Female Athletes

Female participation in sports has increased steadily over the last 3 decades with increasing media recognition and corporate sponsorship. Injury patterns in both sexes are similar but there are some subtle differences. These differences are generally related to the increased average size of the male athlete.

Males also have increased muscle mass and decreased body fat compared to females. These differences are due to hormonal levels.

Estrogen levels are higher in females, it promotes increased body fat while androgen which increases muscle mass, is found in higher levels in males.

Females have a smaller heart size and fewer red blood cells than males. This contributes to the poorer performances in endurance sports by females. However females do not lag significantly behind in strength based sports once the differences in muscle mass are taken into account. Women can gain as much strength as men on a relative basis with no increased risk of injuries.

There is no convincing evidence that performance is affected by the menstrual cycle. World best performances have been recorded at all stages of the menstrual cycle including the premenstrual and menstrual phases.

There are 3 injuries that are more common in females compared to males. These are Anterior Cruciate Ligament (ACL) tears, stress fractures and patella femoral problems.

ACL injuries
It is unclear why females should be more prone to ACL injuries but several theories have been postulated including increased joint laxity, hormonal influences and muscle strength.

Patellofemoral Injuries
Patellofemoral (knee cap) problems are thought to occur more in females because of the increased Q angle of the knee.

Stress fractures
Females with stress fractures should be investigated for menstrual problems. Women who are amenorrheic are more prone to stress fractures.

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