By Dr. Ashley Austin
As the primary care sports medicine doctor for the New York Liberty — and a former Division I athlete — I’ve seen more sports injuries than I can count.
It’s easy to get injured doing what we love — injury prevention, treatment, and recovery are natural parts of any athlete’s journey. But even as more eyes turn to women’s sports, and female athletes surge in popularity, there’s still a great deal that sports medicine doctors don’t know about actually treating women.
We need increased investment in women’s sports science — not just to improve outcomes for elite athletes, but to improve care for women and girls across the healthcare system.
Women have long been underrepresented in medical research. Before Congress mandated inclusion in the 1990s, researchers rarely included women in medical trials. In the 1970s, the Food and Drug Administration even explicitly recommended excluding women of childbearing potential. Many — predominantly male — researchers simply considered male bodies the norm, and assumed that they could apply the results of all-male trials to women.
But women are not just “tiny men.” They have very different anatomies and physiologies, which in turn respond very differently to physical activity compared to men — especially as they get older. I’ve seen it firsthand.
Women routinely undergo significant hormonal and bodily changes that can dramatically affect their movement. I’ve previously written, for instance, about how pregnancy affects women’s movement — and that we need intentional and individualized approaches to optimize postpartum recovery.
Many are familiar with the hormone-induced changes that occur in pregnancy. Similarly, the aging woman experiences musculoskeletal changes. Some are directly due to hormones, and many are entirely unique to women.
As women age and eventually enter menopause, their estrogen levels decrease. That decline can lead to reduced muscle mass and bone mineral density. Women can lose about 2% of bone mass each year before menopause — and at least 3% after. As a result, women face a greater risk of osteoporosis. With a weakened bone anchor system, they are also at an increased risk of musculoskeletal injuries like tendon injuries — such as rotator cuff tears — and stress fractures.
Women are now competing and working out at high intensity levels for longer than ever before, both at the professional and recreational level. We need to expand our understanding of how best to support them and aid injury prevention and longevity.
Now’s the time to push for more research efforts and funding. Women’s sports have never been so popular. Media coverage for women’s sports reached a record 15% in 2024.
We’re entering a new era for women’s sports. It’s time for women’s medicine to catch up.
Dr. Ashley Austin is a Primary Sports Medicine Physician in the Women’s Sports Medicine Center at Hospital for Special Surgery (HSS) in New York City. This piece originally ran in Newsweek.
