Preventing ACL Injuries in Female Athletes

Posted by Brigham and Women's Hospital September 25, 2014

Elizabeth Matzkin, MD

Since the passage of Title IX in 1972, there has been a dramatic increase in female athletic participation. There also has been a corresponding increase in the number of female athletes experiencing injuries. Anterior cruciate ligament (ACL) injuries are of particular concern in women.

Elizabeth G. Matzkin, MD, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and Team Physician for Stonehill College Athletics, explains why female athletes are at greater risk for ACL injuries. Though ACL reconstruction surgery can repair these injuries in the short term, many women may face an increased risk of arthritis in their knees as they age.

In this video, Dr. Matzkin advises female athletes on how they can reduce their risk of ACL injuries through proper training.

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Last-Minute Tips for Marathon Runners

Posted by Brigham and Women's Hospital April 3, 2014

Make sure that you're prepared for race day before you head to Hopkinton – and the finish line. (Photo by Steve Gilbert)

Last month, Dr. Elizabeth Matzkin, Surgical Director of the Brigham and Women’s Hospital Women’s Sports Medicine Program and Team Physician for Stonehill College Athletics, offered runners important advice on how to prevent overuse injuries, which account for over 20 percent of running injuries in the leg. Now, with the Boston Marathon only days away, she has some last-minute tips for avoiding injuries and other problems on race day.

Hopefully, you and the thousands of runners training for the Marathon have avoided the most common overuse injuries of the legs by having trained properly over the past few months. The numerous hours and miles of training are now complete, and the last bits of preparation can begin.

Here are a few last-minute tips for avoiding injuries and other problems on April 21:

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Stress Incontinence and Female Athletes

Posted by Brigham and Women's Hospital March 13, 2014

Nearly one in three young women experiences stress urinary incontinence during exercise.

Author: Joy Shine, MSPT, CLT, a senior women’s health physical therapist in the Department of Rehabilitation at Brigham and Women’s Hospital Joy also works with the Women’s Sports Medicine Program, directed by Elizabeth G. Matzkin, MD.

As a part of your training routine, you may be focused on strengthening a variety of muscle groups in your legs, arms, or abdomen. But there’s an important area you may be missing. Did you know that nearly one in three young women experiences stress urinary incontinence, or urine leakage, during exercise?

During physical activity, especially high-impact sports like running and jumping, there is an increase in intra-abdominal, or belly, pressure,” explains Joy Shine, MSPT, CLT. “The pressure causes the bladder, bladder neck, and urethra to move downward, allowing the involuntary passage of urine.”

A Training Routine for Your Pelvic Floor Muscles

Pelvic floor muscles support pelvic organs and prevent urinary leakage. If these muscles are not coordinated well enough, however, they will not effectively do their job. The good news is that simple exercises can be done to help strengthen the pelvic floor muscles and prevent urinary leakage during exercise, as well as coughing, sneezing, laughing, or heavy lifting – other common causes of stress urinary incontinence.

  • Pelvic floor muscle exercises (commonly known as Kegel exercises) are performed by contracting the pelvic floor muscles, providing closure around the anus, vagina, and urethra. During a pelvic floor muscle contraction, a squeeze and upward lifting sensation can be felt around the vagina and anus when contracting these muscles correctly. Performing three sets of 8-12 slow-velocity repetitions, two to four times a day, are advised for pelvic floor muscle strength training.
  • “The Knack” is a pre-contraction and hold of the pelvic floor muscles before and during activities that increase intra-abdominal (belly) pressure.

“The beauty of these exercises is that they can be done anywhere and at any time,” says Joy. “It’s important, however, to make sure that you are doing these exercises correctly and regularly for maximum effectiveness.”

Seeking Treatment for Urinary Incontinence

Talk with your doctor if you are experiencing symptoms of stress urinary incontinence. In some cases, your primary care physician may recommend that you work with a pelvic floor physical therapist who can guide you in the proper contraction of your pelvic floor muscles and give you tips for properly engaging your pelvic floor muscles. If these exercises don’t provide enough control over symptoms, a urogynecologist can provide additional treatment options.

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Stress Fractures in Women Who Exercise: A Red Flag?

Posted by Brigham and Women's Hospital January 28, 2014

Females who regularly exercise and experience repeat stress fractures may not be consuming enough calories and nutrients.

Today’s post was adapted from an article written for the American Academy of Orthopedic Surgeons by Dr. Elizabeth Matzkin, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and Team Physician for Stonehill College Athletics, and Emily Curry, BA,  research assistant for the Women’s Sports Medicine Program.

If you are a female who regularly exercises and experiences repeat stress fractures, take note. You may not be consuming enough calories and nutrients to sustain your current activity level.

“We are seeing more and more female athletes, including recreational athletes, with stress fractures accompanied by low energy, irregular periods, and/or decreased bone density,” says Dr. Matzkin.

Inadequate nutrition intake, abnormal menstruation, and premature bone loss are components of a spectrum of interrelated medical issues that make up what is known as the Female Athlete Triad. A stress fracture is a common symptom of the Female Athlete Triad.

“Because bone loss cannot be reversed, these women are at risk for osteoporosis, which can lead to repeat fractures and serious bone issues down the line,” explains Dr. Matzkin. “That is why it is so important to recognize and address the Female Athlete Triad as quickly as possible.”

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Being Fit: Does Size Matter?

Posted by Brigham and Women's Hospital December 23, 2013

Playing sports or being athletic doesn’t always translate into being healthy.

Today’s post, written by Dr. Elizabeth Matzkin, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and Team Physician for Stonehill College Athletics, was adapted from an article that originally appeared on  A Nation in Motion, sponsored by the American Academy of Orthopedic Surgeons.

Are bigger athletes stronger? Are thinner athletes faster? Not necessarily – different body types provide advantages in different sports. Contact athletes, such as football linemen, are often bigger compared to endurance athletes, such as cross country runners, who may be leaner. Unfortunately, neither extreme may be healthy. Being too lean or too overweight can result in health problems. Athletes need to supply the appropriate amount of energy and nutrition their body needs for their particular sport to achieve optimal health and performance.

Gaining weight does not equate to becoming stronger. Excess body weight can lead to increased blood pressure, increased cholesterol, and possible bone problems. Overweight athletes are at increased risk of injury to their muscles, bones, and joints, and their hearts have to work harder to keep blood flowing.

In contrast, being thinner does not equate to being more fit. These athletes are at higher risk of musculoskeletal injuries, such as stress fractures, as well as strains on the cardiovascular system. Female athletes who do not eat enough will have problems associated with “the female athlete triad” – low energy availability, amenorrhea (absence of menstrual periods), and low bone mineral density.

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Treating Injury and Pain: Ice or Heat?

Posted by Brigham and Women's Hospital December 5, 2013

Often when someone gets injured or feels pain, they wonder whether to treat it with cold or heat.

Today’s medical information comes from Elizabeth Matzkin, MD, Surgical Director of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and recently appointed Team Physician for Stonehill College Athletics, and Kaitlyn Whitlock, PA-C, physician assistant in the Women’s Sports Medicine Program.

Often when someone gets injured or feels pain, they wonder whether to treat it with cold or heat. Below are a few simple guidelines to help you determine which approach to take.

What should you do if you get injured from a fall or collide with something/someone?

The answer is ICE. Injuries that occur after a twist, fall, or collision may produce localized swelling and bleeding. Treating the affected area(s) immediately with ice will work as a vasoconstrictor (narrowing blood vessels), limiting the amount of bleeding and decreasing inflammation. Decreasing inflammation also will decrease pain. Heat, on the other hand will expand the blood vessels, causing more bleeding and pain.

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