Why Youth Soccer and Football Players Tear Their ACLs in the Fall

ACL tears become especially visible during the fall because soccer and football expose young athletes to repeated cutting, landing, deceleration, and contact once practices and games ramp up. Fall itself isn’t the cause. Risk comes from the sport, the athlete, and how prepared their body is for those demands.

Why Are ACL Tears So Common in Soccer and Football?

Soccer and football both put the knee through movements that can place high loads on the ACL, including planting, cutting, stopping quickly, landing, and reacting to another player.

A large study of ACL injuries in U.S. high school athletes recorded 617 ACL injuries across more than 9.4 million athlete exposures. Girls’ soccer had the highest ACL injury rate at 12.2 per 100,000 athlete exposures, followed closely by boys’ football at 11.1 per 100,000. Across the sports studied, ACL injuries occurred 7.3 times more often in competition than practice.

That makes sense when you look at what happens in a game. Soccer players accelerate, press, plant, and change direction while reacting to opponents and the ball. Football adds many of the same cutting and deceleration demands along with blocking, tackling, and contact.

An ACL tear often happens during a movement an athlete has performed hundreds of times before. The difference is that the speed, force, body position, and reaction all line up in a way the knee cannot tolerate.

Why Do ACL Injuries Seem to Increase Once Fall Sports Start?

Fall brings a large increase in exposure to the movements and competitive situations where ACL injuries occur.

A recent study that tracked 3,381 ACL injuries across 782,856 soccer player-seasons found that October accounted for 15.7% of all ACL injuries, the highest percentage of any month in the study. January was next at 13.5%.

That doesn’t mean October itself makes the ACL more vulnerable. By that point in the season, athletes are deep into practices, games, tournaments, high-speed cutting, and repeated competitive exposure.

Competition appears particularly important. A study of ACL injuries in U.S. high school soccer found that injury rates were almost 15 times higher during competition than practice for girls and nearly nine times higher for boys.

That fall ramp is easy to see locally. Pleasanton RAGE’s 2026 recreational season began on August 22 and runs through the fall, putting September right in the middle of regular practices and competition.

For families balancing club practices, games, school, and additional training, this is a good time to ask whether the athlete is physically prepared for everything being added.

Are Girls More Likely to Tear Their ACL Than Boys?

Yes. In comparable cutting and pivoting sports, adolescent girls generally have a higher ACL injury rate than boys, and that difference becomes more noticeable during adolescence.

The high school soccer research found an ACL injury rate of 13.23 per 100,000 athlete exposures in girls compared with 4.35 in boys, roughly three times higher. Only about 30% of girls’ ACL injuries involved player-to-player contact, compared with nearly half of the injuries in boys.

The newer soccer study found another important age-related pattern. Girls didn’t have significantly higher ACL incidence than boys in the youngest categories, but the difference became significant in players older than 14.

Puberty changes the body quickly. Strength, coordination, limb length, body mass, and movement mechanics all have to adapt while the sport itself becomes faster and more demanding.

In a longitudinal study of 315 young athletes, knee-abduction movement during landing increased through puberty in female athletes while the same change wasn’t seen in males.

That doesn’t mean every teenage girl moves poorly or is destined for an ACL injury. It does mean adolescence is an important time to make strength, landing, and movement training part of athletic development.

Do Soccer and Football Players Tear Their ACLs the Same Way?

No. Soccer ACL tears are more commonly non-contact, while football has a larger contact component.

A large analysis of ACL injuries in high school soccer and football found that 61.5% to 66.4% of soccer ACL injuries were non-contact, depending on playing surface. In football, contact accounted for roughly 50% to 61% of ACL injuries.

For a soccer player, the injury may happen while planting to change direction, slowing down, landing, or defending without anyone hitting the knee.

Football athletes face many of those same demands, but direct and indirect contact add another layer of risk.

That distinction matters for prevention. You can’t train away every tackle or unpredictable collision, but many ACL tears occur during movements athletes can practice and become better prepared to handle.

Can Youth ACL Tears Actually Be Prevented?

You can’t eliminate ACL injuries completely, but well-designed prevention programs can meaningfully reduce the risk.

One of the strongest examples comes from a randomized trial involving 4,564 female soccer players ages 12 to 17. Athletes in the intervention group completed a 15-minute neuromuscular warm-up twice per week focused on core stability, balance, and knee control.

There were 7 ACL injuries in the training group compared with 14 in the control group, representing a 64% lower ACL injury rate in the athletes doing the prevention program.

That’s an important message for parents. ACL injury prevention doesn’t necessarily require adding another hour-long workout to an already packed schedule.

The bigger challenge is consistency. Prevention work needs to become part of normal training rather than something an athlete starts only after a teammate tears an ACL.

What Should ACL Prevention Training Include?

Effective ACL prevention training usually combines strength, balance, jumping and landing, deceleration, and change-of-direction control.

A broader review of ACL prevention research also supported multicomponent programs that combine several types of training to reduce noncontact ACL injury risk in young female athletes. 

For soccer and football players, training may include:

• Lower-body and single-leg strength
• Jumping and landing control
• Balance
• Stopping and decelerating
• Cutting and changing direction
• Trunk control
• Progressively faster sport-specific movement

What Can Parents Do During the Fall Season?

Parents can help by looking beyond whether their child is simply “in shape” and paying attention to whether training prepares them for the movements their sport demands.

Useful questions include:

• Does the warm-up include jumping, landing, balance, and movement control?
• Is your athlete strength training consistently during the season?
• Are they coached on how to stop, land, or change direction?
• Have they recently gone through a major growth spurt?
• Are club, school, private training, and tournaments leaving very little recovery time?
• Are recurring knee pain, swelling, or instability being evaluated?

More activity doesn’t automatically mean better ACL protection. The athlete also needs the strength, coordination, and movement capacity to handle what the sport keeps asking them to do.

If you want to know where your athlete has meaningful strength or movement deficits rather than guessing from how they look on the field, BPR’s performance and injury prevention assessments can help identify areas worth addressing.

What If My Child Already Tore Their ACL?

Once an ACL tear has happened, the priority shifts from prevention to preparing the knee for recovery.

If surgery is planned, the weeks beforehand can still be productive. BPR’s ACL Prehab program works on swelling, knee extension, quad activation, walking, and strength instead of treating the period before surgery as dead time.

The condition of the knee before surgery matters because strength and motion deficits can carry into postoperative rehabilitation.

From there, athletes who undergo reconstruction can continue into post-surgical ACL rehabilitation and eventually the higher-level strength and return-to-sport work required to get back to competition.

Where Can Youth Athletes Work on ACL Injury Prevention in Pleasanton?

Bax Performance Rehab works one-on-one with youth athletes in Pleasanton who want to build the strength, movement control, and sport-specific capacity needed for soccer, football, and other cutting and pivoting sports.

The goal is to prepare athletes more deliberately for the forces and movements they face as practices, games, and tournaments become faster and more demanding.

BPR serves athletes and families throughout Pleasanton, Dublin, Livermore, San Ramon, Danville, and the wider Tri-Valley.

If you want a clearer picture of how prepared your athlete is for the demands of their sport, book your free discovery call with Bax Performance Rehab.

FAQs

At what age should kids start ACL prevention training?

There’s no single age when ACL prevention suddenly becomes necessary. Young athletes can begin learning age-appropriate strength, balance, landing, and movement skills before adolescence, then progress those skills as their bodies and sports become more demanding.

Does wearing a knee brace prevent an ACL tear?

A brace shouldn’t be treated as a substitute for strength and neuromuscular training. Whether a brace has a role depends on the athlete, previous injury, sport, and medical guidance.

Does artificial turf increase ACL injury risk?

Research has found differences in ACL injury patterns between playing surfaces, but surface is only one part of the risk picture. The high school soccer and football surface study found differences by sport and injury mechanism, which makes a simple “turf causes ACL tears” conclusion too broad.

Should youth athletes strength train during soccer or football season?

Yes, appropriately programmed strength training can remain part of an in-season plan. The volume and intensity should fit around games, practices, recovery, the athlete’s age, and their current training experience.

Reviewed by Dr. Rob Bax

Dr. Rob Bax, PT, DPT, OCS, CSCS

Dr. Rob Bax is a Doctor of Physical Therapy, Board-Certified Orthopedic Clinical Specialist, and Certified Strength and Conditioning Specialist at Bax Performance Rehab in Pleasanton, California. BPR works with youth athletes and active adults throughout the Tri-Valley.