In 98 the American Journal of Sports Medicine featured an article titled "The Organization Between the Menstrual period and Anterior Cruciate Ligament Accidents in Female Athletes. inches This article confirmed the suspicion that many mentors already had, which is that hormonal, as well as anatomical, predispositions were to blame for the seeming epidemic of female athlete ACL tears. I possess come to the summary that there are three major reasons that girls are more than four times more likely then men to tear their ACL's playing sporting activities. (1)   In order to make hypotheses about women's increased susceptibility to ACL tears, one must first understand the basic body structure of the knee, and the purpose of the ACL. First, the knee is a joint composed of four bones; the femur, the tibia, the fibula and the patella. The knee joint is padded by sections of cartilage (menisci) on both the medial and lateral part. The ACL is 1 of four major ligaments accountable for stability in the knee. The ACL originates in the notch of the distal portion of the femur, and inserts into the tibia. Because of its origins and insertion, its main purpose is to protect the knee from too much anterior translation of the tibia.   The first part of the hypothesis we will discuss is the hormonal reason behind women's increased susceptibility to ACL tears. Doctor. Kurt Spindle, an orthopedic surgeon Sexiest Female Athlete in Nashville, has done probably the most relevant research on this percentage of the female athlete's epidemic. In the study, he uncovered that women were three times more likely to tear the ACL when these were on their period. He explains this by stating that during a female's period the hormones luteinizing and follicle stimulating hormone are allowed to enter the bloodstream stream and these hormones makes contact with the ACL's recently learned energetic hormone receptors. It is believed that this increase in hormonal levels can actually temporarily alter the structure of the ligament, therefore leaving the ACL more prone to tearing. Dr. Spindle also cited that women who had been taking oral contraceptives were less likely to tear their ACL's. The main reason for this is the fact that oral contraceptives skyrocket estrogen and progesterone levels, creating luteinizing and follicle stimulating hormones not to be released.   The second reason female athletes are at least four times as likely to rip their ACL is due to difference in the anatomy of the hip. The term "Q-Angle" is defined as "a measurement of the angle between the Quadriceps (Rectus Femoris is usually used) and the patella tendons (3). " Q-Angles in women are usually at the very least five degrees larger than that in men, which causes an increased stress on almost all of the ligaments of the hip and knee. The hip structure most women have is great for giving birth, but not so excellent for playing sporting activities that require lots of multidirectional movement.   The third reason for female ACL tears is an anatomical predisposition as well. The intercondyler notch is a section of the knee, between the condyles, that the ACL glides through during extension and flexion of the knee. There are two rounded portions one on each side of the notch that are condyles. These condyles provide a big source of stabilization for the knee. Consider of the condyles as your knuckles when you put two fists (femur and tibia) together. One of the condyles main purposes is to give the ACL additional help in protecting against to much anterior movement of the tibia. Women have smaller condyles (less knee stability) as well as a smaller intercondyler notch. The fact that women typically have smaller condyles is a distinct physical disadvantage that leaves women with less knee balance in general. In addition , the smaller intercondyler notch, women have, can lead to the ACL being pinched or torn inside the joint. So there are a host of physiological distinctions in the knees joint of women that drop them off more susceptible to ACL tears.   So, elaborate a girl to do? Should girls with large hips avoid playing sporting activities requiring multi directional motion? Should girls sit away from playing sports when on their period? Ought to collegiate athletic programs require their female athletes to land on oral contraceptives to lower their chances of season or career-ending ACL tears? There are evident legal and moral issues involved with asking female athletes to take oral birth control pills but it's an option I might not be astonished to see this option explored. However, my answer to this question is a resounding NO. A study made by the United states Journal of Sports Treatments declared the women who go through lower extremities injury prevention workouts are sixty-two percent less likely to experience traumatic knee injuries (5). This tells us that corrective/preventative exercises are definitely the way to go.