For a while there was a big push to find out why female athletes have more knee ligament injuries than males. What was the final conclusion to all the studies done?

Unfortunately, there hasn’t been one final result to hang our hats on. Researchers are still sorting out differences in sport type, training, anatomy, age, body mass index (BMI) and many other possible factors.

There’s been some concern that girls don’t increase in strength like boys do, and this may be contributing to the knee ligament injuries. The anterior cruciate ligament (ACL) seems to be at greatest risk. Landing jumps with the knees too close together has been studied as a possible cause of ACL injuries, too.

One of the most recent large studies of young athletes (ages 9 to 17) compared strength and lower limb control and alignment by age and gender. Leg strength and alignment were measured in over 1,000 young athletes (boys and girls). Three specific tests were carried out.

The results showed that girls’ hamstring strength stops increasing around age 11. Boys’ strength continues to increase until age 14. This may be a factor in the rate of ACL injuries. Lower limb (and especially knee) alignment didn’t change with increasing age or strength. Boys and girls were very similar in this area. Other studies have shown differences in the force of landings between boys and girls.

It’s likely that gender differences in ACL injuries is multifactorial — in other words, caused by many things combined together. It remains to be seen which factors are most important.