Since the world athletics championships came to a close last weekend I found myself with some attention capacity to spare over the past week. This led me to realise it had turned distinctly chilly outside. Despite the chill in the air, it has been a productive week. Sophie, the poster girl for the Develop stream who regular readers have met previously, had the dubious pleasure of seeing me more than usual this week, as we hit the gym to revise her strength training plan, in addition to her regular movement session at the track. I also met Sophie’s grandfather, who came along to the track and after the session asked me the question ‘do girls run differently than boys?’. My answer was, ‘yes - if we are not careful’. Which leads me to the theme of this week’s post: the unique requirements and necessity of preparation for young female athletes.

GIRLS HAVE A TOUGHER TIME THAN BOYS…

Young female athletes get nothing for nothing. Girls have to work for everything, and in the absence of appropriate intervention, it all becomes harder when they hit their adolescent years. When boys hit puberty they benefit from spontaneous gains in size, strength, power, and speed. Girls get no such luck.

To add injury to insult, once they reach adolescence, girls become more injury-prone. If we consider non-contact injuries to the knee and ankle, depending on the sport, adolescent female athletes suffer 2-10 times more injuries than boys of the same age. Overuse injuries, such as jumper’s knee and the runner’s equivalent, also become more prevalent among female athletes post puberty.

In fact, puberty sort of sucks if you’re a girl. Whilst limbs become longer and hips become wider, most muscle groups do not spontaneously catch up, so you get relatively weaker as the muscles are now at more of a mechanical disadvantage due to the longer levers and change in moment arm. This makes it tougher to stabilise lower limb joints under dynamic conditions, and renders the female athlete less able to resist the internal and external forces encountered during sport.

Naturally, girls make the best of the situation and find a way, despite these challenges. The one muscle group that does keep up with the changes that occur during puberty and becomes stronger is the knee extensors (quadriceps). Accordingly, girls tend to alter their strategy to preferentially load the link where they are relatively stronger. Adolescent females tend to preferentially use their stronger quadriceps muscles, both to apply force to generate propulsion (when jumping, accelerating, changing direction), and to absorb energy, such as when landing, decelerating, etc.

Unfortunately, the quadriceps-reliant and knee-dominant strategy has a number of downsides, not least when it comes to injury risk. In fact, these characteristic changes in biomechanics during jumping, landing, running, and changing direction are implicated in the non-contact and overuse injuries that are prevalent among adolescent female athletes. The altered movement strategy is also not stellar from a performance viewpoint. Jump height, jump distance, speed, and change of direction scores thus tend to plateau in female athletes during the years that follow puberty.

TO THE RESCUE!

Happily, female athletes are not doomed to this fate of being susceptible to injury and having their performance flat-line once they reach adolescence. With intervention we can give girls the boost in force-generating capacity that boys get for free. We can also address the problematic movement mechanics that females tend to adopt in the absence of this boost.

As described with Sophie, what is called for is a two-pronged strategy that involves both strength training and movement skills training. We do however need both elements. It is not sufficient to just attempt to teach female adolescents how to move in a more mechanically efficient way. After all, they adopted the strategy they have for a reason (i.e. out of necessity). In the absence of intervention to address the strength deficits responsible we cannot expect the new movement patters to stick under ‘live’ conditions.

Remedial strength training to develop the necessary capacity is an essential piece of the puzzle. Targeted strength training provides the gateway to enable the athlete to use the options we are teaching them. The muscles of the hip are an important focus, to develop the ability to generate propulsion from the hip, and provide stability to the lower limb in all directions. Likewise, remedial strength development for the hamstrings is a key piece of the puzzle, given their integral role in running gait particularly, and providing stability to the knee, notably protecting the ACL.

Once again, Sophie provides a case study for this dual-pronged strategy and process. Sophie’s strength development has proceeded in parallel with her regular movement skills sessions. As we developed the necessary force generating capacity at each link in the chain (hip, knee and ankle), we have simultaneously worked on Sophie’s capability to utilise this capacity and express it in more mechanically effective athletic movements. As Sophie has become stronger, we have now progressed her strength training program, to mirror the more challenging athletic movement we have moved onto and the attendant higher force demands.

In an ideal world, young female athletes would commence strength training prior to puberty. In many instances, this would mean girls engaging in regular strength training from around age 11. Clearly this is far from common practice currently, despite the consensus in the sports medicine and paediatric sports science literature on the need, the merits, and demonstrated safety when undertaken with qualified supervision.

Whilst we have some way to go, all young female athletes would benefit from heeding the advice to engage in strength training under supervision and seek coaching input to realise the performance and injury protection benefits. I encourage the reader to share this information and spread the word..!

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