I am writing in response to this article: Why More and More, Young, Fit Women Are Suffering With Hip Pain.

 

I am a Doctor of Physical Therapy who specializes in work with female athletes in Seattle, WA. Day after day I am confronted with the sad reality that our medical system has created a sense of fragility in women all over the country.

 

Throughout healthcare and the media, we continue to plant harmful seeds that a woman’s body is the source of her problems, pain, or injury, when more and more evidence tells us that this simply is not true.

 

Over and over again it is written in articles as such: “women are more likely to suffer its effects over time, partly because their biology creates the perfect recipe for hip pain of all varieties.”

 

Please, tell me: what is the biological recipe for hip pain? A concoction dealt at birth perhaps? Is it just the affliction known as, being female?

 

Statements such as this, “Women also tend to have wider hips than men and need extra-strong glutes—especially the gluteus medius, the muscle at the top of the butt—for support and stability,” are completely inaccurate.

 

The width of a woman’s hips, does not determine the required strength she needs to live her life however she sees fit and to play sports. As if women weren’t already nervous enough about the size and shape of their butts, now they need to be concerned about if they’re “strong enough” to support their activity needs. To insinuate that a naturally occurring anatomical difference makes our biological evolution somehow fail to work is not only inaccurate, but insulting.

 

Women’s biology seems to be a go-to explanation for the issues we face and is used in healthcare, sporting magazines, fitness circles and the media. This narrative implies that being born a woman dooms us to a life of injury and pain. It is as if “female-ness” is a disease and one we can do nothing to treat except to avoid potentially dangerous things.

 

Women are made to feel trapped by our bodies. Destined for a life of suffering and pain because of the way we were born. It is absolutely ridiculous. Never mind that these things are equally potentially dangerous, if not more so, to men.

 

When you dig into the literature on FAI (femoral acetabular impingement), MEN have more incidence of it than women! [1] And yet, you post: “Both sexes are equally prone to FAI.”  LIES.

 

And on top of that studies show us that radiographic findings of FAI in senior athletes are not associated with OA (osteoarthritis) and not associated with poorer function. [2]. And yet you write, “If six months of gentle workouts and PT don’t lead to significant improvement, it’s time to have your hips evaluated by a specialist, since the end stage of hip dysplasia or FAI is osteoarthritis.”

 

You implore women to BE CAREFUL out there. Telling them they need to be “gentle” with their bodies and their activity choices. Again, implying fragility.

 

When consumers read articles like this it further perpetuates the myth that valuable exercise and sport are dangerous. While once a concern, we now know that the benefits outweigh the risks. Yet your article implies that women, because of their “fragility,” are taking quite the risk by participating in sport with only an offhand disclaimer about the positive nature of this trend.

 

We know the powerful effects language and words can have on people in a negative way [3–5]. We have convincing evidence that indicates women are more susceptible to the use of scary and threatening information and language [6]. Which comes as no surprise, when women are repeatedly reading about how their bodies will break if they push them too hard.

 

As a respected resource for a safe and popular sport, you have a responsibility to provide information that is both accurate and non-threatening in nature.

 

We (women) are not wilting flowers. We are strong, robust, STABLE human beings! Our hormones are not our demise, they are our strength. I have had enough of this. Women and girls need to be less careful out there and play MORE sport.

 

Subtle, or even blatant, fear-inducing messages like these have a trickle-down effect. It starts with a concerned parent, and it ends with a girl, then a woman, afraid to push her body and explore the limits of her potential, for fear that she will break.

 

Ultimately we know our bodies have the ability to adapt. The effects that sport participation have for women and the health of women everywhere, are incredibly robust and far outweigh the risks.

 

Here’s to all the women who push hard, run fast, lift heavy, and defy the odds. I see you. I’m with you. I hear your battle cry.

 

 

Sincerely,

 

References:

1. Gerhardt MB, Romero AA, Silvers HJ, Harris DJ, Watanabe D, Mandelbaum BR. The prevalence of radiographic hip abnormalities in elite soccer players. Am J Sports Med. 2012;40: 584–588.

2. Anderson LA, Anderson MB, Kapron A, Aoki SK, Erickson JA, Chrastil J, et al. The 2015 Frank Stinchfield Award: Radiographic Abnormalities Common in Senior Athletes With Well-functioning Hips but Not Associated With Osteoarthritis. Clin Orthop Relat Res. 2016;474: 342–352.

3. Bedell SE, Graboys TB, Bedell E, Lown B. Words that harm, words that heal. Arch Intern Med. 2004;164: 1365–1368.

4. Kuzminski SJ. Sticks and Stones Can Break Your Bones, Words Can Also Hurt You. J Am Coll Radiol. 2016;13: 7.

5. Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018;48: 519–522.

6. Vambheim SM, Flaten MA. A systematic review of sex differences in the placebo and the nocebo effect. J Pain Res. 2017;10: 1831–1839.

 

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