Gender differences in muscular protection of the knee

Abstract

This chapter summarizes the differences between male and female athletes in the knee’s anatomical structure and neuromuscular system. There are multiple protective systems for the anterior cruciate ligament (ACL) during physical activity, including the knee’s anatomical structure and neuromuscular system. This system generates and limits the inherent qualities of the knee including laxity, stiffness, and strength. Parameters of this system that may be tested include proprioception, muscle reaction time, and muscle time to peak torque. Gender differences exist in neuromuscular indices, as well as in balance and hamstring-quadriceps recruitment patterns. However, the influence of these differences on ACL injury susceptibility remains uncertain. This is due to a lack of a clear understanding of the multifactorial mechanism of ACL injuries, especially in the female population, with newer evidence pointing toward structural, mechanical, and neuromuscular factors. Continued research in neuromuscular control is justified because unlike many anatomical and physiological factors, it is modifiable.