Female involvement in sports has increased tremendously at the high school level. Although early studies indicated that female athletes needed to train at lower levels of intensity than male athletes, it appears that this was more a social than a physiological problem. Today, female athletes are able to train and compete at levels comparable to male athletes.
Although there are differences in performance that are gender-related, athletic injuries are related more to the player's sport than gender.
However, some sports-related injuries, such as stress fractures and ACL tears, are more common in women. Gender based differences in anatomy, physiology, and training may contribute to these increased incidences.
ACL - Anterior cruciate ligament (ACL) injuries occur most frequently in pivoting and cutting sports such as basketball, soccer, and volleyball. National Collegiate Athletic Association injury data show that female athletes injure the ACL more frequently than their male counterparts do. The greater incidence of ACL injuries in women probably stems from complex, interrelated factors, possibly including hamstring-quadriceps strength imbalances, joint laxity, and the use of ankle braces. Successful treatment often includes surgery.
Stress Fractures - There are many contributing factors to the greater frequency of stress fractures in women. Male athletes may have greater muscle mass, which absorbs shock better. In a study of female athletes, decreased calf girth was a predictor of stress fractures of the tibia. The larger width of male bones may also absorb shock better.
Bone mass and bone mineral density can vary widely in females due to several factors, including hormonal influences and menstrual irregularities. Low calcium intake and eating disorders may contribute to the development of stress fractures. Conversely, oral contraceptive pills appear to help prevent stress fractures in female athletes.
For both men and women, a rigid, high-arched foot absorbs less stress and transmits greater force to the leg bones, which may increase stress fracture risk. And studies of female athletes have shown that having one leg slightly longer than the other can increase the risk of stress fractures.
The Female Athlete Triad - is defined as the combination of disordered eating, amenorrhea and osteoporosis. This disorder often goes unrecognized. The consequences of lost bone mineral density can be devastating for the female athlete. Premature osteoporotic fractures can occur, and lost bone mineral density may never be regained. Early recognition of the female athlete triad can be accomplished by the family physician through risk factor assessment and screening questions. Instituting an appropriate diet and moderating the frequency of exercise may result in the natural return of menses. Hormone replacement therapy should be considered early to prevent the loss of bone density. A collaborative effort among coaches, athletic trainers, parents, athletes and physicians is optimal for the recognition and prevention of the triad. Increased education of parents, coaches and athletes in the health risks of the female athlete triad can prevent a potentially life-threatening illness.
