Women and Sports Injury Prevention

By Ross Ashcraft & Dawn Ikley

Men and Women are different.  The differences become more and more clear the closer you look at our anatomy.  The variations become more profound when we look past the skin and at the bones and muscles underneath.  Women becoming more active in sports has resulted in science looking deeper into the needs women have that are different than men.


Women are twice as likely to sustain an ACL tear in sports.  The ACL, is one of four major ligaments of the knee.  Women are at a dangerously high risk when participating in basketball and soccer.  Knee injury among females is roughly five times higher per player per hour than for males.  With government legislation and the trend of adolescents to participate in a single sport year round, the number of women and the level of competition in many sports will continue to rise.  The increase interest and study in both men and women is helping to lead to discoveries that can benefit both men and women.


The knee joint lies between the two rounded ends of the thigh bone or the femur.  The ACL moves within the notch that connects the thigh and shin (aka the tibia).  It provides most of the stability of for the knee.  It prevents the tibia from moving too far forward and from rotating too far inward under the femur.  Women have a narrower space between these bones than men.  Less space in this area allows less trouble free movement for women.  With this lack of space, the bones can pinch the ACL, as the knee bends.  This pinching then leads to ACL tears.  It is possible that with the help of proper strength training as well as changes in certain activities that ACL injuries can be prevented.


Neither men nor women athletes can strengthen their ACL directly; however, strength and training to the adjacent muscles of the knee, hip, and ankle can support this vital ligament and prevent injury.

Neuromuscular training has also been developed to prevent ACL tears.  In general, our movements during activity are mostly unconscious.  Neuromuscular training teaches your body better biomechanical movements and improved control.  It trains the athlete in the proper ways to land from a jump position, pivot side to side, and move the knee without placing as much force on the ACL.  Neuromuscular training attempts to break the poor habits we have formed and allow the body to move safely and efficiently.


When combined with Clinical Sports Massage techniques an athlete is truly prepared to recover from injury and get back to peak performance.  Find a therapist that specializes in one of the following techniques:  Rehabilitation Massage, Neuromuscular Massage, Medical Massage, Clinical Massage, Clinical Sports Massage, or Outcome Based Massage.  If they are experienced and credentialed in any of these modalities they should have sufficient skills to increase your athletic performance.


The following is taken from The Santa Monica Sports Medicine Research Foundation.  It is a great treatment that you can do at home.  In the reference section is a link to the entire strength training routine.  Try the stretch portion I’m embedding, and you’ll see how thorough this system can be.

The PEP Program:

Prevent Injury and Enhance Performance

A.  Calf stretch (30 seconds x 2 reps) Elapsed Time: 1 to 2 minutes

Purpose:  stretch the calf muscle of the lower leg

Instruction:    Stand leading with your right leg. Bend forward at the waist and place your hands on the Ground (V formation).  Keep your right knee slightly bent and your left leg straight.  Make sure your left Foot is flat on the ground.  Do not bounce during the stretch.  Hold for 30 seconds.  Switch sides and repeat.

B.   Quadriceps stretch (30 seconds x 2 reps) Elapsed Time:  1 to 2 minutes

Purpose:  stretch the quadriceps muscle of the front of the thigh

Instruction:   Reach back with your right hand and grab the front of your right ankle.  Bring your heel to buttock.  Make sure your knee is pointed down toward the ground.  Keep your right leg close to your left.  Don’t allow knee to wing out to the side and do not bend at the waist.  Hold for 30 seconds and switch sides.

C.   Figure Four Hamstring stretch (30 sec x 2 reps) Elapsed Time:  1 – 2 min

Purpose:  To stretch the hamstring muscles of the back of the thigh.

Instruction:  Sit on the ground with your right leg extended out in front of you.  Bend your left knee and rest the bottom of your foot on your right inner thigh.  With a straight back, try to bring your chest toward your knee.  Do not round your back.  If you can, reach down toward your toes and pull them up toward your head.  Do not bounce.  Hold for 30 seconds and repeat with the other leg.

D.   Inner Thigh Stretch (20 sec x 3 reps)  Elapsed Time:  1 – 2 min

Purpose:  Elongate the muscles of the inner thigh (adductor group)

Instruction:  Remain seated on the ground.  Spread you legs evenly apart. Slowly lower yourself to the center with a straight back.  You want to feel a stretch in the inner thigh.    Now reach toward the right with the right arm.  Bring your left arm overhead the stretch over to the right.  Hold the stretch and repeat on the opposite side.

E.   Hip Flexor Stretch  (30 sec x 2 reps)    Elapsed Time: 1 – 2 min

Purpose:  Elongate the hip flexors of the front of the thigh.

Instruction:   Lunge forward leading with your right leg.  Drop your left knee down to the ground.

Place your hands on top of your right thigh, lean forward with your hips.  The hips should be square with your shoulders.  If possible, maintain your balance and lift back for the left ankle and pull your heel to your buttocks. Hold for 30 seconds and repeat on the other side.


How would YOU help an athlete? Leave a comment and tell us HOW you would handle an athletic injury!







48 thoughts on “Women and Sports Injury Prevention”

  1. I will implement these stretches in my own life, I work for a veterinarian and I have seen a lot of ACL injuries and repairs.
    Being able to teach your body the proper way to move and to strengthen it self is very important for joint longevity.

  2. Some of these stretches don’t necessarily feel good but I will keep doing them because of issues with my hamstrings and hips. The stretch I like the most is the calf stretch. I also didn’t know that women were more prone to ACL injury than men; so now that I have that knowledge, I’m more prone to keep myself healthy. Thanks!

  3. well, ive never torn my ACL. But, that explains why we did so many stretches, hamstring, hip flexors,quads and thighs. I can say, that if these stretches are done correctly, im sure they could prevent a lot of injuries

  4. I knew that women are more likely to have knee injuries. I found this out when the doctors told me I had “runners knee” which I don’t understand, because I never run! Maybe these stretches could help when it starts giving me problems.

  5. How did you know I have a fear of breaking or twisting my knees?! My knees are prone to pop out of place and it is most uncomfortable. I hate hearing about knee injuries; it always makes me cringe. Thank you for the tips! Might give me a little peace of mine :).

  6. There are too reasons why women are more prone to ACL tears but I’m still eager to find out the 2nd reason. Other than that, I guess i learn something new everyday.

  7. O love stretching and it is always nice to learn new stretches, thank you for this. Also.. Didn’t know women were more prone to ACL tears.. interesting.

  8. I really like this info and can and will make good use of this having a few boys around me that are athletics and having a nephew that has already torn his ACL, I will imply these stretches with him.

  9. These all are fantastic points. I was a division 1 college athlete and have had chronic knee pain from old athletic injuries. While in college I spent a lot of time doing physical therapy and rehab in the athletic training clinic. Every time I was in there overhakf the athletes receiving treatment were female. It amazes me that with proper training, stretching, and bio mechanical modification women can compete at the same level as men and not have to worry about the greater risk of injury.

    1. Excellent point, Shannon. In no way am I implying that women can’t compete with a men in sports. Women just need to recognize that they need to TRAIN different than a man in order to perform as a top athlete. We are all different. Those differences are awesome and should be celebrated.

  10. I didn’t know that women were more prone to have knee injuries. And the stretch with the half-ball thing seems really fun and challenging, I’d like to try it. Also, these stretches are really good, they are great to do and feel good afterwards. I’ve always liked stretching but I didn’t know that stretching helps strengthen your muscles, and protects your ligaments from tearing.

  11. I really like this blog because I’m trying to pursue a career in sports massage and this will be very helpful if I am working with women in the field.

  12. the figure four stretch is perfect for me right now seeing as my hamstrings were worked with the “exercise” we did and left my hams so tight but with stretching helped a lot.

  13. I love all these stretches and have done them all, more know than ever. I actually have a torn ACL injury and stretching with proper technique is a huge key factor in preventing injuries.

  14. Wonderful Blog. It truly shows how important that it is to stretch before activity. This is great information about how to protect one’s body from injury by stretching. Very useful.

  15. I had no idea that girls had a higher risk of injuring the ACL. I will recommend that they cross train those muscles to prevent being out of their favorite sport.

  16. This is really good to know. I wish I had learned this back in school I tore ligaments in my ankles 3 times in high school.

  17. Very good information to know! As a female soccer player it’s very important to know how to go about preventing acl injuries! Wish I had known this years ago!

  18. I wish i knew more about this in school. I dislocated my knee and lost my scholarship over it. Maybe these exercises and stretches could have helped me get back faster and stronger.

  19. I would use ice, rest ,and light exercise to treat an injury, aim glad this blog came up again, I have been trying to find these stretches. They look easy to do and not time consuming I will try them after my walks and before bed.

  20. I didn’t realize men and women’s knees are so different. I’m already a fan of stretching since it lengthens your muscles and makes you feel better after a workout but that is good info to know that someone with knee problems can be referred to a massage specialist to help get them back to their regular routine. I’ll have to tell my husband who dislocated his knee from MMA and my sister’s boyfriend who tore his ACL in a rodeo.

  21. This information is awesome!I’ve actually heard a so called “expert” say that stretching doesn’t help prevent injuries. He probably has never done anything active.Stretching is definitely very important!

  22. Well that’s easy I would make a workout program where you make sure that there isn’t a muscle imbalance. For instant lets do the ACL. A lot of the time it’s the hamstring that pushes the ACL out of place. Because the hamstrings are stronger then the quadriceps and the quads can’t keep the knee in the right place cause the hamstring is pushing. So what I would do what make a workout program that make sure the two muscles are balance in strength.

  23. i knew men and women had differences in anatomy but i didnt know that they were so much more susceptible to knee injuries.

  24. I like the PEP routine and do most of the moves daily. I would have an injured athlete do the R.I.C.E. method. R.I.C.E. is Rest, Ice, Compression, and Elevation.

  25. Wow I had no idea the women’s ACL is so different than a man’s. But it does make sense now. How would I handle an athlete? If I was a therapist to an athlete (especially female) I would email this to them and work on some of the techniques with the. So they can have every advantage as possible.

  26. I remember when we talked about this in class a few weeks ago. I think proper body mechanics go a long way in prevention of injuries in women athletes and in everyday life. And of course R.I.C.E. for healing but it’s also very important to have a healthy diet, be hydrated, and stretch before and after activities.

  27. I didn’t know there was a difference between men and women either, I liked all the exercises and I can see how it would benefit the athlete.

  28. This is good stuff. I would tell the athlete about these techniques to help them prevent tearing there ACL. If an athlete did get hurt I would use the P. R. I. C. E

  29. I didn’t realize that men and women were different. I will share with my daughter who has many friends who play softball and many other sports. I believe everyone know somebody who had had an ACL injury.

  30. I had no idea there was a difference. I play tennis (well, I took the year off to go to school) but I’m going to share these stretches with the women on my team. I have a bad habit of skimping on the stretches and warm -up because I just want to get out there and play; I’ll have to work on that.

  31. The vast differences in women and men are interesting and the stretching is very important to have your clients learn.

  32. Nice to know that women are more likely to hurt their ACL than men, I didn’t know that. I would have thought it was the other way around. Like they put in some ways to stretch and help prevent that from happening. ☺️☺️

  33. Wow I never knew there was such a difference between the sexes when it came to stretches and injury, this will be very helpful for my future practice.

  34. I like the The PEP Program and will recommend to my son and his basketball team. Stretching is vital in sports.

  35. Stretching is so important! Men and women have very different bodies so it make sense that different stretches will work better for them. Good information to know!

  36. never knew that women have a higher chance of hurting their ACL.
    i would help an athlete by the use of massage and stretching/ROM. I would first ask for a dr. note to make sure that the injury was ready for me to work on them.