What Girls Aren’t Always Taught: Soft Tissue Doesn’t Heal Like Bone

A conversation with Dr. Dee and Dr. Livesay on knees, training load, and why “push through” can backfire


TL;DW - here's a succinct summary of our conversation with Dr. Dee and Dr. Livesay !


In girls’ sports, pain is often treated like a motivation problem: work harder, stretch more, tough it out. But in this conversation, Dr. Dee and Dr. Livesay (engineering and biomechanics researchers) make a different point: sometimes pain is not something to conquer — it’s information.

Their biggest message for young athletes is about a body system that gets misunderstood constantly: soft tissue.


What Girls Aren’t Being Taught

Athletes learn a lot about conditioning, strength, and form — but many don’t learn a basic (and crucial) reality: Ligaments, tendons, and cartilage do not behave — or heal — like bone and muscle.

Bones and muscles are richly supplied with blood, which brings oxygen and nutrients (an “infinite buffet,” as they describe it). But many soft tissues are comparatively avascular, meaning they have far less direct blood supply. That matters because it changes everything about recovery:


Micro-Tears: The Injury You Don’t See Until It’s Big

One of the most useful ideas they shared is that many “sudden” injuries aren’t sudden at all. Soft tissue can accumulate micro-tears over time — tiny disruptions that feel like soreness or tightness. If the body doesn’t get enough time to remodel and repair, those micro-tears can compound until one moment becomes the breaking point.


They describe it like patching a wall quickly: your body can fill the gap fast, but early repair is often less organized and more vulnerable. If you keep loading it too soon, you can turn a manageable issue into a catastrophic one.


Why “Don’t Bounce When You Stretch” Actually Matters

Athletes hear this cue all the time — but rarely get the science behind it. Soft tissue is viscoelastic (they compare it to taffy or Silly Putty):


Bouncing during a stretch can spike load on tissues and contribute to micro-damage over time. So the “slow and controlled” advice isn’t about being cautious — it’s about how tissue actually behaves.


Fatigue Changes Mechanics Before You Notice

They also highlight something coaches don’t always teach clearly: many injuries happen late — not because athletes are weak, but because fatigue changes timing and positioning. 

When the body is tired, tiny shifts in mechanics matter: a foot lands a centimeter off, the knee angle changes slightly, alignment drifts — and that can be enough to overload vulnerable tissue.

That’s why “form, form, form” isn’t just about performance — it’s protection.


Girls Need Permission to Listen to Their Body

A big thread in this conversation is that young athletes often feel pressure to override discomfort. 

But biomechanics researchers frame it differently: If something hurts, that’s data. And learning to interpret that data is a performance skill.

They also touched on the complexity around menstrual cycles and injury risk: there may be statistical patterns, but that doesn’t automatically mean hormones “weaken ligaments.” It may be driven by fatigue, sleep disruption, pain, stress, or altered movement patterns — reminding us how often girls are left without clear education for what’s happening in their bodies.


Where Engineering Can Help

They offer a powerful lens: injury risk isn’t one simple “female vs male” explanation — it’s distributions, variability, and systems. Engineering approaches can help by:


Their practical takeaway is surprisingly simple: Train as close as possible to how you compete — same surfaces, same footwear, same movement demands — so your body isn’t surprised when it matters most.