Women's Knees

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Crucial Advice About Women's Knees
One out of every four sports injuries involves the knee, and female athletes have a much higher rate of knee injuries than men. Here's how to safeguard your knees.

Women are more likely to develop “runner’s knee,” for instance, and are especially susceptible to a debilitating rupture of the anterior cruciate ligament (ACL), which helps stabilize the knee joint. Women are two to eight times more likely to have an ACL injury than men in the same sports. Such injuries are a special concern in downhill skiing, and female skiers face a three-fold higher risk.

A combination of factors may help explain the higher risk of knee injuries, particularly to the ACL, among women. Women’s knees, on average, are supported by smaller, weaker muscles. Women have a wider pelvis than men, and their thigh bones angle inward more sharply from hip to knee, making their knees less stable. They also tend to have stronger quadriceps and weaker hamstrings, and such an imbalance in thigh muscles can contribute to knee injuries. Moreover, studies have found that women are more prone to ACL injuries during the first half (pre-ovulatory) phase of their menstrual cycle, suggesting that hormones may affect ligaments and other connective tissue.

Here are steps to reduce the risk, especially if you’re a woman who plays a sport:

• Strengthen your leg muscles, notably the hamstrings (located at the back of the thigh), which, along with the quadriceps (on the front of the thigh), power knee movements.

• Try to move in a balanced crouched position when exercising or playing a sport. Women tend to move and land in a more upright position, partly because their quads are usually more dominant. The more you bend your knees and hips, the more your hamstrings take over, and this better balance between quadriceps and hamstrings helps protect the ACL.

• Don’t suddenly intensify or lengthen your workouts.

• Make sure your shoes, particularly exercise shoes, fit well and are not worn out.

• Check your feet and legs. The knee sometimes pays the price for foot abnormalities (such as flat feet), overpronation (the feet roll inward too much), or poor leg alignment (such as knock-knees), which can put greater stress on the joint. You’ll need professional advice about this. An orthotic device—a custom-made arch support—may help correct some foot or alignment problems.

• Avoid the following, especially if you have knee problems: leg extensions with heavy weights and locked knees; deep lunges or full squats; running downhill; cycling with the seat low and in high gear; or taking large steps when on stairs or stair-climbing machines. Don’t exercise on very hard surfaces. Don’t wear high heels, except for special occasions.

• If you are overweight, lose weight. Excess weight puts increased stress on the knee joint.

• If you have been suffering from knee injuries from exercise or sports, consult a physical therapist specializing in sports medicine, who can evaluate how you move when performing different activities and suggest treatments as well as ways to prevent further problems.