Sex Differences in Injury Recovery

According to Empirical Research, Men and Women Often have Different Recovery Rates for Certain Injuries

Are there differences in injury recovery outcomes depending on whether you are male or female? According to scientific research, depending on the circumstances, the answer is "yes."

Link to the Original Article

Despite recent debates in the public discourse regarding the differences between the sexes, biological males and females indeed have many different physiological characteristics and needs. The biological sexes differ chromosomally, hormonally, and overall physiologically. These are important factors to take into account when it comes to individualizing health practices. How might this translate over to injuries and recovery? There are generally two lines of thought when it comes to these topics, the first of which says that men and women are no different in these physiological life facets and the second of which says they are completely different. As is to be expected, the research bears out a middle-ground.

When it comes to the susceptibility of getting injured, the research shows that men and women do differ but only slightly. That is, men who are athletes get injured at a higher frequency than women who are athletes. For instance, in a study done on 1900 powerlifters (1), men sustained acute injuries at a much higher rate than women, even when training and competitive success were controlled. This is partly because, generally speaking, women have greater flexibility and range of motion than men. Further, it is also partially since women, on average, make smarter training choices than men (i.e., not ego lifting or doing more than necessary.). Hence, the main takeaway here for men is to become more flexible and drop the training ego. A good route to doing both of these simultaneously is by doing yoga. Research shows that yoga can increase flexibility & range-of-motion and decrease stress & anxiety (2,3,4) — the latter components are a potential cause contributing to the higher rate of male proclivity to bite off more than they can chew in their training. Likewise, most of these injuries muscular hip & lower back injuries. These are areas that should be mobilized with much more focus on highly active men. A good yoga routine can definitely help with this.

When it comes to the actual injury recovery process, the differences between the sexes become a bit more nuanced. This is because not all injuries are the same. For instance, in traumatic brain injuries, men and women tend to recover at a very similar rate. Still, women tend to be able to “appraise their injury-related impairments more accurately than men at discharge,” which is indicative of women in the long term fairing better than men during such recovery processes. (5) Contrastly, research shows that older men have a much better recovery time than older women regarding injuries on bodily extremities. (6,7,8) Some injuries, like muscle sprains, show almost no differences between the sexes. Hence, when they become injured, the best thing that any individual can do is consult with their doctor to discuss these differences. If you are injured and the recovery process is unfavorable to your sex, ramping up recovery techniques to a higher level than is normal, like physical therapy, rest, or occupational therapy, might help you get around the average recovery inequities. This will partially entail doing research on your injury and consulting your doctor on your findings. A good source for this is PubMed. Most articles regarding this topic on PubMed are free to the public and accessible to all. Just type in your injury with the added “sex differences in recovery” to see if you are at an advantage or disadvantage in your injury, and talk with your doctor on adjusting accordingly.

Sticking to the topic of sports-related injuries, however, studies show that women take slightly longer to recover than men. (9) In particular, the recovery process took longer to start for women — approximately 6 days longer. A lesson for female athletes in light of this research is when injured, be patient. Don’t jump back into your sport too soon and risk getting reinjured. “Sex should be considered as part of the clinical decision-making process when determining a plan of care for this population.” Such injuries are primarily ankle sprains, knee injuries, and plantar fasciitis. (10) Hence, a good tip for women involved in athletics is to work on mobility for the hips, glutes, ankles, calves, and feet. A good resource for this is the book called Becoming A Supple Leopard by Dr. Kelly Starrett.

Overall, depending on your biological sex, you might be in a better or worse situation depending on your injury. Luckily, the injury frequency rates that differ between the sexes can be mitigated through proper training and mobilization. Finding out what sort of injury you have if you are injured is the most crucial aspect in mitigating the potential inequities in recovery that gender might play a role in. This might require the work of doing some research and having hard conversations with your doctor, but ultimately it will be worth it in the long run if you want to return to your pre-injury life as soon as possible.

Citations:

  1. Patton, Andrew. What I Learned About Injury Rates from Surveying 1,900 Powerlifters. Stronger By Science (Greg Nuckols). 5 Sept 2017. Accessed 25 June 2019.

  2. Polsgrove, M Jay et al. “Impact of 10-weeks of yoga practice on flexibility and balance of college athletes.” International journal of yoga vol. 9,1 (2016): 27–34. doi:10.4103/0973–6131.171710

  3. Anne Tiedemann Sandra O’Rourke Romina Sesto Catherine Sherrington The Journals of Gerontology: Series A, Volume 68, Issue 9, September 2013, Pages 1068–1075, https://doi.org/10.1093/gerona/glt087

  4. Smith C1, Hancock H, Blake-Mortimer J, Eckert K. A randomized comparative trial of yoga and relaxation reduces stress and anxiety. Complement Ther Med. 2007 Jun;15(2):77–83. Epub 2006 Jun 21.

  5. Niemeier, Janet P et al. “Gender differences in awareness and outcomes during acute traumatic brain injury recovery.” Journal of women’s health (2002)vol. 23,7 (2014): 573–80. doi:10.1089/jwh.2013.4535

  6. Leslie R. Harrold, Judith A. Savageau, Glenn Pransky, Katy Benjamin. (2008) Understanding the role of sex differences in work injuries: Implications for primary care practice. Disability and Rehabilitation 30:1 pages 36–43.

  7. Merete K Dekkers, Kjeld Søballe. (2004) Activities and impairments in the early stage of rehabilitation after Colles’ fracture. Disability and Rehabilitation 26:11 pages 662–668.

  8. Hans Bosma, Robbert Sanderman, Winnie Scaf-Klomp, Jacques Th. M. Van Eijk, Johan Ormel, Gertrudis I.J.M. Kempen. (2004) Demographic, health-related and psychosocial predictors of changes in depressive symptoms and anxiety in late middle-aged and older persons with fall-related injuries. Psychology & Health 19:1 pages 103–115.

  9. Stone, Sarah et al. “Sex Differences in Time to Return-to-Play Progression After Sport-Related Concussion.” Sports health vol. 9,1 (): 41–44. doi:10.1177/1941738116672184

  10. Robert H. Shmerling, MD. The Gender Gap In Sports Injuries. Harvard Medical School. 3 Dec 2015. Accessed 25 June 2019.

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