The Women Who Taught Me the Most About Resilience: A Note on Treating Female Athletes in St. Johns County

The female athletes I treat are some of the most resilient, determined, and underserved patients in my practice.

I want to change that.

There is the 52-year-old pickleball player who was told by two different providers that her hip pain was 'just arthritis' and she should 'take it easy.' She came to me frustrated and frankly a little defeated. Eight weeks later, she was back on the court — stronger and more confident than before.

There is the CrossFit mom in her mid-forties who had been quietly managing pelvic floor symptoms for years because no one had ever told her that a physical therapist could help with that. She thought it was just something she had to live with after having kids. It is not.

There is the 60-year-old runner who completed a half marathon six months after a hip replacement, because she refused to accept that her running days were behind her. She was right to refuse.

Each of these women came in with different conditions, different goals, and different histories. What they had in common was that their concerns had been minimized somewhere along the way. That is something I take seriously.

This is not just about being sensitive or inclusive — it is about physiology. Female biomechanics are genuinely different from male biomechanics in ways that directly affect injury patterns, recovery timelines, and treatment approaches.

A few examples that matter clinically:

• Hip and knee alignment: Women typically have a wider pelvis relative to femur length, which creates a greater Q-angle at the knee. This contributes to higher rates of ACL tears, patellofemoral pain, and IT band issues in female runners and athletes.
• Hormonal fluctuations: Estrogen levels affect ligament laxity throughout the menstrual cycle. Research increasingly shows that injury risk — particularly ACL and other ligament injuries — is not uniform across the month. This matters for training load management.
• Pelvic floor function: This is one of the most underaddressed areas in women's health PT. Core stability, hip function, and pelvic floor health are deeply interconnected. Issues here affect performance and recovery in ways that go far beyond the obvious.

Women in sports and fitness often get a diluted version of performance-based care. The assumption — sometimes unconscious, sometimes not — is that female patients want a less aggressive, more conservative approach. In my experience, that is often exactly backwards.

The active women I treat in Jacksonville and St. Johns County are not looking to be managed. They want to compete. They want to keep up with their grandchildren, finish their race, swing the club, and live without pain. They deserve a clinical approach that matches that ambition.

Performance physiotherapy for female athletes means taking the goal seriously. It means understanding the physiology. It means not settling for 'good enough' when the patient clearly has not settled for it herself.

To every female patient who has trusted me with their care — thank you for pushing back when the answer did not feel right. Thank you for advocating for yourselves. Thank you for showing up with high expectations. You have made me a better clinician.

If you are an active woman in the Jacksonville or St. Johns County area who has been told to rest, wait it out, or accept your limitations — I would encourage you to get a second opinion. Your goals are worth fighting for.

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