Downloaded from http://journals.lww.com/c-orthopaedicpractice by BhDMf5ePHKbH4TTImqenVHwXmMsAVI5gi362E2/Y11E6esPM32HRch9+zlIm90xlYQudkzSSfgg= on 01/17/2019 Sports Medicine Rotation Current topics in women’s sports medicine: evaluation and treatment of the female athlete Miho J. Tanaka, MD Women’ s Sports Medicine Program, Johns Hopkins University, Baltimore, MD ABSTRACT The passing of Title IX in 1972 has led to a rapid increase in the number of female athletes, and with this, the field of women’ s sports medicine has continued to grow. As the number and type of female athletes continue to increase, our role as sports medicine surgeons is to meet the needs of this rapidly changing field by improving our knowledge of the injuries, treatments, and outcomes that are specific to this population. Our understanding of injury prevention and long-term outcomes after anterior cruciate ligament injuries is still evolving, yet this is a clear area for future study in female athletes. The role of gender in concussions and its relationship to musculoskeletal injuries continues to be explored. The unique element of pregnancy in athletes, which is gaining increasing attention, leads to a greater need for multidisciplinary care. Because of this, close collabo- ration with specialists who can augment our knowledge of the treatment of sports medicine conditions and maintaining awareness of the rapidly changing field of women’ s sports medicine will allow us to continually improve care for female athletes. Key Words women, sports, ACL, musculoskeletal injury, gender, pregnancy INTRODUCTION T he passing of Title IX in 1972 led to a rapid increase in the number of female athletes, and with this, the field of women’ s sports medicine has continued to evolve. The number of girls playing high school sports has increased from 1.3 million in the 1973-74 school year to 3.4 million in the 2017-18 school year. 1 During this time, high school sports participation in girls demonstrated a growth rate 2.3 times greater than in boys, which grew from 4.1 to 4.6 million in the same period. Although it is important to understand this growth in terms of quantity and number of female athletes participating, it is equally important to understand the qualitative changes that accompany these trends. Table 1 compares the five most common sports played by high school girls in 1973 and 2017. During this timeframe, the number of female participants in sports that we consider to be historically female sports, such as gymnastics, have decreased, while the participation of girls in historically male sports, such as wrestling, ice hockey and football, has grown at a rapid rate, particularly over the past 20 yr. 2 The responsibility and skill of the sports medicine physician in evaluating and treating athletes relies on the knowledge of not only the injury itself, but the incidence, risk factors, and relevance to a particular athlete’s sport. Unfortunately, as it relates to women in these relatively newer sports, there is very little data about the epidemiology and pathophysiology of such injuries. The development of women’s sports medicine programs at academic centers around the country can aid in the development and dissemination of knowledge regarding this evolving population of athletes. The purpose of this review is to highlight the current and relevant topics in the evaluation and management of the female athlete. ANTERIOR CRUCIATE LIGAMENT (ACL) INJURIES AND PREVENTION ACL injuries are four to eight times more common in female athletes than male athletes. 3–5 With the increasing number of female athletes, the number of ACL reconstructions performed in TABLE 1. Most commonly played sports by high school girls (data from national Federation of High School Sports) 1973-1974 No. participants (100,000) 2017-2018 No. participants (100,000) Basketball 308 Track and field 489 Track and field 299 Volleyball 447 Softball 110 Basketball 412 Tennis 0.84 Soccer 390 Swimming 0.74 Softball 367 Financial Disclosure: The author reports no conflicts of interest. Correspondence to Miho J. Tanaka, MD, Associate Professor, Department of Orthopaedic Surgery, Director, Women’s Sports Medicine Program, Johns Hopkins University, 601 N. Caroline St. JHOC 5250, Baltimore, Maryland 21287 Tel: +410 955 6825; fax: +410 614 1451; e-mail: mtanaka4@jh.edu. 1941-7551 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. SPECIAL FOCUS Volume 30  Number 1  January/February 2019 Current Orthopaedic Practice 11 Copyright r 2019 Wolters Kluwer Health, Inc. All rights reserved.