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March 16, 2000 (Los Angeles) -- Women may be at higher risk for sports-related injuries than men simply because they are less fit, according to a study in the American Journal of Preventive Medicine. "The key risk factor for training injuries appears to be physical fitness, particularly cardiovascular fitness," not gender, the authors write.

Lead author Nicole Bell, ScD, MPH, and colleagues followed more than 500 male and more than 350 female Army recruits through a standard eight-week basic training course. They evaluated physical fitness levels by measuring times for both a one- and a two-mile run and by measuring the number of sit-ups and push-ups each person could do at the beginning and at the end of the course. During the eight weeks, the women experienced twice as many injuries as the men, including nearly 2.5 times as many serious injuries requiring significant loss of time.

However, gender differences diminished when the investigators classified injury risk according to level of fitness. Among the fastest women runners, the risk of injury was nearly identical to that of the fastest men, and with each descending level of fitness, as measured by run time, the risk of injury remained similar between the sexes.

"The military draws from the general population, so what we can say is that a lot of women are getting hurt because there are a lot of unfit women in the general population," Bell tells WebMD.

By the end of the training cycle, the women had narrowed the fitness gap considerably, making significantly greater improvements than did the men. According to Bell and her colleagues, these findings support previous studies showing that people who start training at a lower level of fitness improve more dramatically, relative to those who were in better condition to begin with.

A parallel in civilian life can be seen in the "weekend warrior," who is sedentary all week and then injures herself during a weekend tennis game, says Janet Freedman, MD, assistant professor of rehabilitative medicine at New York University and author of the chapter on exercise in The Complete Women's Healthbook, published by the American Medical Women's Association. "We tell people that they need to be in better shape to do the activity." Freedman, who was not involved in the study, encourages her patients to pursue a regular exercise program during the week so they are fit enough to engage in weekend sports.

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