Studies show that young girls involved in sport are four to six times more likely to injure the anterior cruciate ligament (an important stability ligament in the knee) than boys. Why is this? Many factors have been hypothesized including muscular imbalances, poor use of hamstrings and gluteal muscles (in the buttocks), and joint laxity. However, it seems to me that none of these should be specifically more problematic for girls.
These injuries commonly occur in early puberty. For girls one of the biggest changes to the skeletal structure at this age occurs in the pelvis. As girls hit puberty the pelvis changes shape drastically, going from narrow and straight below the rib cage to a much wider curvier silhouette. The result is a significant change in the alignment of the hips.
What is this Qurious Angle?
When we look at someone standing straight, we assume that the thigh bones (called femurs) are completely vertical just because we see that the thighs are vertical. The femurs, however are not aligned straight up and down. They are at a slight angle towards the middle. This is referred to as the Q angle in the medical world.
When girls enter puberty and the pelvis widens rapidly, the Q angle also changes. The femurs become even more slanted towards the middle as the upper end gets pushed out with the widening pelvis. This is normal.
The injury risk, I believe, comes from the muscles not adjusting quickly enough to this change in the angle at the hips. The muscles are accustomed to pulling at a certain angle, so when this angle changes rapidly they get a little discombobulated.
Maintaining Stability a Must
At this time, if we do not pay particular attention to maintaining stability around the hips and pelvis then injury can easily result. I have treated girls at this age who have completely lost activity in the muscles that would provide them this stability. This can be improved with hands-on treatment.
It is also especially important to treat seemingly minor injuries that can affect alignment and stability (for more information read this blog post), as anything that compromises the muscles around the hips and pelvis is particularly problematic for girls at this age. Even if the injury is in an area seemingly unrelated to the hips and pelvis, the resulting compensatory movement patterns can affect this critical area. If your daughter is active in sports, you may also want to visit a physiotherapist for an assessment of alignment and stability in order to avoid injury altogether.
Another excellent resource is a programme called FIFA 11+ which is focused on injury prevention through a specific set of warm-up exercises targeted at alignment and stability. This programme can be used by athletes in any sport and has been proven to reduce injury rates by up to 50%. It is available to everyone for free so speak to your daughter’s coach about incorporating it in practices.
Don’t let girl power be defused by injury. A relatively small time investment now can pay off big time down the road. Keep her safe and in the game.