From Friday night lights to weekend club tournaments, sports are a huge part of life for many Berkley students. However, behind the highlight reels and big wins, one serious injury is becoming more and more common: ACL tears. Research suggests that approximately one in three people will experience an ACL tear at some point.
What is an ACL Tear?
Mayo Clinic describes an ACL tear as “a tear or sprain of the anterior cruciate ligament (ACL) – one of the strongest bands of tissue that helps connect your thigh bone (femur) to your shinbone (tibia).” As a result, when people tear their ACL, they often report hearing and feeling a “popping” sensation in their knee, followed by swelling, a feeling of instability, and an inability to put pressure on the knee because the pain is too unbearable.
Specifically, these tears have been more common to occur in sports that involve sudden stops, quick changes in direction, or awkward landings. For example, movements like cutting, pivoting with a planted foot, jumping and landing off-balance, or colliding with another player—such as during a football tackle—can all trigger an ACL injury.
Additionally, certain health and training factors can also increase the risk. Poor conditioning can mean less muscle support around the knee. Using sports gear or footwear that is worn out or not properly fitted can put extra stress on the joint. Continual strain from high-intensity training without enough rest can also weaken the body over time and make injuries more likely.
Although anyone can experience an ACL tear, research shows that girls are injured at higher rates than boys in many cutting and jumping sports.
Why Girls Face Higher ACL Risk
A 2020 Yale Medicine study found that girls are two to eight times more likely to tear their ACL compared to males. On the contrary, while experts know girls are at higher risk, there isn’t one reason why this happens.
New research done in 2023, from Northwestern Medicine, has identified risk factors that contribute to girls being more susceptible to ACL injuries, including anatomy, biomechanical factors, hormones, and the way many girls are trained and coached.
Anatomically, on average, girls generally have wider hips. As a result, this creates a larger angle where the thigh bone meets the knee—called the quadriceps angle, or the Q-angle. This means that when girls run, jump, or quickly change direction, the force moves through the knee in a way that can put extra strain on the ACL.
Girls also tend to have a smaller space inside the knee joint where the ACL sits. This means there is less room for the ligament to move, making it more likely to be pinched or torn during high-stress activities like sports.
Additionally, girls’ ligaments are typically looser compared to boys’. Looser ligaments allow the knee to move around more, which can make the joint less stable and more likely to shift out of place during quick movements which can make their knees less stable. ACL tissue is also usually thinner in girls, so it takes less force to injure.
Biomechanical factors add another layer of risk. Researchers from Northwestern have found that “when girls land, it’s usually in an upright posture, resulting in straighter knees and less core engagement.” Landing with a straight knee and limited hip and core involvement transfers more impact directly to the ACL, rather than spreading the force throughout the legs and trunk. As a result, many girls learn to move and land this way early in their sports careers and are not always taught their strength training or proper landing mechanics to protect their knees.
Hormones are also believed to play a role in ACL injuries in girls. Northwestern Medicine suggests that “The elasticity of collagen in the knee is impacted throughout different stages in the menstrual cycle, resulting in a higher risk of ACL injury.”
At certain times of the month, the ligaments may be slightly looser and less able to withstand sudden twisting or pivoting, increasing the risk of injury during games or intense practices. Scientists are still studying exactly how strong this connection is, but many other experts now see hormones as one possible piece of the puzzle.
Another possible reason for the higher ACL injury rate in girls’ sports is the rise in speed, intensity, and physical contact in sports that are now more popular among girls, such as flag football, lacrosse, hockey, and wrestling. While the level of competition and athleticism has gone up, injury-prevention programs, strength training, and sport-specific warmups have not always kept pace, especially at the youth and high school levels.
Impact in Berkley
Junior Kara Neiman has torn both her right and left ACLs. Neiman was active in the athletic community throughout middle school, through her sophomore year of high school. In eighth grade, Neiman was running with the ball up the court, until she tripped while dribbling and heard “a pop” in her right knee, followed by what she describes as her knee “exploding with pain.”
Despite this, she returned to sports and became a top rebounder and scorer on Berkley’s freshman basketball team and was dominating in the paint with her layups, until her second ACL tear during a staff appreciation game at Berkley.
Another player had landed on her left leg after a rebound, and Neiman shared that the“pop” felt similar to her first time, but this time it was especially hard because “it was a home game and everyone was watching.”
After surgery, she spent practices shooting on the sidelines while her teammates scrimmaged because “There were no specific workouts or warmups my coach had me do for ACL prevention,” she says, raising questions about how much structured prevention is built into everyday high school sports. Her recovery took about nine months, and she has since stopped playing sports to avoid another tear. Neiman encourages younger female athletes to stay healthy and also to take injury prevention seriously.
Neiman’s story is similar to many of those who have torn their ACL’S, particularly when it comes to the mental toll and the financial burden.
Many athletes at Berkley have experienced feelings of devastation, frustration, or even depression while they are sidelined due to injury. In conversations with athletes who have been unable to play, clear patterns emerged in the way they feel and think. Their shared experiences reveal how sports are a major part of how athletes see themselves, especially as teammates and competitors. When an injury suddenly takes that away, it can feel like they have lost a piece of their identity. On top of that, practices and games are usually a big source of social connection, routine, and stress relief. Being unable to play has left many injured Berkley athletes feeling isolated from the activities that once brought them joy, confidence, and a sense of purpose.
In addition to the mental toll from injuries, the surgery for repairing ACL tears is expensive, considering how common they have become. The National Institute of Health conducted a nine-year study that consisted of “229,446 outpatient arthroscopic ACL reconstructions.” They found that the “Median immediate procedure cost was $9,399.49.” However, with “health care utilization,” the cost rose to $13,403.38. These prices do fluctuate, depending on insurance coverage, but the potential for such high costs has led many athletes to quit sports after their first treatment rather than risk further financial strain.
Leg Workouts Berkley Softball is Doing to Prevent ACL Tears
College softball has become a rapidly growing pastime for girls across the nation. But with the rise in participation comes a rise in injuries—especially ACL tears. Because softball requires quick changes in direction and frequent jumping for all positions, including base running and hitting, ACL tears have become increasingly common, serving as an implicit warning for new and experienced players alike.
Berkley varsity softball assistant coach Hope Kapelanski has seen this issue up close. Kapelanski, a former catcher for Adrian College as a catcher, shared that during her collegiate career, “a few of [her] teammates had ACL tears, some meniscus, and MCL tears.” In response, her college team adopted a stronger focus on proper warmups and conditioning.
“As a team, we really focused on warming up correctly and getting stronger,” Kapelanski said. “The stronger you are, the less likely ligaments in your legs are to tear, because you’re stronger.”
Through her experience, Kapelanski also learned how interconnected the body is, especially in the lower half. “A lot of your lower half is all connected,” she explained, which is why she emphasizes full-body preparation before intense activity. “Make sure before you do anything, your whole body’s loose,” She added. “You don’t want to just jump into something; that’s when you get hurt.”
Kapelanski has brought those lessons to Berkley softball’s offseason workouts. She incorporates exercises like box jumps and change-of-direction drills to help athletes build strength and stability.
“We do a lot of the change in direction work, because that’s when a lot of ACL tears do happen.” She said, “Your body can’t handle that. So when we work on some of those drills in the gym, when we’re changing direction a lot, we’re trying to train our body to be used to that.”
By focusing on strength, proper warmups, and sport-specific movements, Kapelanski and the Berkley softball program hope to reduce the risk of ACL injuries and keep athletes healthy and on the field.
From varsity fields and courts to youth leagues, Berkley athletes are facing the same risks highlighted in national research. Stories like Kara Neiman’s and the efforts of coaches like Hope Kapelanski prove that while ACL tears can change an athlete’s path, smarter training and intentional warmups can change the story. The more our community talks openly about these injuries and how to prevent them, the better chance we have of keeping girls playing the sports they love. An ACL tear can change an athlete’s season, but education and focused training can change the outcome.
