No Bones About it: Men and Women Aren’t Equals in Orthopedics

By Lisa Esposito

Whether they’re young athletes, middle-aged adults or seniors playing competitive sports, females and males are vulnerable to problems with their bones and joints. Even with similar conditions, treatment and recovery can vary by gender. A new study looks at the Venus-Mars divide in orthopedic conditions, as experts work to raise awareness among men and women, parents and physicians.

Different Risks

If you’re a man, watch your fingers and hands – fractures are more common in males. If you’re a woman, you’re more vulnerable to tearing a key ligament in your knee or spraining an ankle. And you’re more likely to have knee osteoarthritis – the ‘wear’-and-tear’ arthritis that can become more disabling with age.

Women are also at higher risk for osteoporosis and have more hip fractures related to the bone-thinning condition. However, men with the same fracture are more likely to suffer major complications, according to a review article in the June issue of the Journal of the American Academy of Orthopaedic Surgeons. The review looked at findings from previous studies, which show men are more likely to develop conditions such as pneumonia and systemic infections after a hip fracture, and to die within the first few months of being injured.

“Osteoporosis in men is often underdiagnosed because nobody thinks of it as a man’s problem. They think of it only as a problem for small, Caucasian women. Not true,” says Dr. Jennifer Moriatis Wolf, an orthopedic surgeon and the lead study author. “And the mortality rate for men after osteoporotic fractures is higher than for women.”

Men: Muscles and Tendons

Soft-tissue injuries are more common in men, says Dr. Timothy Miller, an assistant professor of clinical orthopaedics at The Ohio State University. These include tears to the Achilles tendon, distal biceps, quadriceps and pectoral tendons. Women are more likely to have bone injuries, says Miller, who is also a team physician with OSU Sports Medicine.

A distal biceps tendon  rupture, an arm-muscle injury, is a man’s problem. “It’s almost unheard of in women,” Miller says. The tear typically happens to men between ages 30 and 60 during manual labor such as lifting and carrying large, heavy loads, which they suddenly drop, ramping up demand on the muscle.

The Achilles tendon , located to the back and center of the ankle, above the heel, is injured about three times as often in men, Miller says, although Achilles tears are growing more common in women. The area takes a beating from different forces during speed training and uphill running, jumping and contact sports – or non-inline sports. “Inline sports are simple running, swimming or cycling when no lateral or side-to-side motion takes place,” he explains. Basketball, football and soccer, with their sudden changes in motion, are cutting sports.

Women Athletes and Knees

For young athletes who play cutting sports, the anterior cruciate ligaments, vital to knee stability and movement, are vulnerable to injury. Women and girls face higher risk for ACL tears than men and boys in similar activities. However, the gap has narrowed since the early 2000s, Miller says.

Why women are more vulnerable to ACL tears is uncertain. It might be partly due to reproductive hormones that affect joint laxity, or looseness. Anatomical differences in pelvis width, leg alignment and knee articulation may be factors, Miller says.

Related Articles

Back to top button