SACHA PFEIFFER, HOST:
The sports world and science have known for decades that female athletes injure their ACLs more often than male athletes, and tearing that knee ligament can mean surgery and many, many months of rehab. But why are women more susceptible than men? A new study funded by FIFA - soccer's international governing body - will look into whether menstrual cycles play a role.
Dawn Scott will be following this study closely. She's a performance coach and applied sports scientist in elite women's soccer. She's worked with the women's national soccer teams in the U.S. and England, and she advises FIFA, and she's with us now to talk about efforts to prevent ACL injuries in women. Hi, Dawn. Thanks for coming on.
DAWN SCOTT: Hi. Thank you for the invite.
PFEIFFER: I realize you're not involved with this study, but help us understand how a woman's period could have any connection to an injury to her knee ligament.
SCOTT: I think that, for me, is a misconception because I think it's much broader than that. Injuries anyway, and especially ACL injuries, are very multifactorial. And I think for many years, we focused a lot on sex differences and hormones - obviously, menstrual cycle period being the hormonal factors. And for the last 10, 20 years, we haven't seen any change in ACL injury rates in females. However, in males, that rate is coming down. So I think we need to go broader than that and look at the full picture of the risk factors and causes of ACL injuries.
PFEIFFER: Athletes work with coaches to strengthen themselves and work on stabilization - things that will ideally prevent injuries. But this study's interesting because it's suggesting that despite all the training they may do, there could be biological factors that play a role in injuries. And I can imagine that would be quite - that could be quite devastating. An athlete might think, I did something wrong when, in fact, it's about her body. What are your thoughts about that psychological element and how athletes should handle that?
SCOTT: I think it's the whole education process. Part of the reason girls drop out of sport at a faster rate than boys is because they either don't get education at all in terms of, you know, sex differences and hormones, or they do, but it's not from somebody who has the expertise, the understanding of that. So, again, I think it's important that, you know, you look at school curriculums for education so that girls do get that understanding of their bodies and actually, at times, use the hormones to their advantage and, you know, are they maximizing potential as females? Because, you know, for all of these years, females, girls have been trained with boys because actually only 6% of the sport science research is totally focused on female athletes, female subjects.
PFEIFFER: From your coaching perspective, how much could nonbiological, nonbiomechanical factors play a role in ACL injuries? I'm thinking about type of shoe, type of training, grass versus turf, maybe condition of pitch.
SCOTT: Yeah, a hundred percent. I mean, there's only one real brand, IDA Sports, who designed the soccer cleat based on the shape of the female foot. We tend to have a wider front foot, narrower heel. And then, I think, it's the interaction between the soccer cleat and the surface. Is the player wearing the right boot for the right surface, or whether that is turf, whether it's grass. And, again, does the player have the luxury or the fortune to change or have multiple soccer cleats so that they can change and have the optimal cleat for the right surface?
PFEIFFER: You've touched on this a little bit, but I think for many parents of young athletes listening and female athletes themselves, they crave specific advice or tips on how to train and play in a way that is most likely to protect their knees. What are your top line pieces of advice for players and their parents?
SCOTT: I think some of it is that injury-reduction exercises. Strength is important. But then also that recovery piece of sleep, nutrition, hydration and making sure lifestyle choices and behaviors are optimal to prepare the player going into a transitional game, but then also recover them afterwards.
PFEIFFER: You know, and quite a compliment to you, many players on the U.S. women's soccer team say you were a huge part of their World Cup success a few years ago. Because of your perspective and the success you've had with the players you've worked with, what more do you think can be done to support players?
SCOTT: I think education is a massive one. Like I said, part of the reason girls drop out of sport at a faster rate than boys is they're trained as boys, not girls. So I think making some of that education globally accessible, and I think then we start to understand and give the female the best chance to optimize their performance.
PFEIFFER: That is performance coach and applied sports scientist Dawn Scott. Thank you.
SCOTT: Thank you. Transcript provided by NPR, Copyright NPR.
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