Torn ACL - Causes

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What causes a torn ACL?

Most anterior cruciate ligament injuries occur due to injury, usually in a sport or fitness activity. The ligament gets stretched or tears when the foot is firmly planted and the knee locks and twists or pivots at the same time. This commonly occurs in basketball, football, soccer, and gymnastics, where a sudden change in direction stresses and damages the ligament. These injuries are usually noncontact, occur at low speed, and occur as the body is decelerating.

ACL injuries may also occur when the tibia is pushed forward in relation to the femur. This is the mechanism of injury that occurs because of a fall when skiing, from a direct blow to the front of the knee (such as in football) when the foot is planted on the ground, or in a car accident.

Risk factors for ACL injury in women

Women are more prone to ACL injuries than men. Women have slightly different anatomy that may put them at higher risk for ACL injuries:

  • The intercondylar notch at the end of the femur is narrower in women than men. When the knee moves, this narrower space can pinch and weaken the ACL.
  • Women have a wider pelvis than men, and this causes the femur to meet the tibia at a greater angle (called the Q angle). This increases the force that the ACL has to withstand with any twisting motion, increasing the risk of damage.
  • Genetic differences may put the female ACL at risk. Female muscles tend to be more elastic and decrease the protection that the hamstring muscles can provide to the ACL. Hormonal changes during menses may also affect elasticity. Moreover, female hamstrings react and contract a millisecond slower than in a male, increasing the risk of ACL damage when landing from a jump.
Return to Torn ACL (Anterior Cruciate Ligament Tear)

See what others are saying

Comment from: Melodie in LA, 35-44 Female (Patient) Published: April 21

I tried to move a 300 lb. box onto a truck bed and I was wearing flip flops and therefore as I shoved onto the box to push deep into the bed, it pushed me off of the tailgate and I landed with my left leg locked onto asphalt, about 4 feet from the ground. I heard and felt my knee give in opposite direction and popped. I waited 1 month to find MRI showing a severed ACL (anterior cruciate ligament). I had surgery and am still recovering but I am very happy they can even fix that these days. I am still very active and cannot wait to jog and run again.

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Comment from: Sheena, 25-34 Female (Patient) Published: April 27

I was playing soccer, jumped high and landed with my knee locked and immediately went down. Initially I was told it was a sprain and it would heal in about 2 weeks. Ten days after the initial injury, someone had the door open for me and I rushed a little, immediately I went down! That day, my doctor ordered an MRI and a brace. Today, I just found out I have a torn ACL (anterior cruciate ligament). Hopefully, I'll get surgery super soon.

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