Why are women more prone to sports injury?

There may be a gender gap in pay, with men receiving more prize money in 30% of sports, but there is also inequality when it comes to sports injuries.

There is no one sole reason why women are more susceptible to sports injury than their male counterparts, as there are a number of factors. We take a look at the five most common injuries among female athletes and what might be the cause.

1. Anterior cruciate ligament tears

The anterior cruciate ligament, known as the ACL, is one of the four ligaments that supports the knee joint and provides much of its stability. The ACL is vulnerable to damage when landing from a jump or a sudden change in direction so it is a high risk injury in a wide range of sports, including football, netball, basketball, volleyball, skiing and snowboarding.

Although the roll call of male sporting stars that have torn their ACL is extensive, ACL tears are actually four to six times more likely to occur in female athletes than male. The International Olympic Committee has reacted to the high degree of ACL injuries affecting female athletes competing at both the Winter and Summer Games by convening a panel of medical practitioners, physiotherapists, biomechanists and other specialists to address the problem, with a particular focus on injury prevention.

It is thought that poor knee alignment is a major factor in ACL tears and women have a wider pelvis that affects alignment between knee and ankle. In female athletes this causes the knee to fall inwards when landing, bending and pivoting. Women also tend to land more upright putting pressure on the knee. Addressing this from a biomechnical point at an early point could help prevent ACL injury.

There are also anatomical differences between men and women that contribute; women have less muscle mass than men to support the knee and a narrower knee joint for the ACL to pass through. Hormones could also play a role as it seems there may be an increased risk during the menstrual cycle although this has not been fully proven.

2. Ankle sprain

This is a very common sports injury that affects both men and women, but a study in 2013 found that women were more susceptible than men. The ankle is a complex mechanism, made up of two joints, the subtalar joint and the true ankle joint, and supported by a framework of ligaments. Ankle instability is a key factor in ankle sprains and women’s ligaments tend to be more lax than men’s – also female muscle tissue is more elastic which could be a contributing factor to a higher rate of ankle sprains in female athletes.

3. Patellofemoral syndrome

Another knee problem that is more common in women is patellofemoral syndrome, with women more than two times more likely to suffer from this condition. Pain is caused by the patella or kneecap rubbing against the femur when the knee is flexed or extended. One theory is the Q angle, or quadriceps angle where the upper leg bone meets the lower leg bone, is greater in women causing the quadriceps to pull on the kneecap.

4. Stress fractures

Women are more susceptible to stress fractures, particularly in the foot or lower leg and this can be the result of a syndrome known as the female athlete triad. These are three separate health concerns; the first is ‘disordered eating’ where the female athlete may try to lose weight to improve athletic performance leading to eating disorders. The second is amenorrhea, where nutritional deficiencies and excessive training result in a decrease in hormones that affect the menstrual cycle and, finally, bone loss or osteoporosis caused by low oestrogen levels and poor nutrition.

5. Plantar fasciitis

Alignment issues in the foot increase the risk of developing tears in the supporting tissues in the heel and the arch of the foot.

Is there anything women can do to prevent sports injury?

Strength conditioning can be key to strengthening the supporting muscles and, if done properly, to correct any muscle imbalance. A 2012 study published in the Journal of Bone & Joint Surgery reviewed ACL injury prevention progammes and found that they could reduce risk of ACL injury in female athletes by 52%.

Professor Cathy Speed offers a holistic approach to fitness and is highly experienced in treating female athletes, particularly endurance runners. Every aspect of performance is reviewed including nutrition and preparation to ensure optimal efficacy. For more information or to arrange a consultation at her Cambridge Sports Medicine Clinic, call 01223 200 595.