Why Women Are More Likely To Get Ligament Injuries

Dr. Bojan Zoric on the field at the London 2012 Olympics

It’s finally soccer season! But along with buying new shin guards and figuring out new ways to get rid of grass stains, soccer season can also be called “injury season” for the thousands of high school and college students that play the sport. Soccer is one of the most popular sports among young women in Massachusetts, and with that comes increased injuries—torn ligaments in particular. Little did we know that the team physician for the U.S. Women’s National Soccer Team lives and works right here in Massachusetts on the North Shore.

According to the NCAA, female soccer players are two to three times more likely to suffer an ACL injury than male athletes. The injury can keep a player out for six to eight months or longer, and sometimes, a player never fully returns to pre-injury strength. Dr. Bojan Zoric, an orthopedic surgeon specializing in sports medicine at Beverly Hospital and Sports Medicine North also happens to be the team physician for the U.S. Women’s National Soccer Team. Zoric, who has traveled with the team for the last four years, including the London Olympics where Team USA scored their way to a gold medal, has seen his share of sports injuries. The worst, he says, has to be a complete knee dislocation. “Have you ever seen a finger point in the wrong direction before? Now imagine that with a knee.”

Zoric, who played soccer professionally for Sweden before receiving his medical training at Harvard Medical School, says that there is a huge “huge upswing” in new and recurrent patients during the fall sports season, because football, women’s soccer, and women’s basketball are all sports where ligament injuries are common. “Most of these injuries really apply to any sports that require pivoting or changing direction,” he says.

Zoric says that women’s soccer in particular produces a lot of injuries like sprains of ankles and knees, and more severe ligament injuries like a torn ACL. Women experience these injuries more than men because, he says, women have a higher predisposition to those kinds of injuries. “There has been multiple studies that have looked at it, and females tend to be much more flexible and have laxity, or looser joints, because of hormones,” he says. “As [women] go through their monthly cycles, it has an effect on ligaments, and if you are more flexible you are putting greater stress on the ligaments.”

But it’s not just about monthly cycles or looser joints that makes women more likely to get a ligament injury. Women tend to land differently than men after a jump and unfortunately, it’s not for the better. “If you look at the biomechanics of how a women jumps and lands, they land in a more disadvantageous way, and it’s the way that they’re biomechanically built. There are efforts to teach women how to land in a proper manner or how to jump, land, and push off correctly,” Zoric says. “When you look at female athletes, they land with their knees together in a knock-knee fashion, where as men land with their knees straight over their joints and shoulder width apart, which is significantly better.”

When it comes to treatment, Zoric says that the most common is surgery. “With these ligament injuries surgery is the only way to repair or reconstruct and then it’s a long six to eight months before they’re back on the field. Prevention goes a long way.”  So, in order to not miss the entire season for a ligament injury, it makes sense to take a proactive approach when it comes to fall sports.

Zoric recommends a six week preseason (or during season if your fall sport of choice has already begun) program in order to minimize the chances for injury. The program focuses on three aspects: improving balance (lunges, single leg jumps), teaching how to land properly, and a strength and conditioning program. “We’ve seen in people who follow the program there is a significant decreased risk of injuries.” For the full program, click here.

The coaching staff on the field before the semi-finals in London. Dr. Zoric is far right.

Here is a video of the program you can do at-home.: