d.). Why women have more ACL injuries than men. https://www.nm.org/healthbeat/healthy-tips/why-women-have-more-acl-injuries-than-men

[3] U.S. National Library of Medicine. (2016, March 24). The female ACL: Why is it more prone to injury?. Journal of orthopaedics. https://pmc.ncbi.nlm.nih.gov/articles/PMC4805849/

(4)  ACL tears and the menstrual cycle: Is there a connection? | northwell health. (n.d.-a). https://www.northwell.edu/news/insights/acl-tears-menstrual-cycle-health-podcast

(5) Advances in orthopaedic surgery have reduced the ACL Recovery Timeline. Shortened ACL Recovery Timeline | Alex Morgan Overcomes Injury | GBO. (n.d.). https://www.greatbasinortho.com/articles/advances-orthopaedic-surgery-have-reduced-acl-recovery-timeline