Muscles to Blame for
Women's Knee Injuries
Excerpt By Linda Carroll, Reuters Health

Women who participate in jumping and pivoting sports, such as basketball, volleyball and soccer are eight times more likely to rupture a knee-stabilizing ligament than are men.

The reason women are more likely to injure the anterior cruciate ligament (ACL) may be weakness in the muscles surrounding the knee, according to a new study.

Women who participated in jumping and pivoting sports had knee muscles that were weaker not only than those of men who played the same sports but also than knee muscles of women who participated in other sports, such as bicycling, crew and running, according to a study published in the Journal of Bone and Joint Surgery.

The results show that training for women who participate in sports that carry a higher risk of this type of knee injury may not be adequate, study co-author Dr. Edward M. Wojtys, said in an interview with Reuters Health.

Cruciate ligaments crisscross in the knee. The cruciate ligament located toward the front of the knee is the ACL. Athletes can injure or rupture the ACL by pivoting or changing direction rapidly, landing from a jump or slowing down from running.

For the new study, Wojtys and his colleagues looked at the ability of knee muscles to keep the joint stable in men and women who were of comparable size and weight.

"When you look at the forces that the knee joint sees during sports -- and in day-to-day living -- those forces are much higher than what the ligaments can withstand," Wojtys said. "So the only way ligaments can survive is if the muscles provide protection for them."

Wojtys and his colleagues compared 24 college athletes -- 12 women and 12 men -- who were competing in sports with a high risk of ACL injury to 28 other athletes -- 14 women and 14 men -- who were active in sports that carry a low risk of such injuries.

The researchers tested the ability of muscles to protect the knee by using a device that held the upper leg in place, but twisted the lower leg. Women who played high-risk sports did the worst on this test.

The study shows that training may need to be different from women than men, Wojtys said. And it's not just a matter of strengthening the muscles.

"You need to work on stuff like agility," Wojtys said. "You need to teach people how to engage and mobilize that protective strength at the right time.

"The great news is that we already have preliminary data showing that we can improve things with training programs."

SOURCE: Journal of Bone and Joint Surgery 2003;85-A:782-789.

Reference Source 89

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