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Home > Current Trends and Perspectives: Women's Sport and Women's Health

Current Trends and Perspectives: Women's Sport and Women's Health

Published: June 11, 1999

Preface
Medical doctors (and others whom the public holds in high esteem and credibility) have a tremendous social responsibility to provide a balanced perspective on disease, illness, and injury. History demonstrates that they have failed to do so:

· In the late 1800s, when women were emancipated from the home by the bicycle, there were doctors who wrote in respected medical journals of the dreaded disease "bicycle face." Imagining the pain of a female sitting astride a bicycle, they warned of a wrinkled face response and the permanence of such disfigurement. The effect of such warnings was to keep women away from this recreational sport.

· In the 1920s, following the first running of the women's 800 meters in the Olympic Games, an irresponsible journalist erroneously reported that all 11 runners had collapsed. In fact, nine ran, all nine finished and one fell at the finish. Medical doctors followed with cautions about the lack of aerobic capabilities of women due to their smaller hearts, lungs and circulatory capacities and the event was dropped from the Olympic program. It wasn't until the 1950s that a women's running event over 200 meters was reintroduced to the Games.

· Throughout the 1930s, medical doctors warned that high stress sport would negatively impact a female's reproductive system.

· In the 1980s and 1990s, medical doctors warned the public about eating disorders and the female athlete triad (eating disorders/osteoporosis/ amenorrhea), which affected female athletes in the image sports of figure skating, gymnastics and diving.

· In the 1990s, medical doctors suggested hormonal deficiencies and a woman's Q angle anatomical deficiency (angle between hip and knee) in support of the popular media, notably a major article in Sports Illustrated, heralding anterior cruciate injuries as the new scourge in women's sports.

The simple phenonomon of medical doctors giving their attention to these developments coupled with lack of balanced reporting in the media creates fear and has a deterrent effect on the participation of girls and women in sport.

In all of these situations the medical establishment had acted prematurely. It is happening again with the medical profession's reaction to more female than male ACL injuries. Few physicians are asking all the right questions and considering all possible causative factors.

· What is the result of women not having access to the best coaches and not learning good mechanics in basic skills?

· What is the result of women not laying down a solid strength base early in their athletic careers, the result of not having the same access to weight rooms and strength coaches as their male counterparts?

· What is the result of less highly trained women at the high school level entering high powered college programs where they are immediately taxed at levels far beyond their physical strength and endurance levels? Is this producing fatigue over time that increases susceptibility to injury?

Similarly, few physicians are asking whether there is gender bias in their profession which has an impact on how they consider the health status of women. The medical and media professions are predominantly male and maybe too eager to reinforce the strength and dominance of males and dismiss women in sport?

· I travel all over the country as a public speaker. I love talking to high school boys, because they reflect the male view before the veil of political correctness disguises their true feelings. When speaking with young boys, it is terribly important to them for me to acknowledge that males are better athletes than females. Males jump higher, throw farther, run faster, dunk basketballs better and are more interesting to watch than female athletes. They listen intently as I ask, "Who is the better athlete, Mike Tyson or Sugar Ray Leonard?" Initially struck silent by the question, they then respond with considerable chagrin, "That's not a fair question! Those are boxers in two different weight classes. They don't compete against each other. They are both great boxers." To which, I quietly respond, "Exactly." Why the need to have dominance acknowledged?

I know this is a long preface, but the point is an important one. Any message of difference between the genders must carry a strongly worded reminder that (1) different does not mean "less than" and (2) the benefits of sports for women far outweigh any negatives.

The Good News

The good news for physicians is that they will continue to see more girls and women playing sports and needing their services:

· The ideal stereotype of what an American female should be is in the midst of radical change. Prior to 1970, a women was only allowed to be a caretaker (wife, librarian, teacher, nurse, social worker), decorative object or sex object. Today's standard is an active female who is permitted to use her body to compete, to demonstrate strength and endurance and pursue the same professions as her male counterpart. That radical change is good for women's health.

· The sedentary life of our grandmothers and mothers that has led to one of every two women over the age of 60 being osteoporotic, is probably past, at least for those generations of women 40 and under.

· Female participation in sports and fitness will continue to increase, led by the permissiveness of this stereotype and even influencing the activity habits of older females.

· Capitalism will reinforce the American female's active lifestyle. This huge and lucrative market will be wooed by the sporting goods and apparel industry.

The Bad News

The bad news is that the primary contributing factors underlying female injuries in sports will not be going away any time soon:

· Moms and dads 40 and under "get it", grandmas and grandpas 65 and older are taking their granddaughters to play sports but the dinosaurs 40-65 are still holding the purse strings. The dinosaurs of this trifurcated population are still withholding financial support and their full support of sports participation for women because they grew up in a culture where they were taught that "girls can't throw", "no one is interested in watching girls play", and "girls aren't interested in sports". This dinosaur group is also making decisions about the employment of quality coaches for girls' teams, access to weight rooms, assignment of athletic trainers and promotions personnel and the quality of athletic facilities provided to girls' teams. All of these factors are related to injury prevention. Until these folks retire, women's sports in our schools and open amateur sports will experience a gender gap.

· Girls continue to enter organized sport two years later than boys and with less experience and skill. Parents are still pushing their sons to be great athletes and telling their daughters that sport is where you can play with your friends and have fun. This importance of skill message must become consistent to both genders because the #1 reason why children stay in sport is because it is fun. If you don't have skill you don't have fun. It is simply no fun to strike out three times in a row.

· Coaches continue to hurt players because of the dominant philosophy that "more is better" and "no pain, no gain." We are in desperate need of a national system of coach training and certification. Not only will they continue their tendency to overtrain and overstress, they are without proper knowledge of biomechanics and basic exercise physiology.

· Our sport culture will continue to demand sports specialization as college athletic scholarships and professional sport salaries become more visible and desirable as the golden ring. Such single sport focus will continue to breed overuse injuries and must be condemned by physicians.

· Fathers will continue to dominate as key influencers of female athletes (we are still 5-10 years away from the first generation of female athletes training their daughters) and girls will continue to be pushed as their fathers were and will experience extraordinary pressures to please.

· This and the next generation of young athletes will continue to seek ways of differentiating themselves and will explore ever more dangerous and complex extreme sports.

· Both girls and boys will experience less developmental free play because of concerns for their safety. Organized play will simply not provide the balanced general, basic motor skill activity they need early in life. Children need both.

· Few people realize that we have lost almost all of our physical education programs. Only one state still requires mandatory physical education K-12 (Illinois). We need to make a major push to get qualified physical educators into the elementary schools. They have migrated to high school simply to provide positions for coaching elite sports. This must change. U.S. Senator Ted Stevens, Chair of the Appropriations Committee, has just filed a bill which would provide $400 million in incentives for mandatory physical education in our schools. It needs to pass and it needs to be modified to provide for mass participation and instructions by qualified physical educators at the elementary school level.

· Female athletes will continue to suffer from being forced into male model choices of sports. Over the last twenty years, schools have dropped women's field hockey and gymnastics because male athletic directors didn't understand those sports or didn't want to pay the salaries necessary to provide good coaches.

· Female athletes will be susceptible to natural substance abuse. Fortunately, continued pressure to maintain slim and appealing bodies will deter female athletes from embracing steroids as a forbidden substance of choice. This is one instance where the negative imperative to be beautiful will, in fact, benefit women.

· There will be more mature women entering the world of regular physical activity because of concern for their health and fear of debilitation.

· Time will continue to limit female participation in sports. If a woman chooses to add sport to her life, it will come at the expense of sleep. Her mate is not taking any responsibilities off her plate and work has become almost mandatory.

The Challenges

Any recommendations coming from the medical profession should:

· Call for mandated certification and training of coaches

· Condemn sport specialization at early ages

· Support cross training and mutli-sport activity

· Strongly support mandatory daily physical education in the elementary school conducted by trained physical educators

· Call for building an early strength base among all females and strength training throughout females' lifespans

· Emphasize the benefits of sports participation

A balanced perspective on injury and participation is essential. A strong emphasis and consistent messaging on the importance of exercise, fitness and sports participation for girls is critical. Clear and specific instructions to parents and educators - in plain, unambiguous language - is essential.