In the early evening of March 27, 1964, a magnitude 9.2 earthquake roiled Alaska. For nearly five minutes, the ground shuddered violently in what was, and still is, the second biggest temblor in recorded history.

Across the southern part of the state, land cracked and split, lifting some areas nearly 12 meters — about as high as a telephone pole — in an instant. Deep, house-swallowing maws opened up. Near the coast, ground turned jellylike and slid into bays, dooming almost everyone standing on it. Local tsunamis swamped towns and villages.
Not many people lived in the newly formed state at the time. If the quake had struck in a more developed place, the damage and death toll would have been far greater. As it was, more than 130 people were killed.

In The Great Quake, Henry Fountain, a science journalist at the New York Times, tells a vivid tale of this natural drama through the eyes of the people who experienced the earthquake and the scientist who unearthed its secrets. The result is an engrossing story of ruin and revelation — one that ultimately shows how the 1964 quake provided some of the earliest supporting evidence for the theory of plate tectonics, then a disputed idea.

Using details from his own interviews with survivors — along with newspaper articles, diaries and other published accounts — Fountain focuses his story on two places near Prince William Sound. More people died in the port of Valdez (a familiar name because of the 1989 Exxon Valdez oil spill) than in any other Alaskan community, while the small village of Chenega suffered the highest proportional loss of life. Fountain’s tracking of the myriad small decisions people made that fateful day — that either put them in harm’s way or kept them safe — is meticulous. The experiences of the survivors and the lost are haunting.

Interwoven with stories of the human tragedy is Fountain’s account of the painstaking scientific gumshoe work necessary to piece together how such a monster earthquake had occurred. That’s where George Plafker, a geologist with the U.S. Geological Survey, comes in. In surveying the quake’s aftermath, Plafker, along with others, noticed something strange: There was no surface evidence of a fault large enough to explain the colossal shaking or the widespread uplift and sinking of land over hundreds of thousands of square kilometers.

Today, scientists know that Earth’s outer layer is divided into giant pieces and that the motion of tectonic plates — as they bump together or slide past each other — helps explain how some earthquakes occur. But in the mid-1960s, plate tectonics was just a hypothesis in need of real-world validation.
Plafker’s crucial contribution was to realize that the powerful Alaskan quake had no surface fault because it took place at what is now known as a subduction zone, where dense oceanic crust sinks under lighter continental crust. The insight into the quake’s origin provided some of the first real proof of tectonic plate movements.

Throughout the book, Fountain weaves in brief histories of key people and ideas in the development of the theory of plate tectonics. For those familiar with the history, Fountain doesn’t offer much new. People less familiar may find it a little difficult to keep one geologist straight from another geophysicist.

But The Great Quake is an elegant showcase of how the progressive work of numerous scientists over time — all the while questioning, debating, changing their minds — can be pieced together into an idea that reshapes how we see and understand the planet.

When Hurricane Maria’s 250-kilometer-per-hour winds slammed into Puerto Rico on September 20, they spurred floods, destroyed roads and flattened homes across the island. A week-and-a-half later, parts of the island remain without power, and its people are facing a humanitarian crisis.

The storm also temporarily knocked out one of the best and biggest eyes on the sky: the Arecibo Observatory, some 95 kilometers west of San Juan. The observatory’s 305-meter-wide main dish was until recently the largest radio telescope in the world (a bigger one, the FAST radio telescope, opened in China in 2016).

As news trickled out over the past week, it appeared that the damage may not be as bad as initially reported. The observatory is conserving fuel, but plans to resume limited astronomy observations September 29, deputy director Joan Schmelz tweeted earlier that day. “#AreciboScience is coming back after #MariaPR.”

But the direct whack still raises the issue of when – and even whether – to repair the observatory: Funding for it has repeatedly been on the chopping block despite its historic contributions to astronomy.

Arecibo’s recent work includes searching for gravitational waves by the effect they have on the clocklike regularity of dead stars called pulsars; watching for mysterious blasts of energy called fast radio bursts (SN Online: 12/21/16); and keeping tabs on near-Earth asteroids.

It played a key role in the history of the search for extraterrestrial intelligence: In 1974, astronomers Frank Drake, Jill Tarter and Carl Sagan used it to send messages to any extraterrestrial civilizations that might be listening (SN Online: 2/13/15). It was also the telescope that, in 1992, discovered the first planets outside the solar system.

Arecibo also holds a special place in my personal history: Watching actress Jodie Foster use the giant dish to listen for aliens in the movie Contact when I was 13 cemented my desire to study astronomy. I chose to go to Cornell University for undergrad in part because the university managed Arecibo at the time, and I hoped I might get to go there. (I never did, but my undergrad adviser, Martha Haynes, uses Arecibo to study the distribution of galaxies in the local universe.) And one of the first science stories I ever had published was about Cornell professors testifying to the National Science Foundation, which owns Arecibo, to defend the observatory’s funding.
Ten years after that story ran in the Cornell Daily Sun, Arecibo’s funding situation is still in doubt. It’s not clear how the recent damage will affect its future.

Telescope operator Ángel Vázquez sent the first damage reports via short-wave radio on September 21. A line feed antenna, used to receive and transmit radio waves to study the Earth’s ionosphere, broke off and fell onto the observatory’s main dish, damaging some of its panels. A second, 12-meter dish was thought to have been destroyed entirely.

But the smaller dish survived with only minor damage. “Initial reports said it had just been blown away, but it turned out that was not correct,” says Nicholas White of the Universities Space Research Association, which co-operates the observatory with SRI International, a nonprofit headquartered in Menlo Park, Calif., and Metropolitan University in San Juan, Puerto Rico. “That looks like it’s fine, although obviously we have to get up there and check it out.”

On September 23, observatory director Francisco Córdova posted a picture to the observatory’s Facebook page of two staff members standing in front of the big telescope dish with an outstretched Puerto Rican flag. “Still standing after #HurricaneMaria!” the post declares. “We suffered some damages, but nothing that can’t be repaired or replaced!”
The line feed antenna is a big loss, but it should be replaceable eventually, White says. And the damage to the main dish is fixable. Among the tasks was to get inside the Gregorian dome — the golf ball‒like structure suspended over the giant dish — and make sure the reflectors within it were aligned correctly. (Those reflectors were knocked askew by Hurricane George in 1998, says Cornell radio astronomer Donald Campbell.)

Meantime, Arecibo staff, who managed to safely shelter in place during the storm, “have been showing up for work, funnily enough,” White says. “People just want to get back to normal.”

But normal is also a state of uncertainty. The NSF, which foots $8.3 million of the observatory’s nearly $12 million a year operating costs, has been trying to offload their responsibility for it for several years. (NASA covers the balance.) And NSF’s agreement with the three groups that jointly maintain and operate the observatory runs out in March 2018. In 2016, the NSF called for proposals for other organizations to take over after that.

The NSF can’t estimate yet how expensive the repairs will be or how long they will take to complete, so it’s reserving comment on how the damage will affect decisions about the observatory’s future. “We need to make a complete assessment,” says NSF program director Joseph Pesce.

Personally, I hope the observatory remains open, both for science and for inspiration. I’m still waiting for a reply to that 1974 Arecibo message.

New observations of the whirling cores of dead stars have deepened the mystery behind a glut of antimatter particles raining down on Earth from space.

The particles are antielectrons, also known as positrons, and could be a sign of dark matter — the exotic and unidentified culprit that makes up the bulk of the universe’s mass. But more mundane explanations are also plausible: Positrons might be spewed from nearby pulsars, the spinning remnants of exploded stars, for example. But researchers with the High-Altitude Water Cherenkov Observatory, or HAWC, now have called the pulsar hypothesis into question in a paper published in the Nov. 17 Science.

Although the new observations don’t directly support the dark matter explanation, “if you have a few alternatives and cast doubt on one of them, then the other becomes more likely,” says HAWC scientist Jordan Goodman of the University of Maryland in College Park.

Earth is constantly bathed in cosmic rays, particles from space that include protons, atomic nuclei, electrons and positrons. Several experiments designed to detect the showers of spacefaring particles have found more high-energy positrons than expected (SN: 5/4/13, p. 14), and astrophysicists have debated the excess positrons’ source ever since. Dark matter particles annihilating one another could theoretically produce pairs of electrons and positrons, but so can other sources, such as pulsars.
It was uncertain, though, whether pulsars’ positrons would make it to Earth in numbers significant enough to explain the excess. HAWC researchers tested how positrons travel through space by measuring gamma rays, or high-energy light, from two nearby pulsars — Geminga and Monogem — around 900 light-years away. Those gamma rays are produced when energetic positrons and electrons slam into low-energy light particles, producing higher-energy radiation.
The size and intensity of the resulting gamma-ray glow indicated that the positrons slowly dissipated away from their pulsar birthplaces, getting bogged down by magnetic fields that permeate the galaxy and twist up the particles’ trajectories. That sluggish departure suggests the particles wouldn’t have made it all the way to Earth, the researchers conclude, and therefore couldn’t explain the excess.

Astrophysicist Dan Hooper of Fermilab in Batavia, Ill., disagrees. He still thinks pulsars are the best explanation for the rogue antimatter. The gamma ray measurements are just one method for studying how cosmic ray particles propagate through space. Other methods indicate that the pulsars’ positrons should be able to make the trek across the galaxy swiftly enough to get to Earth, he says. “I have every confidence that those particles are now reaching the solar system.”

Ruling out pulsars still wouldn’t point the finger at dark matter. “I think they’ve made a good case that these pulsars are not the source,” says astrophysicist Gregory Tarlé of the University of Michigan in Ann Arbor. Instead, Tarlé thinks that scientists can explain the excess positrons by better understanding what happens as cosmic ray particles travel through space. Protons interacting with the interstellar medium — particles that permeate the spaces between stars — could produce positrons that would explain the observations, without invoking either dark matter or pulsars.

The conflict leaves physicists with their work cut out for them. “In order to prove that it’s dark matter, you have to prove that it’s not something ordinary,” says HAWC researcher Brenda Dingus of Los Alamos National Laboratory in New Mexico. Although the new result disfavors the most obvious ordinary candidates, Dingus says, other possibilities are still in the running. “We need to look harder.”

To halt the misuse of opioids, it may help to slash the number of pills prescribed, a new study suggests.

Five months after the implementation of new opioid prescription guidelines at a University of Michigan hospital, roughly 7,000 fewer pills went home with patients — a drop that might reduce the risk of accessible pills leading to substance abuse. But the opioid reduction didn’t leave patients who had undergone a routine surgery with more pain, the team reports online December 6 in JAMA Surgery.
“The decline in opioid volume after the intervention was dramatic,” says physician Mark Bicket of Johns Hopkins University School of Medicine, who was not involved in the study.

Around 50 percent of people who misuse opioids get the drugs from a friend or relative for free, while 22 percent obtain them from a doctor, according to the U.S. Department of Health and Human Services. Michael Englesbe, a surgeon at the University of Michigan in Ann Arbor, says that part of doing a better job of managing patients’ pain “will be preventing chronic opioid use after surgical care and making sure fewer pills get into the community.”

Englesbe and colleagues looked at 170 people who had a minimally invasive surgery to remove their gallbladders at the University of Michigan hospital from 2015 to 2016. All had received a prescription for opioids. Of those patients, 100 completed a survey detailing how much of the prescription they took, whether they also used a common painkiller such as ibuprofen or acetaminophen, and how they rated their pain during the first week after surgery.

The 170 individuals typically received a prescription equivalent to 40 to 60 tablets, each containing 5 milligrams of hydrocodone. Seven of the 170 patients requested an opioid prescription refill. The 100 patients who completed the survey used very little of their prescriptions, usually somewhere from one to 12 pills. And their average pain score on a scale of zero (no pain) to 10 (the worst pain imaginable) was five.
Based on this information, guidelines for opioid prescriptions following the same type of surgery were implemented at the hospital in November of 2016. The researchers recommended prescriptions of 15 opioid pills, plus the use of common painkillers.

In the five months after the guidelines went into effect, 200 patients had the gallbladder surgery. Five of those patients asked for an opioid prescription refill. Eighty-six of the patients filled out the survey and reported that they used even less of their prescriptions — from zero to nine pills — than the pre-guidelines survey group. These patients also noted the same average pain score as the previously surveyed group and similar common painkiller use.

The study demonstrates “a relatively simple intervention at the institutional level with promising results,” Bicket says. “Patients receive opioid prescriptions within a health care system, so it makes sense to focus on getting our systems to work better in reducing the unnecessary supply of opioids after surgery.”

Along with this gallbladder procedure, Englesbe and colleagues have developed opioid prescribing recommendations for other routine surgeries, such as appendix removal and hernia repair, for the state of Michigan.

There have been hints for years that playing football might come at a cost. But a study this year dealt one of the hardest hits yet to the sport, detailing the extensive damage in football players’ brains, and not just those who played professionally.

In a large collection of former NFL players’ postmortem brains, nearly every sample showed signs of chronic traumatic encephalopathy, or CTE, a disorder diagnosed after death that’s associated with memory loss, emotional outbursts, depression and dementia. Damaging clumps of the protein tau were present in 110 of 111 brains, researchers reported in JAMA (SN: 8/19/17, p. 15).
Those startling numbers captured the attention of both the football-loving public and some previously skeptical researchers, says study coauthor Jesse Mez, a behavioral neurologist at Boston University. “This paper did a lot to bring them around.” And that increased awareness and acceptance has already pushed the research further. “The number of brain donors who have donated since the JAMA paper came out has been astronomical,” Mez says.
As the largest and most comprehensive CTE dataset yet, the results described in JAMA are a necessary step on the path to finding ways to treat or prevent CTE, and not just for professional athletes.
Former college and high school football players’ brains were also examined, though in small numbers. Three of 14 high school players and 48 of 53 college players had signs of CTE. Many of the brains were donated by relatives who suspected something was amiss. That skewed sample makes it difficult to draw broad conclusions. Still, the study raised troublesome questions about the safety of youth sports.

Those questions haven’t been answered, though other research this year provided clues. A study of concussed hockey players ages 11 to 14 suggested that young brains may need more time than is usually allotted to heal after a hard knock. Players had troublesome changes in white matter tracts — nerve cell bundles that carry messages across the brain — three months after injury, despite normal thinking and memory abilities, researchers reported in November in Neurology.

To fully understand CTE, scientists need a way to identify and follow the disease as it progresses. A comprehensive study is now under way to look for CTE markers in live people, and has already hit on one clue.

Compared with postmortem brain tissue taken from healthy people and those with Alzheimer’s, tissue from people who had CTE had higher levels of an inflammation protein called CCL11, Mez and other researchers reported in September in PLOS ONE. In people with CTE, the more years that a person played football, the more CCL11. CCL11 levels, or other factors circulating in cerebrospinal fluid or blood, might one day let scientists monitor the brain health of athletes and others exposed to head trauma.

The battle of the sexes, at least among certain ocean mammals, may come down to well-placed skin folds, suggests research by Patricia Brennan, an evolutionary biologist at Mount Holyoke College in South Hadley, Mass., and colleagues.

In some species, enhanced male-female genital fit has evolved over time in ways that make mating easier. This is an example of what scientists call congruent evolution. In other species, genital anatomy reflects a battle, as shape and form change over time to give one sex an edge in control of fertilization. Fittingly, this is called antagonistic evolution.
Brennan’s recent collaboration, examining genitalia of porpoises, dolphins and seals, required extra creativity. In previous studies, her team used saline to inflate preserved penises from birds, snakes, sharks and bats. But the tough, fibroelastic penises of the cetaceans would not inflate with saline alone. So her collaborator, Diane Kelly, a penis biomechanics expert at the University of Massachusetts Amherst, suggested pressurizing the saline with a beer keg.

“We looked at each other and said, ‘This could be the best or worst idea we’ve ever had,’ ” Brennan laughs. But it worked. The scientists then created vaginal endocasts with dental silicone and made 3-D mathematical models to examine male-female fit. The team, led by marine mammalogist Dara Orbach of Dalhousie University in Halifax, Canada, described the work in the Oct. 11 Proceedings of the Royal Society B.

Story continues below image
The results show both antagonistic and congruent coevolution. In the model vaginas of short-beaked common dolphins ( Delphinus delphis) and harbor seals ( Phoca vitulina ), penises encountered no physical barriers to penetration.
But in harbor porpoises (Phocoena phocoena) and bottlenosed dolphins (Tursiops truncatus), the scientists found vaginal folds that may help females physically exert choice over sperm. By subtly changing body position during sex, females may use those folds to decrease penetration depth, reducing the likelihood of fertilization by unwanted males, Brennan says.
Brennan’s work has, understandably, made a splash over the years, attracting media coverage and, in 2013, criticism. Conservative news websites and internet trolls attacked her research, calling it “wasteful government spending.” Surprised by the reaction, Brennan responded publicly with an essay in Slate , arguing that basic science moves society forward and is a valid and valuable use of public funds. The experience convinced her that scientists must defend basic science.
Our ability to innovate is undermined without curiosity-driven science, she says. Brennan has developed an outreach program on basic science and plans to keep expanding knowledge of vertebrate genitalia. “In every species we have looked,” she says, “we have found something weird that nobody else knew.” Reason enough to keep discovering.

NASA’s next mission will go where some spacecraft have gone before. The two finalists in the agency’s selection process will return to either Saturn’s moon Titan or comet 67P/Churyumov-Gerasimenko, NASA announced in a press teleconference on December 20.

The Dragonfly mission would launch a drone-like craft to Saturn’s largest moon in 2025 that would land in 2034. NASA’s Cassini-Huygens mission showed that Titan has lakes and rivers of liquid ethane and methane, and may have chemistry that is conducive to life.
“We can test how far prebiotic chemistry has progressed in an environment that we know has the ingredients for life,” said lead investigator Elizabeth Turtle of the Johns Hopkins Applied Physics Laboratory in Laurel, Md.

The other finalist, the Comet Astrobiology Exploration Sample Return (CAESAR) mission, would launch a spacecraft before the end of 2025 to collect a 100-gram sample from the surface of comet 67P, which was mapped by ESA’s Rosetta spacecraft, and return it to Earth in 2038.

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Rosetta’s mapping work “dramatically improves the chances of success for a very difficult activity, which is grabbing a piece of a comet,” said lead investigator Steven Squyres of Cornell University.
Each project will receive funding to further develop the mission concepts. In July 2019, NASA will announce which mission will fly.

Two other missions, one to search for signs of life in the plumes of Saturn’s moon Enceladus and one to land on Venus, will receive funding to tackle specific technology questions to prepare the missions for future competitions.

No story on the Science News website is complete without visuals. And when it comes to videos, those visuals have lives of their own on other platforms. In addition to incorporating videos into some of our articles, we also post videos to the Science News YouTube channel and the Science News magazine Facebook page, where thousands of people watch them each year.

We tackled all manner of subjects in video form in 2017— from popular events like the eclipse to significant discoveries like the detection of gravitational waves from colliding neutron stars to basic scientific questions like how tuna steer. Our most-viewed videos reflect this variety.
Here are the top five video stories from our YouTube channel in 2017:

1. How do mosquitoes dine and dash? (SN: 11/11/17, p. 13)
2. Light and gravitational waves reveal a neutron star crash (SN: 11/11/17, p. 6)
3. A star explodes: the story of supernova 1987A (SN: 2/18/17, p. 20)
4. How are frog tongues so sticky? (SN: 3/4/17, p. 11)
5. Wild male cuttlefish duke it out over a female (SN Online: 5/12/17)
6. Light and gravitational waves reveal a neutron star crash (SN Online: 10/16/17)

Light and gravitational waves revealed a neutron star crash | …
Gravitational waves from colliding neutron stars have been detected. Here’s why that’s such a huge deal. (Full story: http://ow.ly/JjMn30fUmMJ)

Posted by Science News Magazine on Monday, October 16, 2017

2. Cassini’s timeline to destruction (SN Online: 9/11/17)

The timeline to Cassini’s destruction
On September 15, the Cassini spacecraft will plunge into Saturn and burn up in the atmosphere. Here’s what its final moments will look like, as narrated by lead propulsion engineer Todd Barber.

Posted by Science News Magazine on Tuesday, September 12, 2017

3. How to pack wings like a ladybug (SN Online: 6/13/17)

Watch ladybugs fold their wings like origami masters
Ladybugs are probably better at packing than you are. Here’s how they fold up their wings into tiny spaces. (Full story: http://ow.ly/eZpw30cyS0T)

Posted by Science News Magazine on Saturday, December 2, 2017

4. Seven times Curiosity proved how awesome Mars used to be (SN Online: 8/4/17)

7 times Curiosity proved how awesome Mars used to be | Science…
On August 5, 2012, Curiosity landed on Mars. Since then, it’s taught us a lot about the Red Planet. Here are some highlights. (Read the full story here: http://ow.ly/T1sS30ebhKx)

Posted by Science News Magazine on Monday, September 25, 2017

5. Gecko grippers work in low gravity (SN Online: 6/28/17)

These gecko-inspired grippers could grab hold of space junk in…
Space junk can be dangerous. But most adhesives don’t work in space. So NASA looked to gecko toes for the answer. (Read more: http://ow.ly/9Mn430dbPAb)

Posted by Science News Magazine on Tuesday, August 29, 2017

A new robotic arm made of DNA moves 100,000 times faster than previous DNA machinery.

The DNA nanobot is shaped like a gearshift, with an extendible arm that ranges from 25 to more than 400 nanometers long that’s attached to a 55-by-55-nanometer platform. Researchers remotely control this DNA device, described in the Jan. 19 Science, with electric fields that tug on charged molecules in its arm. Those electric fields help the nanomachine’s arm move much more quickly than previous DNA robots, which relied on chemical interactions between DNA molecules to move (SN: 9/11/10, p. 18).

Friedrich Simmel, a biophysicist at the Technical University of Munich, and his colleagues could swivel their DNA robotic arm 360 degrees in a matter of milliseconds. To lock the arm down in particular positions, the team built latches made of short, single-stranded DNA into the platform.

Such quick, efficient DNA nanobots could someday help move tiny cargo, such as molecules or nanoparticles, in a nanofactory that manufactures new types of materials.

"It's the worst possible news on the eve of the tournament," said England midfielder Izzy Christiansen to BBC Sport. Spanish football journalist David Menayo called it "a jug of cold water" thrown over his nation.

They were referring to the loss of Alexia Putellas, who suffered a torn ACL on the eve of this the women's Euro 2022 tournament, leaving Spain without their reigning Ballon d'Or winner. The loss of such a superstar was evident, as Spain, a pre-tournament favorite, looked tame in bowing out to England in the quarterfinals.

Just a week later, young France star Marie-Antoinette Katoto suffered a similar fate in the Euro group stage, and a toothless Les Bleus attack fell short in the semifinals to Germany.

Bright young USWNT star Cat Macario, who lit up the Champions League for Lyon en route to winning the title over Putellas's Barcelona, tore her ACL in the early stages of a meaningless Ligue 1 match in early June. Two weeks later, legendary American striker Christen Press tore her ACL during NWSL play with expansion club Angel City FC. Just a month prior, Macario's Lyon teammate Dzsenifer Marozsan suffered the same fate, ruling the German star out of the Champions League final and leaving her sidelined for the Euros.

It doesn't stop there. USWNT defender Tierna Davidson went down in March of 2022 with an ACL injury during a shortened NWSL preseason. The Australian national team lost three players to ACL tears in a year's span, including young superstar Ellie Carpenter, who has already collected a massive 57 caps at just 22 years old, but went down in late May. A similar rising star for the German national team, Giulia Gwinn, suffered the injury in early October of 2021, her second ACL tear at just 23 years old.

As time progresses, the list just continues to grow — NWSL finalists Kansas City Current saw midfield fixture Claire Lavogez fall victim in the 2022 playoff quarterfinals. In the run-up to the 2023 Women's World Cup, stars Beth Mead and Vivianne Miedema both suffered ACL tears that ruled them out of the game's biggest event.

"The amount of ACL injuries in professional women's soccer in the last two years has just been shocking," Christen Press told ESPN in May of 2023. "If this happened on the men's side, we would have immediately seen a reaction of 'how are we going to solve this and figure this out, and make sure that these players are going to be available at the biggest moments of their career?'"

This is not just limited to the top of the game; clubs and college programs across the United States are noticing an increase in serious knee injuries. The Wake Forest women's team, a top ACC Division I program, has suffered six ACL tears in the past year, an increasingly common struggle for NCAA women's soccer coaches to navigate.

ACL tears have always been a danger in both men's and women's football, but as top players across the women's global game began dropping like flies, The Sporting News began asking questions. It turns out, there are scientific reasons to explain the wave of ACL tears that strike women's soccer.

Women soccer players more prone to ACL tears than men?
Over recent years it has become mainstream knowledge that women are, quite simply, more prone to serious knee injuries than men.

Slight anatomical differences between men's and women's bodies, largely concerning variations in hip structures, leave women at a higher risk of ACL tears or other serious knee damage. "These are trends that we've seen in the sports medicine world for years now," said Dr. Howard Luks, Chief of Sports Medicine and Arthroscopy at New York Medical College and a 20-year orthopedic sports surgeon with over a thousand ACL surgeries under his belt.

"Women in general are at higher risk. They have various differences compared to male athletic counterparts."

Research published by the Yale School of Medicine shows that women are two to eight times more likely to suffer ACL tears than men. Due to a wider hip structure, the knees of females are angled slightly differently, putting more pressure on the ACL. The differences are incredibly slight, but the effects can be witnessed over long periods of time.

"The ACL sits within a narrow notch on the inside of the knee joint," Dr. Luks noted. "That notch has more narrow confines in females, which can increase the risk of injuries."

While anatomical differences between sexes are a large contributing factor, there's another significant difference from males to females. There's medical evidence to support that women are significantly more prone to injury during their menstrual cycle. Given the private and personal nature of this information, research has not permeated the athletic community.

"Our ligament tissue changes based on the influence of hormones," Dr. Luks explains. "The best example of this is a woman's pelvis expands significantly due to the influence of hormones, but pelvis ligaments are not the only ones to change during the various cycles that occur."

Even with all the above, an individual's sex is not the only contributing factor in the ACL tears that occur with greater frequency in women's sports. Playing multiple sports, especially at a young age, can help.

"We've seen an increase in ACL tears due to single-sports participation," says Dr. Luks, explaining that repeated pressure in the exact same manner without variation over time can increase the risk of injury.

"The same stress on the same limbs in the same joints on the same ligaments month after month without any rest has an impact."

ACL injury prevention in women's sports
In recent years, women's soccer and other women's sports have sought to acknowledge the differences in injury risk, and to take steps to try and develop methods of prevention to counter the potential causes.

FIFA 11+ program

While there's no silver bullet when it comes to injury prevention, there's one program that stands out from the rest. The FIFA 11+ program was cited by multiple interview subjects for this report, and often without any prompting.

The FIFA 11+ program focuses on forcing athletes to build muscle memory for one key part of athletics, particularly soccer, that athletes often overlook: landing. The program is designed to be implemented as a short 10-minute warm-up performed before training and/or matches to positively reinforce proper landing techniques.

"They look at the way women jump and land on a surface, and what happens in their knees and ankles," says Brian Maddox, head athletic trainer for NWSL club North Carolina Courage. "They find that [women] move with more motion in their knees and hips when they land."

Dr. Luks, a proponent of the FIFA 11+ program, pointed to a superstar of the men's game for inspiration. "Watch Ronaldo when he lands on a header in the box. He lands on a flexed knee, the leg is as straight as possible, and when he lands he cushions the blow by going into a single-legged or a double-legged squat. These are all techniques that are taught [in the program] to diminish ACL ruptures.

"It's drilled into their heads," Dr. Luks explains. The idea being that such a simple action becomes healthy muscle memory. "Let's say you break your ankle, I put you in a cast, I take the cast off — your muscles are all atrophied. Half of that weakness is loss of muscle strength, but the other half of it is the lack of neuromuscular connections — your brain is no longer connected to those muscle fibers."

Dr. Luks' hypothetical metaphor is meant to show that building neuromuscular connections can create what we know as "muscle memory."

Wake Forest women's soccer senior defender Lyndon Wood, who serves as president of the school's Student Athlete Advisory Committee and is conducting her own research on ACL injuries in women's sports, said she brought the FIFA 11+ program to the Demon Deacons. It was quickly given approval by longtime head coach Tony da Luz.

"I felt like something needed to be done; anything we can do to keep one more girl on the field longer we should do," she said. "I brought it to [Wake Forest Sports Medicine program director] Dr. [John] Hubbard and Tony, and they were like 'Yeah, let's do it.'"

U.S. Soccer medical staff confirmed to The Sporting News that FIFA 11+ and other similar models are employed in training programs at all national team levels, although they would not dive into specifics of the programs at the different levels.

The FIFA 11+ program, however, still has yet to catch on everywhere. When Dr. Luks, whose three kids all play youth soccer, brought the FIFA 11+ program to the directors of their youth soccer programs and volunteered his time, they didn't jump at the opportunity.

"We went out to the schools assuming they would love it…no. Nobody wanted it. I can't explain it, and I was never given a good reason."

Special training regimens
The topic of a woman's menstrual cycle and how it affects injury risk in athletics is a sensitive one, and as a result, action has been slow in taking shape.

An assistant coach at a NCAA Division I women's lacrosse program in a Power 5 conference confirmed to the Sporting News that their program has just this season begun to track their athletes' cycles with the backing and participation from the players themselves.

With this information, women experiencing their menstrual cycle conduct separate, lower intensity training to minimize the risk of injury. It's not yet a practice that's widely adopted, and the same coach indicated that the women's soccer team at his school has yet to implement this same practice.

That's not surprising, says Maddox, the head trainer with the NWSL's Courage. "To my knowledge, it is not widely done in the U.S. because it can be a sensitive subject for some." Maddox says that he is aware of one top European club that does track their athletes' cycles, although he's not sure if they have yet to offer separate training based on the information.

It was widely covered following their 2019 Women's World Cup victory that U.S. women's national team players tracked their menstrual cycle throughout the four years leading into the tournament, and national team players publicly stated that there were several off-field programs implemented to complement this with regards to sleep and mental health. However, U.S. Soccer did not confirm whether these methods currently impact training intensity and injury prevention practices.

This may be the next step in the evolution of injury prevention in women's soccer if the USWNT's experience and that of other college programs yields positive results.

An assistant coach at another NCAA Division 1 women's lacrosse program confirmed to the Sporting News that their program suffered five ACL tears in the past year, and all five women were on their period at the time they were injured.

Mental health and injuries
In recent years mental health has gained increased attention throughout the athletics community, and its importance in injury prevention and recovery is being recognized as part of that push.

"Taking care of the athlete holistically…mentally and nutritionally, those resources are available to athletes these days when maybe they weren't as dialed in 15 or 20 years ago," says Maddox, who has prior athletic training experience in the NHL and minor league baseball.

"You can't disregard the mental aspect of it, this day and age every professional team across sports has those resources available to the athletes because it's useful."

When asked what she's learned through the recovery process, USWNT defender Tierna Davidson told The Sporting News, "Just to be patient with myself. It feels cheesy and simple, but I think as athletes we are impatient because we want results and we want to be 100 percent as quick as possible.

"But I think that through this process I have learned how to celebrate where I'm at in each stage, and not getting down on the fact that I suck at heading at the moment or I'm not as fast at the moment, or whatever it is."

A long way still to go
While more information is being gathered, some programs across the globe have been slow to implement change due to social and societal boundaries that are still difficult to breach.

"[ACL injury research] became a really hot topic in the late '90s and early 2000s," says Maddox. "That's when a lot of the research was conducted, specifically with regards to why women tear their ACLs more than men."

Maddox explains that strength training is a key part of injury prevention, but that the culture around women's sports doesn't lend itself to nearly the amount of strength training that is prevalent in men's sports.

"The way women are training from the youth on up…the emphasis in men's sports and boys sports is that you're not an athlete unless you lift weights. That culture is slowly hitting women's athletics, but it's behind the men."

When asked what they've learned in recent years regarding ACL tear prevention, the U.S. Soccer Federation didn't share any specific details or data points, except to confirm that it's top of mind with their programs.

"U.S. Soccer continuously builds loading programs for players. We work diligently with their clubs and/or universities in monitoring the players and develop individualized plans based on multiple factors in building out ACL prevention, but also soft tissue injuries as well. This has been a long-standing pillar for U.S. Soccer’s care of its players."

Why have so many women's soccer stars torn their ACLs?
The ability to pinpoint specific causes of injuries is ultimately an inexact science. When it comes to the human body, there are so many factors and variables that can affect an athlete's propensity or resistance to injury.

U.S. women's national team star Alex Morgan, who tore her ACL way back in high school, told The Sporting News during a USWNT press conference in the fall of 2022 that she thinks it's possible a shortened preseason and extended competition at the domestic level in the United States could be to blame for injuries in her part of the world.

"We look at the [NWSL] Challenge Cup, it was a great preseason tournament to have," Morgan said in early September in reference to the kickoff tournament of the U.S. women's professional season. "But having that bonus set for players to win, having it be a little more competitive than I think players were really ready for, having players playing 90 minutes week-in and week-out…is that the best for players in the first five weeks of the preseason? Probably not."

Dr. Luks says a quick ramp-up to competitive matches early in the season potentially increases the risk for injury. He explained how a proper and full preseason is critically important to avoiding injury during the year. Essentially, nerves that direct muscle movements connect to those muscles via "motor end plates" which degrade over time. Preseason, which features a slow increase in repetitive activity, is required to rebuild those connections.

"If you don't have connections to all the muscle fibers, I don't care how many weights you put on the rack, it's irrelevant, you're only exercising a third of the muscle fibers, because the other two-thirds don't have a connection to your brain, so they're not firing," Dr. Luks explains. "So that's such a critical component of a preseason program."

The Chicago Red Stars' Davidson, who suffered her ACL tear in preseason training in March 2022 before the Challenge Cup, was less convinced there was a common link in the rash of injuries that afflicted the stars of the women's game in 2022, but she acknowledged that an accumulation of minutes could potentially be responsible for her injury.

"I definitely think you can point to the volume and load that a lot of international players take through their club and country, so I'm sure that a bit of fatigue has to do with it. Sometimes it could just be coincidence, I don't know everybody else's schedule, but I do think there could have been some overuse of players."

A look at the numbers does support Davidson's suspicions. From January to November of 2021, the 24-year-old played 3,224 minutes across both club and international duty, including 1,780 minutes after the start of August. Add in three February 2022 national team appearances in the SheBelieves Cup, and with the short preseason ramp-up, she suffered her tear in March.

Many of the top international players injured this spring had similarly heavy loads. The chart below illustrate the range of matches and minutes played by some of the stars who suffered the ACL injuries (statistics via FBref.com).

Work load for soccer stars prior to ACL injury
(Note: Players listed below in alphabetical order.)

Player Date Range Games Minutes
Tierna Davidson Jan 22, 2021 — Nov 30, 2021 41 3,224
Giulia Gwynn Aug 29, 2021 — Oct 2, 2022 43 3,305
Marie-Antoinette Katoto Aug 5, 2020 — Jun 25, 2022 66 5,145
Catarina Macario Jul 1, 2021 — Jun 1, 2022 45 3,021
Dzsenifer Marozsan Jan 15, 2021 — Apr 12, 2022 70 4,893
Christen Press Oct 4, 2020 — Jun 11, 2022 36 2,686
Alexia Putellas Sep 19, 2020 — Jun 25, 2022 36 2,846
The table above shows 30-year-old Marozsan played close to 5,000 minutes across a 15-month period. So did 24-year-old Katoto, who logged 5,145 minutes over two years. Christen Press's numbers don't quite jump off the page, but what stands out is that she had little activity between mid-July 2021 before the Challenge Cup in March 2022.

The schedule congestion is not unique to these players specifically, but many top players across the globe are juggling busy club and international schedules that are increasing in load as the women's game explodes in popularity.

Alex Morgan, who's been a professional since 2011, ultimately labeled the rash of star knee injuries in 2022 an "unlucky run." But what is clear is that there are more variables that impact a women's soccer player's injury chances than in the case of a male player. And there's more research and information sharing that still can be done to investigate each of those factors.

Was it an unlucky run? We'll find out soon enough in the lead-up to the expanded Women's World Cup with 32 teams in July 2023. Given the names forced to sit out due to injury in the summer of 2022, a similar rash of injuries would not go unnoticed ahead of the biggest tournament in the sport.