23 Sep 2021

Why Females Can Be More Susceptible to Injury When Sprinting

BOS Education

Oftentimes when we see female athletes the first thing we notice is the outward protrusion of the kneecaps.

The angle of the knee is a measurement of the angle between the quadriceps muscles and the patella tendon and provides useful information about the alignment of the knee joint.

We have worked with hundreds of female athletes who commonly share the same problem. We’ve dealt with multiple ACL, Ankle, and Hip flexor injuries. Herrington et. al, 2020 compared patellar mechanics between those with no pain & those with anterior knee pain.⁣ ⁣

Furthermore, women have a wider pelvis due to childbirth reasons: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356512/ | This wider frame and lack of optimal IR for athletic performance can cause females to become more susceptible to lower extremity injuries.

This angle is greater in females than males. ⁣This can explain why females tend to have a wider pelvis which is skeletally biased towards external rotation, abduction, & flexion.⁣ ⁣

The wider the pelvis and the more external rotation present, the wider the lateral “bowstring” force pulling the patella to the outside (Kernozek et. al, 2008).⁣ ⁣

This is a huge factor in ACL tears & rehab. However, for so long, rehab was concerned about the VMO quad muscle, which as you can tell in the above picture is responsible for a more medial pull of the patella.⁣

WHEN SPRINTING & RUNNING

Female as it pertains to their pelvis is oftentimes biased towards a state of eccentric force absorption (more females), then the knee valgus likelihood is much higher due to the lack of internal rotation necessary at the pelvis.⁣ ⁣

There is a substantial evidence suggesting that females experience a greater incidence of abnormal mechanics & related pathologies of the patellofemoral joint than males (Fithian et. al, 2004; Powers et. al, 2002).⁣ ⁣

Ironically, despite this skeletal bias of ER, ABD, FLX, weakness of the muscles that control those joint actions are particularly weak in otherwise normal & healthy females (Boling et. al, 2002, Robinson 2007).

3 ASSESSMENT TOOLS

Lying IR Test

Seated IR Test 30 degrees

Toe Touch and Squat

5 EXERCISES TO PERFORM

90/90 Knee Roll with Bridge

SL Heel Bridge Lift w/ Reach

Side-lying Adductor MB Raise

Front Rack Wall Hold

THE SOLUTION

In early phases of acceleration with females, we teach attacking from above.

Why? This tends to coincide with a powerful hip drive and stiff ankle contact, resulting in efficient elastic recoil with minimal strain on the hamstrings.

Keeping the force application elastic at higher speeds helps spread the stress across more connective tissue, incorporating better use of the tendons and fascia with less localized trauma to the posterior chain.

When performed properly, athletes look like they are bouncing down the runway rather than forcing their way.

In contrast, poor frontside lift reduces the available range of motion at the hip upon entering ground contact, so force will be lower.

Additionally, the body posture will feature a pelvis rotated toward the ground (excessive anterior tilt) rather than a neutral position. This posture effectively puts greater eccentric strain on the hamstrings, causing them to absorb more force directly into the muscle, resulting in greater tissue trauma.

Heel striking too far in front of the body as a result of this posture forces the hamstrings to operate first as a braking system and then as a propulsive system.

Essentially, the hamstrings are being forced to help prevent the athlete from falling on their face, which means double the responsibility and a greater risk of damage.