Girls and athletics


The Title IX provision of the Education Amendments passed in 1972 prohibits discrimination regarding access to educational programs and activities that receive federal financial assistance.

According to the Youth Risk Behavior Surveillance conducted by the Centers for Disease Control and Prevention (CDC), about half of female adolescents now participate in school or club sports.1 That's a good thing-right? It's good that girls have an opportunity to compete athletically, to keep their bodies strong and fit, and to develop confidence in their physical abilities. There is even evidence that aerobic fitness and participation in sports is associated with enhanced learning.2

Competitive athletics can have adverse consequences, however, and we are learning that those consequences are different for girls than they are for boys. Concussion is reported more frequently among female athletes, primarily those participating in soccer and basketball, and there is some evidence that recovery from concussion is prolonged compared with males who suffer concussion during sports.3 Anterior cruciate ligament tears occur 3 to 8 times more often in females than in males participating in sports.4 In this issue, Kelsey Logan, MD, describes the female athlete triad, another health risk for female athletes.

It would be inappropriate to conclude from these studies that playing competitive sports is too risky for girls. The accumulating data can help us understand, however, how girls can be better protected from injuries and adverse health effects of athletic participation. Strength training, counseling about dietary habits, and advice to avoid focusing on a single sport have all been proposed as methods to avoid specific adverse consequences of competitive sports. Parents, coaches, and game officials must be educated about appropriate training and methods for injury prevention.

It's our responsibility to anticipate situations that put girls and young women at risk and to continue to investigate more effective methods for preventing injury.


1. Grunbaum JA, Kann L, Kinchen SA, et al. Youth risk behavior surveillance-United States, 2001. MMWR Surveill Summ. 2002;51(4):1-62.

2. Roberts CK, Freed B, McCarthy WJ. Low aerobic fitness and obesity are associated with lower standardized test scores in children. J Pediatr. 2010;156(5):711-718.

3. Covassin T, Swanik CB, Sachs ML. Sex differences and the incidence of concussions among collegiate athletes. J Athl Train. 2003;38(3):236-244.

4. Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy. 2007;23(12):1320-1325.e6.

5. Broshek DK, Kaushik T, Freeman JR, Erlanger D, Webbe F, Barth JT. Sex differences in outcome following sports-related concussion. J Neurosurg. 2005;102(5):856-863.

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