Women are often more prone to certain orthopedic conditions due to differences in anatomy, hormonal influences, and lifestyle factors. Here, we explore some of the most common orthopedic conditions that affect women.
Frozen Shoulder (Adhesive Capsulitis)
Overview: Frozen shoulder, or adhesive capsulitis, occurs when the tissues surrounding the shoulder joint thicken and tighten, leading to restricted movement and significant pain. While the exact cause remains unclear, it often develops after periods of immobility following injury or surgery. It is most prevalent among individuals aged 40 to 60 and is more common in women than in men.
Causes and Risk Factors: The risk of developing a frozen shoulder increases after shoulder surgeries or injuries that limit arm movement. People with systemic diseases such as diabetes, hyperthyroidism, or cardiovascular disease are also at a higher risk. Hormonal differences, particularly around menopause, may contribute to the higher incidence in women.
Symptoms:
- Gradual onset of pain and stiffness in the shoulder
- Limited range of motion, both passive and active
- Difficulty performing everyday tasks such as reaching overhead or behind the back
Diagnosis: A diagnosis is typically made through a clinical examination and medical history. Imaging tests like X-rays and MRI may be used to rule out other conditions.
Treatment:
- Non-surgical: Physical therapy, anti-inflammatory medications, corticosteroid injections, and shoulder manipulation.
- Surgical: Arthroscopic surgery may be considered in severe cases to remove scar tissue and release the joint capsule.
Prevention: Maintaining shoulder mobility and performing regular exercises can help prevent frozen shoulder, especially after an injury or surgery.
ACL Injuries
Overview: The Anterior Cruciate Ligament (ACL) is crucial for stabilizing the knee during activities that involve sudden stops, changes in direction, or pivoting movements. ACL injuries are particularly common in athletes who participate in high-impact sports such as soccer, basketball, and skiing. Studies have shown that female athletes are at a higher risk of ACL injuries than their male counterparts.
Causes and Risk Factors: Women are more susceptible to ACL injuries due to a combination of anatomical, hormonal, and biomechanical factors. These include:
- A wider pelvis, which affects the alignment of the femur and tibia.
- Greater joint laxity, which may be influenced by estrogen levels.
- Differences in neuromuscular control, which can affect landing mechanics and knee stability.
Symptoms:
- A “popping” sensation at the time of injury
- Rapid swelling and severe pain
- Instability or inability to bear weight on the affected leg
Diagnosis: An ACL tear is often diagnosed with a physical examination followed by imaging studies, such as MRI, to assess the extent of the injury.
Treatment:
- Non-surgical: Physical therapy, bracing, and activity modification for partial tears or less active individuals.
- Surgical: ACL reconstruction surgery is recommended for complete tears, particularly in athletes or active individuals.
Prevention: Injury prevention programs focusing on strength, balance, and proper landing techniques can significantly reduce the risk of ACL injuries in female athletes.
Ankle Injuries
Overview: Ankle injuries, such as sprains, anterior tibialis tendonitis, and posterior tibialis tendonitis, are common in women and can be attributed to several factors, including anatomical differences and footwear choices.
Causes and Risk Factors:
- Wearing high-heeled or unstable footwear increases the risk of ankle sprains.
- Anatomical differences, such as a narrower heel and increased pronation, can lead to greater instability.
- Engaging in sports or physical activities without proper footwear or warm-up exercises.
Symptoms:
- Pain, swelling, and bruising around the ankle
- Difficulty walking or bearing weight
- Instability in the ankle joint
Diagnosis: A clinical examination and imaging tests, such as X-rays or MRI, are used to diagnose the extent of the injury and rule out fractures.
Treatment:
- Non-surgical: RICE (Rest, Ice, Compression, Elevation), physical therapy, and bracing.
- Surgical: Surgery may be required in cases of severe ligament tears or fractures.
Prevention: Strengthening exercises, balance training, and wearing appropriate footwear can help prevent ankle injuries.
Neuroma
Overview: A neuroma is a benign growth of nerve tissue that most commonly develops between the third and fourth toes. Women are more prone to developing neuromas due to anatomical foot differences and the frequent wearing of narrow or high-heeled shoes.
Causes and Risk Factors:
- Wearing tight or ill-fitting shoes that compress the toes.
- High-impact activities that put repetitive stress on the feet.
- Anatomical factors such as a high arch or flat feet.
Symptoms:
- Tingling, burning, or numbness in the affected toes
- Pain that worsens with activity or wearing shoes
- A feeling of a pebble or lump under the ball of the foot
Diagnosis: Diagnosis is primarily based on a clinical examination, but imaging tests like ultrasound or MRI may be used to confirm the diagnosis.
Treatment:
- Non-surgical: Padding, orthotic devices, anti-inflammatory medications, and corticosteroid injections.
- Surgical: Neurectomy may be performed if conservative treatments fail to relieve symptoms.
Prevention: Wearing properly fitting shoes with adequate support and avoiding high heels can help prevent neuromas.
Thumb CMC Arthritis
Overview: Carpometacarpal (CMC) arthritis at the base of the thumb is more common in women, particularly after menopause. Estrogen is believed to play a role in joint laxity and wear.
Causes and Risk Factors:
- Aging and joint degeneration
- Hormonal influences, particularly post-menopausal estrogen decline
- Repetitive stress or overuse of the thumb joint
Symptoms:
- Pain at the base of the thumb, especially during pinching or gripping activities
- Swelling and tenderness
- Decreased strength and range of motion
Diagnosis: A clinical examination and X-rays are typically used to diagnose CMC arthritis and assess the extent of joint damage.
Treatment:
- Non-surgical: Splinting, anti-inflammatory medications, corticosteroid injections, and physical therapy.
- Surgical: In severe cases, joint reconstruction or arthroplasty may be required.
Prevention: Avoiding repetitive thumb movements and using ergonomic tools can help reduce the risk of developing CMC arthritis.
Trigger Finger
Overview: Trigger finger occurs when the flexor tendon in the finger becomes inflamed, causing it to catch or lock when bending. This condition is more common in women, particularly in the 40 to 60 age range.
Causes and Risk Factors:
- Repetitive hand use or gripping
- Conditions such as diabetes and rheumatoid arthritis
- Hormonal changes that affect tendon elasticity
Symptoms:
- Pain and tenderness at the base of the affected finger
- Stiffness and a “catching” sensation when moving the finger
- A clicking or popping sound when the finger is extended
Diagnosis: A diagnosis is usually made based on symptoms and a physical examination. Ultrasound may be used to visualize the tendon and confirm the diagnosis.
Treatment:
- Non-surgical: Rest, splinting, anti-inflammatory medications, and corticosteroid injections.
- Surgical: Release of the A1 pulley to allow smooth tendon movement.
Prevention: Avoiding repetitive gripping or pinching motions can help prevent trigger finger.
Ganglion Cysts
Overview: Ganglion cysts are fluid-filled lumps that commonly form on the back of the wrist or the base of the fingers. These cysts are more prevalent in women and are often associated with repetitive stress or arthritis.
Causes and Risk Factors:
- Repetitive wrist or hand movements
- Joint or tendon irritation
- Osteoarthritis
Symptoms:
- A visible lump or swelling
- Pain or discomfort, especially with wrist movements
- Numbness or tingling if the cyst presses on a nerve
Diagnosis: Diagnosis is primarily clinical, supported by imaging studies such as ultrasound or MRI to determine the cyst’s size and location.
Treatment:
- Non-surgical: Observation, aspiration of the cyst, and immobilization.
- Surgical: Excision of the cyst if it causes significant symptoms or recurs frequently.
Prevention: Avoiding repetitive wrist movements and managing underlying conditions like arthritis can help prevent ganglion cysts.
Osteoporosis
Overview: Osteoporosis is characterized by a loss of bone density, increasing the risk of fractures. It is significantly more common in women, particularly post-menopausal women, due to the decrease in estrogen, which helps maintain bone density.
Causes and Risk Factors:
- Hormonal changes, particularly reduced estrogen levels after menopause
- Family history of osteoporosis
- Inadequate calcium and vitamin D intake
- Sedentary lifestyle and lack of weight-bearing exercise
Symptoms: Osteoporosis is often asymptomatic until a fracture occurs. Common sites for fractures include the hip, spine, arm, or leg as a result of a fall.
Diagnosis: Bone density scans (DEXA scans) are the standard for diagnosing osteoporosis and assessing fracture risk.
Treatment:
- Non-surgical: Calcium and vitamin D supplementation, bisphosphonates, hormone replacement therapy, and weight-bearing exercises.
- Surgical: Surgical intervention may be necessary for fractures resulting from osteoporosis.
Prevention: Adequate calcium and vitamin D intake, regular weight-bearing exercise, and lifestyle modifications such as quitting smoking and reducing alcohol consumption can help prevent osteoporosis.
While these orthopedic conditions are common in women, they can affect anyone. Understanding the risk factors, symptoms, and treatment options is crucial for early diagnosis and effective management. If you are concerned about any of these conditions or would like more information on prevention, consider scheduling an appointment with your orthopedic surgeon.
By staying informed and proactive, you can better manage your orthopedic health and maintain an active, pain-free lifestyle.
