Men and women show different adaptations of quadriceps activity following fatiguing contractions: an explanation for the increased incidence of sports-related knee injuries in women?

We investigated whether adaptations of quadriceps muscle activity to fatiguing exercise differs between sexes. Fifteen healthy men (age, mean ± SD; 22. ± 2.4 yr, body mass 70.5 ± 11.4 kg, height 1.72 ± 0.06 m) and 15 healthy women (age, mean ± SD; 21 ± 1.8 yr, body mass 60 ± 7.5 kg, height 1.62 ± 0.07 m), all right leg dominant, participated in the study. Participants performed a submaximal isometric knee extension contraction at 50% of the maximum voluntary contraction (MVC) sustained until task failure before and after a fatiguing exercise. Surface electromyography (EMG) was simultaneously recorded from nine regions distributed over the medial, middle and lateral locations of the quadriceps muscles in a longitudinal direction corresponding to the vastus medialis, rectus femoris (RF) and vastus lateralis muscle, respectively. A significant reduction in maximal force and time to task failure were observed after fatiguing exercise for both sexes (P < 0.001). However, women displayed greater myoelectric manifestations of fatigue specifically for the RF during the post-fatigue sustained contraction (P < 0.05). The RF is more susceptible to fatiguing exercise in women compared to men which may partly explain the higher risk of knee injuries among female athletes during competitive sports.