We are joined this week by Dr. Katherine Vadasdi, an orthopaedic surgeon at the Orthopaedic and Neurosurgery Specialists in Greenwich. Dr. Vadasdi, who attended Dartmouth Medical School and has spent time at the Hospital for Special Surgery and the Columbia University Medical Center, recently participated in a talk at Greenwich Academy discussing, among other topics, injuries and injury prevention in female athletes. She later took time out of her schedule to talk to the Citizen about the injuries that seem to be inherent in female athletes, why the number of injuries seems to be on the rise and how to prevent those injuries.

Dr. Vadasdi, thank you for the time.

Of course. Thank you for the interest.

Talk a little bit about injuries in young female athletes and why are we seeing more and more girls getting hurt playing sports?

Well, in the last 20 years or so there has been a lot more involvement in sports by females at younger ages. They are participating at a more intense level at a younger age so we're seeing numbers arise in ways that we've never seen before.

What sort of injuries do girls seem to be getting a lot of?

We've seen an increase in injuries including ACL injuries, stress fractures, knee problems and concussions. We've learned that an ACL injury for instance, is 2.5 to 9.5 times more likely in a female than a male doing a similar activity.

Why is that?

There are a lot of theories as to why girls have a higher predisposition for something like an ACL injury. It starts with the anatomy of the female athlete, including wider hips and the alignment of the knees and then goes to the anatomy of the knee itself including less room for the ACL and a smaller ACL all together. Women tend to have looser ligaments. All that is stuff we cannot change.

Please elaborate more on some of the other injuries.

Females seem to have more concussions than men but part of that might simply be because the injury is reported more often. The numbers there aren't really clear. But what we do know is that girls tend to have more severe symptoms for a longer period of time, which is why it's important to make sure that the athlete is fully recovered and symptom-free before they get back onto the field. Stress fractures are also big as an overuse injury, especially in the lower extremities. The biggest concern here, however, is not the bone injury per se, but the female triad of eating disorders, osteoporosis and then stress fractures. It's a particular problem because you aren't just addressing the injury but you're addressing the larger issue.

So what can be done to prevent these kind of injuries?

Well, like I said, there are things you can't change about the female anatomy but what you can change is how they train and take care of themselves. One such way is achieving muscle balance, especially between the quadricep and hamstring. Women tend to have stronger quads than hamstrings, which can result in injury, so working to balance them out is big. Also we see that the way girls land a jump or lunge plays a role in injuries. Females tend to be more upright and their legs straighter so training them to maintain a more athletic crouch with their knees directly over their feet will help minimize the risk. There are also various strength and conditioning programs that we are trying to get into a team's warm-up regimen and there is good data that these types of focused programs help prevent injury.

Dr. Vadasdi, thank you for the time and insight.

My pleasure.