Females have More Knee Pathology than Males

Is this unfair or what?  Women have more knee pathology than men do. They have twice the knee osteoarthritis (the long term wear-and-tear type) and they injure their knees playing sports up to 4 times as often as males. These are not just sprains that one gets over quickly; they are the serious kind of problems that lead to knee replacement and knee reconstruction surgery.

The unfairness overwhelmingly comes from things women can’t control – structural weaknesses and hormones. There are things women can moderate to control these factors, but first, here are the reasons women end up with more knee problems than men

• Wider pelvis bones in women create a larger angle (called the “Q angle”) at the knee that exerts more stress at the knee than what occurs in men. This causes the knees to rotate inwardly too much. Knees that rotate inwardly too much are a cause of overpronating and lower arches in women. This wears knee cartilage down, the culprit behind osteoarthritis.

This is where high heels come in – if there is already an angle between the pelvis and thigh that causes bone degeneration, heels accentuate that angle.

• Looser ligaments that surround and support the knee – women’s ligaments are looser than men’s.  That means the knee and surrounding tendons and ligaments are less stable and more likely to be injured in activities that call upon strenuous use of the knee, such as sports.
• Lack of the same circulating androgens hormones that men have.  These hormones are what make men develop more muscle mass than women.  Women can’t bulk up the way men do.   Men are innately able to develop stronger leg muscles that provide protection around the knee.
• Weaker medial (inside) thigh muscle development than men have.  Equal balance between the lateral (outer) and medal thigh muscles provides stability at the knee.

Here is how women can reduce their risks:

• Arch supports: Arch supports change rotation from the foot up, decreasing the inward motion caused by the increased Q-angle.  Get the real deal – from a podiatrist or Pedorthic store (such as Smart Feet) or office – not the drug store.
• Reduce high heel wear:  Womens should start early with this policy:  Wear heels and pumps on a “2 Hour Shoes” only basis.  Many women have to dress professionally for work or they dress up for church and other activities.  Wearing heels or pumps isn’t always really necessary so much as a belief that fashion-wise, they are not “dressed” unless they are in heels. Regardless, most women throw the shoes off their feet as soon as they can get away with it because their feet hurt when they wear them.   The older they get, the less willing they are to tolerate the discomfort and their risk of falling in them increases.
• Lower body muscle development: The stronger the leg muscles and ligaments are, the more the knee is protected.  Attention should be paid to medial thigh muscle development as discussed above.  Paying a physical trainer a one-time fee to supply directions for a lower body strength exercise program that can be done on your own is well worth saving the knees.  Keeping muscles strong as women age can make the difference between a disability free life and one with knee disability.

Text: Carole Romig Copyright 2011 Image: myportfolio.usc.edu