The headline of the macho male athlete suffering a career-altering knee injury on the field does not tell the full story. In fact, female athletes are actually much more likely to experience knee injuries than men.Female athletes like Mia Hamm, the Williams sisters, and Lisa Leslie prove that women are just as serious about sports these days as the guys, but women are six to eight times more likely to injure a knee.
There are several theories for this discrepancy, all of which fall into the category of intrinsic and extrinsic factors. Intrinsic factors include muscle strength, anatomy, and hormones. These tend to be gender specific, and more difficult to change. Extrinsic factors involve the type of sport, an athlete’s skills and form, landing techniques, and endurance. Fortunately these are factors that can be modified to reduce the chance of injury.
Dr. Henry Goitz, Chief of Sports Medicine for the Medical College of Ohio, says that knee injuries typically fall into three categories: ligament tears, cartilage tears, and patellar tendonitis.
"Ligaments are like cables that keep the bones together," said Goitz, "when the cable pops it’s a big injury."
Ligament tears often occur when an athlete is stepping and their foot gets stuck while the rest of the body is pivoting. This is common on the soccer field when a player steps in a hole, or the contact of the shoe to the ground is so good, that the foot stays while the rest of the body turns and the player feels a pop. Dr. Goitz says 80 percent of the time the pain is due to tearing of the anterior cruciate ligament, or ACL.
According to the American Academy of Orthopedic Surgeons, female athletes are three to four times more likely to suffer an ACL injury than male athletes. The majority of ACL tears occur in women ages 15 to 25.
Cartilage tears are less common, but still series injuries. "Cartilage is like a cushion or lubricant" in the knee, when a cushion tears, usually from a twisting of the knee, the pain is sharp. Dr. Goitz says surgery to repair cartilage tears or ligament injuries has a very high success rate.
The good news is, "in today’s sports medicine," said Dr. Goitz, "we can actually reconstruct or make a new ligament, or make it work like new, at a very high predictable rate, from the professional ball player to the recreational athlete."
ACL and cartilage injuries are less common in the recreational athlete, or the female who exercises regularly to stay in shape. These women are more susceptible to sprains and strains that typically result from a lack of conditioning the muscles to rigorous exercise. The muscles that surround the knee are actually what undergo the strain. The most common condition is called patellar tendonitis. This is characterized by an achy soreness, like tennis elbow, but in the knee. The pain is focused in the spot where the thigh muscles attach to the knee. It can occur after exercise, because the thigh muscles exert a continuous pulling on the knee joint.
"The goal is always to warm up and stretch before any activity," said Goitz. "So if you go to a gym it’s nice to do some flexibility stretches, maybe get on a bike and do some warming up, and get some blood flowing, then go do some aerobics and do some lifting, or play ball and go for a brisk walk," he said.
And when done exercising, Dr. Goitz said it’s important to cool down and stretch the muscles again.
"If you want to play you gotta pay," said Dr. Goitz. "You can’t just say today, I‘m gonna play soccer tomorrow, and play at a high competitive level, I think that’s where the risk comes in."
And though it may be hard to admit, age does play a major role in injury susceptibility. Dr. Goitz says that after the age of 30 the tissues and most of the body’s muscles become less elastic, and even less forgiving with each subsequent decade.
But the good news is, "I would never tell a woman not to do something as long as they condition," said Dr. Goitz. Because most experts agree, the benefits of athletics and exercise to women are much greater than the risks of knee injury.
