August 1999 Bulletin

Workshop focuses on injuries of female athletes

Speakers at Women's Health in Sports and Exercise workshop press briefing, are, from left, John Porter (D-Ill.), senior member of House Appropriations Committee; Stephen Katz, MD, PhD, NIAMS director, and Sandra Perlmutter, executive director, President's Council on Physical Fitness and Sports

Today, female sports and fitness participants-ranging from young girls to their elderly grandmothers, and professional soccer players to weekend golfers-are an increasingly prominent part of public life. At the same time, there are challenges to previous assumptions that the methods of training, risks of participation and the effects of exercise on physical and emotional health are the same for men and women.

Recognizing the recent growth of knowledge in this arena and its importance to issues of women's health, the Academy and the National Institute of Arthritis and Musculoskeletal and Skin Dieeases (NIAMS), a component of the National Institites of Medicine, cosponsored the "Women's Health in Sports and Exercise" workshop in June.

"The biggest driving force behind the meeting was the enormous and very positive growth in female participation in sports at the elite level as well as fitness and exercise activity," said Joan A. McGowan, PhD, chief of the musculoskeletal diseases branch at (NIAMS). "While many great benefits are derived from this increased participation, it is also leading to potentially serious injuries. We wanted to gather national leaders in the field-both scientists and practitioners-to discuss what the major issues were and determine whether more research and scrutiny could prevent injuries in women."

The invitation-only workshop, held June 11-13, 1999, in Hunt Valley, Md., drew approximately 60 participants and covered a broad range of topics, including physical training and response; injury diagnosis, frequency, severity, and cost; effect of exercise on general health and specific disease conditions; and psychosocial implications of participation in sports and exercise. The meeting was intentionally scheduled just prior to the Women's World Cup, the largest female athletic event ever, in order to benefit from the attention that would already be focused on women in sports.

During the course of the weekend, 32 experts provided written summaries of current knowledge on specific topics. William E. Garret, Jr., MD, the workshop's principal investigator, moderated a session on current trends and perspectives. The musculoskeletal injury session was divided into three sub-topics: epidemiology of sports injuries, moderated by Jo Hannafin, MD; specific injury locations, Elizabeth Arendt, MD; and sport specific injuries, moderated by Letha Griffith, MD. Other sessions included musculoskeletal fitness, moderated by Don Kirkendall, PhD; general health issues emphasizing known gender differences, Steve Blair, PEd; and psychosocial health issues, Carol Teitz, MD.

"Physicians who treat athletes thought there was need for further research on ACL injuries in women, not only because it's such a devastating injury for an athlete, but also there is great concern that it may contribute to chronic osteoarthritis later in life," Dr. McGowan said.

"Another issue of concern is the 'female triad', where you have the combination of excessive exercise, an eating disorder and amenorrhea. This triad is particularly common in long distance runners, gymnasts, ballet dancers -sports in which being extremely lean is thought to be an asset. It is a very serious health threat; the athletes become osteoporotic and actually start to lose bone mass, only stopping when they suffer a stress fracture or a full fracture."

At a briefing organized by the Academy and NIAMS on June 29, Dr. Garrett and other orthopaedic surgeons discussed the dramatic increases in sports and exercise participation by females; the increased risk of injury, especially when compared to male injuries; and the need for more research.

Also attending the briefing were John Porter, (R-Ill.), senior member of the House Appropriations Committee and chairman of the Labor, Health and Human Services and Education Subcommittee; and Stephen I. Katz, MD, PhD, director of NIAMS.

This workshop is the 12th scientific symposium cosponsored by the Academy and NIAMS. Each year, the Academy's committee on research generates a topic for the symposium, which must be approved by NIAMS. The Academy and NIAMS jointly underwrite the annual symposium.

Since 1988, the Academy has published a reference text that is an outgrowth of the previous year's scientific workshop. The text on the Women's Health in Sports and Exercise Workshop will be published in the year 2000.

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