WEAK-KNEED

Friday, August 1st 2008 @ 10:18 PM    post viewed 1968 times

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There is usually pain, sometimes a lot, and a sound of a "pop" so loud others on the field can sometimes hear it. It requires complicated reconstructive surgery and six to nine months, or more, of rehab.

"When an ACL ruptures into a viscous liquid and it can't be stitched back together; it must be replaced with tissue taken from elsewhere in the body," Sokolove explains, sometimes, with cadaver tissue.

Some researchers estimate girls rupture their ACL's at five to eight times the rate of boys and young men.

But gender differences in sports injuries goes beyond blown out ACLs: Research suggests that as sports registration among girls grows, girls and young women are suffering a range of injuries - ankle sprains, severe knee injures, generalized knee pain, shin splints, hip pain, back pain and stress fractures - at rates well above boys.

Research shows girls suffer higher concussions rates than boys in sports played by both sexes. According to the National Collegiate Athletic Association (NCAA) in the U.S., girls or young women who play soccer experience concussions at the same rate as male football players, "which I find pretty staggering," Sokolove said in an interview. Researchers blame the gender split on smaller heads and weaker necks. The neck is the shock absorber for the head, and if it's not as big or muscled, the head absorbs more impact.

Concussions in women's ice hockey are "off the charts. They have the highest rate of concussions that the NCAA measures," says Sokolove, a contributing writer for the New York Times Magazine and the author of two previous books, The Ticket Out: Darryl Strawberry and The Boys of Crenshaw and Hustle: The Myth, Life, and Lies of Pete Rose.

Why the greater rate of injuries in girls, particularly in cutting and pivoting sports that involve the knees and lower extremities - basketball, volleyball, lacrosse and soccer? Theories range from not enough muscle in the right places to pure biomechanics - how girls run as opposed to the way boys run, for example.

Sokolove also blames "overplay and early specialization." Fall soccer, spring soccer, indoor soccer, summer and weekend away tournaments. "These 14- or 15-year-old girls are playing schedules that are far more rigorous than college or professional athletes."

"We're giving them too many opportunities to get injured, and not enough time to rest and heal. And it's disastrous. It's not a good culture for boys or girls but it's too often disastrous for girls."

Ottawa nutrition and exercise specialist Beth Mansfield says "these young kids are now being taught how to tackle and go in against the ball - how to be more aggressive. You have to ask yourself, should we be so competitive at a younger age? Should we be choosing our sport at such a young age, or should we develop all-round athletes and start choosing at 17 or 18?"

The central character in Sokolove's book is Amy Steadman, "a marvellous, fearless, fast defender" who was on course to being one of the great soccer players of her generation, until she suffered four ACL ruptures in the same knee.

"The first time she walked toward me, if I had not known that she was an athlete, let alone an elite one, I would have never believed it, because she walked very stiffly. She walked like an elderly woman." Now 23, she will likely need an artificial knee by the time she is 30.

"She's an extreme case, but she's not by any stretch of the imagination a singular case," Sokolove says. Since an article adapted from his book was published in the New York Times Magazine in May, Sokolove says he has heard from dozens of young women saying, "I am Amy Steadman." Women who were injured, went to rehab, returned to the field and then were injured again.

According to the Canadian Soccer Association, female registration in soccer has surged in the last decade to 366,510 females in 2007 from 167,913 in 1996.

There are about 1,075 players in Calgary's Blizzard Soccer club, about half of them girls. "With girls, we probably see two or three ACL injuries a year," normally, in those aged 15 to 18, says general manager Alan Rickwood. "In the last year we've not had any boys with ACL injuries."

Proper exercise and warm-up programs can reduce the injury risk. The Blizzards encourages teams, especially the more competitive ones, to do extra fitness training.

Sokolove says girls can be taught how to change their running and landing postures - essentially, to run more like boys.

Boys tend to run in a more flexed position, he explains, with knees bent and butts down. "And they land from jumps and they decelerate in that positions. It's more of sort of an athletic or even a warrior posture."

Girls tend to run in much more upright postures, with their knees straight or sometimes even locked.

"A lot of people say that's how girls are built, their hips are wider. But if you're going to play soccer five or six or seven times a week, or basketball, that's not a good position to be in. And it can be modified." The younger the age, the better.

Another physiological reason is that when boys move through puberty, they add muscle and get stronger, "often through no particular effort of their own," Sokolove says.

"Girls don't get appreciably stronger. They add fat cells, their body composition changes in that way." They also get more flexible, sometimes overly flexible, and they're not surrounded by sufficient muscle to protect joints and keep them stable.

"Muscular support and strength around the joints is always a little less in women, even when they're fit," says Dr. Wanda Millard, a professor in the department of medicine at the University of Western Ontario who specializes in sports medicine.

Girls are also more vulnerable to stress fractures, usually related to hormonal issues.

Sokolove, a father of three whose 19-year-old daughter is a college athlete and who talked to dozens of researchers, female athletes and their parents and coaches at all levels of play, wrote the book because he loves sports, and he particularly loves sports for girls.

Research shows girls who play sports have more self-esteem and lower levels of depression than girls who don't play sports.

"I can make a case that sports are better for girls than they are for boys, because girls get all the benefits of learning how to compete, learning to be fit, learning to deal with disappointment and accepting victory with grace."

Sports socialize boys "often in some unfortunate ways," Sokolove says. "A bunch of boys together on a team sometimes promotes misogyny. In the U.S. our glorified pro athletes are arrested at strip clubs and brawling. The girls don't get into that, not very much, anyway."

To play competitive sports is to accept the possibility of injury, he says. But it's up to parents "to go in and talk to the coach and say, is this working? If my daughter is sore or she's injured or she's just worn out to say, in this the schedule she ought to be playing? Is she getting enough time to rest? Is this whole team getting enough time for rest and healing?"

"The intent of the women's sports revolution is not to have a bunch of girls leave the field of play and turn into young adult women who are compromised physically."

 

Sheila Weaver, Founder and CEO SheLovesSports.com "The ultimate social network for active girls and   women"