Why girls sports injuries can be different from boys

From the outside, girls’ sports can look nearly identical to boys’ — the same drills, the same schedules, the same expectations to compete harder and longer each season. But beneath the surface, female athletes face a distinct set of physical demands and injury risks shaped by anatomy, development and even hormones.

From higher rates of ACL tears and concussions to the pressures of early specialization and year-round play, those differences matter.

Here, sports medicine physician Dr. Pulak Patel shares insights into how injuries to female athletes can differ from those of males and what can be done to prevent them.

Do you see different injuries with female soccer players than with male players?

Yes. In general, there are certain injuries females are set up for just by our anatomy. One of those can be anterior cruciate ligament (knee) injuries. The rate can be in higher in females due to our body alignment, body composition and even different hormonal factors. Another thing we see is a higher rate of concussions in female soccer athletes. We believe this to be due to decreased neck size and strength, as well as increased head acceleration in comparison to their male counterparts.

Does the prevalence of ACL injuries have to do with the angle of women’s hips?

Yes, the quadriceps angle (Q-angle), which is the angle between the upper and lower leg, is greater in women due to having a wider pelvis. We do know that a greater Q angle is associated with an increased risk of an ACL injury.

Might concussion risks have to do with a difference in muscle mass for girls?

In younger athletes, we think about high concussion rates due to neck muscles not being fully developed and maybe some technique issues. We also believe there to be decreased neck strength at play, even in fully developed female athletes. There are also hormonal differences at play, although not well understood.

How should parents ensure their kids get those breaks?

We recommend against early sports specialization. We don't think athletes who are youth should be just sticking to one sport and doing that sport year-round. They need to make sure they are balancing out different muscle groups by diversifying the sports they do and learning different techniques from those different sports as well. This helps prevent injuries and actually improves their athleticism.

How much rest is ideal for youth athletes?

Youth athletes should not play a single sport for more than eight months a year.

What about short-term rest?

Recovery is very important. Ideally, our young athletes should have a minimum of two days off per week from training and competition. Sleep is really important, too. There’s a lot of correlation with performance in sport and injury prevention and the amount of sleep you're getting. Then nutrition, obviously, keeping well-balanced there and making sure your intake is matching the demands that are required of you as an athlete, with an emphasis on high protein consumption and healthy carbohydrates.

Why is sleep so important for athletes?

A big part about sleep is all the recovery that happens overnight. You have muscles you put through high demands. A part of your recovery beyond just the nutrition and the stretching and taking days off is making sure that overnight, active recovery is happening too.

How can female athletes walk the line of keeping a healthy weight?

I don’t think there’s a certain number we should be chasing as female athletes. The focus should be on accepting our constantly evolving bodies and talking to our athletic staff and doctors about specific health concerns.

What are some warning signs that you’re not getting proper nutrition?

One of the major signs is abnormal menstruation patterns. It used to be accepted that if you're a female athlete, you only have two or three periods a year, and that's fine. We should be shooting for normal periods, with a goal of 12 periods a year. Another sign of inadequate nutrition is recurrent injuries, particularly stress fractures.

What are some other areas athletes should emphasize to prevent injuries?

Core strength is imperative for athletes of all ages and levels. It is also important to make sure that if you're working out one muscle group, the opposite muscle group is also being activated to balance things out. Another thing is warming up and cooling down in a specialized way, depending on your sport. For soccer, specifically, dynamic warmups are important to promote blood flow to the muscles and prepare the body for the intensity of the sport’s demands. We do have data to suggest that dynamic activity before putting your body through more explosive activities is preferred and improves performance.

Are girls doing too much weight training too soon? Not enough?

I think weight training is very beneficial, but the issue with young folks is a lot of them aren't being properly supervised and getting set up for injuries. For most sports, I see how resistance training can be very beneficial in improving strength and coordination. We do know that supervised resistance training is safe and does not increase risk of growth plate injuries. But if they’re doing resistance training without supervision, then it's not really worth it. The risk of injury probably outweighs any benefit.

Is there anything to be done to prevent concussions?

How do you know when it’s time to go to the doctor, not just for a concussion, but any sports injury?

If you're not training, maybe on a rest day, and something is bothering you pretty significantly, or if you’re getting woken up from sleep because of pain, or it's impacting your performance, you can't push it as much because you’re scared that the pain is going to worsen — those are all signs it's something you should tell somebody about. It’s really important to always communicate with your coaches, the athletic trainer and your parents, even if you feel like maybe it's nothing.