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Speaker 1: Already and this is the Daily This is.

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Speaker 2: The Daily OS.

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Speaker 1: Oh, now it makes sense. Good morning and welcome to

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Speaker 1: the Daily OS. It's the third of January. I'm Billy

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Speaker 1: and we are back for our last episode of tda's

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Speaker 1: summer series. For many of you, this will be your

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Speaker 1: last day before you go back to work on Monday,

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Speaker 1: so we hope you've had a very relaxing break and

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Speaker 1: that you are enjoying the hot weather. Today we're talking

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Speaker 1: about why women are more prone to injuries during sport. Specifically,

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Speaker 1: they are more prone than their male counterparts to rupturing

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Speaker 1: their ACL. To understand this, Chloe spoke to Adam Walker,

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Speaker 1: who is a physiotherapist and researcher specializing in the area

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Speaker 1: of ACL rehabilitation. Here is that chat. Hi, Annam, thanks

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Speaker 1: for joining us on the podcast.

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Speaker 2: Hi Chloe, thanks for having me so.

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Speaker 3: Matilda's captain Sam Her has just been added to the

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Speaker 3: growing list of female football players hit with the dreaded

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Speaker 3: ACL injury, And I want to start really broad. Can

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Speaker 3: you explain what an ACL injury is and why it's

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Speaker 3: more prevalent in female athletes?

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Speaker 2: Yeah? Absolutely, so.

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Speaker 4: The ACL is one of the major ligaments in the knee.

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Speaker 4: It runs through the center of the knee and basically

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Speaker 4: it provides stability to the knee, particularly during sporting movements

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Speaker 4: such as jumping and landing and cutting and change of directions.

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Speaker 4: So we would typically associate an ACL injury with those

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Speaker 4: high risk activities, which is most of our team sports

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Speaker 4: that are particularly prevalent here in Australia, so AFL soccer,

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Speaker 4: the rugby codes, basketball, netball. We love playing those sports

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Speaker 4: here in Australia, So Australia actually has the highest rate

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Speaker 4: of acls in the world and that's largely because we

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Speaker 4: love playing sports that stress the ACL. And then, unfortunately,

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Speaker 4: for a variety of different reasons, females are significantly any

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Speaker 4: higher risks to injure their ACL compared to males, and

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Speaker 4: depending on where you read it really depends, it could

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Speaker 4: be anywhere from two even even up to eight times

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Speaker 4: more likely for females to injure their ACL. So it's

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Speaker 4: certainly becoming a big problem at the moment, and obviously

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Speaker 4: it's been highlighted again by Sam Kerr and then previously

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Speaker 4: with the Soccer World Cup, and of course the rise

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Speaker 4: of AFLW and NLW are really starting to highlight this

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Speaker 4: issue of ACL injuries in female athletes.

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Speaker 1: So is this a new trend?

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Speaker 2: Then it's definitely not a new trend.

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Speaker 4: There's been literature on the higher rates in females for decades.

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Speaker 4: But I think it is that exposure that we're getting

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Speaker 4: now to female sports, and in reality, the rise in

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Speaker 4: female sports participation has just been astronomical, particularly in the

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Speaker 4: last five years, and the sponsorship and exposure in television

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Speaker 4: rights and female athletes getting more and more known to

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Speaker 4: the community, which is obviously a fantastic thing.

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Speaker 2: That it's just really highlighting issues.

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Speaker 4: So it's definitely not but it's hopefully this increased attention

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Speaker 4: we can actually start to take some steps forward to

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Speaker 4: change it for the future.

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Speaker 3: So you said there, we're a variety of different reasons

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Speaker 3: why women are at higher risk. First, I want to

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Speaker 3: focus on the specific biology we have that makes us

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Speaker 3: more prone to these kinds of injuries. Can you talk

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Speaker 3: me through that?

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Speaker 4: Yeah, absolutely, It's probably important to highlight at the start

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Speaker 4: that it's not just how women are build and there

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Speaker 4: is more and more evidence growing that's now considering more

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Speaker 4: socio cultural, environmental and kind of gendered in environment that

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Speaker 4: women grow up in. That also influence the injury risk.

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Speaker 4: So I'm sure we'll touch on that, But from a

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Speaker 4: biological perspective, we've got changes in the shape of female's

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Speaker 4: hip anatomy that is different to males that predisposes them

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Speaker 4: to getting into positions associated with an acl injury occurring.

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Speaker 4: So that's typically a wider hip and what's called a

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Speaker 4: Q angle where there's a difference in the angle from

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Speaker 4: the hip to when we draw a line down to

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Speaker 4: the knee, which has been associated with aco injury. So

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Speaker 4: that's one side of thing, is the bony anatomy of

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Speaker 4: the hips and the knees of women. And the second

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Speaker 4: side of the biology is the hormonal factors, which is

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Speaker 4: getting also getting a lot of attention at the moment,

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Speaker 4: and there's still a lot of questions around the influence

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Speaker 4: of the mental cycle on a female's injury risk and

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Speaker 4: how those variations in hormones through the cycle influences a

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Speaker 4: person's risk to injury. So it's a little bit hard

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Speaker 4: to say on that front, but there's a lot of

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Speaker 4: good people doing research in that area that can hopefully

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Speaker 4: provide some answers. Probably the third thing in from the

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Speaker 4: biological is that physical aspect that is that typically females

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Speaker 4: are generally not as strong and not as powerful as

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Speaker 4: males and have that strength around their knees and in

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Speaker 4: their lower half of their body compared to their male counterpowers.

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Speaker 2: That may also predispose them to ACL injury.

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Speaker 3: What's the role of the external factors, like I'm thinking

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Speaker 3: the fields that women are playing on or the shoes

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Speaker 3: that they're wearing, what kind of influence does have on injury?

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Speaker 4: Yes, so we're just starting to get some footwear being

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Speaker 4: released by the big companies now that is like football boots,

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Speaker 4: those kind of things that are specifically designed for females

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Speaker 4: and female feet, and there is some evidence around how

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Speaker 4: the traction of the boot and the surface that they

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Speaker 4: play on influences somebody's risk of acy on injury. Generally,

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Speaker 4: the more the higher attraction the service, the greater the risk,

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Speaker 4: and certain studs and certain designs of boots are definitely

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Speaker 4: associated with an increased risk of injury that ties into

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Speaker 4: the playing service with the type of surface and the

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Speaker 4: facilities available at female athletes. Unfortunately, they are often, certainly

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Speaker 4: at the community and the amateur level, playing on more

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Speaker 4: suboptimal fields than their male counterpouts, which may also increase

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Speaker 4: their exposure to suboptimal playing services from attraction perspective, or

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Speaker 4: even just the continuity of the surface compared to other

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Speaker 4: grounds available to males.

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Speaker 3: Is the reason they're playing on those less optimal playing

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Speaker 3: fields or don't have the boots is because of funding reasons?

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Speaker 3: Am I right in thinking that?

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Speaker 2: Yeah?

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Speaker 4: Generally, across all codes, the male version of the code

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Speaker 4: is obviously still prioritize, and that's where most of the

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Speaker 4: funding and the revenue generation is from and where there

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Speaker 4: is greater levels of participation as well. So clubs will

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Speaker 4: naturally have that bias towards the areas that either generate

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Speaker 4: the most revenue or have the highest number or highest

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Speaker 4: level and highest number of participation. But hopefully, obviously that's

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Speaker 4: going to change with time.

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Speaker 1: If we look specifically at someone who's just like Samco

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Speaker 1: who's just been told they have ruptured their ACL what

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Speaker 1: does recovery look like?

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Speaker 4: So it's regarded as one of the most devastating injuries

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Speaker 4: in sport, and for good reason as well, because the

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Speaker 4: amount of time loss required after the injury and the

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Speaker 4: rehab after the injuries just is significant. So most people

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Speaker 4: will have time at least twelve months out of sport.

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Speaker 2: Some people may return sooner.

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Speaker 4: Sometimes it takes people much longer to return to sport,

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Speaker 4: but generally speaking, most people are looking at twelve months

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Speaker 4: out of sport after somebody injures their ACL. There are

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Speaker 4: a couple of different ways that some people can go,

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Speaker 4: but the majority of people in Australia are still getting surgery.

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Speaker 3: So if Sam was your patient, would there be any

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Speaker 3: way that she'd be ready to play for the Maturdas

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Speaker 3: at the Olympics in July?

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Speaker 4: It seems very unlikely at this point. There is case

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Speaker 4: studies at the professional level, anything is possible.

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Speaker 2: When the Winter.

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Speaker 4: Olympics roll around every year, we always hear these crazy

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Speaker 4: stories of skis and snowboarders who have injured their ACL

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Speaker 4: weeks before or months before the Olympics and have gone.

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Speaker 4: And I've certainly seen other people in summer Olympic sports

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Speaker 4: that have gone and done that.

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Speaker 1: So I do understand a lot of your research focuses

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Speaker 1: on ACL injury prevention in women and girls, specifically, if

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Speaker 1: you can just expand a little more on what do

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Speaker 1: you think can be done to mitigate the risks of injury.

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Speaker 4: So the first thing which doesn't only apply to women

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Speaker 4: and girls is the widespread implementation of injury prevention programs.

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Speaker 4: We know that they are rarely performed at the community level,

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Speaker 4: and there is substantial evidence now from a variety of

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Speaker 4: different sporting codes across different areas of the world that

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Speaker 4: demonstrates that with a more formal injury prevention program which

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Speaker 4: typically replaces a standard warm up at sport, we can

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Speaker 4: reduce the risk of ACL injury by about fifty percent,

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Speaker 4: even up to sixty percent.

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Speaker 2: So just the.

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Speaker 4: Simple training of staff, coaches, parents, volunteers at clubs and

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Speaker 4: sporting grounds from the junior level through to semi professional

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Speaker 4: sport can go a long way in reducing ACL injuries.

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Speaker 4: So that's the more practical side on the ground is

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Speaker 4: where we're at. Then at the top level of that,

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Speaker 4: then we've got funding of research into to women and

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Speaker 4: ACL injury which will hopefully then be able to feed

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Speaker 4: down the evidence which will support the greater financial funding.

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Speaker 2: To help women.

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Speaker 4: With exposure to high levels of training, development and facilities

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Speaker 4: and those factors that we've touched on so far.

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Speaker 1: Adam, thank you so much for jumping on the pod today.

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Speaker 2: Thanks for having me. I really appreciate it.

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Speaker 1: That's all we have for you today. Thank you so

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Speaker 1: much for listening to tda's summer series, and we'll be

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Speaker 1: back again next week. My name is Lily Madden and

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Speaker 1: I'm a proud Arunda Bungelung Cargoton woman from Gadighl Country.

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Speaker 1: The Daily oz acknowledges that this podcast is recorded on

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Speaker 1: the lands of the Gadighl people and pays respect to

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Speaker 1: all Aboriginal and Torres Straight Island and nations. We pay

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Speaker 1: our respects to the first peoples of these countries, both

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Speaker 1: past and present.