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Review Question - QID 4

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QID 4 (Type "4" in App Search)
Women athletes have a higher rate of ACL tears than male athletes in the same sport. While the cause is likely multi-factorial, which of the following factors has been shown to contribute most significantly to this observation?

ACL size

2%

73/4106

Estrogen levels

3%

139/4106

Neuromuscular coordination and training

76%

3138/4106

Intra-articular notch size

5%

205/4106

Valgus leg alignment

13%

535/4106

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There are many theories to account for the increased incidence of ACL tears in women athletes. While each of the answers may contribute, recent studies have shown that differences in the level of neuromuscular training and coordination play the most significant role. This is a potentially modifiable factor and jump training and plyometric conditioning programs have been shown to decrease the rates of ACL injury in women.

The Griffin and the Harmon papers are reviews by experts in ACL injury which list all of the answers as contributing factors to increased ACL injury rates seen in women athletes. Of these, neuromuscular imbalances were felt to be both the most significant and of particular interest because they are potentially modifiable.

The Zebis reference states that neuromuscular training increased EMG activity for the medial hamstring muscles, thereby decreasing the risk of dynamic valgus. This observed neuromuscular adaptation during sidecutting could potentially reduce the risk for non-contact ACL injury.

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