The anterior cruciate ligament injury is one of the most feared amongst basketball athletes but what fans fail to recognise is those female players are two to eight times more likely to suffer than men.

Earlier this year, veteran sports journalist Mechelle Voepel wrote for ESPN recalling her experience documenting ACL injuries in women's sports:

"From Sue Bird to Tamika Catchings to Sheryl Swoopes, it has happened to many of the greatest who have ever played, and every fan of women's basketball has likely been impacted by it."

There are no tell-tale signs for ACL injuries as Voepel explains, they can range from harmless cuts and jump-stops to legs bending in ways they never should. Likewise, reactions also varied from agony and rage to teams not even knowing if the player was injured.

Torn ACLs have ended seasons and even careers but why do women suffer more than their male counterparts? There have been numerous studies in this area but the most recent research highlights that a difference in the biomechanics (how our bodies move) between men and women plays a significant role.

Hormonal differences between men and women have also been suggested as a possible reason because the ACL has hormone receptors for estrogen and progesterone. It is thought that when the concentration of these hormones change they could play a role in ACL tears although scientists have disregarded the severity of this theory. 

Mechanically, landing position and valgus alignment are thought to be the main reasons behind this catastrophic injury. When athletes land from a jumping position, men tend to absorb more of the impact energy by landing with their knees bent, whilst women land straight-legged which transfers the force to the knee joint.

Furthermore, women have a different valgus alignment in their knees, meaning the bone segment distal to a joint is angled outward, and this places more stress on the knee ligaments as a result.

Although this is not the most positive news, understanding why means female athletes do have the ability to change the likelihood of an ACL tear. Neuromuscular training programs can aid athletes in modifying their biomechanics and train muscles to better control the stability of their joints and reduce stress on ligaments.

Surgery and rehab programs have also improved to better cater to women suffering from ACLs with strength training, conditioning, and nutrition playing a major role in getting athletes back on their feet. Understanding that women require a different rehab program to men is crucial in providing them with the best care possible.