during a football tackle or a motor vehicle collision)These movements cause the tibia to shift away from the femur rapidly, placing strain on the knee joint and potentially leading to rupture of the ACL. About 80% of ACL injuries occur without direct trauma. Risk factors include female anatomy, specific sports, poor conditioning, fatigue, and playing on a turf field. Female predominance
Female athletes are two to eight times more likely to strain their ACL in sports that involve cutting and jumping as compared to men who play the same particular sports. NCAA data has found relative rates of injury per 1000 athlete exposures as follows:
Mens basketball 0.07, womens basketball 0.23
Mens lacrosse 0.12, womens lacrosse 0.17
Mens football 0.09, womens football 0.28The highest rate of ACL injury in women occurred in gymnastics, with a rate of injury per 1000 athlete exposures of 0.33. Of the four sports with the highest ACL injury rates, three were womens – gymnastics, basketball and soccer.Differences between males and females identified as potential causes are the active muscular protection of the knee joint, differences in leg/pelvis alignment, and relative ligament laxity caused by differences in hormonal activity from estrogen and relaxin. Birth control pills also appear to decrease the risk of ACL injury. Dominance theories
Some studies have suggested that there are four neuromuscular imbalances that predispose women to higher incidence of ACL injury.
There is evidence that engaging in neuromuscular training (NMT), which focus on hamstring strengthening, balance, and overall stability to reduce risk of injury by enhancing movement patterns during high risk movements. Such programs are beneficial for all athletes, particularly adolescent female athletes.Injury prevention programs (IPPs), are reliable in reducing the risk factors of ACL inquiries, referring to dominance theories. The ligament dominance theory reduced peak knee abduction moment but should be more focused on prioritizing individualized, task-specific exercises focusing on an athletes risk profile. It is more beneficial than a generic program. There is an increase in hip and knee flexion angles, such as plyometrics and jump-landing tasks, which reduces the risk of quadriceps dominance. However, there were no changes found for peak vGRF, which measures for "softer" landings. Unfortunately, there was no conclusive data on how IPPs reduces the risk associated with leg dominance theory. Treatment
Treatment for ACL tears is important to:
Reduce abnormal knee movements and improve knee function
Build trust and confidence to use the knee normally again
Prevent further injury to the knee and reduce the risk of osteoarthritis
Optimise long-term quality of life following the injury

Nonsurgical
Nonsurgical treatment for ACL rupture involves progressive, structured rehabilitation that aims to restore muscle strength, dynamic knee control and psychological confidence. For some, the ACL may heal without surgery during the rehabilitation process (i.e. the torn pieces re-unite to form a functional ligament).The purpose of exercise treatment is to restore the normal functioning of the muscular and balance system around the knee.