{"id":11854,"date":"2026-02-16T06:00:48","date_gmt":"2026-02-16T05:00:48","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=11854"},"modified":"2026-02-13T16:10:54","modified_gmt":"2026-02-13T15:10:54","slug":"female-woman-and-girl-athletes-lower-extremity-injury-risk-separating-fact-from-fiction","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2026\/02\/16\/female-woman-and-girl-athletes-lower-extremity-injury-risk-separating-fact-from-fiction\/","title":{"rendered":"Female, Woman and Girl Athletes Lower Extremity Injury Risk \u2013 Separating Fact from Fiction"},"content":{"rendered":"

Over 60% of female\/woman\/girl athlete injuries involve the lower-extremity (e.g., groin, hip, thigh, knee, calf, ankle, foot) (1). <\/span>These injuries disrupt training and competition, increase recurrent injury risk, and can have long-term health consequences. To reduce these injuries, medical and performance teams are often encouraged to target \u2018modifiable risk factors\u2019 such as biomechanics, movement patterns, strength, or training load, but how strong is the evidence behind this advice? This blog summarises a recent systematic and meta-analysis<\/a> that aimed to answer this question, and inform the International Olympic Committee Female woman and girl Athlete Injury pRevention (FAIR) Consensus (2).<\/span><\/p>\n

Why was the review important?<\/h3>\n

Female\/woman\/girl athletes experience different injury patterns than male\/man\/boy athletes, yet most injury prevention practices are based on evidence from male\/man\/boy sport. Without a good understanding of risk factors for female\/woman\/girl athlete lower-extremity injuries, prevention strategies default to assumptions rather than evidence. This gap can lead and over-emphasis of factors with uncertain benefit, perpetuate myths (e.g., role of hormones, menstrual cycle, anatomical features), and divert attention from contextual factors that disadvantage female\/woman\/girl athletes such as limited resources, less training time and support (3, 4).<\/span>\u00a0A systematic review can address this problem by combining evidence across studies to clarify what is known and what is not.<\/span><\/p>\n

What did we do?<\/h3>\n

We searched nine databases for studies that examined potential modifiable risk factors for female\/woman\/girl athlete lower-extremity injuries. Where possible, we pooled results across similar studies using meta-analyses. When this was not possible, we used semi-quantitative syntheses. We also graded the certainty of evidence for each risk factor.<\/span><\/p>\n

What did we find?<\/h3>\n

We included 195 studies involving 1,525,662 participants, but only 2.4% were females\/women\/girls. Across the 59% of studies that reported female\/woman\/girl-specific data, 66 potential risk factors were investigated. There were enough studies to pool data for body mass and body mass index, weekly training distance, muscle strength, artificial turf, off-season plyometric training, readiness to return-to-sport, hop asymmetry, and vertical drop jump biomechanics, while an additional 26 factors were assessed with semiquantitative synthesis. Three key messages emerged<\/span><\/p>\n