Sex and Gender Differences in Pediatric Knee Injuries

Edison, Bianca; Pandya, Nirav K.; Patel, Neeraj M.; Carter, Cordelia W.

doi:10.1016/j.csm.2022.06.002

Cited by 10 publications

(14 citation statements)

References 82 publications

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“…It is believed that females experience neuromuscular lag during adolescent growth spurt, which means that power, strength, and coordination lag are not synchronised as in males 35 . Higher dynamic knee loads and hip strength deficit can increase risk of the gradual onset injury; patellofemoral pain syndrome (PFPS) and can include explanations as to why PFPS are more common in female players 42 .…”

Section: Modifiable Risk Factors For Sport Injurymentioning

confidence: 99%

“…There are several proposed neuromuscular and biomechanical risk factors for ACL injuries that are increased in female players, for example: increased lateral trunk movement, hip adduction, knee abduction moment and dynamic knee valgus, decreased core stability 42 and less hip and knee flexion. Where the latter can result in stiff landings with high knee loads 39,48 .…”

Section: Modifiable Risk Factors For Sport Injurymentioning

confidence: 99%

“…Where the latter can result in stiff landings with high knee loads 39,48 . Females more often have the limb asymmetry and quadriceps-dominant muscle activation patterns associated with ACL injury 42 .…”

Section: Modifiable Risk Factors For Sport Injurymentioning

confidence: 99%

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Injury Prevention in Youth Male and Female Floorball Players : Effects, Compliance, and Experiences of the Knee Control Programme

Åkerlund

2024

Linköping University Medical Dissertations

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Background: Floorball is one of the most popular team ball sports in Northern Europe, particularly among youths. The injury incidence is high, as is the case in other pivoting youth team ball sports, such as football. The injury prevention exercise programme (IPEP) Knee Control is developed to reduce injuries in team ball sports. Though, programme effects and implementation factors in floorball has not been evaluated.The overall aim of this thesis was to evaluate the effects of the Knee Control IPEP and explore players' and coaches' experiences of using Knee Control in youth floorball. Methods:Study A was a cluster-randomised controlled trial (RCT) evaluating the effects of Knee Control in reducing floorball injuries. The RCT comprised of 48 clusters (clubs) with male and female floorball players (12-17 years) on the community level who were randomised into either an intervention or control group. Seventeen clusters (31 teams with 301 players) in the intervention group and 12 clusters (16 teams with 170 players) in the control group were included for analyses. During a pre-season implementation workshop, the intervention group coaches were instructed to use Knee Control and a standard running warm-up before every training session during the season. Control teams continued usual training. Teams were followed during a competitive season (26 weeks). Player exposure to floorball and occurrence of acute and gradual onset injuries were reported weekly via a web-based player survey using the Oslo Sports Trauma Research Centre overuse injury questionnaire. Team and player compliance to Knee Control was reported monthly by coaches. Players were divided into three compliance groups based on their average weekly number of Knee Control sessions: high (≥2 sessions), intermediate (≥1 to <2 sessions), and low dose (<1 session). Additionally, players and coaches in the intervention group answered a post-season survey on experiences using Knee Control.Study B was a qualitative study exploring facilitators and barriers of Knee Control use and how to overcome the barriers. Semi-structured focus group discussions, six with players (11-17 years old, n =42), and two with coaches (n =12) were conducted. Results:In Study A, the intervention group had a 35% lower incidence rate of injuries overall (adjusted incidence rate ratio (IRR), 0.65; 95% confidence interval (CI), 0.52-0.81) and 45% lower incidence of acute injuries (adjusted IRR, 0.55; 95% CI, 0.37-0.83) than the control group. There was no difference in the prevalence of gradual onset injuries. Male players in the high dose group had consistently lower injury incidence and prevalence compared to the low dose group, while no differences between the three compliance groups were seen in female players. Common facilitators of Knee Control use among coaches were support and education for coaches and high player motivation, and common barriers were that injury prevention training was time-consuming, a lack of space to execute the exercises, and a lack of player motivation. Players and ...

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Section: Modifiable Risk Factors For Sport Injurymentioning

confidence: 99%

Section: Modifiable Risk Factors For Sport Injurymentioning

confidence: 99%

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Injury Prevention in Youth Male and Female Floorball Players : Effects, Compliance, and Experiences of the Knee Control Programme

Åkerlund

2024

Linköping University Medical Dissertations

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“…Most of these are non-contact injuries, particularly in sports that require cutting maneuvers ( Renstrom et al, 2008 ; Musahl and Karlsson, 2019 ). Interestingly, females are more likely to suffer ACL injuries than males on a participation rate index ( Ellison et al, 2021 ), often up to 5/1 in some sports such as soccer ( Harmon and Ireland, 2000 ; Ireland, 2002 ; Wild et al, 2012 ; Sutton and Bullock, 2013 ; Edison et al, 2022 ). Often, an ACL rupture requires reconstruction to help stabilize the knee, but even with reconstruction the long-term consequence of the injury is to develop osteoarthritis (OA) at an early age, with up to ∼50% of individuals developing OA within 10–15 years post-injury ( Lohmander et al, 2007 ).…”

Section: Sex Differences In Risk For Injury To Msk Tissues During Dev...mentioning

confidence: 99%

“…Sex differences have been noted for risk to injure elements of the MSK system, for example, injuries to the anterior cruciate ligament (ACL) of the knee, an injury which is more prevalent in young females engaged in some sports with the female to male ratio of 5/1 in some of them ( Harmon and Ireland, 2000 ; Wild et al, 2012 ; Edison et al, 2022 ). Some of the risk for the latter can be traced to changes in joint laxity across the menstrual cycle ( Park et al, 2009 ), while others may be related to muscle function issues between females and males ( Hale et al, 2014 ; Marotta et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

Hart

2023

Front. Physiol.

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Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be “imprinted” in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.

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