Regardless of how deeply one delves into the minutiae of Title IX, the landmark ruling from 1972 that helped level the playing field in amateur athletics by mandating equal opportunities for boys and girls, there is no corresponding goal of achieving an equal share of sports-related injuries.

But, as it turns out, female athletes have not settled for equal. They have been outpacing their male counterparts for common athletic-related mishaps such as ankle sprains, concussions and anterior cruciate ligament (ACL) tears.

Dr. John Nickless, a sports medicine physician at Midwest Orthopaedics at Rush, sees the uptick in his practice, as more and more girls visit his Munster office to seek treatment for injuries from playing soccer and volleyball and running that were far more common among boys until a few decades ago.

“It’s a little bit dependent on the particular injury, but, in general, female adolescents are more prone to injuries,” Nickless says, noting that the data show girls are almost four times more prone to ACL injuries, for example. “There are some genetic and hormonal components that are thought to factor in, but some of the more research-supported factors are neuromuscular in nature. For instance, when it comes to the ACL, female athletes tend to land from jumping in a more upright position, whereas boys seem to absorb the impact a little bit better by bending at the knees. Girls tend to rely on their quadriceps as opposed to their hamstring muscles and also tend to land in a knock-kneed position — both of which put them at an increased risk for ACL injuries.”

Nickless says that girls ages 12 to 15 tend to be at the greatest risk of ACL injuries, commonly in sports that involve more cutting and jumping, such as basketball and soccer. He recommends that boys and girls alike in these types of sports take added care to prevent such injuries.

“There are studies that show that athletes who participate in a neuromuscular training regimen can significantly reduce their risk of injuries — particularly those like ACLs," he said.

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It hasn’t been knee problems but a variety of ankle, hip and foot injuries that have plagued 17-year-old Madelyn Whaling in her track and cross-country career. The Valparaiso High School junior has endured a stress fracture and a case of nerve paralysis, among other ailments, in each case turning to a combination of rest, ice and physical therapy for treatment. The periods of inactivity and recovery have given her a newfound respect for some of the recommendations she’s received from doctors and trainers.

“If I could give any advice to other athletes, it would be to make sure you take care of your body by icing and rolling out,” she says. “It’s also important to do other cross-training activities, such as lifting, to help strengthen the muscles that running alone cannot.”

Nickless would be proud to hear a patient echo advice he has passed on to countless young athletes (male and female) in his career. He believes athletes — and their parents — need to use good judgment in determining how much is too much when it comes to participation in one sport.

“It’s important to diversify training and sports,” he says. “We’re in a time right now when kids are getting almost ‘professionalized’ at a younger age and funneled into one sport. There are a number of studies out that show that these types of athletes who are going year-round with one sport and one motion and not taking time off to let their bodies rest and recuperate are at higher risk for overuse injuries. This can be avoided by incorporating cross-training and a multitude of sports.”

Ultimately, though, Nickless says one of the real keys to preventing injuries can be a little bit harder to gauge, which is why athletes have to make a concerted effort to communicate with their bodies — and with their parents and coaches.

“Paying close attention to biomechanics is probably the best thing to do in terms of preventive care, but that can be a little bit difficult for a parent or an athlete because they’re not always aware of the correct biomechanics,” he explains. “For female athletes, the hamstring in particular should be strengthened — working on flexibility and understanding the biomechanics of how to land and cut using the right muscles to take pressure off of the joints. In most cases, hopefully a school or athletic trainer or (personal trainer) can provide a screening to identify any weaknesses, and to teach the athlete which areas they should really be working to strengthen.”