KINE 2495 -Topic #6b: Conditions in Specific Populations Female Athletes

Common female injuries

ACL
Patellar Subluxation and PFPS
Spondylolysis and Spondylolythesis
Stress Fractures

Biomechanical Predisposition:

Increased femoral obliquity (Q-angle)
Small intercondylar notch
Quadriceps/hamstrings ratio
Hormonal effects

Anterior Cruciate Ligament (ACL) Sprains:

More common in female athletes and are considered to be the most severe of acute injuries.
Females will incur 2-6 times the number of ACL injuries compared to men when matched for age, sport and level of competition.
Mechanism of Injury (MOI):
Valgus force
Hyperextension
Internal rotation of the femur on a fixed tibia
Deceleration with a change in direction

Female Reproductive System, *Controlled by:

Hypothalamus, pituitary, adrenal glands, ovaries, hormones

Female Reproductive System: Stages

Pre-Puberty
Menstrual / Reproductive
Postmenopausal

Menarche

Onset of menstruation / puberty typically occur between ages 9 and 17
May be delayed through strenuous sports training

Amenorrhea - Primary & Secondary

absence of menstruation
Primary: someone who has not had a period by age 15
Secondary: absence of three or more periods in a row by someone who has had periods in the past.

Oligomenorrhea

a menstrual cycle that lasts longer than 35 days or fewer than nine periods in a year

Anovulation

failure or absence of ovulation

Short Luteal Phase

less than nine days is considered abnormally short

Dysmenorrhea

painful periods (menstruation) or menstrual cramps.

RED-S: Relative Energy Deficiency in Sport

a syndrome of impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health caused by relative energy deficiency.

RED-S In Male Athlete

* Prevalence studies of low energy availability in male athletes have been few, however, low energy availability appears to occur among the same at risk sports as for female athletes.
*At risk sports = The weight sensitive sports in which leanness and/or weight are important due to their role in performance, appearance or requirement to meet a competition weight category.

The Pregnant Athlete:

* May continue physical activity and competition up to the 7th month, unless complications are present
* Many females do not continue past third month due to drop in performance
* No indication that exercise is harmful to fetal growth
* Extreme exercise may result in low birth weight

The Pregnant Athlete: Body Changes & Biomechanical Effect

* Postural adaptation leads to increased lordosis & upper spine extension​
* Low Back / Pelvic Girdle Pain
* Approximately 50% of women experience low back or pelvic girdle pain during pregnancy; 25% continue to experience pain 1 year after delivery.

Menopause:

• Means cessation of menstruation
• Typically occurring anytime from age 40 onwards
• Typically gradual changes rather than one specific event

Menopause: Bone Health

* Decrease in bone mineral density is seen commonly in older women and is linked to declines in FSH, LH, progesterone, and estrogen.
* Causes increased risk of stress fractures
* Exercise can help strengthen bones - slow the onset of osteoporosis

* Males lose 0.4% of bone mass/year after age 50​
* Females lose 0.75-1%/ year after age 30-35​
* Bone loss increases 2-3%/year during the first 5 years after menopause​
* Females can lose up to 30% of bone mineral by age 70​
* Females age >65 have up to 50% hip fracture rate​
* Hip fractures are 50 times more prevalent at 70 than at 40​
* Most common sites of fractures are vertebrae, femoral neck and distal radius