Gendered sport environments and their theoretical contributions to women's ACL injury risk: a scoping review

Abstract

Objective To summarize the current literature that describes the gendered environments of women’s sports which are higher risk for ACL injury, and determine whether the existing literature relates gendered aspects of the sport environment to injury.

Data sources Electronic search of Medline, Embase, CINAHL, SPORTDiscus, SCOPUS, and Women’s Studies International databases from inception to March 2024.

Eligibility criteria Studies were included if at least 50% of the study participants were adult women participating in organized sports with higher risk for ACL injury.

Results Of the initially identified 17,148 studies, 854 underwent full text review, and 73 were included in this scoping review. In 19 studies, reference to injury was restricted to one or two direct quotes from an athlete and the other 54 studies had no mention of injury. We identified three repeating patterns describing the gendered sport environments that women athletes encounter. Fifty-five studies described embedded stereotypes that devalue women and women’s sport. Forty-five studies described ways the sport environment reproduces restrictive gender norms for women. Forty-six studies reported that gendered inequities including gendered wage inequality and provision of subpar training facilities were structurally embedded in women’s sport environments.

Conclusion Existing literature describes a range of gendered inequities that exist for women in their sport environments; however, there has been no concerted effort to date to link those gendered environmental factors to ACL injury. Such research is needed if we are serious about eliminating the ACL injury rate disparity between women and men.

What is already known

Historically, gendered disparities in anterior cruciate ligament injury risk have focused on biological explanations

Societal gendered norms and expectations of women can greatly affect their experiences and opportunities in sport environments

What are the new findings

Existing literature describes a range of gendered inequities that exist for women in their sport environments

Only a small percentage (∼25%) of studies describing the gendered aspects of women’s sport environments mention any relation to injury

There has been no concerted effort to link gendered aspects of sport environments to women’s injury risk and experiences

Competing Interest Statement

The authors have declared no competing interest.

Clinical Protocols

https://osf.io/9b7kh

Funding Statement

This work was supported by the Social Sciences and Humanities Research Council through the UM/SSHRC Explore Grants Program

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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Data Availability

All data produced in the present work are contained in the manuscript

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