NCAA: it’s time to do something about ACL tears

Jacki Gemelos, Carolyn Davis, Kristi Kingma, China Crosby, Richa Jackson and Antonye Nyingifa are just a few of the many, many basketball players who have torn their Anterior Cruciate Ligaments (ACL) this year, which put them out for the season.

It’s a storyline hoops fans unfortunately know well, as female athletes have long been known to sustain ACL tears at far greater frequency than male athletes. It is estimated that a staggering 38,000 women suffer ACL tears annually – a rate that is two to eight times more than the rate for men. It seems like to many, more of these injuries have occurred in collegiate hoops this year than usual.

The disparity has been commonly attributed to one or a combination of these factors: the angle of the femur to the knee with the wider hips of females; different muscle recruitment patterns during movement and landings; and hormonal changes during menstrual cycles causing joint laxity.

Interestingly, as can be seen from the same above link, the majority of ACL tears in women occur during non-contact events, such as deceleration activities that happen when landing from a jump, or cutting. This was known at least 17 years ago.

With this in mind, it is outrageous that the NCAA hasn’t done anything to actively prevent ACL tears in its female athletes. Biology is one thing, but preventative jumping and cutting techniques can – and should – be taught. I’m sure there are some strength and conditioning coaches out there that already do this, but clearly, there need to be more. The NCAA needs to mandate that all such coaches teach proper deceleration technique to athletes. Further, they need to train head and assistant coaches to make sure that athletes follow the protocol in regular practices.

Every athlete that loses a season, or a career, due to an ACL injury is one too many. Unless widespread coaching education is implemented, the problem will continue, and may get even worse as the athleticism of the game increases significantly every year.

It is time for the NCAA to take a pro-active approach and develop a program to prevent ACL tears. Now.


  1. I'm also going to pass on a suggestion from the husband- move the referees' point of emphasis down to tripping and knee-to-knee contact. Yes, elbows are still a problem and concussions are not good, but knee injuries (not just including ACLs but injuries like Carolyn Davis's dislocated kneecap and that horrible torn everything Destini Hughes suffered) are more endemic in the women's game, and should be dealt with accordingly.

  2. Great Post. Nice to see people are starting to talk about this. It is a total disgrace and is being intentionally ignored not just by the NCAA, but also by most if not all of the national, regional and state based women's sports organizations.

    There are plenty of training programs out there that could at least mitigate the risk but not one women's sports organization that I'm aware of has embraced trying to implement them.

    It's also important to remember that studies have shown that over 50% of women that have these serious knee problems develop arthritis within 10 to 15 years.

    The ACL problem is just as bad in women's soccer. If you have a chance read "Warrior Girls" by Michael Sokolov.

  3. Speaking of the New York Times some of you might be interested in this article from 2008. It was published in their magazine.

    If you want to expand your understanding of why this problem hasn't been dealt with effectively check out how The Tucker Center for Women's Sports at the University of Minnesota responded to that story. Remember that these people at Tucker are supposedly trying to help women athletes.

    This appears to me to be a gender politics issue. I frankly don't care about that one way or another. I do care that young women are blowing up their knees with likely life changing impacts while those in charge of women's sports don't do a thing about it. It's almost like they just consider these horrible knee injuries to be collateral damage in their real or perceived gender wars.

    Since they won't admit there is even a problem of course they don't see a need for a solution.

    For the record I don't know Mike Sokolove, but I have read his book and respect his work.

  4. This is my last comment. I promise.

    I see you live in SoCal. You may already be aware, but UCLA has two women ballers out with ACL tears. Also CSU Bakersfield has FIVE women ballers out with ACL problems, if you can believe that.

    Can find articles via google. UCLA is from January 2012 and Bakersfield is December 2011.

  5. Thank you, anonymous, for all the great links/info. I will likely have to do another post as more information flows through; I am really passionate about this. I also think that if we can wear pink all month for breast cancer, which effects mostly older women, then we should be able to wear some other color for two months for ACLs, which effect younger athletes.

    I am aware of the ACL issues at both UCLA and CSUB, and have reported on them.

    Where do you live and what do you do for a living?

  6. Hey Sue,

    I live in Phoenix now, but lived in Long Beach and Huntington Beach for many years during my corporate life. I'm a semi-retired finance operations guy. Sorry for the Anonymous tag but I still do some consulting.

    Attended college on a roundball scholarship back in the day and like you and your other readers I just love the game.

    Candidly I had never paid much attention to women's sports I got out of the corporate thing a while ago and slowed down. I started to read the sports blogs and somehow got linked to some ACL injury stories and like you, I'm now officially 100% unhappy about it. I guess the fact that I have a pair of nieces that are now playing volleyball and basketball in high school helped get my attention.

    I asked my sister what the coaches were doing to protect their knees and she had no clue what I was talking about and of course when she asked their coaches they didn't either. So now its personal.

    I hope more people like you with an audience and some guts we can get someone to wake up. I think its going to be tough.

    If you look at how Sokolove was treated it confirms that those of you that make a living selling your writing have a lot at stake when they speak truth to power.

    i appreciate there are women like you and Wendy Parker that aren't afraid to say what needs to be said. Keep up the good work.

    I'll just close by saying that if there was any other sphere of life in which women were getting seriously hurt at at rate of 3 to 8 times more than men there would more outrage than anyone could handle. So people need to look deeper at what is really going on.

  7. Nice to virtually meet you, anonymous. Unfortunately I'm not surprised at the story about your niece's coaches having no idea what to do to protect knees. Most high schools here in the Los Angeles area don't even have a freakin athletic trainer on hand at girls games (there sometimes is for boys, though).

    I agree that if there were another area where women were being hurt at that rate, that there would be outrage. It's definitely a gender politics issue, or conglomeration of issues. The Tucker Center link you provided supports that.

    Thanks for the support. Kind words don't come often enough.

  8. Thanks for the post.

    Injuries that can be prevented are particularly maddening–especially in young people. Collegiate athletes have such a limited window of opportunity that losing a year to a needless injury is egregiously offensive.

    I've recently done some research on ACL injuries, how I found your post, and it's come to my attention that slipping and falling on the ice can also cause an ACL tear. I had no idea.

    ACL injuries due to slipping on the ice are also easily preventable. By adding an ice cleat to your shoe you can significantly reduce your risk of falling and suffering an ACL or other injury.

    Simple solutions to complex injuries.

    Thanks again for the great informative post.

    Winter Walker

  9. Anonymous said…
    Scamp – Is there an English version of your linked website?

    I used Google Translate to get an (admittedly imperfect) English version. I found the German website via Wikipedia's article "List of Awareness Ribbons," by skimming the list and noticing "Back to Sports" was shown under the gold ribbon category.

    I think we should adopt the gold ribbon as our demonstration of support for injured women student-athletes, with particular emphasis on basketball players.

  10. Scamp – Thanks. Seems like a pretty good idea.

    I need to understand more completely what the gold ribbon people actually stand for. Certainly some kind of campaign would be appropriate once the right people and support are lined up.

  11. Anonymous: the sports surgery people in Germany don't have anything to do with all of this. I just stumbled on their use of the term "gold ribbon" and then thought, why not do that?