KEY POINTS:
A "warrior-girl ethos" is leading to an injury epidemic among young female athletes, according to research by one of the world's leading sports specialists.
Those taking part in the "jumping and cutting" sports, such as football, basketball, volleyball and gymnastics, are up to 10 times more likely
to suffer certain injuries, some so serious that they can lead to permanent physical disabilities.
"Girls and young women are increasingly playing competitive sports according to a warrior-girl ethos, whereby they play through pain and rush back from injury," said Michael Sokolove, who has published six books about the sociology and culture of sports.
They are more than five times more likely to rupture the anterior cruciate ligament (ACL) in the knee than men in sports that both sexes play under similar rules, Sokolove discovered. Reconstruction surgery for ruptured ACLs is complicated and the rehabilitation process is long and painful.
But ACLs are not the only injury that young women are more likely to suffer than their male counterparts. In Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports (Simon & Schuster), Sokolove reveals that girls and young women are 10 times more likely than men to injure themselves playing football and 3.5 times more likely to hurt themselves playing basketball.
It is a picture that former British sprint champion Katharine Merry recognises. Over the years she had a series of operations for knee, Achilles tendon and foot injuries and in 2005 she was forced to retire aged 30.
Merry now mentors British junior athletes and runs a sports advice website, elitementor.com. "I started running at the age of 10, but running so intensively was a shock to a young body," she said. "By my mid-twenties I had done 17 years of hard work and it had taken its toll. I wish these sorts of facts and information had been around when I was going through my early training. Perhaps it would have made the difference and kept me from retiring early."
Sport England recently launched a campaign to increase participation in sport and exercise across the British population by 1 per cent every year. But Sokolove believes that, unless such campaigns are matched by research into injuries, they could end up harming young women.
There are many examples bearing out Sokolove's theories. Martina Hingis, who made her tennis tour debut days after her 14th birthday and went on to win five Grand Slam singles titles, was forced to retire at 22 after foot and ankle injuries. Anna Kournikova was forced to retire at the same age with a badly injured right foot.
Girls are also more likely to suffer chronic knee pain, as well as shin splints and stress fractures, Sokolove found, as well as being more prone to ankle sprains, hip and back pain.
"Females appear to be more prone to concussions in sports that the sexes play in common," he said. The reason for the increased rate of injury in young girls is, said Sokolove, partly because the sexes diverge in their physical abilities as they enter puberty and into adolescence.
"Higher levels of testosterone allow boys to add muscle and, even without much effort on their part, get stronger. In turn, they become less flexible. Girls, as their oestrogen levels increase, tend to add fat rather than muscle. The influence of oestrogen makes girls' ligaments lax, which is an injury risk when not accompanied by sufficient muscle to keep joints in stable positions."
Holly Silvers, a physical therapist and the director of research at the Sports Medicine Research Foundation, is so worried about the number of girls coming to her suffering injuries that she designed an ACL injury prevention programme for women. "Females tend to be more erect and upright when they land, meaning they hit the ground harder," she said. "They bend less through the knees and hips and the rest of their bodies, and don't absorb the impact of the landing in the same way that males do."
Others, however, are concerned that drawing attention to the issue will backfire. "Sex differences can easily be perceived as weakness," said Mary Kane, director of the Tucker Centre for Research on Girls and Women in Sport.
"We need to do everything we can to prevent injuries. But it does seem that there is a disproportionate emphasis on things that are presented as signs of women's biological difference or inferiority."
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