Upside Down Medicine

                                                              Joints and Gender

My training as a psychiatrist taught and emphasized the skill of being what I would call a human ethologist. We were to be keen observers of human behaviors, emotions, and motivations, the three pillars of what defines the world of human psychology, much as Jane Goodall observed and studied chimpanzees in Africa. In retrospect, our program at the University of Colorado was exceptional in this regard. I cannot NOT be a human ethologist anymore; it's in my blood.

In my daily office practice, I get to observe many people, more than half of them women. Aside from monitoring their psychological presentations, one cannot avoid their physical gestures as well. I have been struck by how very much women's joint ankles differ from those of my male patients. Indeed, I have also witnessed these differences in all non patients as well. I shall attempt to describe these differences in writing rather than attempt a diagram.

The angles of women's ankles are a good start. My female patients often sit relatively upright on the couch, feet close together, often parallel to one another. More commonly, the woman's has pointed the fronts of her feet towards one another, sometimes creating nearly a 90 degree angle with each other. Most men, by contrast, seem to sit back in the couch, fronts of their feet pointed away from one another. legs splayed apart.  Much as I've tried to have my feet mimic those of my female patients, I found the acute pointed angle difficult to achieve and painful to maintain.

One might argue these typical foot positions represent purely learned behavior, borne of a need to maintain an abundance of modesty.  Perhaps some of this is so,  but I believe that not modesty, but biology, is the more critical factor here. Women's joints are differently angled than men's. If this hypothesis is true,  might it not be the case for other joints as well? Lets examine.

In addition to the office setting, I had many opportunities to take a walking lunch hour in downtown Pittsburgh. Particularly in the summer, when, fewer coverings are needed, I observed again and again the following:  Women's knee joints pointed ever so subtly inward towards their bodies; men's knees are pointed outward. Similarly, when the woman holds her arms down at her sides, her elbows are also pointed medially, while men's elbow's are truly bowed outward. I said above "when the woman holds her arms down at her sides" advisedly, because she mostly do not. Typically, she is holding her arms towards her waist. Her hand are close together near her midriff, her elbows pointed dramatically outward.

Having made this observation, other common female gestures now made more sense. Picture, for example, the female weather forecaster on your local network; see if she is not most comfortable holding her arms just as I've described above. She would seem to feel awkward and uncomfortable holding her arms by her sides like her male peers. Now I could see why women carry their often large purses effortlessly and seemingly comfortably  n the crook of their elbows: this would appear to be their default elbow comfort position. Myself, a male, could not conceive of carrying anything comfortably in the crook of my elbow,.

Now I thought back to my high school years. In those long forgotten days, we still had school books to carry from class to class or to home. How did the boys carry their books? In their down- straightened arms. And how did the girls carry? With, again, acutely bent elbows and pressed against the chest.

Staying with the elbows, I've observed men and women presenting different angles when they are giving a verbal explanation or propounding a thesis. Men will put their arms  forward, elbows near or just anterior to their waist. Women, by cotrast, mostly have their elbows similarly near their waist, but both their hands and forearms are placed so far laterally that they for a nearly straight line between both hands.Watch any erect female and male on TV and see if I am correct.

One interesting spinoff of the female elbow is this:It creates a lovely "hand in glove" effect with her waist. If she stands in front of you, hands at her sides, her elbows are pointed inward exactly where her waist indents. Very elegant to be sure. Another has to do with running. Picture yourself behind a woman running with a man. His knees are pointed straight ahead or slightly outward, his arms and elbows moving backward and forward like the arms turning a locomotives wheels. Her knees are pointed somewhat inward as she runs, as are her elbows.

Consider, finally, how differently men and woman throw a baseball. Her elbow is at a right angle, her upper arm pointed away from her torso. This does not allow for much distance. His arm prior to the throw is straight up above his head, then pulled back as far as possible to effect a longer and stronger catapulting motion.

Even the finger joints are at variance, Women would appear to be able to bend their distal finger joints way far more posteriorly than can men.  Too, most men will hold a pen stabilized against the side of the third finger adjacent to the pointer, then write with the pointer and thumb. I've often seen women holding the pen between the fourth finger and the pinky, essentially controlling the pen with the entirety of the hand.

I offer this long description to propose that the angles of men's and women's joints, especially in their limbs, are quite different, primarily biologically. If moms are teaching their daughters how to be modest, they are only building on what is biologically natural for the young girl.

If nature produced these differences in joint angles, she must have had good reason. Natural selection is not operating without purpose. What functions do these differences subserve? I do not pretend to have full answers to this question, but I believe it is an issue worthy of research.

One function best done by the female elbows may relate to infant care: The high school girl pressing tomes against her chest is employing the same movements she will use if and when she has a child: She is "cradling." her texts.  I surmise that these different joint angles allow her to  cradle more comfortably and for greater lengths of time. This would represent an enormous advantage to her newborn forming a warm, safe and loving attachment to her new mother. I suspect that the greater fluidity of female joints adds to their, perhaps, greater propensity to dance. It certainly makes them more attractive at the activity. 

 Disclaiming any expertise on the physics of various joint angles, I would nonetheless surmise that the angles of male joints help to enhance the power of their greater musculature for running, hunting, and other activities which demand great physical strength.There are myriad activities which call upon males to exert considerable power and torque.

On the one hand, these observations are intrinsically interesting to note.They are obvious when attention is called to them, though quite in the background of consciousness until then. On the other, what hypotheses might we be able to draw from the different angles of male and female joints?