The ACL: Anatomy, biomechanics, mechanisms of injury, and the gender disparity

Abstract

This chapter summarizes the current knowledge regarding ACL anatomy, biomechanics, common injury mechanisms, and the differences in ACL injury rates between male and female athletes. At least two-thirds of ACL tears occur during noncontact situations such as cutting, pivoting, accelerating, decelerating, and landing from a jump. Reduced knee flexion angles, increased hip flexion angles, valgus collapse at the knee, increased hip internal rotation, and increased internal or external tibial rotation are frequently reported at the time of or just prior to ACL injury. Female athletes are at greater risk for sustaining an ACL injury compared with male athletes participating in soccer, basketball, rugby, and handball. Research has shown that comprehensive training programs can effectively "reprogram" the neuromuscular system to avoid potentially dangerous body mechanics and positions.