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Bone Bulletin

Abstract

Introduction

Sex plays a significant role in sports medicine risk factors, but historically, there has been a lack of research involving female participants and investigating physiologic factors unique to female athletes.1–4 Male athletes face a 2.26 times higher risk of hip and groin injuries, a 2.4 times higher risk of hamstring injuries, and a 1.8-2.8 times higher risk of acute fractures, especially in competitive situations.2 Alternatively, female athletes experience a 2-8 times higher rate of anterior cruciate ligament (ACL) injuries, a 3.4 times higher risk of bone stress injuries, a 1.25 times higher rate of foot and ankle injuries, and an 8.64 times higher rate of concussions.2,3,5 While the risk of contact ACL tears is equal between sexes, females have an elevated risk of the significantly more common mechanism of ACL tears: non-contact ACL tears.1,6 Education on the impact of sex in sports medicine is essential for the development of informed orthopedic surgeons. This review explores the physiologic mechanisms behind females' increased risk of ACL injuries, the status of sex-informed orthopedic research, and clinical considerations for providers caring for female athletes.

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