4 common injuries in female athletes and how to prevent them

Fitness & Sports Health

by Baylor Scott & White Health

Jan 17, 2023

Staying active means staying healthy. It’s frustrating when pain or injury slows us down. Adding some simple strengthening exercises to your routine can prevent many common causes of knee and hip pain. Here’s what you need to know.

Why injuries happen in female athletes

Most of the activity we do—walking, running, stair climbing and even strengthening exercise—is in a front-to-back direction. It’s therefore very common to have weakness in the muscles that move the legs in sideways or rotating directions.

Weaknesses in these muscles, which are located in the buttocks, are responsible for several overuse injuries in the hips and knees. Here are some common types of injuries in female athletes.

1. Hip tendonitis

Many people refer to hip tendonitis as “bursitis.” This is pain at the knobby point on the sides of the hip joints. It is painful when lying on your side and can be sore with activity also. 

There are several muscles, mostly in the buttock, whose tendons attach onto that knobby area. When those buttock muscles are weak, it puts stress on their tendons, creating pain at the sides of the hips. This pain can also travel to the buttocks and down the lateral (outside) part of the thigh.

This condition is tremendously common, particularly in middle-aged and older folks. The only effective treatment is restrengthening the affected muscles. Lots of people try stretching for this condition, which isn’t helpful, as the issue is not flexibility—it’s strength.

2. Iliotibial band (IT band) syndrome

The IT band is one of the structures that attaches to the side of the hip. There are several muscles that attach to the same area. If those muscles are weak, the hip tends to rotate inward, putting a funny angle on the IT band. Think of this as similar to wringing out a washcloth.

The pain can be at the side of the hip, the side of the knee or anywhere in between, along the length of the IT band. Normalizing the angle, through strengthening, takes the stress off the IT band.

3. Patellofemoral pain

This is also known as “runner’s knee,” “biker’s knee,” or basically “pick-your-sport knee,” as it’s common with lots of activities. This condition is mostly seen in adolescent to middle-aged people. 

Similar to the above issues, a relative weakness in the muscles that rotate the hip outward results in a tendency to rotate the knee inward. This in turn creates an alignment issue at the kneecap, creating pain in the front of the knee. The pain is worse with stairs, activities requiring balance on one leg (like running), and prolonged sitting. The condition is prevented and treated by—you guessed it—strengthening the weak muscles that are causing the alignment issue.

4. Pes anserine tendonitis

This is tendonitis on the medial (inner) side of the knee. It is caused by the same alignment issues as patellofemoral pain. Prevention and treatment are also the same.

How to strengthen for injury prevention

For all these conditions, the involved muscles are responsible for moving the hip laterally (to the side) and rotating the hip outward. They’re commonly weak, but restrengthening is easy. 

Here are some simple strengthening exercises:

  • Make a loop out of a resistance band and put it around something sturdy, close to the floor. Put the other end around your ankle. In a standing position, pull against resistance. For the proper direction to pull, think of a clock on the floor and you’re standing in the middle. For the right leg, pull towards 4 or 5. For the left leg, pull towards 7 or 8.
  • Lie on your side. Extend the top leg behind you and point your big toe toward the floor. From this position, raise the leg toward the ceiling. If doing this against gravity is too easy, add an ankle weight.
  • In a sitting or side-lying position, tie a resistance band around your knees. Keeping your feet together, open your knees like a clam shell.
  • With a resistance band tied around your ankles, walk sideways, pulling against the resistance.

For any of these exercises, you want 10-15 repetitions to wear you out. If they’re too easy, add resistance. You can use a stronger band or double the one you have. Wrap-around weights work well, too.

For more advanced exercises, a physical therapist is an excellent resource. Your doctor can prescribe physical therapy if needed. Learn more about your physical therapy options.

Good luck and stay active!

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