Women and men can participate fully across sports, but injury patterns are not always identical. Women may face a higher risk of certain knee injuries, including patellofemoral pain and anterior cruciate ligament (ACL) injury. The reasons are complex and can include anatomy, movement patterns, training load, strength and previous injury.

Patellofemoral pain—often called runner’s knee—affects the area around or behind the kneecap and can arise in many sports and everyday activities. An ACL rupture is a more serious injury involving one of the ligaments that stabilizes the knee. Injuries to weight-bearing joints can also influence long-term joint health.

Why can injury risk differ?

No single feature explains an injury. Differences in hip and knee geometry, ligament laxity, muscle strength and neuromuscular control may all contribute. Relative strength between the quadriceps, hamstrings, hips and trunk can affect how the knee responds when an athlete runs, cuts direction, jumps or lands.

Hormonal changes have also been studied for possible effects on connective tissue and neuromuscular control, but findings do not support simple predictions based on menstrual-cycle timing alone. Training plans should therefore focus on each athlete’s movement, workload, recovery and injury history rather than assumptions based solely on sex.

The Q angle

The quadriceps, or Q, angle describes the relationship between the pelvis, kneecap and upper shin. It can be one part of a clinical assessment, but it does not determine whether someone will be injured. A qualified clinician should interpret alignment alongside strength, symptoms and movement.

Build an injury-prevention routine

Anatomy cannot be changed, but strength, technique and training habits can be developed. If you have pain, instability or a previous joint injury, consult a physical therapist, sports-medicine clinician or appropriately qualified trainer before beginning demanding drills.

  • Train the whole movement chain. Include core stability, agility, flexibility and balance. Progressive strength training for the hips, quadriceps, hamstrings and calves can improve control.
  • Warm up dynamically. Begin with easy movement, then add controlled changes of direction, marching, gentle skipping or sport-specific drills. Increase speed and complexity gradually rather than starting at full intensity.
  • Practice jumping and landing. Aim to land softly with the hips and knees flexed, knees tracking in line with the feet and the trunk controlled. Start with low, predictable jumps before adding height, speed or direction changes.
Athlete practicing a controlled lunge outdoors
Technique focus

Slow walking lunge

Step forward with control and lower only as far as you can maintain balance. Keep the front knee tracking over the foot and push through the whole front foot to rise. Use a support or shorten the range if needed; stop if the movement causes pain.

  • Add plyometrics only when ready. Jump training can develop rapid force and landing control, but it should follow an adequate base of strength and balance. Quality matters more than repetition count.
  • Manage training load. Avoid abrupt increases in session length, intensity or weekly frequency. Build progressively and allow recovery after demanding training.
  • Choose suitable equipment and surfaces. Wear footwear appropriate to the activity and replace it when support or traction has deteriorated. Varying surfaces may help manage repetitive load, provided each surface is safe for the activity.
  • Adapt around symptoms. Persistent pain, swelling, locking, giving way or reduced motion warrants professional assessment. Avoid pushing through symptoms or copying a generic rehabilitation plan.
Woman performing a squat during outdoor strength training
Technique focus

Squat-to-rise progression

Stand with feet comfortable and lower into a shallow squat while keeping the knees aligned with the toes. Rise smoothly. A jump may be added only after you can squat and land with consistent control, and when it is appropriate for your fitness and joint health.

Activities that may need modification

There is no universal list of forbidden exercises. If a movement worsens knee symptoms, adjust the resistance, range, speed or duration and seek individual guidance. Heavy knee extensions, deep squats, downhill running or low-seat, high-gear cycling can be demanding for some people, but tolerability depends on diagnosis, technique and training capacity.

Health note: This article provides general education, not diagnosis or a personal exercise prescription. Seek prompt medical care after a traumatic injury, an audible pop with swelling, inability to bear weight, obvious deformity or a locked joint.