DEVELOPING THE YOUNG FEMALE ATHLETE
Emily R Pappas, MS Exercise Physiology
In 2011, Naomi Kutin broke a world powerlifting record, squatting 215 lbs.
She was in the 97 lbs weight class…
…and was just nine years old.
She broke a record previously held by a 44 year old German woman.
Since then, Naomi has become a prodigy with the nickname “Supergirl” in the lifting community. Now, at 16, she has continued to astound, deadlifting 365 lbs in the last Pan American Championships with Team USA.
As you look at your own daughter, you’re probably thinking,
“Thank goodness my daughter wants to play softball…”
“Aren’t girls like Naomi a special case?”
“Is what Naomi doing in that video EVEN SAFE???”
As parents, coaches, trainers…we all walk a fine line.
We want to keep young athletes from the life-long consequences of injury but we still want to help them be their best.
Especially if they LOVE their sport.
No one wants to put out the fire of a young athlete. But when is it our responsibility to draw the line? How can we prepare our young athletes for the risks of their sport?
Until recently, strength training and young athletes has been a taboo subject. Even more so for females.
Most parents have no problems signing their daughter up for softball or soccer, but strength training? It just doesn’t happen that easily.
Here’s the problem: Our girls are getting hurt.
In soccer. In softball. In volleyball.
And, our girls are getting hurt more often- and worse -than our boys.
How do we know?
With more females participating in sports over the last decade, science has devoted a greater focus to female athletes and their development.
Currently, data for gender-matched sports show females present a higher incidence of injuries than male athletes.
And when we think about it….it makes sense!!!
We KNOW that male athletes have more muscle mass and a baseline of strength due to their hormonal makeup (hello higher testosterone!).
YET in gender-matched sports with similar rules (ie softball/ baseball, basketball, soccer, lacrosse, volleyball, etc), males and females are exposed to the SAME FORCES on the field or court.
But we keep throwing our comparatively weaker females on to this field or court.
It’s no wonder our female athletes keep getting injured!
Girls are seeing an increase in injury in sports, particularly
- stress fractures,
- ACL tears,
- and other knee injuries like PFPS (patellofemoral pain syndrome)
What’s the solution? How can we prepare young female athletes for a healthy athletic career?
The science is clear: strength training is not just a necessary training tool for football players; it is a necessary tool for all ATHLETES to help prepare their bodies for the forces imposed in sport.
And based on the current research, it is CRUCIAL we start making strength training a PRIORITY for today’s female athlete. (1)
In this article we are going to discuss:
- When should females begin strength training programs
- The ‘neuromuscular spurt’ girls need for athletic development
- Common injuries and training techniques that reduce risk
- How CULTURE has created a dangerous myth surrounding strength training for girls
Lifting the Myth: How Young is Too Young?
“The young bodies of modern day youth are often ill prepared to tolerate the demands of sports or physical activity.”
So state Keith Barker and Debby Sargent in Strength and Conditioning for Female Athletes (1)
Speed and agility training prior to strength training is dangerous. Yet, parents will sign their daughter up for soccer much sooner than they will sign her up for a strength training session.
In fact, even coaches have a hard time understanding how important strength training is to PREPARE a young body for the forces she’ll face on the field or court.
The problem is: Bad information.
How many times have you heard
“Lifting is dangerous- especially before puberty.”
You aren’t alone.
Scientists have BUSTED these old school myths in the academic world but they still linger around the locker room.
According to research, “if a child is ready to participate in sport, then they are ready to engage in some sort of strength and conditioning” (1)
There is actually a multitude of evidence that shows us that “ALL fitness components are trainable in young female athletes irrespective of stage of maturation” (1)
If you grew up hearing the dangers of resistance training, this can all sound a little crazy.
And we totally get it!
But, no one is going to ask you daughter to deadlift 200 lbs on her first day in the weight room.
When strength training is incorporated as part of a preparation for sport, TECHNIQUE COMES FIRST.
Effective strength training is not simply lifting heavy weights. It involves a focus on movement competency that leads to reduced injury risks and improved performance .
Progressively adding load should always come AFTER efficient technique is established.
Athletes need first to learn HOW to move before they strengthen those movements!
According to the writers of Strength and Conditioning for Female Athletes, “the prescription of resistance training should always be individualized based on factors such as technical competency, biological age, and specific injury risk factors”
When this type of attention is paid to the athlete, resistance training should form a “central training component” for female athletes “irrespective of maturity status.”
Irrespective of maturity status means…THERE IS NO SUCH THING AS TOO YOUNG!
The earlier an athlete learns how to move, the better prepared she is to face those potential injury-inducing forces on the field and court.
Fast Growing Girls: How Growth Is the Key to Unlocking Injury Risk
Do you remember when your daughter learned to crawl? It seemed like just moments later she was running circles around the living room and jumping off the couch.
Nostalgia isn’t completely to blame for how childhood seems to fly by. During childhood, both males and females display a rapid development of their central nervous system. This is why children show quick and incredible improvements in physical tasks like walking, running, and jumping, as well as cognitive tasks like learning to talk.
This period of development is crucial for both sexes. The brain experiences a state of higher neuroplasticity that optimizes development in motor skill competency. As children are exposed to training, improvements in muscle strength, sprint speed, and endurance develop in a similar fashion for both sexes.
However, females leave childhood and begin the adolescent period sooner than males (approx 12yrs vs. 14yrs). This means our girls have less time in this childhood growth period.
It is during the next stage, adolescence, that sex differences relating to athletic performance really being to materialize.
For males (14-18yo), they demonstrate an accelerated gain in physical fitness especially in terms of muscular strength and power. These performance changes are best explained by the relatively greater rise in anabolic hormones (such as testosterone, growth hormone, and IGF-1). The hormonal difference in males leads to greater increases in muscle size and strength compared to females.
This makes sense when we consider the difference in growth between males and females. Barker and Sargent explain “because girls mature approximately two years earlier than boys, they consequently spend less time in preadolescent growth and experience smaller growth rates, resulting in females attaining shorter adult height. (2)
With less time to grow, females also show a delayed neuromuscular growth compared to their male counterparts. Adolescent females have a reason to often appear uncoordinated or aware of her body in space as she grows. Unlike males in adolescence, females do not experience the same naturally occurring neuromuscular spurt (improved brain-body connection). Rather, the spurt they experience is shorter, leaving less time for their brain to catch up to how their bodies are growing.
Studies have shown a female who has growth spurt (or musculoskeletal growth) without a corresponding neuromuscular adaptation (aka teaching her body how to move), is more likely to position their joints abnormally in movement.
These differences are the KEY to helping us unlock why our girls are at experiencing more and more sports-related injuries….
Put simply: Without improved brain-body connections, growing female athletes are at an increased risk of injury!! (3)
Fortunately for any growing athlete regardless of gender, properly prescribed strength training can help trigger this type of neuromuscular spurt. (4)
The conclusion is clear: If a girl is interested in sports, strength training is a must.
Through science we KNOW proper strength training improves her body awareness and brain body connection.
Strength training leads to improved joint mechanics, decreases injury risks, and improves performance!
Again, I want to emphasize that loading up the bar on the first trip to the weight room is not how this works.
Technique should always be taught before- and maintained throughout- load increase.
According to Barker and Sargent, “bodyweight movements based around athletic movements should first be introduced in the form of squatting, lunging, pushing, pulling, jumping, landing, and bracing”
Only AFTER technique is taught should these movements be progressed into loaded movements such as squats, deadlifts, lunges, and step ups. (1)
INJURY RISKS IN YOUNG FEMALE ATHLETES
All sports carry risk of injury.
Injury risk changes from athlete to athlete depending upon a multitude of factors, including:
- Sport type
- Training level
- Time spent in training
- Age of the athlete
- And….whether the athlete is male or female
Let’s revisit the question,
And talk about the particular risks that our youngest female athletes face.
We know early specialization of sport can also increase the risk of injury…particularly serious overuse injury in youth athletes. (1)
Early specialization contributes to increased injury risks when
- >2:1 rime ratio spent in competitive sport compared to unstructured free play
- 8+ months per year spent training in one sport
- Weekly training volume (in hours) is greater than a child’s chronological age
- For younger females, the rapid rate of growth due to puberty may heighten her risk of injury (remember her body is growing but her brain hasn’t made those brain-body connections yet!)
- Exposure to ONE set of motor patterns can lead to muscular and coordination imbalances
Compared to their male counterparts, injuries more common to female athletes can be categorized into two groups
- Acute trauma (think collision injury)
- Overuse injury
Overuse injuries can be defined as the “breakdown and damage of tissues that are a result of repetitive submaximal loading with inadequate recovery time for adaptations” (1)
More repetition without recovery = more breakdown.
The most prevalent overuse injuries in the female athletes experience are:
- Stress Fractures
- Patellofemoral Pain Syndrome (PFPS)
- Anterior Cruciate LIgament (ACL) ruptures
If you are parenting or coaching a female athlete, chances are she is going to run into at least one of these injuries during her athletic career. Let’s take a closer look at what she’s up against.
A stress fracture is defined as “a fracture of a bone caused by repeated (rather than sudden) mechanical stress” (5)
Female athletes experience stress fractures more often than males for a number of reasons. The most common cause? Exposing an athlete to a sudden or greater increase in training load.
In our previous article (why less is not more and more is not less), we explain the relationship between work capacity and training load.
Simply put, if an athlete is exposed to a HIGHER training load than her body has the capacity to handle, injury occurs.
The best way to prevent this injury is to increase their work capacity prior to competitive play. This works especially well when training can be coordinated with foreseen increases in training volume (i.e preseason)
Outside of training load, other causes of stress fractures include
- Menstrual disturbances affecting bone mineral density
- Low calcium intake (common in energy deficient diets)
- Low body fat
- Changes in footwear or training surface
Stress fractures are no joke. These injuries MUST be monitored to prevent further long term injury (like full breaks or the development of muscle imbalances).
If a female athletes is showing signs of
- Gradual onset of pain, aggravated with training
- Local tenderness on touch
- Possible bruising
….these are the early warning signs of a fracture.
Early recognition of these symptoms are KEY to early intervention including training modifications around the injury to allow for the conditioning of other areas of the body to be maintained. (1)
Training AROUND an injury is crucial to help accelerate recovery time and decrease chances of future injury! Check out our article “Should You Completely Rest When Injured” to read more about how working the right way after an injury is critical to recovery.
2. PATELLOFEMORAL PAIN SYNDROME (PFPS)
Patellofemoral Pain Syndrome (PFPS) is just a fancy way of saying your daughter has knee pain.
It is also referred to as “runner’s knee” and is very common in athletes (6)
As an overuse injury, this pain is your body’s way of telling you….your tissues are being pushed TOO HARD. They don’t have the capacity to handle your current level of training.
As a TREATMENT, the goal is to reduce pain! This is the reason you may find a doctor who tells you to “stop squatting” or just stop playing your favorite sport.
Although this is a good SHORT term fix to alleviate pain symptoms, the treatment is counter-intuitive when considering your athlete wants to play!!
Rather than eliminating activity, current literature emphasizes the importance of developing hip strength and flexibility. (7)
Fortunately for athletes, Barker and Sargent explain “every strength session an athlete does is a flexibility-strength workout”. This means through resistance training with an emphasis on movement quality, these workouts will “lead to increases in not only ROM over time, but more importantly concurrent increases in strength over that full range” (8)
For athletes suffering from this type of injury, eliminating a certain movement and only stretching “will not adequately deliver the flexibility/ mobility needs of most female athletes” (8)
Think of it this way, squatting is a FUNDAMENTAL movement pattern. Squats are seen in everything- from everyday tasks like sitting on a toilet to athletic movements like jumping.
Suggesting you ELIMINATE a movement like squatting is a SHORT term approach to alleviate pain. But it WILL NOT address the root of the problem!
Remember, overuse injuries like “runner’s knee” are just your body’s way of telling you that you are not strong enough to handle the workload.
Eliminating a movement that will later help you increase your capacity to handle higher workloads is counter-intuitive to prevent the injury from occurring again!
3. Anterior Cruciate Ligament (ACL) Ruptures
This just in….adolescent girls are now 2 to 10x more likely to suffer injuries to the ACL compared to their male counterparts (9)
Are females just not meant to play sport??
These injury rates are just further evidence that strength training is CRUCIAL for any female engaged in the high forces in sport.
Non-contact mechanisms leading to an ACL tear (like spriting, landing, changing direction), account for 60-80% of ACL injuries.
Females are predisposed to a greater risk of ACL injury due to factors they cant change, like:
- anatomical differences,
- changes in hormonal levels (especially during menstruation),
- muscle imbalances (quad dominance),
- and neuromuscular functioning (10)
Despite these non-modifiable factors, there are factors we CAN modify to help prevent our female athletes from injuring their ACLs
According to Baker and Sargent, “Muscular strength and neuromuscular control are CRUCIAL components of functional knee stability during the execution of sport movements” (1)
Remember: strength training develops control.
Considering most females are quadricep dominant, movements that result in increased hamstring recruitment such as RDLs are essential to reducing the risk of an ACL injury (12, 13)
Already suffering from an ACL injury? Check out our article “So you tore your ACL, now what?” on Breaking Muscle to learn what you can do next!
Putting it all together: The importance of EDUCATION and CULTURE
As a coach or movement specialist, creating an atmosphere for female athletes to feel comfortable is ESSENTIAL in determining the success of a program (1). Studies have shown that females are naturally less confident in their ability to perform resistance training compared to males! (11)
Unfortunately, myths like “lifting gets you bulky” or “lifting is only for guys” are perpetuated in the fitness world and stop many girls from strength training.
From the standpoint of injury prevention, it is CRUCIAL that we educate the athlete, her parents, and coaches on the NECESSITY of strength training for ANY athlete who wants to engage in sport.
As Baker and Sargent explain, “educating young females about the benefit of strength training, coaches can increase motivation, address fears, and dispel misconceptions” (1)
Without this important conversation, we’re putting our girls at even more risk for injury.
Females are just as athletically capable as their male counterparts. But they NEED to be presented with the tools necessary to support their abilities.
We KNOW that male athletes have more muscle mass and a baseline of strength due to their hormonal makeup.
For women who engage in sport, it is CRUCIAL they understand strength training is A MUST to prepare their bodies for the stress of their sport.
The science is clear: strength training is not just a training tool for football players. Strength training is it is a necessary tool for ALL athletes…especially FEMALE athletes.
As a parent or coach, it is OUR JOB to help make strength training a PRIORITY to develop our athletes for the long term.
(1)Sargent, D., Clarke, R. (2018). Strength and Conditioning for Female Athletes. Training Young Female Athletes. Marlborough: Crowood. pp 171-183.
(2) Sherar, L., Mirwald, R., Baxter-Jones, A.D. and Thomis, M. (2005) Prediction of adult height using maturity-based cumulative height velocity curves. Journal of Pediatrics, 147, 508-514.
(3) Ford, K., Shapiro, R., Myer, G., Van Den Bogert, A., and Hewett, T. (2010) Longitudinal sex differences during landing in knee abduction in young athletes. Medicine and Science in Sports and Exercise, 42, 1923-1931.
(4) Hewett, T., Myer G., Ford, K., Heidt, R. Jr., Colosimo, A., McLean, S.G., Van Den Bogert, Al, Paterno, M., and Succop, P. (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. American Journal of Sports Medicine, 33, 492-501.
(7) Barton, C., Lack, S., Malliaras, P., and Morrissey, D. (2013) Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. British Journal of Sports Medicine, 47, 207-214.
(8) Sargent, D., Clarke, R. (2018). Strength and Conditioning for Female Athletes. Mobility for Performance in Female Athletes. Marlborough: Crowood. pp 111-139.
(9) Myer, G., Ford, K., Di Stasi, S., Foss, K., Micheli, L., and Hewett, T. (2015) High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: is PFP itself a predictor for subsequent ACL injury? British Journal of Sports Medicine, 49, 118-122.
(10) Myer, G., Ford, K., and Hewett, T. (2005). The effects of gender on quadricep muscle activation strategies during a maneuver that mimics a high ACL injury risk position. Journal of Electromyography and Kinesiology, 15, 181-189.
(11) Poiss. C., Sullivan, P., Paup, D., and Westerman, B. (2004) Perceived importance of weight training to selected NCAA Division III men and women student athletes. Journal of Strength and Conditioning Research, 18, 108-114.
(12) Ebben, W., Fauth, M, Petushek, E., Garceau, L, Hsu, B., Lutsch, B., and Feldmann, C. (2010) Gender-based analysis of hamstring and quadriceps muscle activation during jump landings and cutting. Journal of Strength and Conditioning Research, 24, 408-415.
(13) DeMorat, G., Weinhold, P., Blackburn, T., Chaudik, S., and Garrett, W. (2004) Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. American Journal of Sports Medicine, 32, 477-483.