Ugh, my knees hurt just reading this lengthy excerpt from Michael Sokolove's upcoming book, "Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports," which appears in this Sunday's New York Times Magazine. Though solid statistics are hard to come by, it does appear that girls in high school and college sports are injured at higher rates than boys. And in particular, ruptures of the ACL -- "a small, rubber-band-like fiber ... that attaches to the femur in the upper leg and the tibia in the lower leg and stabilizes the knee" -- occur up to five times more often among girls than boys. Yeesh.
It's not known why ACL ruptures happen so much more often to girls, partly because it's not always known how it happens to them. While male players more often get ACL injuries from direct blows to the leg, when it comes to girls, according to injury epidemiologist Steve Marshall, "you can look at a video of an injury all day long, and what you see is people in the air. People landing. People cutting. What we can't actually see is what tears the thing apart." But it would seem the likely underlying culprit here is biology. Among other differences, boys tend to grow more muscular after hitting puberty, while girls grow more flexible -- and for all the athletic advantages flexibility confers, it can also increase the risk of joint injury if the surrounding muscle isn't strong enough to stabilize the joint.
The good news is, there are now ACL-injury prevention programs -- exercise series designed to increase strength, balance and coordination -- cropping up around the country, and so far, they're showing phenomenal results. The bad news is, plenty of people are still skeptical of those results, and plenty of coaches are reluctant to adopt any new program that chews up practice time without producing demonstrable improvements in performance. (One would think that keeping players on the field, instead of in hospitals and rehab, would constitute an overall team performance boost, but evidently not.)
More troubling, Sokolove says, some of those who have fought valiantly for girls' access to high school and college sports are wary of trumpeting the greater risk of injury, lest female athletes appear weak or fragile. Now, I'm about as feminist as they come, but that? Is bullshit. I would hate to see anything threaten girls' and women's full inclusion in sports, but when star soccer players are blowing out both knees before they finish high school -- and that's not happening to boys at anywhere near the same rate -- there's a difference that needs to be acknowledged here. It's all well and good to be as tough as any boy on the field when you're 17, but will it feel like such a victory when you're 35 and can't walk?