Training Technique Offers New Hope For Female Athletes

In the past 30 years, there has been an explosion in the number of girls and women participating in all types of sports. There has been a 10-fold increase in high school and 5-fold increase in collegiate sports.

With this massive upsurge comes a disturbing trend — a much higher incidence of injuries for female athletes when compared to boys and men playing at the same level of sports.Studies have shown that girls and women have a four to six times higher incidence of ACL (“anterior cruciate ligament”) injuries than their male counterparts. This can have a devastating impact on the female athlete including being sidelined for the season, loss of scholarships, a decrease in scholastic performance and a 100 times greater chance of being diagnosed with osteoarthritis. Some put the total cost of health care upwards of $625 million.Orthopaedic research scientist, Timothy E. Hewett, Ph.D. was joined by his colleagues, Mary Lloyd Ireland, M.D., and Kevin Shea, M.D. for a media briefing at the 74th Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego Convention Center. The briefing was held Thursday, February 15, 2007. Hewett and the panel discussed their findings about these injuries and the most effective ways to prevent them from occurring.”Pivoting” and “cutting” sports — such as basketball and soccer — put female athletes at greater risk of ACL injuries. Many theories have been forwarded for this disparity. They have ranged from hormonal differences between females and males to women landing with more inward collapse of the knees — putting undue stress on the ACL.Various solutions have been proposed including plyometrics (high-intensity jump training) and technique training. According to Timothy E. Hewett, Ph.D., director of the Cincinnati Children’s Hospital Sports Medicine Biodynamics Center and spokesperson for the American Academy of Orthopaedic Surgeons, “Both strength and balance training are potentially effective but only as an adjunct to these other types of training.”Hewett found that the reason for these serious injuries was how well the female athlete “controlled” her landing. Dr. Hewett conducted a meta-analysis of six studies on “neuromuscular training” to prevent ACL injuries. He found that all the studies advocated use of this method.In a six-week pre-season neuromuscular training intervention program performed three times a week (60 to 90 minute sessions), the rate of non-contact ACL injuries decreased 72%. All of the studies supported combining different types of neuromuscular training to prevent injuries and enhance performance.Another important component of neuromuscular training is having a coach or trainer analyze an athlete’s movements and provide feedback on proper position of the body and her technique. This type of feedback helps the athlete “feel” the proper positions and moves she should be making. In the Hewett study, they asked a trainer to work with the athlete so she could develop an awareness of her movements and make modifications when indicated.A strong neuromuscular program is multi-faceted. Hewett recommends using several different programs. “Off-season and pre-season conditioning programs are critical to preventing these types of injuries. A program needs to combine high intensity jumping exercises and movement, resistance, speed and balance training as well as core strengthening.”(Source: American Academy of Orthopaedic Surgeons : March 2007.)