Women athletes win equal time on
injury list
By: Judy Foreman
April 14, 2008
A week from today, 10,375 women -
and 14,737 men - are expected to run in the Boston
Marathon. The presence of so many women - the most
ever entered in the historic race - is a sure sign
of how far women have come in athletics.
So is this: In 1972, before Title
IX, the law that spurred women's athletics, fewer
than 300,000 high school girls played sports,
according to the National Federation of State High
School Associations. Now it's more than 3 million.
But there's a dark side to this
terrific news: The more girls and women play sports,
the more they, like boys and men, get hurt. And -
attention athletes, coaches, and parents - they get
hurt in different ways.
Last week for instance,
researchers from the Center for Injury Research and
Policy at Nationwide Children's Hospital in
Columbus, Ohio, reported on a stunning injury rate
for young gymnasts, 82 percent of whom are female.
Using data from 100 hospitals
across the country, the team reported in the journal
Pediatrics that every year, roughly 26,600 children
ages 6 to 17 get injured badly enough doing
gymnastics to wind up in the emergency room. This is
a "very high" injury rate, roughly equivalent to ice
hockey, said public health specialist Lara McKenzie,
the lead author.
And gymnastics is just the tip of
the iceberg. Cheerleading is now the leading cause
of direct fatal and nonfatal injuries among high
school and college women, according to the Center
for Catastrophic Sport Injury Research at the
University of North Carolina. "Cheerleading used to
be about shaking pompoms," said the center's
director, Frederick O. Mueller. "Now, it's about
throwing people 20 feet in the air."
Basketball is not exactly benign,
either: It's brutal on that most vulnerable part of
the female athlete's anatomy: the knees.
And even plain old running seems
to be tougher on women's legs than on men's, though
it's not clear why.
This "absolutely does not mean
that women should not play sports," said Dr. Lyle
Micheli , a consultant to the International Olympic
Committee on Women's Sports Issues and director of
sports medicine at Children's Hospital Boston. After
all, in two of the most popular high school sports,
soccer and basketball, no significant differences
existed in injury rates between boys and girls,
according to figures released by the federal Centers
for Disease Control and Prevention for the 2005-2006
school year.
But athletic activities can cause
different injuries in women and girls than in men
and boys. Female athletes and their coaches should
pay increased attention to the anatomical
differences that put girls and women at
disproportionate risks for certain injuries.
The sports injuries that seem to
disproportionately affect women include:
- Tears in the ACL, or
anterior cruciate ligament, in the knee, a
problem that hits basketball and soccer players
especially.
- Plantar fasciitis, in
which activity can cause tiny tears in heel
tissue.
- Compartment syndrome in
runners, in which lower leg muscles get too
tight for the surrounding space, causing severe
pain.
- Shin splints in
runners, in which repetitive stress can lead to
pain and even fractures in the lower leg.
- Kneecap pain.
- Pain along the outside
portion of the leg in the iliotibial band,
between the knee and the hip, known as
iliotibial band friction syndrome.
Women's knees are more vulnerable
than men's because the "Q-angle" - the angle between
the hip and the knee - is greater in women than in
men. While wide hips are good for childbearing, they
mean there is more stress on the knee in moves like
landing from a jump and twisting. This torque can
shred the ACL, a ligament that helps stabilize the
knee. This is a major reason why female athletes
have four times more ACL tears than men do, said Dr.
George Theodore, a Red Sox team physician and sports
medicine specialist at Massachusetts General
Hospital.
Making matters worse for women's
knees, especially among basketball players, is that
women tend to "cut," or suddenly change direction,
differently from men, said Micheli.
"There's more of a tendency for
women to change direction on just one foot, maybe
because of the width of the pelvis, while men often
use two feet."
Wider hips also mean that there
may be more "pull" on the kneecap, which can cause
pain when running uphill. Kneecap cartilage also
seems to wear down more in women than in men. And
women's kneecaps slide around more from side to
side, in part because women have more estrogen,
which can make women's ligaments more flexible than
men's.
Fortunately, solutions exist for
these problems. One is better coaching for females -
to teach them how to run, jump, land, and twist
safely. Another is orthotics, devices that can be
put in shoes to minimize stress on knee, ankle, and
hip joints. And, of course, everyone should use
appropriate safety equipment, such as thicker mats
for gymnasts, helmets for cyclists, and headgear in
soccer, which obviously benefit men as well as
women.
Strength training, or weight
lifting, is an absolute must for female athletes,
just as for males, though the emphasis may be on
different muscle groups. To help prevent knee
injuries, for instance, female athletes need to work
extra hard to build up a muscle on the inside of the
knee called the vastus medialis and to build up
hamstring muscles on the back of the thigh.
"We can't really change people's
anatomy, but we can rebalance muscles with proper
stretching, strength training, and orthotics," said
Theodore of Mass. General.
It's clear that physical
differences are not a reason to keep women from
sports or from playing just as hard as men, said
Laura Pappano, coauthor with Eileen McDonagh of
"Playing with the Boys: Why Separate is Not Equal in
Sports." Pappano said her daughter, now 13, was told
that girls play nine-hole golf while boys play a
full 18.
"The idea that women are doomed
because of injuries is just absurd," Pappano said.
"The whole 'girls will get hurt' argument has done
more to limit women than anything else."
I couldn't agree more. Regardless
of your gender, get out there and play hard. But
train hard, too. And be sure to get the excellent
coaching you need to keep you safe.
Judy Foreman’s column runs every other week. Past
columns are available on
www.myhealthsense.com.
Listen to her live
call-in webcast radio show every Wednesday night
from 8:30 to 9:30 EST on
http://www.healthtalk.com.
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