sex and gender differences

Question 1

what is the sex difference in injuries in team sports

Answer 1

females had 2x higher risk of ACL injuries
males had higher rate of overall, lower, and upper extremity injuries

Question 2

what is important when looking at sex differences in injury risk

Answer 2

compare athletes at the same level, age, and sport

Question 3

what are the differences in ACL injury rate through life

Answer 3

prior to adolescence- boys and girls are the same

adolescence - girls participating in pivoting and jumping sports have 4-6x higher rate of ACL injuries compared to boys in same sport

after growth spurt - girls have higher rate of ACL injuries

Question 4

what are the anatomical factors associated with ACL injury risk

Answer 4

increased knee valgus increasing the Q angle
alignment and dynamic knee control
intercondylar notch (narrower)
variations in tibial plateau and tibial slope (more slope could facilitate the anterior translation of the tibia)

as much variation within sex as there is between sex

Question 5

what are the hormonal factors associated with ACL injury risk

Answer 5

often done in animal models
no evidence that proves estrogen is a mechanism for ACL injury

Question 6

how is hypermobility associated with ACL injury risk

Answer 6

often hereditary
affects both but females more
risk of knee injuries, sublux and dislocations

use beighton score

Question 7

what are the biomechanical factors associated with ACL injury risk

Answer 7

different running, cutting, and landing mechanics

trainable factor

as much variability within sex as there is between sexes

Question 8

what are the NM factors associated with ACL injury risk

Answer 8

ligament dominance (use of passive subsystem instead of active (muscles) to absorb ground reaction forces)

quad dominance (rather than hamstring = more load on ACL)

leg dominance (imbalances)

trunk dominance (impaired trunk muscular control - leads to bad biomech position - strong core reduces joint loading)

Question 9

what are the gendered aspects in the pre-sport environment

Answer 9

gendered parenting, expectations, and stereotyping

different expectations between genders with resistance training and interventions

Question 10

what are the gendered aspects of sport participation

Answer 10

girls = higher starting age (missed the basics of the sport), less quality coaching, less facilities, training, and support

likely influences risk factors