Knee Injuries in Female Athletes

Incidence and Prevention of Knee Injuries in Female Athletes

Dr. Mario F. Cruz

Physical Rehabilitation and Sports Medicine 

As female athletics continue to grow, it has become more evident that there is a greater risk for female athletes to suffer knee injuries as compare to male athletes. Statistically speaking, female athletes have knee injuries three times more than males. Particularly, female soccer players suffer knee injuries eight times more than male soccer players. Most knee injuries in females occur through non contact mechanisms as well as overuse and lack of proper training techniques. There are multiple factors that can contribute to the greater incidence of knee injuries in female athletes.  

Anatomically, the Q-angle, which is the angle formed by the femur in relation to the tibia, is greater in females. This particular angle is largely determined by the width of the pelvis, and since females anatomically have a larger pelvis than males, it makes them more prone to knee injuries. A greater Q-angle causes an increased stress on the knee structures (sometimes known as a valgus collapse), which can lead to serious knee injuries.  

Hormones cause females to have more laxity or to be more flexible than males. Flexibility by itself is not a significant problem. However, having more flexible and loose structures around the knee joint, cause the static stabilizers (knee joint, capsule, and ligaments) to work harder to maintain proper stability of the joint. As a result, more knee injuries take place in female athletes as their muscles, tendons, and dynamic stabilizers are less effective than male athletes. 

Lastly, poor conditioning and lack of proprioception(correlation between the body and the surrounding space) and plyometric training performed by females have led them to more knee injuries as compared to male athletes. Unfortunately, research has shown that female athletes participate of proper conditioning and sports specific programs less than male athletes. On the other hand, recent research has now demonstrated that those female athletes who participate of proper sports specific training suffer less knee injuries than those who do not have access to such training programs. 

Consequently, the sports medicine community has been devoting major efforts to increase awareness and to come up with solutions to reduce this higher rate of knee injuries in female athletes. While there is not much to be done to change the anatomical and hormonal risk factors associated with knee injuries in female athletes, many things can be done to improve the neuromuscular patterns and biomechanical differences in order to decrease the higher incidence of knee injuries for this specific population. This can be achieved by the introduction of preventing programs that are individually catered for the female athlete and that can certainly balance out the odds for knee related injuries. These preventing training programs should be designed to improve strength, speed, power, balance, proprioception, and agility in order to successfully decrease the higher rate of knee pain and injury in female athletes.