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Get to know the “injury gender gap”

Working out is key to staying healthy - but it’s also a balancing act. If you work out too little, you won’t see results. If you don’t balance your workouts with the right nutrition and rest, you could hurt yourself.

Some exercise injuries are relatively minor, such as a pulled muscle, twisted ankle or a strained tendon. Others are more serious, such as a broken bone or a torn ligament.

And while anyone can suffer a workout injury, women tend to be more susceptible to certain injuries than men.

“Women and men have different strengths and weaknesses, physiologically speaking,” explained Dr. Callista Morris, an orthopaedic surgeon specializing in sports medicine. “Most of these differences come from body composition and hormone levels which can be affected by things such as menstruation. These factors make certain injuries more common for women.” 

The best way to prevent workout-related injuries is to be aware of what you may be prone to and to keep workouts within your own personal comfort zone.

Here are some of the most common workout-related injuries for women.

ACL tears
An anterior cruciate ligament (ACL) tear is a common injury for active women. 

“The ACL is a structure that connects your femur to your tibia inside the knee, and helps provide stability,” said Dr. Morris. “However, if you sustain a contact or twisting injury, you could tear your ACL. This may result in immediate pain and swelling with difficulty getting around. Many times, if you plan to stay active, you’ll need surgery to reconstruct your ACL and regain knee stability.”

The reason ACL tears are more common for women is that their knees are designed differently than men’s knees. Women’s knees tend to be more knock-knee (valgus) due to a wider pelvis, which places increased strain on the ACL. Also, the muscles in women’s hips tend to be weaker compared to men’s, resulting in reduced leg control during jumping and landing. As a result, a swift turn or an accidental fall can put excessive strain on the ACL and cause it to tear.  

Strength training can help prevent ACL tears. Strengthening the gluteus medius muscle (located on the side of your hip), hamstrings and vastus medialis muscle (the part of the quadriceps that extends the knee), can decrease ACL tears by up to 50 percent. Talk to your doctor, athletic trainer or personal trainer about how you can use strength training to lower your risk of ACL tears.

Stress fractures
Stress fractures are common for both men and women—especially those involved in high-impact sports and activities. But for women suffering from the “female athlete triad,” stress fractures are even more common.

The female athlete triad is a mix of inadequate nutrition, irregular periods and bone loss. At its most extreme, the triad can be caused by eating disorders, amenorrhea (or absent periods) and osteoporosis

All three of these disorders contribute to weaker bones. But together as the triad, they can significantly increase the risk of stress fractures and broken bones.

“To avoid stress fractures, focus on eating a healthy diet, and make sure your diet contains enough calcium and vitamin D,” said Dr. Morris. “Do workouts that are appropriate for your skill level. If you do high-impact workouts and exercises, or participate in overuse sports such as long-distance running without adequate rest, be aware that they increase your risk of fractures.” 

Talk to your doctor about the risks of the female athlete triad, as well as the specific conditions. 

Plantar fasciitis
You don’t need to be a police officer to get “policeman’s heel.” Plantar fasciitis, also known as policeman’s heel, is a condition caused by inflammation in the thick band of tissue that supports the arch on the bottom of your foot. Plantar fasciitis can cause severe pain in the heel and throughout the arch of the foot—especially in the morning.

Plantar fasciitis is caused by repeated strains and tears of the plantar fascia. While women are not necessarily more susceptible to it than men, having a tight Achilles tendon -also called a heel cord- is a significant risk factor. Exercises like long-distance running, jumping, ballet and aerobic dance all increase the risk of plantar fasciitis.

“To avoid plantar fasciitis, it is extremely important to stretch your Achilles tendon and plantar fascia daily,” noted Dr. Morris. “You can also purchase over-the-counter arch supports for your shoes based on your foot type, such as those for flat feet. They can help support your feet and avoid stressing the plantar fascia. The over-the-counter supports have been proven to be just as effective, if not more so, than expensive custom inserts for plantar fasciitis. If the pain is severe, talk to your doctor. You may need to wear a cast for a short period. They can also help direct the appropriate therapy, as well as evaluate your shoes to make sure they fit the needs of your feet.”


Callista Morris, DO, is a fellowship-trained orthopaedic surgeon specializing in sports medicine. Dr. Morris sees patients at Geisinger clinics in Carlisle and Selinsgrove, and Geisinger’s Woodbine Clinic in Danville. To make an appointment with Dr. Morris or another Geisinger sports medicine specialist,  call 800-275-6401 or visit Geisinger.org.