Female athletes who participate in sports involving jumping and cutting have twice to six times the risk of injury, compared with male athletes participating in similar sports. Most of these injuries appear to have non-contact mechanisms (i.e., they occur not as a result of collisions, but in response to jumps, hard landings, sudden pivots, etc.). Exercise scientists have been perplexed by why females have more injuries. Differences in training and/or coaching, variations in ligament laxity, anatomical disparities, and conflictions in hormones and hormone levels have all been cited as potential causes.
To determine whether the injury rate in female athletes could be moderated by appropriate training, researchers recently put 366 female athletes in soccer, volleyball, and basketball through a programme of
flexibility, plyometrics, and weight training
('The Effect of Neuromuscular Training on the Incidence of Knee Injury in Female Athletes: A Prospective Study, American Journal of Sports Medicine, vol. 27(6), pp. 699-706, 1999). These female athletes were compared with 463 females and 434 young men who did not take part in the programme.
The investigators had previously noted that females tend to land from jumps with straighter knees, compared with males. As a result, instruction in the art of landing with bent knees was included with the flexibility, plyometrics, and strengthening programmes for the female athletes. The same researchers also noted that females tend to have a marked imbalance of quadriceps to hamstring strength (quads too strong, hams too weak). This led the scientists to believe that an appropriate strength programme might decrease injury rates in females.
The study was a prospective one, and over time the rate of injury was 2.4- to 3.6-times higher in the 'untrained' girls, compared with the girls who took part in the flexibility and strengthening regimes. Nonetheless, the trained females still had a 1.3- to 2.4-times greater incidence of injury, compared to males who did not participate in the special training. Thus, it appears that appropriate training can reduce the risk of knee injury in female athletes. The training used in this study did not make female injury rates as low as those of males, however.
Here are some key papers on this important topic:
1. Arendt E, Dick R. 'Knee injury patterns among men and women in collegiate basketball and soccer.' NCAA data and review of the literature. Am J Sports Med. 1995;23:694-701.
2. Chandy TA, Grana WA. 'Secondary school athletic injury in boys and girls: a three year comparison.' Physician and Sports Med. 1985;13(3):106-111.
3. Noyes FR, Mooar PA, Matthews DS, et al. 'The symptomatic anterior cruciate deficient knee. Part 1: The long term functional instability of athletically active individuals.' J Bone Joint Surg. 1983;65A:154-162.
4. Hewett TE, Stroupe AL, Nace TA, et al. 'Plyometric training in female athletes. Decreased impact forces and increased hamstring torques.' Am J Sports Med. 1996;24:765-773.