Female athletes are susceptible to posture problems and orthopedic dysfunctions due to our sex, our architecture (skeletal frame), genetics and psychosocial pressures and concerns. Good news is that these issues can be addressed and corrected with proper screening, corrective exercises and well designed and thought out conditioning programs for the female athlete. Always assess posture and correct postural problems in an athlete before beginning a strength training program. We don't want to load an athlete with external weight on a poorly designed frame. If this happens we are putting the athlete at risk for joint destruction, pain and injury and long term problems as one grows older. Strength training with poor posture will only exacerbate poor postural positions and will cause abnormal wear and tear on and within a joint that is not aligned properly. We are also compromising the joint movements, possibly pinching nerves, reducing blood flow to muscles and connective tissue all leading to injury.
Our skeleton and spine are like the rim and spokes on a bike tire. If the frame/rim of a tire is perfectly round and strong and the spokes are the appropriate lengths providing the same tension in movement, then it will rotate well producing force with no friction on the bike itself. But if the frame/rim is slightly bent, with some spokes pulling on the frame with different tension at different times then the result is a week tire that is compromised and will not rotate well, causing friction with the bike and uneven wear, and over time will fail and break. The same can happen to our frame (skeleton and spine), which is like the rim and spokes. If our frame is not positioned well upright with proper head and shoulder girdle positioning and hip and lower leg alignment then we are prone to joint injury and movement problems. We must correct the foundation first which is our frame. Then we make sure the muscles are strong and balanced around a joint and act properly and in unison with each other to move the frame in a functional manner. It all starts with good posture and good training. For females, addressing posture, balancing muscle groups and strength training functionally (feet on the ground) along with training the stabilizers will create a sound body that is in tune and like a well oiled machine. The main goal being to function properly and adapt to pressures and forces put upon our frame and body in our everyday life and in athletics.
Lets take a look at some areas of concern for female athletes:
1. The head and neck. Females have less extensor mass so if we develop a forward head posture we are significantly increasing the load and tension on our neck muscles creating lots of head aches. At puberty females often develop a forward head posture and rounded shoulders. Correct these 2 problems early by strengthening the neck, chest, shoulders and upper back muscles to hold the correct upright postural position in the upper torso. Cues for good posture in the upper body are: chest up and lifted, head back, shoulders back, jaw over collar bone and eyes, ears and teeth level with the horizon. Our head is heavy, so keep it over your spine and sitting nicely, level on top a properly positioned shoulder girdle to avoid problems.
2. Steep first rib angle. If you have rounded shoulders and the head is jutted out in front of the body changing the shoulder girdle position then there is an increase in the angle of the first rib. This steep angle causes excessive ligament strain in the neck and may lead to the development of a Dowager's Hump. This position increases lordosis in the lumbar spine and hyperextended knees and also leads to a serious condition called Thoracic Outlet Syndrome (T.O.S.). What is T.O.S. you say? This is entrapment of the brachial plexus or the nerve bundle that feed the arms as they come out of the neck through the scalene neck muscles. Between the anterior and medial scalene muscles which are close together. The scalenes hold the head up and on top of the shoulders. If there is constant tension and strain on these muscles then adhesions form, they get enlarge, trapping and irritating the nerve bundle that brings sensation to the arm and hand. If you have pain and tingling or numbness down your arm and into the hand it may be T.O.S. The position of the neck bones is very important in this condition.
3. Shoulder girdle resting position. How our shoulder girdle is positioned over top the rib cage can affect T.O.S., aesthetics, respiration and the first rib angle. It also affects how much pressure is put on the sterno-clavicular joint. We want the rib cage sitting balanced from side to side, not twisted to one side or severely pulled down at any angle. The high repetition of sporting movements can alter the shoulder girdle with tense, tight and shortened muscles on one side. Nerves can be pinched and sterno-clavicular joint gets compressed. Stretching and working on posture with corrective exercises will help improve shoulder girdle positioning. Another great benefit of sturdy positioning is the chest and breasts are lifted creating a more attractive figure.
4. Hip and pelvic alignment or tilt. The pelvic area affects both the upper body and lower body posture. The hip area is a postural control center. Think of your pelvic area as a bucket full of water. We don't want that bucket to be tilted to far forward or backward or the water will pour out losing its weight and control. And, we don't want it pulled down and tilted from side to side. This is a great place to start making changes on posture first. If your pelvis is tilted forward you will have an increased curvature in your low back and develop a weak abdominal wall. Wide hip architecture can lead to a wider Q-angle which is associated with orthopedic dysfunction at the hip and knee producing femoral anteverson and knee valgus (knock knees). At the knee, retro-patellar dysfunction can develop which includes lateral subluxation and chronic tracking problems. Couple a wide Q-angle with knee valgus and one may also see pronation at the foot and ankle. Correcting posture and strength training can remedy all these problems listed above.
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