4 Types of ACL Injuries Women Soccer Players Should Know

Jan 22, 2022


When you think about ACL injuries, the first one that comes to mind are ACL tears - the most infamous of them all. But there’s more. Women soccer players in particular need to educate themselves about the various ACL injuries because they have a higher risk. This post will examine 4 types of ACL injuries and how women in soccer can protect themselves.

4 Types of ACL Injuries

The ACL can sustain injuries in more ways than you’d imagine. But there are four common types of these injuries that can affect soccer players.


ACL Sprain


An ACL sprain occurs when fibers or threads of the ACL ligaments get overstretched, partially torn, or completely ruptured. There are three grades of this:


  • Grade I ACL Sprain - Mild sprain (no tearing) that presents with swelling, moderate knee pain, and some loss of mobility. Treatment doesn't involve surgery since medications, crutches, and ice will provide relief.

  • Grade II ACL Sprain - Moderate sprain with partial tearing that presents with symptoms of mild sprains. But the symptoms are more severe and there is instability. Treatment may or may not need surgery.

  • Grade III ACL Sprain - Severe sprains that involve complete tearing of the ligament. Symptoms include severe pain and stiffness and treatment almost always requires surgery.

ACL Avulsion Fracture

ACL avulsion fractures aren’t too common, but they can affect soccer players from time to time. They occur when a piece of bone breaks off where the ligament attaches to the thigh or leg. The usual cause of this injury is overuse/overexertion or blunt trauma during sports (such as soccer). For example, a hard blow to the leg during a tackle from an opponent trying to steal the ball can result in this type of injury.


ACL Deficient Knee

Many people have knees that have poorly functioning or poorly formed ACLs, a.k.a ACL deficiency (insufficiency). This can happen due to genetics or through injury. It often causes the knees to buckle, especially during physical activity. Although you can live with this injury, it often leads to complications such as osteoarthritis.

Complex and Multi-Ligament Knee Injuries

An ACL injured in more than one way may indicate multi-ligament damage or what’s known as a complex injury. Diagnosing this type of injury usually requires an X-ray and MRI. Multi-ligament damage may include knee dislocations, fractures, meniscal tears, and more. These injuries need advanced medical attention (casts, surgery).

Women’s Risk of ACL Injuries

Why do women soccer players, in particular, need to know about these types of ACL injuries? The answer is female anatomy. Years of research have shown that female athletes have anatomical differences (compared to men) that make them more prone to ACL tears. Two big factors that put them at a higher risk are their “Q-Angles” and hormonal output.

The Q-Angle

The Q-angle refers to the angle formed between the quadricep muscles (quads) and the patella tendon (knee joint). Doctors use this angle as a measurement of sorts.


The wider your q-angle is, the higher your risk of ACL injury becomes. Why? Wide angles are present in people who have wider hips, and wider hips put more strain on the knees. Women typically have wider hips than men, making their knees more likely to buckle under pressure.

Hormonal Differences

Besides having wider Q-angles, womens’ hormonal profiles can affect the stability of their ACL joints. Research studies have linked hormonal fluctuations to changes in ligament stability. It appears to happen more frequently during menstrual cycles.


During the menstrual cycle, hormones such as estrogen and progesterone may cause ligaments to become more “lax” (less stable). This could make them more likely to stretch or tear.







Reduction of ACL Injury Risk

Preventing ACL injuries boils down to conditioning, wearing protective gear, and recovery. Focusing on these three areas can make a world of difference.

Three Steps to ACL Injury Prevention


  • Neuromuscular Training. Overstretched ligaments can occur when players ignore their warmups. But too much stretching before can make joints laxer and more prone to injury. FIFA’s 11+ neuromuscular exercises prepare the nervous system so that muscles and joints move better without overexertion. They can reduce ACL tears as well as other ligament injuries.


  • Leg Guards. ACL injuries can occur when you sustain hard impacts or blunt force trauma to the legs. For example, this can happen with an unintentional kick from a tackle or challenge. Leg guards can reduce up to 90% of impact forces to the legs and knees. Of all women’s soccer protective gear, a leg guard (the right one) is the most effective way to reduce leg injury risks.

  • Proper Recovery and Rest. ACL injuries often strike soccer players who don't get enough recovery time. High-volume practice and game schedules don’t allow for enough recovery time, which is a recipe for injury. Players need to rest and not overdo it on the pitch. Also, recovery protocols such as diet/supplementation, percussion therapy guns, ice baths (cryotherapy) can also help.
  • Putting ACL Injuries to Rest

    Not all women have a very high risk of ACL injuries, of course. With that said, it’s now possible to know your risk by undergoing an assessment from physical therapists or kinesiologists. They’ll examine your biomechanics and measure your Q-angle to determine whether you run or move efficiently.


    This can help you figure out whether you’re at a greater risk for ACL injuries compared to others. Regardless of the outcome, you can protect yourself from the miseries of an ACL injury, and dominate the pitch.


    Need protective equipment for the lower body? Browse through our line of soccer protective gear for women!

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