TOSH - Innovative Holistic Approach for Injuries

TOSH Taking Innovative Holistic Approach to Dramatic Increase in Injuries among Young Female Athletes

Jess Gomez

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Murray, UT (7/28/2008) - Researchers and physicians at TOSH - The Orthopedic Specialty Hospital in Murray are taking aim at the growing problem of injuries among young female athletes.

Since the introduction of Title IX in high school sports, more girls than ever are racking up the kinds of injuries once seen only in seasoned college or professional athletes. And they appear to be suffering higher rates of injuries than their male counterparts.

A recent New York Times article found that girls are more likely to suffer chronic knee pain and stress fractures; are 1.5 times more prone to concussion in the sports both sexes play, such as basketball or soccer; and are up to five times more likely than boys to rupture the ligaments in their knees, the ACL.

"We've seen an explosion in injuries among female athletes, particularly in the teenage population" says Roy Trawick, MD, an orthopedic surgeon at TOSH. The number of girls age 13-17 who had ACL reconstructive surgery at TOSH rose by 60 percent between 2003 and 2007; for girls age 18-22, the number has tripled.

That's why the staff at TOSH is taking a holistic approach to keeping them healthy.

Many young female athletes aren't eating enough, and that jeopardizes not only their performance but also their long-term health, says Kristi Spence, a researcher and sports dietician at TOSH.

Researchers at TOSH conducted two studies of youth athletes in the Salt Lake Valley and found an alarming rate of the 'female athlete triad' - symptoms of disordered eating behaviors, an eating disorder, menstrual irregularities, and injury.

"A lot of these girls will have delayed menarche, or they will begin and then experience irregular cycles or stop menstruating altogether," she says. "In either case, it's a sign their bodies aren't producing the hormones necessary to support reproductive health and build strong bones."

That may lead to a lifetime of pain from arthritis, joint replacement, or easily-broken bones.

"It's hard for them to understand. They're losing weight. Everyone tells them they look great. Maybe they're running faster initially because they're lighter. But theyre risking their health," she says, and eventually performance will suffer.

Spence, a nationally ranked marathon runner, teaches the B.E.S.T youth program. 'Better Eating, Safer Training' is a monthly seminar for athletes age 8 to 20 where teams, individuals, or moms and daughters learn about optimal nutrition and hydration and then go into the kitchen to learn how to prepare healthy meals and snacks.

There are many reasons for the disproportionate number of injuries among girls, says Jim Walker, PhD, sport science director at TOSH. Hormones make their ligaments looser. Ligaments are also smaller and packed more tightly, making them more prone to wear and tear. And reaction times are demonstrably slower among girls and women than boys and men, making them more vulnerable to injury in non-contact sports, says Dr. Walker, who participated in the first-ever study linking hormones and ACL tears.

That's why he trains girls one leg at a time.

"Usually people train and do strengthening exercises with both feet on the ground, but when you think about it, we almost never compete with two feet on the ground. You run one foot at time; you go up for a lay-up on one leg; you plant one leg when you kick a soccer ball," he says.

Dr. Walker's acceleration program puts girls through a series of one-legged drills and exercises -- such as running cones or leaping -- to strengthen the muscles and joints where girls are most vulnerable. The program is sport-specific.

"This not only helps protect against injury, it also improves a young woman's sports performance," he says. "They have better balance and movement and greater core stability."

If girls do become injured, they get the latest surgical care from Dr. Trawick, one of only three surgeons in the Salt Lake Valley to do 'double bundle' reconstruction of the ACL. The knee ligaments contain two bundles of fibers. In traditional ACL surgery, only one is rebuilt.

"There's evidence that if you reconstruct both, you get more rotational stability," he says.

Not only that, he says, but athletes who have the double-bundle surgery are more likely to say later that their athletic performance has returned to its pre-injury level.

"Our goal is want to anticipate those injuries, and head them off if we can," says Dr. Trawick. "If we can't do that, we want to get the back in the game - safely and quickly."

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