Injuries and Female Athletes

Education, preparation and proper technique can go a long way toward preventing injury in female athletes.

A quick glance at a grade school recess will confirm that girls like to run, jump, kick and climb as much as their male counterparts. Since the advent of Title IX in 1972, those same girls have been participating in sports in ever-increasing numbers. As might be expected, increased participation translates to increased sports-related injuries for those young female athletes. While every athlete risks trauma, a variety of gender-related factors may place females at higher risk for certain injuries.

Common Sports Injuries Among Female Athletes

Although injury rates are similar among adolescent athletes, the pattern differs between the sexes. Factors such as form, alignment, body composition, physiology, and physical performance influence all sports-related injuries, but the onset of puberty and its hormonal effects on development are not the same between girls and boys. For various reasons, ankle sprains, shoulder issues, knee injuries, stress fractures and concussion are the most common injuries affecting female athletes.

Hips & Hormones

“There are a lot of anatomical differences between male and female athletes that lend themselves to potential problems,” said Amira Al-Jiboori, a physical therapist at Redbud Physical Therapy in Broken Arrow.

In particular, Al-Jiboori sees a number of female clients with patellofemoral pain syndrome, a dull, aching pain in the front of the knee.

“There’s definitely been a lot of research to show that females are more apt to knee injuries due to our wider pelvises. The tracking of the kneecap is basically ‘off’ because of the angle that being ‘hippy’ creates for women,” she explained. “I start seeing it more frequently at age 12, and then I see a lot of patients with it between the ages of 12 and 18.”

Injuries to the anterior cruciate ligament (a major ligament in the knee), or “ACL” injuries, are also common. These frequently occur during activities – such as basketball, soccer, tennis, gymnastics and volleyball – that involve sudden stops, jumping or changes in direction. Some of this can be attributed to the differences between the way girls and boys move. When landing from a jump, girls tend to land in a more upright position with their knees close together, and when suddenly changing direction, girls are likely to do it on one foot rather than “cutting” with both feet, as boys are likely to do.

Hormones may also play a role in this type of injury and many others.

“The changes with hormones in females really affect ligaments and stability in ligaments and our connective tissue,” Al-Jiboori said.

In general, women have greater flexibility than men due to these looser ligaments and tissues.

“A lot of females who are flexible are often the ones that have the most difficulty with stability and control. Flexibility, in a sense, is actually hypermobility, meaning some of the joints, some of the tissue, is looser than it should be, and can therefore create injury,” she noted.

Hormones also play into what is known as the “female athlete triad,” a combination of irregular menstrual periods, bone loss, and inadequate calorie and nutrient intake (sometimes related to eating disorders.) This can affect performance and put female athletes at higher risk for injury, such as stress fractures.

Overuse

Al-Jiboori sees quite a bit of “overuse” injuries in her practice, too, in both girls and boys. This is an injury that is caused by repeated actions rather than an “acute” injury that happens in an instant (whacking a volleyball over time versus a sprained ankle.)

“Why do we have 10, 12 or 14-year olds getting overuse injuries? We’re not made to do one thing over and over; kids are meant to play,” she commented. “Training in sports specificity is getting so honed in. I think a lot of times, it’s to the kids’ detriment.”

Dr. Brian Coleman, program director of the Primary Care Sports Medicine Fellowship at the University of Oklahoma Health Sciences Center in Oklahoma City, expressed similar concerns.

“I think kids are much more ‘sports aggressive’ now,” he said. “In the past, there wasn’t a whole lot of specific training for one sport, rather kids played every sport, so athletes were doing two things. They weren’t getting quite as strong as early then as they are now, and they were mixing up their activities a lot differently. I think some of the sports specialization movement that’s going on and some of the training probably leads to a bit more injury.”

Prevention

Coleman believes some injuries can be prevented with advanced preparation or “prehab.”

“Strengthening and learning how to land and jump in the right manner with the right foot placement, those kinds of things can help,” he noted. “Making sure kids are conditioned before the season starts is also important. I would also encourage kids to play every sport they’re comfortable playing – just going out for and trying to do things they like to stay active in as many areas as possible.”

Al-Jiboori also believes that injury prevention training and strengthening are key.

“We’ve got to get those hips and core stronger, and change the mechanics of how you land and move,” she said. “We need to understand the foundational things that prevent injury. Don’t just send these athletes out there and make them do really sports specific training. It’s important, and you definitely have to do those things, but teaching them about their core, how to activate their core, teaching them how to control movements in a way that lessens the stress on different parts of the body, whether it’s the knees, the backs the shoulders, this is very important.”

As girls continue to flock to the playing fields, sports-related injuries in female athletes will continue to increase. However, education, proper technique and physical preparation can go a long way towards preventing injury, keeping our young female contenders healthy and active.