Did you know that women are 2 to 6 times more likely to experience a fitness training injury relative to men? Yes, there is a gender inequality regarding injuries. Women are more likely to sustain an injury, and certain injuries are more common in females. In this article, we’ll look at what training injuries are more frequent in women and what you can do to lower your risk of being sidelined by an injury.
An anterior cruciate ligament tear can be a career-ending injury for athletes, and women have a higher rate of anterior cruciate ligament tears relative to men. Researchers have questioned the reasons for this, but one of the strongest theories is that women’s knees turn inward more than a man’s. Plus, when women jump, they land stiff-legged rather than softly with a slight bend in the knees.
Another explanation for why women are more susceptible to ACL tears is they have a wider pelvis relative to a man. Because of the wider pelvic width, a female’s thigh bones turn inward more. This creates a wider Q angle that reduces knee stability.
In addition, women are more likely to have a strength imbalance between their quads and hamstrings. Women often have stronger quads than hamstrings, and this creates an imbalance between the anterior and posterior chain that boosts knee instability. One way to lower the stress on the knees is to correct lower body muscle strength imbalances. Exercises, like squats, are more quad focused, but you can target your glutes and hamstrings more when you squat by using a wider stance. Place your feet around 150% of shoulder width. Also, single-leg squats are effective for targeting the glutes.
Patellofemoral Syndrome (Runner’s Knee)
Women are also at higher risk of patellofemoral syndrome, a painful condition common in runners. Studies show that up to a third of runners develop knee pain because of patellofemoral syndrome at some point. It occurs when the soft tissues around the kneecap become irritated and painful because of repeated stress on the knee from repetitive movements like running, stair climbing, squatting, and jumping.
Why are women more susceptible to runner’s knee? One reason may be the greater Q angle in women, as mentioned for ACL tears. Women also have less muscle lying over the knees for support. Orthopedists also point out that some people with patellofemoral syndrome have abnormal tracking of their kneecap when they bend their leg. Rather than tracking in a straight line, the kneecap moves to the side and presses on the soft tissues that support the knee.
How can you lower your risk of patellofemoral syndrome? Cross-train so you aren’t doing the same movements over and over. Runners are at higher risk because they run and often on a hard surface. If you exercise on a hard surface, switch to a softer surface that will place less impact on your knees. Also, alternate high-impact exercise with lower impact movements to reduce stress on the knees. Repetitive stress is the biggest factor in causing runner’s knee. Make sure you’re wearing supportive footwear that has enough cushioning to absorb stress. Identify and correct muscle imbalances between the quads and hamstrings to reduce stress on the knee joint.
Women are also at higher risk of bone fractures related to sports injuries. One reason is that women have smaller bones relative to men. Plus, men often have more muscle mass over their bones for extra protection against fractures in the event of a fall. Because of the differences in bone size, women have a higher risk of sports-related fractures than men.
You can lower your risk of fracturing a bone by maintaining a healthy bone density and by increasing the thickness of the muscle that overlies your bones. The best way to do that is through lower body strength training using a challenging resistance. In addition, balance exercises will help you reduce the risk of falling. Know your risk factors for osteoporosis and talk to your health care provider about when to start checking your bone density via a DEXA scan. Their recommendations may vary depending on your risk factors. Also, avoid lifestyle habits that lower bone density, like smoking, using excessive alcohol, and crash dieting.
Lower Your Risk of Injury
Now, let’s sum up what you can do to lower your risk of injury. The best way to avoid and injury is to train smartly and not overtrain. Here are some steps you can take to lower your risk of injury:
- Vary your workouts. Don’t do the same repetitive movements over and over. If you’re a runner, swap some of your running sessions for circuit training or strength training and vary the exercises you include in your circuit workouts.
- Wear supportive footwear that fits and absorbs shock and buy a new pair of shoes once they show wear.
- Work on core strength and stability with exercises like planks.
- Don’t change the duration or intensity of your workouts too quickly. If you run, don’t increase your distance by over 10% per week.
- Include flexibility and balance training with your strength and cardio sessions. Balance training can reduce your risk of falling and sustaining an injury.
- Do a dynamic warm-up before each training session to make sure your muscles are warm before launching into a strenuous workout.
- If you take more than a week or two off from training, dial back the volume when you restart and then gradually rebuild again.
The Bottom Line
We all need to exercise and strength training, but no one needs an injury! Women are at higher risk of these three types of injuries. However, you can take the steps above to reduce your risk of ending up with painful knees or, even worse, a bone fracture. Keep training but do it smartly!
- Berkeley Wellness. “Women: Avoid Sports Injuries”
- com. “Preventing ACL Tears – Why Are ACL Tears More Common In Female Athletes?”
- Mayo Clinic. “Patellofemoral Syndrome”
- com. “Patellofemoral Pain Syndrome”
- Clin Orthop Relat Res. 2011 Jul; 469(7): 1900–1905.Published online 2011 Jan 25. doi: 10.1007/s11999-011-1780-7.
- American Bone Health. “Fracture Risk Factors”
- Sports Health. 2013 Nov; 5(6): 514–522.doi: 10.1177/1941738113481200.