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Have posted this before but several local Texas Physical Therapists that specialize in sport injuries report that women's high school and college knee injuries are up 2-3X the past 10+ years. No formal studies to support cause but anecdotally they feel many coaches and programs have tried to increase performance through extreme work outs with knee, foot and ankle injuries often the result. Often a combination where as example bad ankle puts stress on foot or knee with stress fractures or ACL tears the result.