Women have continued to dominate in sports, raking in millions of supporters every year and selling out stadiums. However, as the presence of women continues to grow in male-dominated fields, sports medicine seems to be on the outskirts – and it may be costing athletes their health.

By: Janiah Lindsey

NEW YORK - It’s March 24th and the women’s second round of the NCAA’s March Madness. No. 1 Seed, the University of Southern California (USC) is playing No. 9 seed, Mississippi State with USC leading by 11 points in the first quarter. It’s less than 5 minutes on the clock when USC’s most valued player, sophomore point guard JuJu Watkins, goes down and doesn’t get back up. It would later come out that the star player tore her ACL and is out for the season.

When Watkins hit the floor, social media was flooded with tweets and posts wishing the athlete a speedy recovery. Some fans even wrote tweets jokingly offering the point guard their ACLs, so Watkins could join her teammates back on the court.

But some social media threads, drowned out by all the well wishes and memes, asked the most interesting question: Why did it seem like so many female athletes were getting hurt? And why were they all tearing their ACLs?

When parents sign their children up for sports, there’s one thing they know for certain - their child will get hurt. It’s a way of life. In 2023, 3.7 million people were treated in emergency departments for injuries related to sports and exercise, according to the National Safety Council. In professional sports, orthopedic surgeons and physicians believe the rate of injuries have risen over the past few years. Athletes expect it, trainers expect it, fans expect it. But the rate and type of injury seems to be much higher for female athletes - and it all comes back to the lack of women in certain sports professions.

Laura Collins, a psychotherapist and former D1 athlete, says the injuries female athletes face aren’t because they’re more “delicate” or “smaller,” it comes down to biology and how society thinks about women’s bodies.

“They [researchers] finally looked at women’s cycles, menstrual cycles, and the recognition that if you take the average 28 days cycle, halfway through that cycle, you’ll have the peak of relaxin begins because the body is preparing itself for the hope of being being able to procreate” Collins said. “But in doing so, [relaxin] softens your joints, and it [the muscle] becomes more susceptible to injury.”

The study Collins references found that most female soccer players on the U.S. women’s team had torn their ACLs during their peak cycle of relaxin, a conclusion Collins believes the sports community would’ve deduced quicker if they treated women’s bodies through the lens of biology.

Female athletes are two to eight times more likely to tear their ACL, and the rate of ACL tears is alarmingly high for female soccer and basketball players. These injuries can happen multiple times throughout an athlete’s career, and athletes with previous ACL tears are more likely to sustain the same injury. For women, this was seen as inevitable. For physicians like Collins, this is a pattern.

Research regarding ACL tears has existed for years, the first documented study in 1850, but it was based on two men wrestling. In fact, most research on sports and sports injuries are based on men. Women account for 35 percent of participants in sports science studies and only 6 percent of research studies specifically focus on female athletes. Many protocols athletes follow - nutrition, training, injury - are derived from studies which use men as the base line. It’s only over the past decade that medical journals connected ACL tears and other injuries to hormone fluctuations in female bodies.

This kind of old school, male-dominated approach to sports medicine, and medicine in general, is why diversity is so important to the field.

Women in Medicine

Women have consistently been a growing presence in medicine. As of the 2023-2024 academic year, women accounted for 54.6 percent of medical school students in the United States, according to the Association of American Medical Colleges. In 2022, women made up 38 percent of active physicians in the United States, a significant increase from 28.3 percent in 2007.

Although women continue to break barriers in the medical field, sports medicine remains male-dominated, especially at the collegiate and professional level. A 2023 report found that only 10 percent of women physicians make up all the doctors in Major League Baseball (MLB), 3.3 percent in the NBA, and 3.1 percent in the NFL. In the NCAA, only 35 percent of women were head athletic trainers across all divisions, and the higher the division, the lower the number of female physicians.

*The chart depicts the trends in male and female athletic trainer changes over 11 years by percentage. The listed acronyms include Assistant Athletic Trainer (AAT) and Athletic Trainer (AT) (National Library of Medicine).*

This gender disparity also extends to surgeons nationwide. Women account for 22 percent of active surgeons, according to the Association of American Medical Colleges (AAMC). In orthopedics, there are approximately 1,800 women that are orthopedic surgeons. In 2019, more than 12 Accreditation Council of Graduate Medical Education (ACGME) programs had no women trainees in their program. ACGME is a council that sets standards for medical training programs that must be followed by medical residents and fellows.

In professional sports, these numbers are even smaller: female orthopedic surgeons make up less than 3.6 percent of team physicians.

But how can this happen? If women make up more than half of medical school students, why is there such a large gap in the sports world? Are women just not interested in sports medicine?

According to Taurrya “T” Owens, an assistant athletic trainer at New York University (NYU), that couldn’t be further from the truth. It’s not a lack of interest, it’s not knowing sports medicine is an option.

“If you’re an athlete, you know about the trainers, that’s kind of how I got my first experience with it. Because I love them and they make my experience as an athlete so much better,” Owens recalled, referring to her time as a softball and rugby player for more than 10 years.

The gender gap also derives from a lack of educational opportunity, according to Owens. When she graduated from the University of Alabama, Owens was one of three Black women to complete the degree. At that time, sports medicine and athletic training still was part of the university’s bachelor’s program. Now, most schools have cut those programs and interested applicants have to apply for a master’s in athletic training; it’s a long process and only 284 schools offer accreditation, making it much less attractive to students.

Ultimately, the lack of women in sports medicine is an unfortunate combination of not knowing there are other options and being limited in terms of opportunity. Women may not be excluded intentionally, but there’s a disproportionate number of female physicians in sports medicine anyways. .

The Power of Diversity

Katie Kubiak, 21, adores swimming. The Wisconsin native started when she was two-years-old and was soon qualifying for her first nationals by age 12. Nothing could stop her, until her freshman year when she was diagnosed with late-onset congenital myopathy - a genetic muscle disorder that caused her body to deteriorate overtime.This diagnosis led to major spinal surgery and life in a wheelchair, but it didn’t change her love for swimming.

Kubiak worked hard to get her strength back and ultimately transitioned from able-body athletics to para-athletics – smashing records and joining the United States National Team. Kubiak’s story is one many athletes can relate to, centering around competition, injury, and love for your sport, but for Kubiak, her journey is one that she couldn’t have done without her trainer,

“My PT was incredible. She was a female which, honestly, I think shifted the way I view things because when I did go to the hospital - I mean, I was treated fine - but for me, personally, being nine, ten, eleven, and twelve and having a female physical therapist caring for me and helping to rehab me showed me these endless possibilities,” Kubiak said.

Those “endless possibilities” Kubiak talks about are the possibilities that there’s space for women in sports medicine, rehabilitation, and recovery. The reality is that sports is male-dominated in every sense of the word. There is a disproportionate number of women coaches, surgeons, and athletic trainers compared to men, and that disparity is costing the sports world a lot.

Indeed, there’s room for improvement in sports medicine and athlete care at all levels. It’s time to recognize the disparity in medical care for athletes and address it, especially as women’s sports continue to grow across the country. But, it’s not just about opportunities and options, it’s about changing how sports looks at female athletes and their bodies.

It’s time for a reckoning.

“The things that we have to deal with as female athletes are so different than men, and instead of being supportive of it, most of the time today, in sports culture, it is treated with stigma and shame,” Collins said. “So, that’s what sports medicine needs. There needs to be a reckoning. There needs to be people that accept that we haven’t been doing these things as we should be and let’s say sorry for that, let’s take responsibility, and let’s move forward.”

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The Gender Gap in Sports Medicine Is Costing Athletes Their Health