More and more females are participating in sports at all levels these days, which in all likelihood means that more and more females will have a need for sports medicine care. Much as with other areas of health care, sports medicine is tailored specifically to each gender, due to anatomic and physiologic differences between males and females.
“Starting at the time of puberty, differences in body makeup become more prominent and may cause females to experience different types of injuries,” noted Dr. Matthew Panzarella, one of the physician experts at the Sentara Sports Medicine Center. “In addition, nutrition, training and other health issues all need to be addressed in a gender-specific manner.”
It’s important for female athletes to know which issues are most likely to occur so that measures can be taken to prevent injury in the first place. For instance, female athletes are affected by noncontact anterior cruciate ligament (ACL) injuries two to 10 times more frequently than their male counterparts. ACL injuries commonly occur when an athlete cuts or stops while landing, with the highest risk for females occurring when skiing or playing basketball, field hockey, lacrosse and soccer.
“Research suggests that females are at increased risk due to alignment of their legs, landing mechanics and decreased strength of the hamstring muscles,” said Dr. Panzarella. “The good news is that when the appropriate identification of potential issues occurs and prevention measures are taken for women who may be at increased risk, incidence of noncontact ACL injuries can be reduced by up to 50 percent.”
Other common injuries that occur in female athletes are patellofemoral injuries, such as anterior knee pain, patellar dislocations and patellar cartilage wear. According to Dr. Panzarella, among the risk factors women should watch out for are malalignment of the pelvis, knee and foot; muscle weakness and/or imbalance; altered patellar position; and trauma. When these risk factors are recognized, dislocations and maltracking of the patellofemoral joint can be treated with operative and nonoperative interventions that address both soft-tissue injuries as well as the bony anatomy.
The shoulder is another body part where females have significant differences in comparison to male athletes. High-risk sports related to shoulder injuries in females are diving, gymnastics, swimming, tennis, volleyball and throwing sports.
“Female athletes are at greater risk for shoulder injuries because their anatomy is impacted differently from shoulder motion than male anatomy typically is,” noted Dr. Panzarella. “Increased biomechanical load results from joint laxity, increased muscle and joint flexibility (range of motion), and decreased upper-body strength.”
Lastly, Dr. Panzarella shared that studies have found that female athletes sustain significantly greater numbers of concussions than male athletes—in fact, a few studies have shown the number of concussions sustained by female athletes to be double the number sustained by male athletes, particularly in basketball, soccer and volleyball.
Additionally, female athletes also may sustain more severe concussions for two main reasons. First, women tend to have smaller heads and more slender necks, so they can experience nearly 50 percent more head acceleration during head trauma. Second, hormonal differences between males and females may play a role in effects on the brain after injury, worsening post-concussion symptoms, such as headache, nausea and dizziness, for females. These factors also can lead to a longer post-concussion recovery period for females.
Other Health Issues
It’s also important to note that other health issues may arise due to participation in sports. In female athletes, menstrual dysfunction is two to three times more common than in non-athletes. Among female athletes, 10-15 percent experience an absence of menstrual cycles or lengthened menstrual cycles, which can lower estrogen and/or progesterone levels and lead to lower bone mineral density and a higher incidence of stress fractures and infertility. These low bone density levels also can lead to increased fractures from falls later in life. And since bone mineral density is determined by the bone mass achieved during adolescence and young adulthood, it is crucial for young female athletes to participate in impact sports and strength training in order to maximize bone density.
Additionally, women who are pregnant should consider exercise recommendations specific to their situation. Exercise is recommended throughout pregnancy, with benefits including decreased weight gain and back pain; improved balance, well-being, energy levels and sleep patterns; improved labor; and a quicker postpartum recovery. However, other factors related to sports medicine, such as nutritional needs, appropriate use of X-ray imaging and physical therapy, and the effects of medications on maternal and fetal health, should always be considered. During pregnancy the female athlete also must be aware of changes to the body’s response to exercise, including increased heart rate, cardiac output, blood volume and respiratory rate.
Dedicated to Caring for Female Athletes
“It’s really important for all athletes to be aware of the specific issues and injuries they can face in order to prevent those injuries,” noted Dr. Panzarella. “And, it’s important for us as physicians to understand the unique injuries and health concerns women might face as athletes so that we can treat them as effectively as possible. Ultimately, our goal should be to look at each individual’s situation and work with them so they can get back to their favorite activities as quickly and safely as possible.
The Sentara Sports Medicine Center is dedicated to treating athletes of all levels so they can get back in the game quickly.
Call 434-654-5575 or visit www.MJHOrtho.org for an appointment.