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Women in a Galter LifeCenter osteoporosis prevention class stretch their hamstrings.

5 tips every active woman needs to know

An orthopedic surgeon at Swedish Covenant Hospital weighs in on why females are susceptible to sports or exercise injuries, and what can be done to prevent them.
Tracy Hernandez
Senior Staff Writer
Women in a Galter LifeCenter osteoporosis prevention class stretch their hamstrings.

Whether you are a fan of Women’s World Cup soccer, the WMBA, Olympic gymnastics, amateur triathletes, or a team of weekend warriors right here in Chicago, you likely have witnessed a serious back, hip, knee or ankle injury. Many spectators and participants accept these devastating injuries as an unfortunate part of being active and being a woman.

But they may not have to be, according to Dr. Jennifer Connor, an orthopedic surgeon at Swedish Covenant Hospital.

She explained that women are naturally prone to many injuries. However, over time they may be able to reduce their risk for serious and chronic damage through preventative training.

“Recent research has shown that specialized training and prevention programs can reduce the rate of injuries in women to that of their male counterparts,” Dr. Connor said.

A gender difference

But before focusing on injury prevention, Dr. Connor believes it is important to understand why women need to be aware of their unique risks.

“The reasons behind the increased rate of injuries in women are not completely understood and are multi-factorial,” Connor said. “They may be due in part to neuromuscular control issues, hormonal changes, as well as anatomic differences.”

The difference between the causes of women’s and men’s sports injuries goes far beyond just the angle of a woman’s hips putting pressure on knee ligaments, although that is a factor.

The New York Times Well blog recently reported that fluctuation in a woman’s estrogen levels can impact how her body responds to the demands of exercise and competition, which may put her at higher risk for injury than a man. 

Another factor causing the number of orthopedic injuries in women to rise is the growing number of women now participating in competitive sports at higher intensity levels for longer periods of time.

Injury prevention

While all preventative training should include a balance of stretching, knee and hamstring strengthening and core conditioning, specific exercises will vary, depending on the sport, Dr. Connor said.

For example, ACL (anterior cruciate ligament) tears are one of the most common orthopedic injuries and are more prevalent among female athletes than male. Soccer and other field sport players are at particular risk for ACL injuries due to the frequent changes in direction, accelerations and decelerations, and collisions involved in the sports. Therefore, Dr. Connor may advise an injury-free female soccer player to emphasize lower body strength training and hamstring stretches, and put less emphasis on quadriceps — a regiment that may not be necessary for a male soccer player, but could prevent a catastrophic injury in a female.

Alternatively, she may advise a female long-distance runner or cyclist to work on hip stabilization exercises to avoid tendinitis and bursitis in the knee and hip, whereas back stretches and cross-training may better suit a gymnast or dancer at risk for lower back injuries and stress fractures.

Along with the sport of choice, the age and ability of the woman are also factors that impact what kind of training may help.

“In active young women, in addition to sport-specific training, they need to remember they are at risk for the female athlete triad — the combination of an eating disorder (such as anorexia or bulimia), amennorhea (the loss of a period) and osteoporosis,” Dr. Connor said. “Athletes experiencing one, two or all three of the factors due to over-exercising and lack of calories are particularly susceptible to stress fractures and may be setting themselves up for a lifelong state of bone fragility.”

In the same vein, active adult females — particularly those who are postmenopausal — are also at risk for osteoporosis, and should make special efforts to ensure their diet is rich in calcium and vitamin D, in addition to regular training and stretching.

For all women, regardless of activity level, age or ability, Dr. Connor recommends keeping the following pointers in mind when exercising, participating in sports or starting a fitness plan:

1. Balance your training by cross training. Doing one sport only and repetitively can lead to overuse injuries. 
2. Include stretching as an integral part of your exercise routine. This can be done on your own or through a class such as yoga or Pilates.
3. Eat a healthy and balanced diet. An adequate calorie intake is essential if you're doing high-intensity training.
4. Slowly increase your training. Don't increase your training time or distance by more than 10 percent per week.
5. Listen to your body. If you are in pain, rest. If it doesn't resolve, talk to your doctor. 

Injury treatment

Dr. Connor noted that if an injury does occur, orthopedic medicine, surgical procedures and physical therapy techniques are more advanced than ever— often allowing athletes to return to the field faster and nearly as strong as they were prior to the injury.

“While some injuries have a surgical solution (such as an ACL rupture in a competitive athlete), many knee injuries can be treated non-operatively,” Dr. Connor said. “Non-operative treatment often includes a period of rest from sport, RICE (rest, ice, compression, elevation) and possibly a course of targeted physical therapy.”

If surgery is necessary, the prognosis is brighter than in the past. A recent report on ACL injuries in the LA Times explained that athletes are having better outcomes after orthopedic surgery, thanks to less invasive, more advanced procedures and better post-operative rehabilitation techniques.  

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