Women and wounded knees

The first day University of Maryland midfielder Jen Biscoe stepped onto the soccer field after rehabilitating her torn ACL, she tore it again.

Miss Biscoe, a 21-year-old senior, says she heard the telltale pop and knew she was headed for more surgery.

She isn’t alone. Proportionally, women suffer more ACL (anterior cruciate ligament) injuries than men. Thanks to a greater number of women playing sports at professional and amateur levels, the numbers of wounded female athletes is rising.

The American Academy of Orthopaedic Surgeons reports that female athletes playing certain sports like soccer and basketball are three to four times more likely to injure their ACLs then their male counterparts. Other experts put the figures much higher.

Doctors don’t know for certain why the numbers differ between the sexes, but they have several suspects that may be to blame.

Dr. Wiemi A. Douoguih, an orthopedic surgeon at the Washington Hospital Center, says biology may be a culprit.

“A number of studies suggest an increased ‘Q angle,’ the measure of the angle between the tibia and thigh bone, that may predispose [women] to ACL injuries,” Dr. Douoguih says.

Women also may have less muscle protection in their knees than men, and in some cases, differing skill levels also could contribute to these injuries.

ACLs can suffer partial or complete tears, but each usually demands surgical correction, Dr. Douoguih says. The injuries typically involve sports such as soccer, volleyball, basketball and team handball, he says, games in which pivoting movements are common.

An ACL recovery can take many months, and the initial injury often doesn’t involve any blunt trauma. A good number of tears happen without contact.

“You can sustain very high loads to the ACL with noncontact, … up to six to eight times the body weight, and even greater,” Dr. Douoguih says.

Miss Biscoe, sixth on the university’s all-time career assist list, discovered that on two occasions. Both of her tears happened when she simply planted her foot incorrectly.

The soccer standout has endured five knee surgeries — all on the same knee. She needed three procedures to remove ganglion cysts and two operations to repair her twice-torn ACL. The cysts, which occur more often in women, may or may not have had something to do with the ACL tears, she says.

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