Anatomical differences and unique cultural pressures amount to disproportionately high risk factors for active females, warns Vicki Harber, an exercise physiologist at the University of Alberta, Canada, who has published a comprehensive analysis of health issues as they relate to women in sports.
"With reduced barriers and more participation in sports, we're only starting to understand how high training volume affects women," Harber said. "Research needs to catch up to those numbers."
David Smith, AP
The number of female athletes has soared in recent decades, but athletic training doesn't always take into account the anatomical differences between men and women. Common injuries can be prevented by making minor adjustments to exercise routines, a physiologist said.
From 1971 to 2001, the number of female college athletes quintupled, growing from 30,000 to more than 150,000. Where elite athletes are concerned, women's participation in the Olympics has surged from 13 out of 24 events in the 1984 Games to 28 out of 32 at Beijing in 2008, the Canadian report found.
More women are active, and at a higher level. But soaring injury rates have Harber concerned. Compared to men, female athletes are at a two- to six-fold increased risk of some athletic injuries, because training plans have yet to accommodate specific differences in body composition, muscle imbalances and anatomical structure between men and women.
Injuries are most prevalent in the knees and pelvis. The No. 1 injury among women is tearing or straining of the anterior cruciate ligament, a knee tendon vulnerable to twisting and turning movements common in sports such as skiing, gymnastics and soccer. Because women have stronger quadriceps and weaker hamstrings, they suffer ACL injuries about 10 times more often than men. Harber thinks the injuries are largely preventable, with the right modifications to training.
"Minor changes to exercise routines, to change muscle balance, is all it takes," she said. "But these little tweaks make all the difference."
A series of small training changes have already been adopted by FIFA, the international soccer federation, which launched the Prevent Injury and Enhance Performance program in 2008 to address anatomical causes of injury among female players. A one-year study of 1,400 players concluded that the program virtually eliminated once-common ACL injuries.
Women who play sports are also more susceptible to stress fractures and early-onset osteoporosis than men or their less active female peers. That's because of a mysterious condition referred to as the Female Athlete Triad: a three-pronged health hazard of insufficient energy intake, followed by bone density loss and stress fractures. The ailment isn't fully understood, despite afflicting 15 to 62 percent of female college athletes.
Recently created advocacy groups, such as the Female Athlete Triad Coalition, support research that's trying to get a handle on the dangerous illness, which also wreaks havoc on delicate hormonal systems and can be serious enough to permanently sideline athletes, affect long-term fertility and leave some with the bones of an elderly woman. Inadequate food intake is likely the root cause, and Harber says all signs point to cultural influence.
"It's the same factors that affect all women with pressure to lose weight or attain some ideal body type," she said. "And that's a gnarly, complicated area."
Female athletes are even more vulnerable when they partake in certain sports, where weight or appearance are considered -- wrongly or not -- a factor in competitive success. Running, gymnastics and wrestling are three such examples. Harber says that while male athletes often partake in all-you-can-eat efforts to bulk up, young women are unaware of how large their nutritional needs are.
"It all comes down to knowing what your body needs," she said. "For female athletes, that means a much bigger intake of calories and nutrients than their classmates, who might not be so active."
Ironically, the Female Athlete Triad might be mitigated by increasing young girls' participation in athletics, whether competitive or recreational. Girls who play sports at a young age grow up to have better self-confidence and body image than their peers. That makes them more attuned to their body as an "athletic machine," and less inclined to fall prey to impossible ideals, Harber said.
Studies into the unique factors that affect female athletes are becoming more common. FIFA is unique in its prevention program, but Harber points out that research teams in California and Cincinnati are working exclusively on improving the athletic potential of women.
"None of these problems that female athletes contend with mean they shouldn't be taking on competitive sports," she said. "Knowledge is power, and we need to know how to facilitate the needs of this group of athletes."
And while research meant to optimize the abilities of women in sports plays catch up, media coverage might need to do the same. Last week, a study on coverage of the Olympic Games concluded that female athletes received 5 percent of coverage leading up to the Games, compared with 87.6 percent among men.
