The female athlete's knee

Available data have established that the female athlete is particularly vulnerable to various stress syndromes and noncontact ligament sprains of the knee. Although anatomic differences such as decreased muscle mass and increased joint laxity exist, the primary reason for this disparity appears to be an inadequate level of basic motor skills. The average female athlete has less training and conditioning than the male and has paid less attention to preparticipation fitness. Normal motor function has been defined in terms of required flexibility and coordination so that simple clinical testing can be performed. Normal flexibility may be defined as the unimpeded range of motion at each joint required for running. Coordination is normal when posture and movement are efficient and self-protective. This results from the action of primary neuromuscular mechanisms, which are anthropologic developments to support the unique posture of humans. Poor motor training or reflex inhibition causes secondary, less efficient mechanisms to be substituted for the primary ones, resulting in faulty coordination. These changes can be detected on clinical examination. Assessment of flexibility and coordination are the most important parts of the evaluation of the female athlete, since they relate directly to her most common injury patterns. The underlying neuromuscular physiology governing postural control and movement needs to be considered in planning therapeutic measures.