The anterior cruciate ligament (ACL) in the knee is prone to severe injury more so in women than in men. This information has received much speculation, but the two issues I’m going to focus on right now are the “gait”, which is the pattern of how we walk, and the quadriceps/hamstring imbalances in both men and women.

Women generally have a wider pelvis, which makes the thigh bones angle downward more distinctly than in men. This is called the “Q” angle. The greater the angle, the more pressure put on the inside of the knee.

Women are considered to be more quadriceps dominant, meaning their quadriceps (front of thigh), take more of the pressure while running, jumping, etc. Men on the other hand, rely more on the hamstrings while performing physical activities, thus creating more protection/balance for the knee. The hamstrings consist of the biceps femoris, semitendinosus and semimembranosus muscles and are responsible for extension of the hip, flexion of the knee and internal/external rotation of both the hip and knee.

While we obviously can’t control how wide our pelvis is, we can prioritize our hamstrings during our leg workouts to make them stronger and create a more balanced lower body. This is especially important for runners, skiers, soccer players and equally important to physique competitors for health and aesthetic reasons. The hamstring muscles can often be neglected as they are “out of sight, out of mind.”

Effective exercises for strengthening the hamstrings are stiff-legged deadlifts, prone/standing leg curls, TRX and Stability Ball Hamstring Curls, hyperextensions, Squats and lunges to name just a few. Running backwards also recruits more of the hamstring muscles and prepares them for the tremendous eccentric forces applied to them while running straight ahead. (I don’t recommend you do this while on a treadmill or by the side of a road for obvious reasons). Working to improve proper neuromuscular (balance and speed) training is a must in order to further improve your reaction time and strengthen the hamstrings. Plyometrics training is a great way to increase power, spatial awareness, strength, balance and coordination. It’s wise to learn the correct form of any exercise you implement into your workout, so have a trainer or someone you trust teach you proper body mechanics while lifting weights, especially with the stiff-legged deadlift.

Dynamically warming up and statically stretching as part of a cool-down is a must and will help you create a mind-muscle connection in this neglected area. Consult with your doctor before beginning an exercise program, especially if you have a history of knee problems or have just recovered from ACL surgery.

Have fun!