ACL Injuries Are Rising — Here's Who's Most at Risk

ACL injuries have become one of the defining concerns of youth travel sports — and the data shows the concern is justified.

Between the 2007-08 and 2021-22 school years, ACL tears in high school athletes increased by 12%, according to research from the Hospital for Special Surgery and the Datalys Center for Sports Injury Research and Prevention. That increase happened during a period when overall sports participation remained relatively flat — meaning the injury rate, not just the raw number, went up.

Who carries the most risk

Not all sports and athletes face equal exposure. The data points to two consistent patterns:

• —Girls soccer has the highest ACL injury rate of any high school sport tracked
• —Female athletes overall sustain ACL tears at significantly higher rates than male athletes in comparable sports
• —Sports involving cutting, pivoting, and sudden directional changes carry the highest exposure — soccer, basketball, and lacrosse lead this category
• —Early specialization and high weekly training volume are associated with increased overuse injury risk, which compounds ACL vulnerability over time

Why the rate is going up

Researchers point to several factors driving the increase:

Year-round play has replaced the seasonal rest periods that once gave young athletes time to recover. A child who plays soccer in the fall, trains indoors through winter, and joins a spring club league is accumulating load on developing joints without adequate recovery time.

Early specialization means young athletes are repeating the same movement patterns thousands of times before their bodies have fully developed the strength and neuromuscular control to handle that volume safely.

Competitive pressure — including tryouts, showcases, and the fear of losing a roster spot — pushes athletes to train through pain signals that should be warning signs.

What parents should ask before the season starts

The research points to questions worth raising with any club or program before you commit:

How many days per week does the program train, and is there a mandatory rest day built in? What is the policy when an athlete reports pain or discomfort during training? Does the coaching staff include anyone with formal training in youth athletic development or injury prevention? What is the program's position on year-round single-sport specialization?

A program that can't answer these questions — or dismisses them — is telling you something important about how it views athlete welfare.

The bottom line for travel sports parents

An ACL tear in a young athlete means surgery, 9-12 months of rehabilitation, and a disrupted season at minimum. For female athletes in high-cutting sports, the risk is measurably higher than most parents realize when they sign up.

The data isn't a reason to keep your child out of sports. It's a reason to ask better questions about the program you're about to pay for.