Lourdes Sports Medicine offers complete, timely and caring sports medicine treatment.
Our physicians specialize in the care of professional and amateur athletes as well as “weekend warriors.”
Spring sports season is right around the corner.
That also can mean a variety of aches and pains.
Athletes of all ages and abilities frequently complain of injuries due to overuse.
Dr. Kristen Herbst is here to address women and sports injuries.
Selected Podcast
Are Women More Susceptible To Sports Injuries?
Featured Speaker:
Learn more about Kristen A. Herbst, DO
Kristen Herbst, DO
Kristen A. Herbst, DO is an Orthopedic Surgeon with specialization in Sports Medicine, Arthroscopy, and Shoulder Surgery. She treats a variety of patients from young athletes to weekend warriors. Her training has prepared her well to treat a variety of injuries ranging from sprains and strains to overuse injuries, and fractures, with a special interest in getting patients back to their pre-injury level of activity after meniscus tears, ACL tears, and rotator cuff tears. Additionally, she has had extensive training in the treatment of all shoulder conditions and their surgical treatment including total shoulder replacements.Learn more about Kristen A. Herbst, DO
Transcription:
Are Women More Susceptible To Sports Injuries?
Melanie Cole (Host): It’s a fact. Women athletes and women in general are more prone to suffering certain sports injuries then their male counterparts. My guest today is Dr. Kristen Herbst. She is an orthopedic surgeon with a specialization in sports medicine, orthoscopy and shoulder surgery at Lourdes Health System. Welcome to the show, Dr. Herbst. Let’s speak about women and sports injuries. Why are women more susceptible to certain injuries than men?
Dr. Kristen Herbst (Guest): The number one injury that is different between males and females is ACL tears in the knee. Females are at two to eight time’s greater risk of ACL tears. There are a few reasons for that. Number one, they have some anatomic variables that contribute to this. In general, we have an increase in joint laxity in females, meaning their joints are looser. So, this is a predisposition for ACL tears. Secondly, there has been a noticeable difference in neuromuscular control, meaning the body’s ability to control the muscles and the joints in things like jumping and running activities. Lastly, there are some anatomic variables with the width of the female hip, the notch within the knee where the ACL lives. Those are all things that increase the risk of ACL tears in females compared to males.
Melanie: Are we seeing these ACL problems just in athletes? What causes the ACL tear? You’ve spoken about the differences and our biomechanical differences and the laxity and such, but what movements predispose us to these, too?
Dr. Herbst: ACL tears are usually seen in running and cutting activities. In males, a lot of times, you’ll see an ACL tear on a football field because of a contact injury. In females, it is more commonly seen in a noncontact situation where they cut and they turn and all of the sudden, they lose control of their knee and they tear their ACL. Or, they come down from a jump in a basketball game and they land awkwardly. Those are the two highest mechanisms.
Melanie: What can women do to reduce this risk?
Dr. Herbst: There are a lot of prevention programs for ACLs right now. There are four main principles to each of those prevention programs. They concentrate on balance, strength, proprioception or the body’s ability to land where it is supposed to and plyometric training which is jumping and explosive movement.
Melanie: How does a woman start to go about looking at these if they don’t know how to do plyometrics and they don’t know what proprioceptive training is? Even if they are just a woman who likes to play some weekend games or even just go to aerobics class and do step classes and things. They are still predisposed to this injury.
Dr. Herbst: Sure. A lot of these programs, I really suggest you can find them readily on-line. I really suggest getting in with a health professional that knows these programs and can guide you with these exercises. A huge portion of this is learning how to land correctly. You can’t do that by looking at yourself critically if you don’t know what you’re looking for. It’s really important to get a physical therapist or athletic trainer involved. A lot of places locally offer these kinds of training programs – like I said, large physical therapy or sports conditioning places offer specific ACL prevention programs. It’s really important to get involved with someone that knows what they are doing and they can guide you in the right direction because just doing these exercises on your own, unless you are trained right, can often not do as much as it needs to do.
Melanie: Dr. Herbst, because women’s bodies are more flexible than men’s, does that mean we are sacrificing strength and stability for that flexibility?
Dr. Herbst: In general it is a proven fact that no matter how much you weight train, females will ultimately have about 30% less strength than males. That’s just physiological the way it is. That involves the upper body more than the lower body. But, in general, we just have less muscle mass. The cross-sectional muscle mass in males is 60-85% more than what the average female has and that is just something we can’t overcome. So, we have to do things like train our bodies to land appropriately and work efficiently to be able to overcome those things.
Melanie: What about other parts of our body – the shoulder or the feet? Are we more susceptible in these areas as well?
Dr. Herbst: There are a couple of things in the shoulder that women are more disposed to, specifically frozen shoulder and impingement and stuff. Those we usually see later in life. We don’t see those in the young, active individuals. Usually, it’s the knee. The knee is the number one difference between males and females. Sometimes, if you have flat feet or a pronated foot when you ambulate, those things can come into play as well. But, that’s across the board.
Melanie: What about treatments for these kinds of things? Are you an ice person? When someone asks you should they use heat, should they use ice? If they are sore after working out, what do you tell them?
Dr. Herbst: Ice stops the inflammatory process. I do encourage people to, if they are feeling sore after a workout, if they have any swelling or anything like that to definitely utilize ice. Heat is more useful in terms of trying to warm up, trying to get the body ready for stretching exercises. I usually encourage people to use heat prior to their activity and ice at the end of the day, at the end of activity anytime there is any swelling notable.
Melanie: Doctor, what about bracing. When a woman comes to you and asks if she should use a brace, does it decrease the ability of the muscle to perform its own work? What do you tell them about using a brace?
Dr. Herbst: If there is a notable laxity in that patient, there is definitely a ligament that is loose, whether it has been stretched out from an injury, whether they are just that way naturally, I will utilize bracing. A lot of times people ask, “Can I wear a brace to make my knee feel better?” Knee braces don’t control pain. They only control movement and I only utilize them in someone recovering from a specific knee injury, a knee sprain or a ligament injury or someone trying to get back to play after those injuries. Then, I gradually wean them out of it once their muscle control is back to where it needs to be.
Melanie: Do ACL injuries heal themselves? Some of these injuries we’re discussing in general, do they heal themselves or do they require treatment?
Dr. Herbst: ACL tears do not heal. That has been proven in the literature. They have gone different ways with it in the past and ultimately an ACL tear will not heal on its own. If you want to stay active, if you want to continue to do running and jumping and cutting activities, the ACL tear does need to be addressed surgically. There are other ligaments that tend to heal on their own, ankle sprains and there are different grades of ankle sprains or sprains in general. Oftentimes, if the ligament is just stretched out, as long as you do good, formal physical therapy, that can compensate for the new laxities after that injury and a lot of times, the body will heal just fine and recover from that as the ligament scars down versus actually the ACL needs to be repaired and reconstructed surgically.
Melanie: While we’re talking today about acute injuries, certainly chronic injuries with any kind of activity you do repetitively are a risk. What do you tell women, Dr. Herbst, about cross-training and trying new things so that they don’t do the same thing all the time?
Dr. Herbst: The injuries that we were talking about before are from sudden injuries whereas tendonitis and overuse injuries are from repetitive motion or repetitive activity over time. Those things do become more prevalent as you become more active, as you become older. The things that we need to do to avoid that, like you said, is cross train. There are different ways that you can exercise your body without doing the same thing over and over again. You can utilize things like Pilates and yoga to give the body a rest but, at the same time, give it an active recovery. You can do things like get in the pool. You can use the bike instead of just running all the time. There are definitely things that you want to do to kind of incorporate other exercises to avoid the same exact thing over and over again and lead to things like stress fractures and tendonitis and other more serious injuries as a result of the same activity over time.
Melanie: In just the last minute, it’s such great information, Dr. Herbst, tell us a little bit about Lourdes Health System Sports Medicine and why people should come there for their care.
Dr. Herbst: We have a great sports medicine program. We have everything from the non-operative care. We have physicians that specifically specialize in ultrasound guided injections and PRP injections and utilizing biologics to be able to help you heal to the orthopedic sports medicine side of things where we can incorporate if you have completed rehab and are not doing well, we can give you surgical options. If it is a specific injury that needs surgical intervention, we have that available. We are on the forefront. We are using updated techniques and equipment. We really can provide great care from the beginning to the end and get you in the right physical therapy program and back on the field as soon as we can with it being a safe return.
Melanie: Thank you so much. You’re listening to Lourdes Health Talk and for more information you can go to LourdesNet.org. That’s LourdesNet.org. This is Melanie Cole. Thanks so much for listening.
Are Women More Susceptible To Sports Injuries?
Melanie Cole (Host): It’s a fact. Women athletes and women in general are more prone to suffering certain sports injuries then their male counterparts. My guest today is Dr. Kristen Herbst. She is an orthopedic surgeon with a specialization in sports medicine, orthoscopy and shoulder surgery at Lourdes Health System. Welcome to the show, Dr. Herbst. Let’s speak about women and sports injuries. Why are women more susceptible to certain injuries than men?
Dr. Kristen Herbst (Guest): The number one injury that is different between males and females is ACL tears in the knee. Females are at two to eight time’s greater risk of ACL tears. There are a few reasons for that. Number one, they have some anatomic variables that contribute to this. In general, we have an increase in joint laxity in females, meaning their joints are looser. So, this is a predisposition for ACL tears. Secondly, there has been a noticeable difference in neuromuscular control, meaning the body’s ability to control the muscles and the joints in things like jumping and running activities. Lastly, there are some anatomic variables with the width of the female hip, the notch within the knee where the ACL lives. Those are all things that increase the risk of ACL tears in females compared to males.
Melanie: Are we seeing these ACL problems just in athletes? What causes the ACL tear? You’ve spoken about the differences and our biomechanical differences and the laxity and such, but what movements predispose us to these, too?
Dr. Herbst: ACL tears are usually seen in running and cutting activities. In males, a lot of times, you’ll see an ACL tear on a football field because of a contact injury. In females, it is more commonly seen in a noncontact situation where they cut and they turn and all of the sudden, they lose control of their knee and they tear their ACL. Or, they come down from a jump in a basketball game and they land awkwardly. Those are the two highest mechanisms.
Melanie: What can women do to reduce this risk?
Dr. Herbst: There are a lot of prevention programs for ACLs right now. There are four main principles to each of those prevention programs. They concentrate on balance, strength, proprioception or the body’s ability to land where it is supposed to and plyometric training which is jumping and explosive movement.
Melanie: How does a woman start to go about looking at these if they don’t know how to do plyometrics and they don’t know what proprioceptive training is? Even if they are just a woman who likes to play some weekend games or even just go to aerobics class and do step classes and things. They are still predisposed to this injury.
Dr. Herbst: Sure. A lot of these programs, I really suggest you can find them readily on-line. I really suggest getting in with a health professional that knows these programs and can guide you with these exercises. A huge portion of this is learning how to land correctly. You can’t do that by looking at yourself critically if you don’t know what you’re looking for. It’s really important to get a physical therapist or athletic trainer involved. A lot of places locally offer these kinds of training programs – like I said, large physical therapy or sports conditioning places offer specific ACL prevention programs. It’s really important to get involved with someone that knows what they are doing and they can guide you in the right direction because just doing these exercises on your own, unless you are trained right, can often not do as much as it needs to do.
Melanie: Dr. Herbst, because women’s bodies are more flexible than men’s, does that mean we are sacrificing strength and stability for that flexibility?
Dr. Herbst: In general it is a proven fact that no matter how much you weight train, females will ultimately have about 30% less strength than males. That’s just physiological the way it is. That involves the upper body more than the lower body. But, in general, we just have less muscle mass. The cross-sectional muscle mass in males is 60-85% more than what the average female has and that is just something we can’t overcome. So, we have to do things like train our bodies to land appropriately and work efficiently to be able to overcome those things.
Melanie: What about other parts of our body – the shoulder or the feet? Are we more susceptible in these areas as well?
Dr. Herbst: There are a couple of things in the shoulder that women are more disposed to, specifically frozen shoulder and impingement and stuff. Those we usually see later in life. We don’t see those in the young, active individuals. Usually, it’s the knee. The knee is the number one difference between males and females. Sometimes, if you have flat feet or a pronated foot when you ambulate, those things can come into play as well. But, that’s across the board.
Melanie: What about treatments for these kinds of things? Are you an ice person? When someone asks you should they use heat, should they use ice? If they are sore after working out, what do you tell them?
Dr. Herbst: Ice stops the inflammatory process. I do encourage people to, if they are feeling sore after a workout, if they have any swelling or anything like that to definitely utilize ice. Heat is more useful in terms of trying to warm up, trying to get the body ready for stretching exercises. I usually encourage people to use heat prior to their activity and ice at the end of the day, at the end of activity anytime there is any swelling notable.
Melanie: Doctor, what about bracing. When a woman comes to you and asks if she should use a brace, does it decrease the ability of the muscle to perform its own work? What do you tell them about using a brace?
Dr. Herbst: If there is a notable laxity in that patient, there is definitely a ligament that is loose, whether it has been stretched out from an injury, whether they are just that way naturally, I will utilize bracing. A lot of times people ask, “Can I wear a brace to make my knee feel better?” Knee braces don’t control pain. They only control movement and I only utilize them in someone recovering from a specific knee injury, a knee sprain or a ligament injury or someone trying to get back to play after those injuries. Then, I gradually wean them out of it once their muscle control is back to where it needs to be.
Melanie: Do ACL injuries heal themselves? Some of these injuries we’re discussing in general, do they heal themselves or do they require treatment?
Dr. Herbst: ACL tears do not heal. That has been proven in the literature. They have gone different ways with it in the past and ultimately an ACL tear will not heal on its own. If you want to stay active, if you want to continue to do running and jumping and cutting activities, the ACL tear does need to be addressed surgically. There are other ligaments that tend to heal on their own, ankle sprains and there are different grades of ankle sprains or sprains in general. Oftentimes, if the ligament is just stretched out, as long as you do good, formal physical therapy, that can compensate for the new laxities after that injury and a lot of times, the body will heal just fine and recover from that as the ligament scars down versus actually the ACL needs to be repaired and reconstructed surgically.
Melanie: While we’re talking today about acute injuries, certainly chronic injuries with any kind of activity you do repetitively are a risk. What do you tell women, Dr. Herbst, about cross-training and trying new things so that they don’t do the same thing all the time?
Dr. Herbst: The injuries that we were talking about before are from sudden injuries whereas tendonitis and overuse injuries are from repetitive motion or repetitive activity over time. Those things do become more prevalent as you become more active, as you become older. The things that we need to do to avoid that, like you said, is cross train. There are different ways that you can exercise your body without doing the same thing over and over again. You can utilize things like Pilates and yoga to give the body a rest but, at the same time, give it an active recovery. You can do things like get in the pool. You can use the bike instead of just running all the time. There are definitely things that you want to do to kind of incorporate other exercises to avoid the same exact thing over and over again and lead to things like stress fractures and tendonitis and other more serious injuries as a result of the same activity over time.
Melanie: In just the last minute, it’s such great information, Dr. Herbst, tell us a little bit about Lourdes Health System Sports Medicine and why people should come there for their care.
Dr. Herbst: We have a great sports medicine program. We have everything from the non-operative care. We have physicians that specifically specialize in ultrasound guided injections and PRP injections and utilizing biologics to be able to help you heal to the orthopedic sports medicine side of things where we can incorporate if you have completed rehab and are not doing well, we can give you surgical options. If it is a specific injury that needs surgical intervention, we have that available. We are on the forefront. We are using updated techniques and equipment. We really can provide great care from the beginning to the end and get you in the right physical therapy program and back on the field as soon as we can with it being a safe return.
Melanie: Thank you so much. You’re listening to Lourdes Health Talk and for more information you can go to LourdesNet.org. That’s LourdesNet.org. This is Melanie Cole. Thanks so much for listening.