Why are Injury Rates in Women’s Sport Rising So Quickly?
Injury rates in women’s and girls sport are increasing at an alarming rate. This is especially true of multi-directional sports such as soccer or AFLW.
There are many reasons that have been proposed to explain why women seem to be at greater risk of certain injuries. many of which, are controversial.
In the blog post we delve into the evidence to give the most current consensus on the topic.
The findings of studies examining of the effect of gender on sport injury risk are mixed. With the current (limited) evidence that we do have it seems that males and females have around the same risk of sustaining a sports injury. Studies of rugby and athletics athletes have actually found that males may have a greater risk of sustaining injury than females.
However, females are far more likely to sustain specific types of injury such as ACL ruptures or ankle sprains. For example studies on AFLW have found ACL injury risk to be as high as 9.2 x more likely!
These types of injury have protracted recovery times, poor return to sport rates and high risk of future complications. For more information on these injuries see our previous blog posts.
It has also been indentified that rates of injury in female athletes are also rising much more quickly than their male counterparts.
So Why The Differences?
Injury risk is multifactorial and physical differences are only one part of the answer.
To make it easier we can classify factors that increase risk as being intrinsic (mind and body) and extrinsic (external to the individual).
Extrinsic Factors
1) Disparities In Developmental Environment
Female participation in sport is increasing. However there is still a large disparity between male and female participation rates. In sports that are/were traditionally male dominated this gap in participation rates can over 50%
Lower participation rates make it more likely that these sports receive less access funding, high quality facilities or equipment . Additionally, it can be very difficult to recruit higher level coaches.
These factors all equate to a poor developmental environment, especially when compared with male counterparts who may receive access to all of these things. Unfortunately this increases risk of injury.
This is a chicken and egg conundrum. With lower participation and less funding feeding each other.
2) Lower Training Age
Lower levels of participation mean less teams and a reduced number of leagues.
For example in Cairns we have 8 mens soccer clubs with 4 different leagues (Premier, Reserves, Division 2 and Division 3).
In contrast the female league consists of 5 teams with 2 leagues (Premier and Reserves). This is by no means the fault of the clubs, it is simply due to a lower number of players.
Females who do show potential in a particular sport are therefore fast tracked to higher levels of competition with a lower training age than male counterparts.
Training age is the amount of time spent training in that particular sport, refining attributes such as movement quality, overall skill level and getting exposure to competitive environments.
Promising female players are subject to intense training, high levels of competition, excessive game time, potentially before their bodies are ready. This will of course increase injury risk.
Indeed, studies have shown that ACL rupture risk is substantially greater within a players first 2 AFLW seasons.
Governing bodies are doing much to overcome these issues, however it is also going to take a cultural shift for participation rates to equalise in typically male-dominated sports. Rugby league, union AFL ad soccer are still very much considered “boys sports” and sports such as netball “girls sports”.
3) Footwear
Due to anatomical differences males and females tend to move differently. Despite this footwear for sports such as rugby, AFL and soccer are still designed around the male foot.
Intrinsic Factors
There is a lot of controversy regarding the link between physical differences between gender and injury risk. Many studies are contradictory of each other.
What we can agree on is that on average men and women differ anatomically. For example, whilst men are more likely to have greater levels of muscle mass, women are more likely to have greater levels of flexibility.
Anatomical variance means that men and women run, jump, hop, land and cut differently. This can predispose to certain types of injury and different mechanisms of developing the same injuries.
Q Angle
Women are likely to have relatively wider hip to knee angle (termed Q angle). This increases forces on the knee and makes it more likely that the knee collapses inwards (knee valgus) which may predispose to knee injury
Generalised Ligament Laxity
In general women are likely to have more passive movement in their joints (termed ligament laxity). Whilst this allows greater levels of flexibility.
Studies have shown that laxity may be directly correlated with injury risk for example it can make it more likely for someone to land with their knees hyperextended or ankle rolled outwards.
Both Q-Angle and ligament laxity make it more likely that someone may move in a way which predisposes them to injury.
However movement education, dynamic neuromuscular exercise, strengthening and a comprehensive warm up can all contribute to improving these movement patterns and reducing injury risk!
Other Intrinsic Factors
Hormones/ Menstrual Cycle
Some early studies suggested that female hormones and the menstrual cycle may have an effect on injury risk. However it has now been found that these studies were of poor quality. More research is needed for us to make any firm conclusions and so at present this is not considered a risk factor for injury.