Girls Hit the Hardest

By Ken Reed

ACL injuries among high school athletes have grown 26% over the past 15 years, according to new research developed by the National ACL Injury Coalition.

The National ACL Injury Coalition reviewed injury data for 12 major girls and boys sports over five three-year periods from 2007 to 2022, as supplied by certified athletic trainers in the High School RIO surveillance program. Over the study’s timeframe, the average annual ACL injury rate grew 25.9% to 7.3 injuries per 100,000 athlete exposures.

The analysis revealed that girls and participants in cutting and landing sports injure the crucial knee ligament most often. Rates of injury in girls sports grew 32.3%, compared to 14.5% for boys sports. Among girls sports, soccer experienced the highest average annual rate (13.3 per 100,000 exposures), followed by basketball (12.2) and lacrosse (10.4).

The National ACL Injury Coalition was created in March of 2023 through a partnership between the Aspen Institute and Hospital for Special Surgery (HSS). It is a multiyear effort to reduce injury rates in high school sports participants. The coalition’s members believe rates of non-contact ACL injuries can be significantly reduced through targeted exercises that improve lower body strength and control. Experts call this activity neuromuscular training, which has been associated with fewer ACL injuries, improved athleticism and greater team performance.

The coalition is focused on increasing neuromuscular training in schools, clubs and programs that offer cutting and landing sports. Targeted exercises done regularly can improve lower body strength and control, allowing athletes to change speed and direction more safely.

Two decades of research now shows that targeted exercises done regularly, and over time, can dramatically reduce ACL injury risk. Training works by refining movement patterns, leading to less force on sensitive knee structures while also improving one’s ability to speed up, stop and cut on demand.

“The coalition needs the high school sports community to rise up and meet this challenge with us,” said Dr. Joseph Janosky, lead researcher for the coalition’s analysis and director of athlete health at HSS.

“We need athletic directors, coaches, parents, athletic trainers and the leaders of regional and state athletic associations to commit to safeguarding the health of athletes. If we work together to bridge the gap between research and the real world, the millions of children who play sports will benefit tremendously.”

For more on ACL injury prevention, see “Solutions” from the National ACL Injury Coalition.

Ken Reed, Sports Policy Director, League of Fans


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