Numerous studies have come out in recent years warning about the dangers of children playing sports.
In many of them, a trend prevails: Young girls are more at risk for sports-related injuries.
For instance, they are more prone to concussions and ankle impairments.
Children who play soccer, football, basketball, and lacrosse are at greater risk for anterior cruciate ligament (ACL) injuries, and the rate is higher in girls, the Children's Hospital of Philadelphia reports.
A recent study from Nationwide Children’s Hospital in Ohio looked at children’s soccer injuries in kids aged 7 to 17 over a 24-year span.
During that time, there was a 78 percent increase in soccer-related injuries treated in hospital emergency departments.
Girls were more likely than boys to incur knee or ankle injuries.
Youth sports are on the rise, as are overuse injuries from specializing in one sport, noted Dr. Elizabeth Matzkin, chief of women’s sports medicine at Brigham and Women’s Hospital in Boston.
She told Healthline that half of those injuries could be prevented.
“Females are often hurt more often than boys due to lack of neuromuscular strength training,” she explained. “Females tend to have decreased neuromuscular control at the hip resulting in landing with their knees in a valgus position or knock-knee position. This puts them at risk for injuries such as ACL tears.”
Why are girls at risk?
A lack of strength training isn’t the only thing that makes females more prone to getting hurt playing sports.
Dr. Chris Koutures, a pediatric and sports medicine specialist in California, said girls’ biomechanics are another factor that predisposes them to injury.
The way girls rotate and land can be less stable and less aligned than boys, putting stress on lower extremities, including their knees and ankles.
“We know that young females are at a higher risk for injury,” he said. “Girls don’t have that same alignment [in their lower extremities].”
Hormone fluctuations and menstrual cycles could be another factor that leaves girls susceptible to getting hurt during sports, he added.
Dr. Gary Dorshimer, assistant program director of the Primary Care Sports Medicine Fellowship Program at the Children’s Hospital of Philadelphia, told Healthline that girls also have longer, thinner necks that tend to create more whiplash to the brain compared to boys.
This may explain why girls have a higher rate of concussions compared to boys in similar sports.
Jimmy Onate, Ph.D., an associate professor and co-director of The Ohio State University’s Sports Medicine's Movement Analysis & Performance (MAP) research program, said there are many reasons for the differences in sports injury rates between the sexes.
He explained that structural alignment differences, neuromuscular control patterns, biomechanical patterns, and strength issues — as well as theories about hormone levels — are all factors.
Reporting is another issue.
Girls may be more inclined to tell someone about their concussion symptoms, for example, while boys may be more likely to “tough it out.”
One thought is that boys underreport concussion symptoms and thus are seen as incurring fewer concussions than girls when it is actually a reporting problem, Onate explained.
“We see some trends towards girls sustaining greater injuries in comparable sports such as basketball and soccer for concussions and ACL tears,” he told Healthline. He added that intervening could improve neuromuscular control.
Play or sit out?
In his practice, Koutures sees many adolescents who would benefit from simple exercises to strengthen their bodies, but said most do not commit to it.
The Landing Error Scoring System (LESS) is a field evaluation tool that has been shown to identify high-risk movement patterns when athletes are jumping and landing.
LESS can help identify children who would benefit from an intervention training program to help reduce their risk of serious injury.
Girls tend to have higher LESS scores than boys, another indication that they are at greater risk of injury.
Intervention programs to prevent injury usually include strength and neuromuscular training.
By using these programs, athletic girls may be able to reduce their risk of getting hurt.
High-impact sports like soccer, basketball, and lacrosse may have higher rates of injury for girls than for boys — but activities that have traditionally been aimed at girls have risks, too.
Koutures noted that cheerleading, for example, presents the potential for falls and head injuries.
“That’s also a fairly high-risk activity,” he added.