Training technique offers new hope for female athletes
Study shows female athletes are at greater risk for injury
In the past 30 years, more girls and women have been participating in all types of sports than ever before. Among high-school students, the number of female participants has increased 10-fold, with a five-fold increase in the number of women participating in collegiate sports. With this massive upsurge comes a disturbing trend—a much higher incidence of injuries to the anterior cruciate ligament (ACL) among female athletes than among male athletes playing at the same level of sports.
During a media briefing yesterday, orthopaedic research scientist, Timothy E. Hewett, PhD, joined colleagues Mary Lloyd Ireland, MD, and Kevin Shea, MD, to discuss their findings about these injuries and the most effective ways to prevent them from occurring.
The difference between men and women
Studies have shown that female athletes have an incidence of ACL injuries four to six times higher than their male counterparts. Such injuries can have a devastating impact on the athlete, who may be sidelined for the season, lose athletic scholarships, and experience a decrease in scholastic performance. ACL injuries among female athletes can also result in a 100 times greater chance of being diagnosed with osteoarthritis.
Female athletes who participate in “pivoting” and “cutting” sports—such as basketball and soccer—have a greater risk of ACL injuries. Accounting for this disparity is difficult, and theories have ranged from hormonal differences between females and males to kinematic differences, because women land with a more inward collapse of the knees, putting undue stress on the ACL.
Among the proposed solutions are plyometrics (high-intensity jump training) and technique training. According to Dr. Hewett, “Both strength and balance training are potentially effective but only as an adjunct to these other types of training.”
Dr. Hewett found that the reason these serious injuries occurred had to do with how well the female athlete “controlled” her landing. In his meta-analysis of six studies on “neuromuscular training” to prevent ACL injuries, he found that all of the studies supported combining different types of neuromuscular training to prevent injuries and enhance performance.
One study reported a 72 percent decrease in the rate of noncontact ACL injuries among participants in a six-week preseason neuromuscular training intervention program performed three times a week in 60- to 90-minute sessions.
Another important component of neuromuscular training is having a coach or trainer analyze an athlete’s movements and provide feedback on proper position of the body and her technique. This type of feedback helps the athlete “feel” the proper positions and moves she should be making. In Dr. Hewett’s study, a trainer worked with the athlete so she could develop an awareness of her movements and make modifications when indicated.
Because a strong neuromuscular program is multi-faceted, Dr. Hewett recommends using several different programs. “Off-season and preseason conditioning programs are critical to preventing these types of injuries,” he explains. “A program needs to combine high intensity jumping exercises and movement, resistance, speed and balance training as well as core strengthening.”