Women's participation in sport is booming, but so too is the rate of serious knee injuries

With the introduction of the AFL women's competition, the rise of the Matildas and increasing interest in women's cricket, female participation in sport is booming, but so too is the rate of serious knee injuries.

Women are up to 10 times more likely than men to rupture their anterior cruciate ligament (ACL) — an injury that takes about 12 months to recover from.

Physiotherapist and AFLW player Brooke Patterson is doing a PhD on ACL injuries, and said the reasons women were so susceptible to the injury were largely out of their control.

"Things about our anatomy and the way that our bones angle in, a wider-set pelvis, the actual shape of our knee and how the bones are slopped, the actual size of the ACL," she said.

"Obviously, there are hormonal changes in females as well.

"It's not strong evidence at this stage [but] at certain times of the menstrual cycle, where hormones are in that pre-ovulatory phase, is when they suspect there are changes to the makeup of the ligaments that may put females more at risk at that stage."

Up to 80 per cent of injuries preventable

Knee surgeon Dr Christopher Vertullo performs about 300 knee reconstructions per year.

He has also recently published research showing Australia has the highest rate of ACL surgery in the world, and that the number of young Australians having knee reconstructions has risen more than 70 per cent in the last 15 years.

According to Dr Vertullo, the vast majority of those injuries could have been avoided.

"The good news is that 50 to 80 per cent of ACL ruptures are actually preventable through agility training — just three times a week for 20 to 30 minutes during the playing season," he said.

"It teaches young people how to step correctly, step so they're balanced and not off balance when they do it, and when they land from a jump to keep their knees bent, so they don't hurt themselves."

That is why Dr Vertullo and the Australian Orthopaedic Association are lobbying the Federal Government to implement a national sport injury prevention program.

"We've shown in one of our studies that for every 27 young individuals that are exposed to these programs, which are really cheap and easy to implement, you can prevent one ACL rupture per season, which is incredibly cost effective," he said.

'I really wish I had done more training in regards to my knees'

Eighteen-year-old Ella Cummings knows all too well about the pain and frustration of ACL injuries.

Normally she would be running, sprint training, weight training and playing rugby, but instead she's doing post-surgery physiotherapy thanks to an accident at training.

"After the kick off, I ran up to cover a girl that had caught the ball, she went to step me, and I stepped to cover her and my whole knee just buckled, and I just collapsed," she said.

"It was very, very painful and I had my suspicions. I thought I did my ACL and I was right."

She said she wished she had known about the benefits of agility training before she was injured.

"I definitely think rugby teams should look more into doing agility training," she said.

"To other girls that want to do rugby and AFL, or any of those agility sports, I really advise that they do a lot more training for their knees and for their ankles.

"As a person that loves sport and relies on it a lot, it's not that great of a thought to think that I am going to be out for so long and I really wish that I did more training in regards to my knees."

More training needed at junior levels

The burgeoning AFL women's competition saw a spate of ACL injuries in its first two seasons and sparked concern about the high number of female players being sidelined because of them.

Most professional sports already have injury prevention, but it is at the junior level where there are often gaps.

Brooke Patterson is helping junior girls' clubs in Melbourne to train the next generation of players to protect and stabilise their joints.

"All these programs that have been shown to work and encompass a few key things," she said.

"There's certain types of running drills, strengthening drills for all the different muscle groups in the lower leg, thigh muscles at the front and back, calf muscles, core, gluteal muscles. [They] are all really important key concepts, practicing agility and foot work, jumping and landing."

She has backed calls for a nationwide federally-funded injury prevention program.

Are too many people getting knee surgery?

Despite having had the surgery herself, Brooke Patterson believes too many people are going under the knife.

"I would definitely recommend doing some rehab with a physio first and then seeing if you need to have surgery," she said.

"In the studies they've done, 50 per cent end up needing to have surgery and then 50 per cent don't actually need to have surgery.

"You can get back to the same level of sport, even if you are playing sports like netball and basketball that involve all those kinds of change of directions and jumping activities."

Dr Vertullo said prevention was definitely better than surgery.

"The reason the ACL injury is so devastating is it changes the rest of your life," he said.

"If you tear your ACL, regardless of whether it is reconstructed or not, it's a lifechanging event for yourself and for your knee, you'll have high rates of osteoarthritis and problems in the future."