The Female ACL

By Josh Ortegon

Decreasing Risk of Injuries in Female Athletes

When strength and conditioning programming was first introduced into the high school setting, most programs were primarily focused on the boy’s sports and many times just the football program. In the past 20 years, participation by girls has been on the rise. Many high schools now implement intense programs for female athletes.

It has been well documented that females are more likely to suffer an anterior cruciate ligament (ACL) injury than their male counterparts. Some studies have demonstrated an increased risk of up to 4-6 X among female athletes relative to their male counterparts with 70-80% of injuries a result of non-contact mechanisms. With statistics like these, it is essential for the High School Strength and Conditioning Specialist (HSSCS) to implement programs with females that can help prevent these devastating injuries.

The first step in implementing a preventive strength and conditioning with female athletes is to identify those who are at increased risk. The Functional Movement Screen can be helpful in identifying inefficient movement patterns and asymmetries within those patterns. The FMS has become increasingly popular among HSSCSs due to the tool’s simplicity of implementation and the feedback it can provide.

One performance test that is becoming increasingly popular is the “hop and stop” test developed by Dr. Paul Juris. This simple field test measures the asymmetries in single leg force production and force absorption. Since the majority of ACL injures are non-contact and often occur during deceleration, being able to measure the athlete’s ability to effectively stop while maintaining control is a critical variable.

As a HSSCS, I am always looking for opportunities for our female athletes to implement simple exercises that will help decrease risk of injury. Many times, educating sports coaches on things they can do in practice and within the warm-up is essential in ensuring such training is included. It is also something that we focus on inside the weight room.

Below I have detailed a simple two-day per week program that can be implemented with your female sports teams that can help decrease risk of injury and improve single leg strength, stability, force absorption and production as well as improve performance at the same time.

Day 1:

1. Lunge patterning or lunge specific mobility work
2. Single leg hip bridge (activation) 3 x 15 each leg
3. Linear leaps (stick and hold) 3 x 5 each leg
4. Backward lunges 3 x 10 each leg (progress with load when appropriate)
5. Single leg reach and touch 3 x 10 each leg (progress to loaded single leg dead lift when appropriate)

Day 2:

1. Deep squat patterning or squat specific mobility work
2. Double leg hip bridge (activation) 3 x 20  (load with weight when appropriate)
3. Broad jumps 3 x 10
4. Arms overhead squats 3 x 20 (progress to overhead squat and other squat variations)
5. Monster band walks (multidirectional)

This two-day program can be used in the weight room with appropriate loading progression implemented as well as on field after practice. With the rise of participation in sports and the increased risk of ACL injuries in females, the HSSCS can add programmatic value by implementing specific testing and screening as well as need-specific programs that will help provide athletes with a positive sports and fitness experience which will, in turn, foster the development of active and healthy adults.