Female Athletes & Knee Injury Prevention

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Strength Tek

By Lorne Goldenberg BPE, CSCS, CEP

Research has shown that female athletes have a 4-6 fold increased risk for ACL injury compared to boys playing in the same sports.  This has been found to be a result of boys increasing their strength and coordination at faster rates than girls do. Ironically this thought is supported by greater number of boys who participate in commercial sport training programs that I have been involved with. When I do see young girls coming in for an assessment and program, 9 out of 10 times we see weakness through the hips, knees and ankles. I believe this is preventable!

By providing young girls with direction and a program to develop strength, balance, and power, this will assist the body in protecting the knee, and resulting in better performances on the ice or the field. We utilize this philosophy on all body parts, and work toward the integration of full body movement to enhance fundamental movement skills, such as running, jumping, lunging, twisting, and stepping.  These fundamental movement skill can put a young girl at risk if not addressed.

Ironically in a study1 that looked at moments of abduction and adduction forces on the knee while stair climbing, one of the main findings was that the moment patterns were exclusively abductor (forcing the knee inward) throughout stance, indicating that the ground reaction vector always passed medial to the knee joint center stressing the medial side of the knee and resulting in uneven forces. Although the knee abduction-adduction moment is not in the primary plane of motion when stair climbing (because we are really moving up and down), its magnitude should not be ignored when trying to understand the stability and function of the knee during this movement. This study really underlines the great many forces that act on the knee, even when we think we are just moving straight.

Another factor for girls is the Q-Angle in their hips (see pics below). Females young and old naturally have wider hips than males.  As result of this, when females are running or jumping, they have much greater stresses placed on the knee. Young girls experience the issues in group training exercises, while older females who are active suffer from knee pain from activities such as bootcamps and lean & fit programs that do not take into account specific biomechanical weaknesses in their clients.

There is good news though. It is widely accepted that prevention is much less costly and painful than reactive protocols for sports injuries. If you are injured, proper progressions will ensure a safe return to activity. If you are the parent of young female who plays hockey or soccer, a complete program will prevent this from happening in the future. Make sure you find a qualified strength coach to help you in this situation or ask Strength Tek about one of our distance programs to address this.

1.  (Journal of Biomechanics Volume 29, Issue 3 , Pages 383-388, March 1996 David L. Kowalk,)