While anterior cruciate ligament (ACL) injuries occur in both men and women, according to National Library of Medicine Research, women are two to eight times more likely than males to sustain one of these injuries such as anterior cruciate ligament (ACL) injuries, osteoarthritis, and patellofemoral pain syndrome.
Women showed a much lower knee adduction moment than men but a significantly higher stride regularity. Weight, BMI, discomfort, and impairment were the most common factors explaining variations in gait mechanics among female individuals. In males, differences in gait mechanics were mostly explained by age and disabilities.
Dr. Sinukumar Bhaskaran, Consultant – Adult Joint Replacement & Reconstruction and Robotic Arthroplasty (Hip & Knee), Manipal Hospital, Kharadi, Pune shares why women experience more knee problems than men and how do you prevent it:
Get to know the ACL
The ACL, one of the knee’s four main ligaments, connects the thighbone and shinbone. Its primary function is to regulate motions that involve abrupt stops and direction shifts. As an important ligament, the ACL is susceptible to injury when participating in pivoting activities like football, basketball, tennis, or soccer. Although the ACL can be injured in a collision, noncontact injuries account for most tears in this ligament. When an ACL is damaged, common symptoms include a loud “popping” sound when the damage occurred, extreme pain that prevents you from continuing to play the sport, Rapid edema, and experiencing knee instability. Ligament injuries range from minor to severe.
What Are the Risk Factors?
Knee injuries occur for several reasons, but three key explanations explain why they are more likely in women, which include anatomy, biomechanics, and hormones.
In anatomy, women often have larger hips than men and are more knock-kneed, which means their knees slant inwards. This posture changes the knee joint, raising the risk of ACL damage during motions including jumping, pivoting, and landing. Women’s ACL tissue is generally thinner, therefore tearing requires less force.
When it comes to biomechanics, women usually land in an upright position, which results in straighter knees and less core activation. This differs from how males usually land, with bent knees and more core activation. Another important factor is the strength ratio of the quadriceps to the hamstrings. Women frequently have stronger quadriceps than hamstrings, which can lead to an imbalance that increases the strain on the knee joint, especially when engaging in high-impact exercises.
For hormones, according to the National Library of Medicine, the elasticity of collagen in the knee changes over the menstrual cycle, increasing the risk of knee injury. The health of a woman’s knees can be significantly impacted by hormonal changes over her lifetime. Despite its many physiological benefits, estrogen has been connected to ligament laxity. ACL rips and other ligament injuries are more likely to occur during specific menstrual cycle phases, particularly when estrogen levels are elevated. Estrogen levels also drop in postmenopausal women, which may lead to a reduction in bone density and a higher risk of osteoarthritis and fractures.
Higher Prevalence of Osteoarthritis (OA) in Women
Research shows that women were shown to have a higher prevalence of knee OA (31.6%) compared to men (28.1%). There is statistical significance in this finding (P = 0.007). According to the study, the prevalence of OA knees rose as body mass index (BMI) rose. Differences in muscle strength, body weight distribution, and cartilage composition are some of the causes of this. Overweight is a recognized risk factor for osteoarthritis (OA), and women tend to have a larger body fat percentage, which puts more strain on weight-bearing joints like the knees.
Preventive Measures:
Since knee issues are more common in women, there are several preventative measures that can lower the chance of accidents and degenerative diseases. in which one might mostly include things like strength training, neuromuscular training, low impact exercise, and keeping a healthy weight.
Treatment Options:
Whatever gender, there are the same treatment options for ACL tears, OA, or any other knee injury. The ACL is unlikely to heal on its own if it is completely torn. The main causes of this are the ACL’s immersion in synovial fluid, a fluid found in the knee, and the ligament’s restricted blood supply, which could hinder the fibers’ ability to repair together.
To increase joint stability and lessen knee stress, conservative management techniques include weight control, strength training, and physiotherapy. Injections of corticosteroids, hyaluronic acid, and nonsteroidal anti-inflammatory medications (NSAIDs) are examples of pain treatment techniques that can help reduce pain. Surgical procedures such as arthroscopy, ligament reconstruction, or total knee replacement can be required in cases with greater severity. Targeted treatment programs that focus lifestyle changes and rehabilitation can greatly increase mobility and improve performance.