Mark Herz: Women’s sports are on the rise in Massachusetts. We’ve got professional women’s hockey seing sold out crowds and a professional women’s soccer team starting play next year. And if you are watching the Super Bowl, another sport getting a push is girl’s flag football. Another aspect of women’s sports coming to the forefront, unfortunately, is the amount of injuries. According to an article in Harvard Health Publishing, women are more prone than men to suffer many of the most common sports-related injuries. Lauren Pak is a longtime local devotee of flag football and an athletic trainer who, along with her husband Jason, has over a million followers on Instagram. She also recently injured her knee playing her beloved sport. She joins us now along with her physical therapist, Lenny Macrina, out of Waltham, to learn more about what causes these kinds of injuries and why women are more at risk for them. Lauren, Lenny, thanks for joining us.

Lauren Pak: Thanks for having us.

Lenny Macrina: Thank you.

Herz: Lauren, this was this was pretty emotional for you. I follow you on Instagram and I was surprised when that happened to you. I felt for you. And you’ve been really brave and open about this journey you’re on now and you’re still on. Can you share some of that, how this happened and what it’s been like for you?

Pak: Sure. Yeah. So I think a lot of people were surprised by this injury, myself included. This was something that I trained to avoid. I’ve been a personal trainer for the past almost 20 years. I’ve learned a lot about anatomy, physiology. Injury is not always avoidable, but I was at least trying to prevent it as much as possible. And still I ended up tearing my ACL playing flag football. It was a non-contact injury. It was just a plant and change direction, I heard the pop of my knee and knew immediately what it was. And it was pretty devastating just knowing that this is a very long road to recovery. I am in my late 30s, so I’m losing my time as an athlete in terms of being able to continue playing flag football. So there was a lot of moments that were pretty emotional about this injury.

Herz: Yeah. Well, Lenny, what’s it like when women or girls who are very active like Lauren and they come in with a knee injury, and that happens to them because of the sports they’re playing in particular?

Macrina: Yeah, it’s an emotional time for everybody, especially the patient and the family. Everybody is affected and they are about to embark on a journey with me that takes months, sometimes over a year, to get back. And so it’s a very emotional time for me to help them through that, both physically and mentally.

Herz: OK and tell us more about the recovery process. Lauren, let’s start with you. I didn’t know that, actually, that it might actually be a whole year. You’re a few months in, I think now.

Pak: I’m currently almost four months, three and a half months post-op, four and a half months post-injury. So I had about a month in between having the injury, getting the MRI, getting on the surgeon’s schedule and all of that. Then I’m about 14 weeks post-op now. And it was an ACL rupture and a meniscus tear. So it was sort of a double surgery, double recovery. The meniscus adds a little bit of extra time at the beginning for not being able to bear weight. So having to be on crutches with your leg fully locked out in a brace. It’s just a very long journey. Even though it was six weeks non-weight bearing, that felt like forever to me as somebody who is a very active person. So those weeks feel like an eternity when you’re in it.

Herz: Yeah, I can imagine. And Lauren said that she had trained to avoid this. Lenny, I’m sure you don’t just help people after this has happened, like you’re helping Lauren and other people post-surgery. But I’ve been in PT myself. I know prevention is a big deal. So tell us, how do we understand prevention?

Macrina: Yeah, we’re learning, but we don’t know it all — and that seems to be the case for most things. Injuries will happen, unfortunately, you just hope it doesn’t happen to you. But there are programs out there that help to reduce the amount of injury, especially for organized sports. You look at what used to be called the FIFA 11. It’s now called the 11+ program that’s been out there — or that is out there — and it’s kind of a 20-minute program that people can do prior to a game or prior to a practice, especially for soccer, lacrosse and sports of that nature that we call a level one sport with a lot of running, cutting, and jumping. There’s a pep program and others that help to reduce injuries. There is some research to show that injury reduction can occur in maybe about a 50% reduction, but it’s not a 100% reduction. So it’s up to us to try to train them with jumping correctly, working on strength training, hip strengthening, core strengthening, and landing correctly from a jump. So many different aspects we can train in all of our athletes. Unfortunately, females have a higher risk and so we do our best, but it still does occur.

Herz: I just want to stick with you, Lenny, for a moment. You said females have a higher risk. Do we understand why that is?

Macrina: It’s evolving. We have some theories. Some theories get thrown out. It’s complicated. Some say it has to do with hormones, laxity in the tissue. Some say that it’s maybe landing techniques. It could be the position of ... what we call a leg position, a femur position, so a thigh bone position that might be more prone for injury. Females play more sports now than they ever have before. There’s so many different avenues to go down, but it’s still not 100% known why.

Herz: Well, Lauren, you’re an expert on training and injury prevention in your own right. So what has this taught you? And for you and your husband, Jason, who do this together, has this redirected you in terms of what you’re putting out there in terms of content, trying to help people?

Pak: I yeah, I actually had like a small existential crisis at the beginning when this happened because I felt like, am I a fraud and then the more I looked into what is out there for trying to minimize the risk for injury, for ACL tears, I was doing it all. And so it’s OK that this happened. It doesn’t mean I was doing anything wrong and obviously it means that I can still look at my training a little bit differently, try to make any adjustments that I possibly can work with, wanting to try to make sure I don’t have any imbalances that I didn’t know about. All of those things I’m going to be working on and I’m going to be sharing, but I think continuing to put out information about how to be strong and how to move well, all of that is going to continue because something that I’ve noticed that has been very eye opening for me is how much my level of fitness has helped me in this recovery. So it didn’t end up preventing this injury, but it has made my recovery so much easier. I think that that’s something worth sharing as well.

Herz: Sounds like it. Lauren Pak, a local flag football devotee and somebody on the recovery from a knee injury, sharing her expertise. And also Lenny Macrina, her physical therapist. Really great to hear from you. Thank you both.

Macrina: Thank you for having us.

Herz: My pleasure. This is GBH.

All over the country, women’s sports have seen a meteoric rise . The Bay State has been no exception to this. Massachusetts got a new women’s professional hockey team last year, and will soon add a women’s soccer team to its roster with BOS Nation FC.

But with this massive growth in women’s sports, physicians are seeing an alarming rise in women’s sports injuries, which can entail a long and difficult recovery.

Lauren Pak is a personal trainer and fitness influencer who, along with her husband Jason, has over 1 million followers on Instagram . She knows the difficulty of dealing with physical injuries all too well, following a recent ACL and meniscus tear while playing flag football.

“It was a non-contact injury,” she recalled. “It was just a plant and change direction, I heard the pop of my knee and knew immediately what it was.”

Pak, in her mid-30s, says the injury was devastating given her age and the length of recovery, which doctors say could take up to a year.

“It’s just a very long journey,” she said reflecting on the surgery. “Even though it was six weeks non-weight bearing, that felt like forever to me as somebody who is a very active person.”

Lenny Macrina is Pak’s Waltham-based physical therapist . He says that women experience higher risks of sports injury than men, though the exact reason is unknown.

“Some say it is has to do with hormones [or] laxity in the tissue. Some say that it’s maybe landing techniques. It could be ... a thigh bone position that might be more prone for injury,” he said.

One thing that is known, Macrina said, is the importance of injury prevention training.

“Injuries will happen,” he said. “Unfortunately, you just hope it doesn’t happen to you. But there are programs out there that help to reduce the amount of injury.”

Those include the FIFA 11+ Program , a 20-minute exercise plan that can be done prior to a game or practice, particularly for soccer, lacrosse, and other sports with a lot of running, cutting and jumping.

“There is some research to show that injury reduction can occur in maybe about a 50% reduction, but it’s not a 100% reduction,” Macrina said. “So it’s up to us to try to train [athletes] with jumping correctly, working on strength training ... and landing correctly from a jump.”

Pak trained with all that in mind. While she knows injuries can happen even with prevention techniques, she said it was emotionally challenging.

“It’s OK that this happened. It doesn’t mean I was doing anything wrong,” Pak said. “Obviously it means that I can still look at my training a little bit differently, try to make any adjustments that I possibly can work with.”

As Pak heals, she said she’ll keep putting out content on how to be strong and move well, noting that her physical fitness has made her recovery easier. “I think that that’s something worth sharing as well,” she said.