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Over the past decade several studies have examined the ratio of injury of female athletes to male athletes and many have shown that women are more likely to sustain injuries, specifically to the knee and hips, than male athletes. In fact, a recent study looked at NCAA cross-country runners and showed that the injury rate in women’s cross-country was 1.25 times that of men’s cross-country. Furthermore, 50% of these injuries were hip and knee injuries. But why?

The answer is evolution.  Testing has shown that women have a lower hamstring to quadriceps torque and strength ratio than their male counterparts. What this means is that the muscles and ligaments involved in running, kicking and pivoting have to work harder in female athletes in an effort to create balance and control. This overexertion is often what leads to injuries such as ACL tears, tendonitis, joint injuries and fractures.

However, this does not mean females should give up or avoid sports but simply means that women may need to be more mindful of these differences and utilize innovations in neuromuscular training to develop these muscle groups in an effort to reduce the risk of injury. Using neuromuscular training techniques, female athletes are taught how to position their upper body and trunk prior to pivoting, kicking or making contact with the ground. These programs also work to optimize the gait and stride when running to reduce repetitive strain and tendon injuries.


Dr. Nicholas Alexander is the Founder of Mahwah Valley Orthopedic Associates and a Board Certified Orthopedic Surgeon specializing in both the surgical and non-surgical treatment of hip and knee conditions.  Dr. Alexander completed his Fellowship in Adult Reconstruction and Reconstructive Surgery of the Hip and Knee at the Johns Hopkins School of Medicine and has over two decades of experience. He also serves as the Chairman of the Valley Hospital Total Joint Center. Dr. Alexander has offices in Mahwah and Clifton, NJ.  If you, or someone you love, is considering treatment for chronic knee pain, contact us today for a consultation.

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