Gender differences in sport injury risk and types of inju-ries: a retrospective twelve-month study on cross-country skiers, swimmers, long-distance runners and soccer players

Abstract

This twelve months survey compared injury risk and injury types by genders (312 females, 262 males) in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05), and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05). When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR) 5.8, 95% confidence interval (CI) 1.3 to 26.4, p < 0.05) while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05). After adjustment for exposure time (injuries/1000 exposure hours) significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05). Six athletes had an anterior cruciate ligament (ACL) injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05), but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training. Key pointsOnly a few sport injury studies have compared in-jury rates between the sexesOverall gender-related risk for acute and overuse injuries in top-level athletes between the sexes was smallSome gender differences in the specific anatomical locations of injuries as well as in specific injuries in sports were foundSome of these differences seem to be explained by the differences in the amount of training.

Keywords: Male; acute injury; athletic injuries; female; over-use injury.

Figure 1.

Location and proportions (%) of acute injuries by gender. A higher proportion of female than male athletes had acute injury in the heel (6% vs. 1%, p < 0.05). A higher proportion of male than female athletes had acute injury in the upper back (4% vs. 0 %, p < 0.05).

Figure 2.

Proportion (%) of subjects with at least one acute injury in different tissues by gender. A higher proportion of female than male athletes had ligament injuries (46% vs. 33%, p < 0.05). A higher proportion of male than female athletes had muscle injuries (44% vs. 31%, p < 0.05).

Figure 3.

Location and proportions (%) of overuse injuries by gender. A higher proportion of male than female athletes had overuse injuries in the posterior thigh (8% vs. 1%, p < 0.01), toe (4% vs. 0%, p < 0.05), and upper back (4% vs. 1%, p < 0.05). A higher proportion of female than male athletes had overuse injuries in the ankle (9% vs. 3%, p < 0.05).

Figure 4.

Proportion (%) of subjects with at least one overuse injury by tissue type and by gender.