Women and Knee Pain

Women and Knee Pain 

By Daniel Rocha LMT CPT CNS 

The knee joint is made of bone, ligaments, cartilage, and fluid and moves with the help of surrounding muscles and tendons. If any of these structures is degraded, the knee becomes injured. Whether it is a minor or significant problem, a knee injury will involve a certain amount of pain and a degree of difficulty in walking.

The five most familiar knee problems are arthritis, tendonitis, bruises, cartilage tears, and damaged ligaments, with arthritis being the most prevalent problem of the bones of the knee. The ligaments and tendons of the knee also become injured, whereas the anterior cruciate ligament (ACL) damage is a predominant problem of knee ligaments and tendons. Knee injuries occur due to accidents, impacts, traumas, sudden or awkward misalignments, and degeneration.

Minor knee injuries can be treated at home with rest and ice packs. Serious injuries require physicians, surgeons, and rehabilitation experts. Various surgeries are required to correct the worst knee injuries, such as a ruptured ligament or tendon.

Risks that increase knee injuries include:

  • Excessive weight, being obese, because of the additional weight being carried in part by the knees.
  • Sports and activities that are considered high risk for knee injuries, such as basketball, racquetball, downhill skiing, and tennis.
  • Overuse, repeated activities can lead to fatigue in the muscles around the joints and contribute to tissue damage.
  • Neuromuscular abnormalities, such as different lengths for legs and misaligned knees, can increase the likelihood of knee injuries.
  • Muscle inflexibility and weakness provides less support for the knee and adds to more stress placed upon the knees.
  • Previous injuries to the knee make is more likely that future knee injuries will occur.
  • Gender increases the likelihood of certain types of knee problems; that is, males are more likely to have some knee problems (such as a dislocated kneecap), while females are more likely to have others (such as Osgood–Schlatter disease).
  • Age increases the likelihood of more knee problems. (Dupler 2020)


Women and knee injuries 


The knee is susceptible to injury at all times, as it must withstand impacts of three to four times one's body weight. Sports increase these stressors. Nearly every woman will encounter knee pain at some point as women are particularly defenseless. Women have more acute and chronic injuries and more overuse syndromes of the knee than men due to anatomy involving poor exercise training or hormones. Women now participate more in athletics, increasing the number of sports-related knee injuries in girls and women.

Women are different from men

Women suffer more knee injuries and chronic knee pain than men do. That has been reflected since the 1970s where female school sports have risen 800%. More women now participate in organized athletic programs, but they also incur a disproportionate number of knee injuries.

At the college level, 1 in 10 women athletes will suffer a severe knee injury, compared to only 1 in 50 college-aged male athletes. In high school, even where the play is less intense, the total number of knee injuries increases to an estimated 50,000 annually. ACL tears account for the most significant proportion of these injuries: they're three to four times more widespread among women than men.

The factors involved in this phenomenon include that women have wider hips than men do, causing the femur to descend at a further inward angle, placing a more significant load on the inside of the knee. This inward angle stresses the ACL and distributes the weight on the joint unevenly, causing degeneration of the cartilage. Women have some inherent loosening of the ligaments around the knee due to hormonal changes during the menstrual cycle which affects ligament laxity.

Another factor involves when women jump, landing with their knees inward, stressing the ACL and the collateral ligaments and cartilage. Note that the notch through which the ACL passes is narrower for women than men, making it more susceptible to tearing.

Women’s quadriceps muscles are considerably stronger than their hamstrings, putting strain on the ligaments, especially the ACL, which is used to stabilize the knee during jumps, turns, and slowing down from running.

Women do not run as men do. Studies have shown that women rely more on their quadriceps muscles, and men use these muscles equally. Women run more upright; men run in a more crouched position. Women do not bend their knees when changing direction rapidly, placing more stress on the inside of the knee.


For a naprapath, massage therapist, or physical therapist, it is essential to know the structural components of the knee as well as the orthopedic tests involved to diagnose a knee injury. Knee injuries are more prevalent among women and can provide a manual therapist with a better approach when treating female athletes. Women are structurally different and move differently than men, so the risk of injury increases with sports activity. Knowing the differences improves the patient’s treatment and after-care, including corrective exercise. 

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Dupler, D. (2020). Knee Injuries. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine (6th ed., Vol. 5, pp. 2922-2925). Gale. https://link.gale.com/apps/doc/CX7986601067/HWRC?u=lirn33148&sid=bookmark-HWRC&xid=d3d2dae3


Joint Problems - Soft-tissue knee injuries in women. (2002, July). Harvard Women's Health Watch, 9(11). https://link.gale.com/apps/doc/A87075796/HWRC?u=lirn33148&sid=bookmark-HWRC&xid=ca53c625

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