It Takes 2 Years for WNBA Players to Return to Elite Performance After ACL Reconstruction

    In a study from sports medicine researchers at the Henry Ford Health System in Detroit, Michigan, players in the Women’s National Basketball Association (WNBA) did not regain their elite performance level for at least 2 years after they returned from anterior cruciate ligament (ACL) injury and reconstructive surgery – about 1 year longer than players in the National Basketball Association (NBA) who sustained the same injury.

    In addition, WNBA players had significantly lower performance numbers in games played, games started, minutes played, points scored, rebounds, assists, and blocked shots during the season in which they returned to play, according to the study, which was published in the Orthopaedic Journal of Sports Medicine.

    RELATED: Read the full study here

    The researchers noted that the findings are important for both players and coaches to set reasonable expectations for returning – not only at the professional level, but also at collegiate and high school levels.

    Studies have confirmed that female athletes are 2 to 10 times more likely to sustain an ACL tear than male athletes, depending on the sport. With basketball players, females are at 2 to 7 times greater risk. Numerous studies have identified causes that contribute to high rates of ACL injuries in female athletes including differences in:

    • Lower extremity muscle activation
    • Joint laxity
    • Neuromuscular control
    • Knee anatomy
    • Hormonal factors

    “The data on WNBA players’ ACL tears and reconstruction has been previously studied, but what previous investigations did not evaluate is the performance levels after returning from these injuries,” said Kelechi Okoroha, MD, the study’s senior author.

    “The players we studied were back playing after 7 months, but the statistical data revealed that they didn’t return to their previous performance numbers on the court until their second or third year back on the court.”

    In addition, “the WNBA players returned to competition at a lower rate (69.5%) than NBA players with similar injuries (88.9%) and their performance numbers were measuredly lower once they returned,” Dr. Okoroha said.

    In this retrospective study, researchers evaluated ACL injuries that occurred in 59 WNBA players between 1997 and 2018, assessing the impact of the injury on return to sport and performance level. Data were collected for each player before and after injury to evaluate changes in playing time and statistical performance. Players who returned to play after ACL reconstruction were compared with their uninjured counterparts.

    Key performance findings on average in the first year after surgery:

    • Games played decreased from 69.6 to 57
    • Minutes played decreased from 23.4 to 18.4
    • Points per game decreased from 10.2 to 6.5

    Dr. Okoroha has led similar respective performance studies of male athletes in the NBA, National Football League, and Major League Baseball. He believes the Henry Ford research is important in understanding outcomes in male versus female athletes and accurately counseling those returning from ACL injury.

    As a former college basketball player and team captain at Xavier University of Louisiana, Dr. Okoroha also brings a player’s perspective on the implications of ACL injuries, “Some of my teammates suffered ACL ruptures,” he said. “These are devastating injuries that not only impact a player’s morale and outlook but also require a great deal of mental and physical work to return to previous performance levels.”


    Tramer JS, Khalil LS, Ziedas A, Mehran N, Okoroha KR. Return to play and performance in the Women’s National Basketball Association after anterior cruciate ligament reconstruction. Orthop J Sports Med. 2020 Sep 16;8(9):2325967120947078. doi: 10.1177/2325967120947078. eCollection 2020 Sep.