Why are women more likely to suffer ACL injuries than men?

Children who fail to master basic physical skills such as running and jumping at an early age are at significantly greater risk of serious knee injuries later in life, according to new research from Coventry University.

The research warns that girls are particularly vulnerable, a finding that has been echoed in women’s football, with England forward Michelle Agyemang becoming the latest of dozens of high-profile female players to suffer a season-ending cruciate ligament injury.

Research has shown that women are up to eight times more likely to suffer the injury than their male counterparts.

The study, which assessed 105 grassroots football players aged 13 to 16, found that those with poor functional movement skills (FMS) – including running, jumping, jumping, skipping and kicking – were much more likely to show poor landing mechanics – the ability to land in the best way to absorb shock in the knees.

Girls scored worse than boys, increasing their risk as they transitioned to competitive sports.

“The link between FMS and injury risk is much stronger in girls,” says Mike Duncan, director of Coventry University’s Research Center for Physical Activity, Sport and Exercise Sciences.

“People think PE will solve it, but PE in many primary schools is taught by the class teacher who is not specifically trained in primary PE, and they are also hampered by time constraints, while grassroots sports coaches are generally not trained in embedding FMS into their sessions.

“If they start taking football training with more complex exercises, they may have difficulty performing them.”

The consequences of ACL injuries can be long-lasting.

They almost always require surgery and long-term rehabilitation and increase the risk of a second ACL injury and arthritis in the repaired knee later in life.

While experts dismiss the idea of ​​an epidemic in elite football, UEFA chief Zoran Bahtijarevic said numbers are rising at youth level as girls flock to football.

“We can expect an epidemic of ACL injuries under the radar, with an explosion of participation,” Bahtijarevic told Reuters. “The peak of injuries in women is between the ages of 15, 16 and 19.”

The general consensus is that the cause of ACL injuries is multifaceted.

“Hormones also play a role as women get older – their hips become wider than boys’ and so the force on their knees is different,” Duncan noted.

«That’s why FMS at a younger age is even more important for girls than for boys. If we’re better at FMS, our brains can better adapt to situations where we have to unexpectedly land in a certain way while running or jumping, which in turn helps reduce the risk of injury.»

Published on October 31, 2025