What makes the female athlete different?




What makes the female athlete different?

– Adrien Dannhauser

To celebrate woman’s month, we decided to do an article on what makes the female athlete different and how we can build her up to become stronger and more resilient.

The 2020/2021 Olympics has the most female athletes that has ever participated in an Olympic event. Females made out 48.8% of participants this year and they competed in more than 300 events. The USA was the country with the most female athletes.

How is the female athlete different from a male athlete?

Physiological, anatomic and psychological differences between males and females creates unique patterns of illness and injury.

Anatomically females have:

  • Shorter legs
  • Lower center of gravity
  • Smaller body frames (generally smaller bones)
  • Narrow shoulders
  • Smaller heart, thoracic cavity and lungs
  • Greater Q- angle at elbows and knees – creating a knock knee effect.
  • Wider hips

Physiological differences are:

  • Lower BMR, aerobic/anaerobic capacity
  • Lower VO2 Max (Lower by 10- 305)
  • Less Upper extremity strength (40-75% as strong)
  • Less Lower extremity strength (60 – 80% as strong)
  • Greater % body fat than males
  • Hormonal status differs: presence of estrogen. Lack of androgenic hormones.

There are obviously conditions that females experience that their male counterparts will never experience and these include:

  • Menstruation
  • Pregnancy
  • Osteoporosis/bone density issues

This is due to the presence/ absence of estrogen and other hormones unique to the female.

What injuries are female athletes more prone to develop?

  • The “Female Athlete Triad”
  • ACL injuries in the knee
  • Laxity related issues in the spine, shoulder and elbow joints
  • Patella femoral pain in the knee
  • Ankle injuries
  • Stress fractures/bones health issues

What does this mean for the athletic preparation and performance?

When a female athlete train and prepare for their specific sport event we need to take the above into consideration and focus training on specific areas to help decrease their chances of developing certain injuries. It’s also important to recognize when an athlete has faulty movements and to refer to a specialist when necessary.

Let dive deeper into each some of these injuries…

  • The “Female Athlete Triad”

Female athlete

The Female Athlete Triad was first described in the early 1992. The relationship between 3 independent entities; eating disorders, Amenorrhea (menstrual irregularities) and Osteoporosis make up for the female athlete triad.

These females normally struggle with low energy availability due an eating disorder or disordered eating behaviors. The decreased energy availability has an effect on the bone mineral density as well as menstrual irregularities. Menstrual irregularities will have an impact on the bone mineral density and vice versa, making this condition a very complex one. Thy key is to balance the energy expenditure and to make sure there is enough input to create a healthy energy balance.

Clinical eating disorders includes Anorexia and Bulemia. Disorder eating behaviors include:

  • Restrictive eating
  • Fasting
  • Frequently skipped meals
  • Infrequent binding and purging
  • Diet pills, laxatives, diuretics and enemas

Calcium, iron and zinc is common deficiencies in female athletes. Remember that food is fuel for athletes, research recommends a balanced, well-rounded diet with lots of fruit and veggies in. Experts may recommend a multiple vitamin/mineral supplementation, but athletes should try and strive to get it from their diets instead. Experts recommend to stay clear from engineered food because natural foods contain important components that interact in highly complex ways to benefit overall health. A well-fueled body has the best chance of optimal performance.

The body tends to “do what it can” to restore energy balance and promote survival, BUT in doing so impairs overall health.

Not having a menstrual cycle is not normal (except with pregnancy) and athletes need to consult a doctor about this issue. They need to look at their diets and change some eating habits to restore normal hormonal balance.

Consequences of amenorrhea include reversible loss of reproductive capacity, possibly irreversible bone loss that can ultimately lead to stress fractures.

Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fractures.

The risks for stress fractures include:

  • Low bone mineral disorder
  • Menstrual disturbances
  • Late menarche
  • Dietary insufficiency
  • Genetic predisposition
  • Biomechanical abnormalities
  • Training errors
  • Bony geometry

Bone impairments during the critical years of bone growth for young athletes, may impact the bone throughout a lifetime.

Physically active girls and women should be educated about proper nutrition, safe training principles, and warning signs of the Female Athlete Triad.

  • Knee Injuries

The two most common injuries female athletes get is anterior cruciate ligament (ACL) and patella femoral pain syndrome.

ACL injuries normally occur because of contact injuries like a collision or non-contact mechanism like landing, twisting and abrupt stops where movement is not controlled. Females are 3-8 times more prone to get an ACL injury than males.

Patella femoral pain syndrome develops with overtraining and is usually as a result of a increased angles at the knee joint that put stress on the patella that leads to pain. Weak muscles in the core and hip also contribute to this mal-tracking of the patella.

There is no conclusive answer as to why females get hurt more often at the knee, but the following might contribute:

  • Anatomical differences – lower extremity alignment, muscle strength and ligament laxity are some of the intrinsic factors that can play a role.
  • Coaching and performance – Conditioning, coordination and skills is something coaches, parents and physio can improve.
  • Equipment- like shoes and surface of play.

Sports that require a lot of directional change like gymnastics, netball and soccer offer more risks for ACL injuries.  Sports like running can contribute to patella femoral pain syndrome.

Coaches and healthcare professionals need to identify when things are being done wrong or poorly and to make the athletes aware of the problem movements or habits. Training needs to correct these faulty movements and strengthen the right muscles.


  • Ligament laxity

Shoulder joint laxity

Females tend to have more ligament laxity in the spine, shoulders, ankles and elbow joints. Hormones play a big role in this type of injuries as females have more elastin in their bodies.

Elastin is also an important hormone during pregnancy that increases laxity to aid the growing baby with space. With the increase laxity the pregnant female athlete is more prone to develop injuries.

Females have common postural dysfunction especially in the shoulder complex that can lead to tendinitis and ligament injuries


How can we address some of these issues?


  • Pre-season screening of athletes

Prevention is always better than cure and it can significantly aid in injury prevention. The key is to identify faulty movement patterns before injury occurs and to make the athletes aware of these problem areas. Train athletes to fix the problem by building the female athlete to become stronger and more resilient.

How do the build the female athlete?

  • Core and hip stability

Core training

The core and hip muscles are the power source of the human body and it plays a very important role in movement, injury prevention and sport performance. Female Athletes therefore need core stability during all activities, perhaps even more than their male counterparts.

Just Physio has a great new technique to help activate the core through muscle activation and facia release. This technique is easy to maintain and it will help athletes to cheat less and use the correct muscle for the correct movement pattern. For more information on how to activate your core please read our blog!

  • Upper body strengthening!

Upper body training

Females have smaller body frames with weaker upper body muscles than males. It’s therefore important for women to improve overall upper body strength by focusing on the bigger muscles first.

Monitor training and rest when necessary to avoid injuries.

To increase performance athletes, need to work on endurance, speed, power and strength.

The fastest and most powerful athletes in the world are those that place the greatest amount of force into the ground surface area in the shortest period of time. An intricate balance of power, speed and strength.

If you are a female athlete, make sure you get proper pre-season screening to identify possible faulty movement pattern. Find a coach and a health care provider that understands how to build up the female body be stronger and more resilient.

Call us today if you need help with individual training programs and pre-screening!

Book at Just Physio!