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PURPOSE OF REVIEW: Fastpitch softball is one of the most popular sports among youth and high school female athletes. Despite some similarities to baseball, key differences between the two sports result in different injury patterns, and there is comparatively less literature describing injury epidemiology in fastpitch softball. The purpose of this review is to describe the epidemiology, biomechanics, and injury prevention efforts in regards to fastpitch softball injury with a particular focus on underhand pitching. RECENT FINDINGS: The injury rate in softball is relatively low and extended time loss injuries in particular are uncommon. Lower extremity injuries are more common overall in softball, but pitchers more often suffer upper extremity injury. Pitchers account for a relatively small proportion of all injuries recorded, but represent a similarly small subset of team rosters, with most teams carrying only a few pitchers in total. The underhand pitching motion exerts significant glenohumeral distractive forces and high stress across the biceps-labrum complex. Core and lower extremity strengthening play an important role in injury prevention for softball pitchers and position players. Fatigue and number of games pitched are tied to increased strength deficiencies and pain in fastpitch softball pitchers, yet pitch count limits are not employed in any major fastpitch softball leagues. While overall injury incidence is low in fastpitch softball players, the potential for overuse injury in pitchers in particular is noteworthy and not nearly as scrutinized as within the baseball community. Critical longitudinal tracking of softball injuries at varying levels of play would be helpful to better understand the sports injury risk. There are currently no formal pitch count limits enforced in a majority of fastpitch softball leagues. Core and lower extremity strengthening, pre-season conditioning, and monitoring of pitchers for signs of fatigue may be helpful in injury prevention.

Background: Female patients tend to suffer a greater risk of reinjury and worse patient-reported outcome measures (PROMs) after anterior cruciate ligament reconstruction (ACLR) than male patients, regardless of the graft type used. Purpose/Hypothesis: This study explored the role of donor-recipient sex mismatching to help explain these sex-based disparities in outcomes after ACLR with an allograft. The hypothesis was that allograft donor-recipient sex mismatch would adversely affect surgical outcomes at a 2-year follow-up, with male-to-female graft donations yielding the lowest rates of success. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent primary ACLR with an allograft between 2012 and 2022 were eligible for recruitment. The following PROMs were collected from baseline through a 2-year follow-up: Knee injury and Osteoarthritis Outcome Score subscales, Marx activity rating scale, visual analog scale for pain, and Veterans RAND 12-Item Health Survey. Demographic and graft-specific variables were also collected. Sex- matched cases were compared with sex- mismatched cases and an identical subgroup analysis was performed for female patients only. Results: Of the 112 included patients (N = 70 women), 59 (52.7%) were sex mismatched. The mean patient age was 40.7 ± 10.9 years, and the mean body mass index was 26.8 ± 4.7 kg/m2. Most reconstructions (89.3%) used a semitendinosus tendon graft, with a mean implanted graft diameter of 9.7 ± 0.5 mm (quadrupled). Of the mismatched cases, 96.6% involved a male allograft donated to female recipients. Overall, the matched group demonstrated higher PROM scores across all time points compared with the mismatched group, although statistical significance was only reached for the Marx score at baseline (P =.012) and 1 year postoperatively (P =.022). In the female-only subgroup analysis, a larger graft diameter was measured in the mismatched cases (receiving male allografts) compared with the matched female cases (9.7 ± 0.6 vs 9.2 ± 0.4 mm, respectively; P =.002). Moreover, the mismatched cases tended to report better postoperative PROM scores, although this trend was not statistically significant. Conclusion: The study findings indicated that male donors provided larger allografts than female donors, and that donor-recipient allograft sex matching did not contribute significantly to ACLR outcomes. Other factors may be more important to outcomes in female patients. [ABSTRACT FROM AUTHOR]

The use of creatine as a dietary supplement is widespread. However, its reported performance benefit has been largely demonstrated in male populations. The aim was to evaluate the effectiveness of creatine supplementation in improving exercise performance in active females. A secondary aim was to appraise the quality of research in this area. Five databases were searched from the earliest record to July 2024. Eligible studies used supplemental creatine as an intervention with physically active female participants and reported an exercise performance-related outcome. Study quality was appraised using the Critical Appraisal Skills Program randomised controlled trials checklist with four additional items related to methodological considerations for research with active females. Performance outcomes were categorised as strength/power, anaerobic, or aerobic. Of the 10,563 records identified, 27 studies were included. Participant calibre ranged from recreationally active to elite. Creatine interventions ranged from five days to 12 weeks and included a range of dosage strategies. Compared to placebo, 3/11 studies showed an improvement in strength/power outcomes, 4/17 showed an improvement in anaerobic outcomes, and 1/5 showed an improvement in aerobic outcomes. Study quality varied, but methodological considerations for research with female athletes were poorly addressed by most studies. Although some benefits were reported, most studies showed no improvement in performance compared to placebo. The heterogeneity in participant characteristics, performance tests, creatine intervention, insufficient consideration of the unique physiological characteristics of females, and an overall small evidence base limits our understanding of how creatine supplementation influences physical performance in active females. [ABSTRACT FROM AUTHOR]

The pelvic floor and its associated disorders are a unique and often overlooked aspect of women's rugby. This review discusses relevant biopsychosocial considerations specific to the pelvic floor and rugby. Pelvic floor disorders can present at any time across the female lifespan but are more prevalent during pregnancy and postpartum. This is due to the substantial physiological and anatomical changes experienced during pregnancy and vaginal childbirth. Consequently, pelvic floor disorders can impact a player's ability to perform, maintain engagement with, or return to, rugby due to symptoms. Players need to be informed, supported, and guided through focused pelvic floor muscle training to condition the muscles and 'ready' them for the varied demands of rugby. Health and fitness professionals should understand the risk of pelvic floor disorders across the female lifespan and screen players for symptoms when supporting them to maintain or return to rugby. Rugby players who are symptomatic of pelvic floor disorders should be signposted to specialist services and/or resources to manage their symptoms. Once engaging in rugby training, ongoing evaluation of player load tolerance and implementation of individualized strategies to support managing rugby‐related loads to the pelvic floor should be considered. Finally, surveillance and research focusing specifically on rugby players and pelvic floor function are needed. Highlights: High force‐related activities, such as rugby, challenge the pelvic floor muscles (PFMs) and can increase a player's susceptibility to pelvic floor disorders (e.g., stress urinary incontinence, feeling a bulge inside or outside the vagina)Pelvic floor disorders can present at any time across the female lifespan, with pregnancy and childbirth being two commonly reported risk factors for such disordersPredisposing (genetics), inciting (pregnancy and vaginal childbirth) and intervening (lifestyle, aging) factors likely influence pelvic floor load tolerancePFM training has level 1 evidence to be a first line treatment for urinary incontinence and pelvic organ prolapse in the general female population. We encourage PFM training to be incorporated into rugby training programmes across all ages, levels and roles regardless of whether pelvic floor disorder symptoms are present or not [ABSTRACT FROM AUTHOR]

Background and Objectives: Collision-sport athletes, such as rugby players, are at risk of sport-related concussion (SRC). Women are known to be at higher risk of SRC and may experience more severe and chronic symptomology than men. Knowledge of the factors that affect a player's disclosure of their concussive symptoms could help to inform strategies to improve compliance with reporting and management of head injuries. The aim of this study was to investigate the factors that may impact women rugby players' disclosure of a concussion. Methods: Twenty-eight adult (≥18 years of age) elite and semi-elite women rugby players from the UK and Ireland (n = 17) and the United States (n = 11) were interviewed on their playing background and SRC experience in women's rugby via one-on-one interviews (UK and Ireland) or an online questionnaire (US). Results: SRC data were analysed inductively using a thematic analysis approach to determine the potential reasons for SRC non-disclosure in women's rugby. Four main themes were identified which may influence a player's SRC non-disclosure: 1. women rugby players are self-managing SRC; 2. work-related concerns impact on SRC disclosure; 3. players and support staff lack knowledge on SRC management; and 4. poor internal and external communication affect the support players receive when injured. Conclusions: The findings were consistent across players from different countries. This research highlighted several factors that may impact on women rugby players' disclosure of SRC regardless of country of origin (UK, Ireland, or US) and access to concussion care. Coaches and management teams should be aware of these reasons, which may enhance how they discuss and manage concussion. There is a clear need for further education on concussion for players and support staff and for strategies to create environments where women can openly discuss their concussion concerns. [ABSTRACT FROM AUTHOR]

Objective: Athletic heart syndrome (AHS) represents a physiological and morphological adaptation of the heart to longstanding intensive training. Left ventricular (LV) chamber sizes are primarily affected by the complex interplay of sportsassociated factors. AHS in females substantially varies from males due to underlying physiological, hormonal, and anthropometric differences. This study aims to explore the influence of sports-related factors on left heart chambers in young female athletes (FA). Methods: A cross-sectional study was conducted in 28 young FA, who undergo training for at least 3 months with a minimum of 3 times weekly sessions. They were divided in 2 groups: endurance (END) and mixed-training (MIX). We assessed using echocardiography: left atrial volume index (LAVI), end-diastolic (EDV) and end-systolic (ESV) LV volumes, LV mass index (LVMI). Comparisons were performed using t-tests or Mann-Whitney U tests. A MANCOVA was selected to determine the relationship between sports-related factors and left heart indices. Post-hoc contrast and margins tests were conducted to show a correlation with exact cardiac parameters. Results: Groups were matched by age, body surface area, and total training duration. However, weekly training time (WTT) was higher in END athletes (12.7 (5.3) vs. 5.7 (0.8), p<0.001) and left cardiac indices were greater in END athletes than in MIX counterparts: LAVI (28.8 vs.18.7 ml/m2, p=0.009), EDV (81.1 (11.7) vs 66.1 (16.8) ml, p=0.01), ESV (29.6 (10.8) vs. 20.5 (10) ml, p=0.01) and LVMI (68.3 (11.7) vs. 59.2 (8.2) gr/m2, p=0.02). According to MANCOVA, higher WTT (p=0.03, η² = 0.44), was associated with increased LAVI, EDV, and LVMI values. Mean differences obtained from contrast analysis showed significant variations of only LVMI between training groups (-13.17, p=0.04). Post-hoc analysis revealed significantly higher values of all chamber parameters in END athletes (p<0.001). Conclusions: Young FA have distinct cardiac adaptations based on training type and training load time. END athletes exhibited greater volumetric indices and LVM compared to MIX athletes, emphasizing the significant influence of training intensity and modality on cardiac remodeling. Furthermore, the hypothetical moderating role of the WTT in the relationship between training type and left heart chamber sizes was observed. These findings emphasize the importance of individualized cardiac evaluation in FA for the adequate management of the AHS. [ABSTRACT FROM AUTHOR]

Background and Purpose Recent changes to medical recommendations for exercise in pregnancy and postpartum have expanded to include recreational athletes. While women are transitioning into motherhood at the height of their athletic careers, there is limited guidance on musculoskeletal training from pregnancy through safe return to activity. The lack of education and support in this population may lead to increased prevalence of symptoms and delay of treatment, ultimately hindering athletic performance. The purpose of this case series is to assess pelvic floor symptoms through implementing a new pre- and postnatal exercise training paradigm in a group of women aiming to return to recreational athletics. Study Design Case series Methods Six recreationally athletic women between 25-35 years of age were referred to physical therapy during pregnancy to participate in this protocol. The women completed a standardized pregnancy and postpartum rehabilitation plan focused on core and pelvic floor control in addition to specific strength and mobility training. Results Pain, urinary dysfunction, and pelvic floor muscle strength were assessed at six weeks postpartum and at discharge. Meaningful improvement was noted in pain, urinary dysfunction, and muscle strength by the time of discharge. Conclusion The decrease in symptoms and improvements in measures of musculoskeletal health suggests that a physical therapist guided rehabilitation protocol may be useful as part of the standard of care to reduce prevalence of pain and dysfunction, particularly in the recreational athlete population. Improving understanding of exercise training in this population may minimize musculoskeletal symptoms and encourage additional research to improve the standard of care for this group of patients. Level of Evidence Level 4 [ABSTRACT FROM AUTHOR]

This study compared the mechanical and physiological load placed on Division I female collegiate lacrosse athletes (1) with and without hormone contraceptive (HC) use and (2) with and without menstruation during training and games. Athletes' (20.6 ± 1.5 years, HC users = 9, naturally cycling (NC) athletes = 9) workloads—total distance traveled (TD, m), max speed (km∙h−1), accelerations (repetitions), decelerations (repetitions), and high-intensity distance (HID, m)—were measured through VX Sport wearable microtechnology in training sessions (n = 87/athlete) and games (n = 17/athlete). Analyses showed no statistical group differences based on HC use or not, and no differences during menstruation versus non-menstruation for training or games. However, while not statistically different, athletes taking HCs performed worse during menstruation, with a 5.1% decline in decelerations, 3.4% decline in TD and HID, 1.2% decline in max speed, and 1% decline in accelerations. NC athletes did not show this same decline with menses. Given that withdrawal bleeding exacerbates performance reduction of HC users, it may be beneficial for these athletes to consider skipping their withdrawal bleed if it is likely to coincide with a game. Further research needs to be carried out to see if these trends are consistent across other female athletes in other sports. [ABSTRACT FROM AUTHOR]

This document is a list of references for various articles related to the topic of youth sports specialization and its impact on athletes, particularly female athletes. The articles cover a range of issues including mental health, injury rates, eating disorders, and the experiences of low socioeconomic status families in youth sports. It is important to note that the document does not endorse any specific products or claims made by manufacturers. [Extracted from the article]

Women's wrestling is actively practiced in many countries. While severe spinal injuries pose a threat to an athlete's career and health, research on severe spinal injuries in female wrestlers remains limited. The aim of this study was to investigate the characteristics of severe spinal injuries and post-injury management in Korean female wrestlers. We enrolled 54 female wrestlers participating in the national team selection competition. Interviews were conducted to examine the characteristics of spinal injuries that resulted in a time loss of more than three weeks from training throughout their athletic careers and their post-injury management practices. Approximately 46% of participants experienced severe spinal injuries, and 52% faced re-injuries during their wrestling careers. These injuries predominantly occurred during technical training due to overuse during tackling and standing attacks. The most frequent injuries were lumbosacral disc injuries (72%) and cervical disc injuries (20%), with 36% requiring surgery. Nearly half of the injured athletes received specialized rehabilitation, yet roughly 76% resumed training without medical clearance. Athletes injured during their student years were notably less likely to receive specialized rehabilitation compared with those injured during their professional careers (p = 0.011). On average, athletes returned to play within 2.7 to 3.0 months. Spinal injury characteristics and post-injury management were not significantly different between the light- and heavyweight classes. While Korean female wrestlers are at a high risk of experiencing severe spinal injuries and re-injuries during their careers, appropriate post-injury management is often lacking, highlighting the need for proactive intervention by healthcare professionals to prevent recurrent spinal injuries in female wrestlers and to ensure safe return to training. [ABSTRACT FROM AUTHOR]

Background: Hormonal contraceptives (HCs) and the menstrual cycle have been suggested to affect symptom severity and postconcussion recovery. Additionally, hormones have been a suggested rationale for sex differences between female and male athletes on concussion assessment. Researchers have yet to explore the effects of HC use on baseline symptomatology, including symptom reporting and provocation. Purpose: To examine the influence of HC use on a baseline symptom reporting and vestibular/ocular provocation battery. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 61 college-aged individuals (21 HC-using women, 21 non–HC-using women, 19 men) were administered a baseline symptom battery consisting of the Post-Concussion Symptom Scale (PCSS), Headache Impact Test-6 (HIT-6), Pediatric Vestibular Symptom Questionnaire (PVSQ), and Vestibular/Ocular Motor Screening (VOMS). The main outcome measures consisted of PCSS symptom reporting (total symptoms, symptom severity score, and symptom factors), HIT-6 and PVSQ total scores, and VOMS item (ie, saccades, convergence, or vestibular/ocular reflex) symptom provocation scores. Results: Significant differences were reported on HIT-6, with the highest headache reporting in the HC group (P =.026). On the PVSQ, the HC group also reported greater dizziness and unsteadiness symptoms than the non-HC group (P =.023). Similar findings existed on the PCSS, with the HC group reporting greater total symptoms (P <.001), symptom severity (P <.001), and vestibular-somatic (P =.024), cognitive-sensory (P =.004), sleep-arousal (P =.001), and affective (P <.001) factors compared with the non-HC group. Smooth pursuit (ie, following finger smoothly with eyes) was the only VOMS items with differences between groups (P =.003), with the HC group having greater provocation compared with non-HC users (P =.020). Conclusion: HC use was associated with overall symptomatology and worse self-reported symptoms on vestibular-related inventories and concussion symptom scales and factors when compared with non-HC users and male controls. Additionally, HC users reported higher VOMS provocation scores on the smooth pursuit item than non-HC users and male controls. [ABSTRACT FROM AUTHOR]

A high prevalence of low energy availability (LEA) has been reported in female football players. This is of concern as problematic LEA may evolve into a syndromic pattern known as relative energy deficiency in sport (REDs). Given the difficulties in accurately assessing LEA, our study shifts emphasis to measurable indicators of REDs, serving as proxies for health detriments caused by LEA. The present cross‐sectional study aimed to quantify the risk of REDs and to assess the prevalence of indicators indicative of the syndrome. 60 players (tiers 3 and 4) from three Norwegian football teams were analyzed as a single cohort but also stratified based on player position and menstrual status. The proportion of players at risk for REDs was 22%, that is, 17% with mild, 3% with moderate to high, and 2% with very high/extreme risk, respectively. The majority of the cohort (71%) presented with no primary indicators, while 20%, 7%, and 2% presented with one, two, and three primary indicators, respectively. Regarding secondary indicators, 57% had none, 33% had one, and 10% had two indicators. For associated indicators, 30% had none, 42% had one, 18% had two, 8% had three, and 2% had four indicators. Player position did not affect the prevalence of REDs indicators. Among noncontraceptive users (n = 27), secondary amenorrhea (AME) was reported by 30%. These findings indicate that health and performance teams should prioritize universal health promoting strategies rather than selective or indicative strategies. Particularly, focus on nutritional periodization to secure sufficient energy availability, mitigating the risk of problematic LEA and REDs should be addressed. Highlights: Of the total cohort (n = 60), 22% of players were classified as at risk for REDs, among which 5% demonstrated high to severe risk, while 78% were not at risk.Amenorrhea (AME) was reported by 30% of noncontraceptive users.An individual risk potential for REDs aside, our findings argue for health and performance teams prioritizing universal interventions such as nutritional periodization to decrease unwanted exposure to problematic low energy availability (LEA). [ABSTRACT FROM AUTHOR]

BackgroundLongitudinal performance tracking in sports science is crucial for accurate talent identification and prognostic prediction of future performance. However, traditional methods often struggle with the complexities of unbalanced datasets and inconsistent repeated measures.PurposeThis study aimed to analyze the longitudinal performance development of female 60 m sprint runners using linear mixed effects models (LMM). We sought to generate a practical tool for coaches and researchers to establish benchmarks and predict performance development.MethodsWe analyzed 41,123 race results from 8,732 female 60 m track sprinters aged 6–15 years, collected from the Swiss Athletics online database between 2006 and 2021. Only season-best times per athlete and only athletes with at least 3 season-best times in their career were included. LMM was used to generate performance trajectories, benchmarks, and individual predictions. A practical software tool was developed and made available to allow individual performance prediction based on race times from previous seasons. In addition, classic empirical percentile curves were constructed using the Lambda-Mu-Sigma (LMS) method.ResultsLMM handled the dataset's complexities, producing robust longitudinal performance trajectories. Compared to empirical percentiles generated using the LMS method, which provided a retrospective view of performance development, the mixed model approach identified individualized longitudinal performance developments and estimated predictions of future performance. The best-fitting model included log-transformed chronological age (CA) as a fixed effect and random intercepts and slopes for each athlete. This model explained 59% of the variance through fixed effects (marginal R2) and 93% through combined fixed and random effects (conditional R2).ConclusionLMM provided longitudinal sport performance data, enabling the establishment of performance benchmarking and prediction of future performance. The software tool can assist coaches in setting realistic training goals and identifying promising athletes.

Objective: Athletic heart syndrome (AHS) represents a physiological and morphological adaptation of the heart to long-standing intensive training. Left ventricular (LV) chamber sizes are primarily affected by the complex interplay of sports-associated factors. AHS in females substantially varies from males due to underlying physiological, hormonal, and anthropometric differences. This study aims to explore the influence of sports-related factors on left heart chambers in young female athletes (FA). Methods: A cross-sectional study was conducted in 28 young FA, who undergo training for at least 3 months with a minimum of 3 times weekly sessions. They were divided in 2 groups: endurance (END) and mixed-training (MIX). We assessed using echocardiography: left atrial volume index (LAVI), end-diastolic (EDV) and end-systolic (ESV) LV volumes, LV mass index (LVMI). Comparisons were performed using t-tests or Mann-Whitney U tests. A MANCOVA was selected to determine the relationship between sports-related factors and left heart indices. Post-hoc contrast and margins tests were conducted to show a correlation with exact cardiac parameters. Results: Groups were matched by age, body surface area, and total training duration. However, weekly training time (WTT) was higher in END athletes (12.7 (5.3) vs. 5.7 (0.8), p

Introduction: Hyperandrogenism in women's sports is a topic that has been controversial for years and has been discussed and debated internationally. It concerns the participation of women with elevated testosterone levels in sports competitions, especially in disciplines where physical strength and performance are crucial. Gender categorization in sports has a biological basis and stems from significant physiological differences between men and women. The aim: To ensure fair competition and equal opportunities for all participants. Materials and methods: A systematic review explored the link between androgen levels and athletic performance improvement. Google Scholar and PubMed were searched in polish and english language. Results: The issue of hyperandrogenism in sports often arises in the context of controlling the fairness of competition. Many researchers and sports activists argue that high levels of testosterone can give an unfair advantage, especially in sports requiring strength and speed. Therefore, the International Olympic Committee (IOC) and other sports organizations have introduced limits on testosterone levels in women competing in certain sports. It is also worth noting that hyperandrogenism is not always due to doping or unfair practices. Often it is a physiological condition that can result from individual genetic characteristics. The approach to this issue requires consideration of both aspects of fair competition and the rights of athletes to compete without discrimination based on their natural physiological characteristics.

Studi purpose. There are many cases in athletics where performance declines, especially in women, due to excessive anxiety. Often, they think this is a normal thing, but this can have fatal consequences and interfere with the performance of female athletes in short-distance running events. Thus, this study aims to examine the relationship between anxiety and short-distance running performance in female athletes. Materials and methods. The method used in this research is a descriptive method with a quantitative approach involving 12 female athletes aged 12-15 years. This research uses a total sampling technique. The instrument in this research is the Competitive Sport Anxiety Inventory-2 (CSAI-2) which also takes the results of the 100m sprint data in the Portue 2023 competition to determine the performance of short-distance running athletes. Data analysis was carried out using SPSS version 25 using the Pearson correlation test. Results. The results of the study show that there is a significant relationship between anxiety and the short distance running performance of female athletes. Conclusions. The author can conclude that the anxiety experienced by female track and field athletes, especially in the 100m sprint event, must be managed as well as possible because if not, it can cause female track and field athletes to experience a decline in performance.

Abstract This study forged an interdisciplinary design partnership between an apparel designer, biomechanical kinesiologist, and a professional female athlete to design and test a novel new upper body performance garment for improved fit, mobility, comfort, donning/doffing and throwing performance in female professional athletes. Researchers collaborated to address garment functionality and performance during the multi-phase prototyping design process. The final designed performance top was tested against a control for satisfaction differences with fit, mobility, comfort, donning, and doffing, along with throwing performance utilizing a mixed methods questionnaire and motion capture equipment. Open-ended questions were analyzed with content analysis, while quantitative measures utilized ANOVA and independent t-tests. Results indicated the designed performance top had higher fit satisfaction and more optimal positioning during the overhead throw when compared to the control garment, with no difference in comfort or mobility, and the designed top had lower donning and doffing satisfaction. The designed performance top illustrates the need for further research in increasing satisfaction in donning and doffing with bust/bra satisfaction in performance garments and future research to better understand the psychological sensory cues in posture cueing garments.

This study forged an interdisciplinary design partnership between an apparel designer, biomechanical kinesiologist, and a professional female athlete to design and test a novel new upper body performance garment for improved fit, mobility, comfort, donning/doffing and throwing performance in female professional athletes. Researchers collaborated to address garment functionality and performance during the multi-phase prototyping design process. The final designed performance top was tested against a control for satisfaction differences with fit, mobility, comfort, donning, and doffing, along with throwing performance utilizing a mixed methods questionnaire and motion capture equipment. Open-ended questions were analyzed with content analysis, while quantitative measures utilized ANOVA and independent t-tests. Results indicated the designed performance top had higher fit satisfaction and more optimal positioning during the overhead throw when compared to the control garment, with no difference in comfort or mobility, and the designed top had lower donning and doffing satisfaction. The designed performance top illustrates the need for further research in increasing satisfaction in donning and doffing with bust/bra satisfaction in performance garments and future research to better understand the psychological sensory cues in posture cueing garments. [ABSTRACT FROM AUTHOR]

Cervical muscle strength has been demonstrated to reduce concussion risk in high school athletes, and interventions to improve this in male rugby players have elicited strength improvements. However, the feasibility of introducing neck‐strengthening interventions into women's rugby has not been investigated. This study sought to pilot a neck‐strength intervention in university‐level women's rugby players. A fixed‐frame dynamometer was used to assess the multi‐directional isometric neck‐strength of 14 university women's rugby players (20.3 ± 1.0 years). Between baseline and end‐of‐season testing, a neck‐strengthening program was completed. Interviews were conducted with six players and two coaches to understand program engagement. Interviews were transcribed verbatim and processed via inductive content analysis. Increases in absolute neck‐strength post‐intervention in left and right lateral flexion (left 85.4 ± 29.7 N to 108.2 ± 41.6 N, p = 0.02, right 87.4 ± 33.3 N to 110.5 ± 40.3 N, p = 0.01) and flexion (128.4 ± 28.8 N to 147.9 ± 30.5 N, p = 0.01) were perceived positively by the players although there were suggestions that greater adaptability according to training age and more variety was required. Participants initially demonstrated limited awareness of neck‐strength training but engaged well with the exercises once the potential benefits were understood. This intervention shows promise as an effective, palatable strategy to improve neck‐strength in university women's rugby players. Further research is needed to establish whether such improvements in neck‐strength are associated with meaningful reductions in head impact occurrence. Highlights: Neck‐strength training has proved an effective strategy for reducing concussion incidence in high‐school and elite male populations but is yet to be investigated in females.A neck‐strengthening intervention was introduced in a team of university women's rugby players, who were later interviewed to understand their experiences of the intervention.Multi‐directional neck‐strength was tested via an Isometric Neck‐Strength Testing Apparatus, purpose‐built to mimic the scrum position associated with rugby.Improvements to neck‐strength reached significance in flexion and lateral flexion strength, and the intervention was received positively by players and coaches. [ABSTRACT FROM AUTHOR]

This study examined the type, frequency, and severity of symptoms experienced by naturally menstruating women and combined, monophasic, oral contraceptive pill users and their perceived effects on exercise performance and recovery time posttraining. Forty-two recreationally active women; 21 naturally menstruating and 21 combined, monophasic, oral contraceptive pill users participated in the study. Data were collected using two approaches: (a) an online 54-part retrospective survey and (b) a daily questionnaire. "Total number of symptoms," "symptom index score," "average symptom severity," and "symptom index × severity score" were calculated from the retrospective data set. Real-time symptom data (i.e., "symptom frequency per phase" and "phase symptom frequency × severity score") were calculated across predefined cycle phases from the daily questionnaire. The retrospective survey showed that symptoms were commonly reported by recreationally active women, but there were no differences in symptomology between the groups (p >.113). The daily questionnaire showed both groups experienced a greater frequency and severity of symptoms while bleeding (p ≤.001), which was associated with perceived reductions in exercise performance (odds ratio = 1.04–1.07) and a perceived longer recovery time posttraining (odds ratio = 1.03–1.04). The results from this study show that cycle-related symptoms were commonly reported by a group of recreationally active women, with no difference in symptomology between naturally menstruating women and combined, monophasic, oral contraceptive pill users. The magnitude of symptoms was greater while bleeding, which was associated with a perceived reduction in exercise performance and a longer recovery time posttraining. [ABSTRACT FROM AUTHOR]

Background: Establishing evidence-based recommendations specific to female athletes has been overlooked in sports medicine. Achilles tendon rupture is one of the most common musculoskeletal injuries, occurring in 15 to 55 per 100 000 people annually. Differences in injury rates could be due to hormonal effects, as estrogen receptors have been identified in tendons along with decreased tendon strain based on oral contraceptive use. The primary purpose of this study was to audit the representation of female athletes in the literature regarding Achilles repair. Methods: An electronic search was performed using PubMed to identify articles related to Achilles repair using the protocol by Smith et al. Studies were assessed by population, size, athletic caliber, study impact, research theme, and menstrual status. Results: Female representation across all studies was 1783 of 10 673 subjects (16.7%). Composition of included studies was predominantly mixed-sex cohorts with 131 of 169 (77.5%) included studies. Within mixed-sex cohort studies, the total representation of female athletes was 1654 of 8792 participants (18.9%). Thirty-two studies were male only, constituting 1540 participants, whereas 3 studies were female only composed of 86 athletes. Importantly, the disparity between male and female representation worsened as the athletic caliber of the study population increased, with 5.0% female representation in studies with professional athletes. No study collected data related to menstrual status and its potential relationship to Achilles rupture or postoperative outcomes. Conclusion: Mixed-sex cohort studies underrepresented female athletes, and male-only cohort studies were more common than female-only studies. These findings indicate a need for increased representation of female athletes as well as acknowledgment of menstrual status in research related to Achilles repair. Future studies should focus on representation of female athletes and data collection related to sex-specific hormones, hormonal contraceptive use, and menstrual status to improve treatment of Achilles tendon ruptures for female athletes. [ABSTRACT FROM AUTHOR]

Abstract Background The menstrual cycle and its impact on training and performance are of growing interest. However, evidence is lacking whether periodized exercise based on the menstrual cycle is beneficial. The primary purpose of this proposed randomized, controlled trial, the IMPACT study, is to evaluate the effect of exercise periodization during different phases of the menstrual cycle, i.e., comparing follicular phase-based and luteal phase-based training with regular training during the menstrual cycle on physical performance in well-trained women. Methods Healthy, well-trained, eumenorrheic women between 18 and 35 years (n = 120) will be recruited and first assessed for physical performance during a run-in menstrual cycle at different cycle phases and then randomized to three different interventions: follicular phase-based training, luteal phase-based training, or regular training during three menstrual cycles. The training intervention will consist of high-intensity spinning classes followed by strength training. The menstrual cycle phases will be determined by serum hormone analysis throughout the intervention period. Assessment of aerobic performance (primary outcome) and muscle strength, body composition, and blood markers will be performed at baseline and at the end of the intervention. Discussion With a robust methodology, this study has the potential to provide evidence of the differential effects of exercise periodization during different phases of the menstrual cycle in female athletes. Trial registration ClinicalTrials.gov NCT05697263 . Registered on 25 January 2023

Background and Objectives: Collision-sport athletes, such as rugby players, are at risk of sport-related concussion (SRC). Women are known to be at higher risk of SRC and may experience more severe and chronic symptomology than men. Knowledge of the factors that affect a player’s disclosure of their concussive symptoms could help to inform strategies to improve compliance with reporting and management of head injuries. The aim of this study was to investigate the factors that may impact women rugby players’ disclosure of a concussion. Methods: Twenty-eight adult (≥18 years of age) elite and semi-elite women rugby players from the UK and Ireland (n = 17) and the United States (n = 11) were interviewed on their playing background and SRC experience in women’s rugby via one-on-one interviews (UK and Ireland) or an online questionnaire (US). Results: SRC data were analysed inductively using a thematic analysis approach to determine the potential reasons for SRC non-disclosure in women’s rugby. Four main themes were identified which may influence a player’s SRC non-disclosure: 1. women rugby players are self-managing SRC; 2. work-related concerns impact on SRC disclosure; 3. players and support staff lack knowledge on SRC management; and 4. poor internal and external communication affect the support players receive when injured. Conclusions: The findings were consistent across players from different countries. This research highlighted several factors that may impact on women rugby players’ disclosure of SRC regardless of country of origin (UK, Ireland, or US) and access to concussion care. Coaches and management teams should be aware of these reasons, which may enhance how they discuss and manage concussion. There is a clear need for further education on concussion for players and support staff and for strategies to create environments where women can openly discuss their concussion concerns.

This study compared the mechanical and physiological load placed on Division I female collegiate lacrosse athletes (1) with and without hormone contraceptive (HC) use and (2) with and without menstruation during training and games. Athletes’ (20.6 ± 1.5 years, HC users = 9, naturally cycling (NC) athletes = 9) workloads—total distance traveled (TD, m), max speed (km∙h−1), accelerations (repetitions), decelerations (repetitions), and high-intensity distance (HID, m)—were measured through VX Sport wearable microtechnology in training sessions (n = 87/athlete) and games (n = 17/athlete). Analyses showed no statistical group differences based on HC use or not, and no differences during menstruation versus non-menstruation for training or games. However, while not statistically different, athletes taking HCs performed worse during menstruation, with a 5.1% decline in decelerations, 3.4% decline in TD and HID, 1.2% decline in max speed, and 1% decline in accelerations. NC athletes did not show this same decline with menses. Given that withdrawal bleeding exacerbates performance reduction of HC users, it may be beneficial for these athletes to consider skipping their withdrawal bleed if it is likely to coincide with a game. Further research needs to be carried out to see if these trends are consistent across other female athletes in other sports.

Purpose of reviewThe exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes.Recent findingsFemale athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.

Yuka Tsukahara,1 Satoshi Kodama,2 Saaya Kikuchi,1 Carly Day3,4 1Department of Sports Medicine, Tokyo Women’s College of Physical Education, Kuitachi, Tokyo, Japan; 2Department of Neurology, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan; 3Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA; 4Franciscan Physician Network, West Lafayette, IN, USACorrespondence: Yuka Tsukahara, Department of Sports Medicine, Tokyo Women’s College of Physical Education, 4-30-1 Fujimidai Kunitachi, Tokyo, 1868668, Japan, Tel +8180-3688-6128, Fax +81471-60-6112, Email yuka.voila@gmail.comPurpose: The Athlete Sleep Behavior Questionnaire (ASBQ) is an 18-item self-reported questionnaire that can be used to screen for sleep disorders in athletes and assess environmental, behavioral, and sports-related factors along with sleep disorders. This study aimed to analyze the reliability and validity of the ASBQ translated into Japanese (ASBQ-J).Patients and Methods: 111 female collegiate athletes completed both the initial test and retest. Independent variables were what kind of sports they perform, level as an athlete, grade (freshman, sophomore, junior, senior), and age. The reliability of the survey was assessed using Cronbach’s alpha and intraclass correlation, and Pearson’s correlation coefficient was calculated to determine the correlation between the total ASBQ scores and three components which were routine/environmental, behavioral, and sports factors.Results: A total of 37.8% of athletes had ASBQ scores equal or less than 36 indicating good sleep. However, 19.8% of athletes scored more than 42, indicating poor sleep. Cronbach alpha was 0.62 and 0.65 for test and retest, respectively. Intraclass correlation was 0.78 (P < 0.01), indicating sufficient internal consistency and test–retest validity. Mean ASBQ scores were 38.5 ± 5.0 and 37.0 ± 6.5 for test and retest, respectively, and it was not significantly different between the two groups (P = 0.37). The correlation coefficients between the ASBQ-J and component scores were all statistically significant (all P < 0.01).Conclusion: ASBQ-J is a reliable questionnaire for assessing sleep disorders in athletes whose primary language is Japanese.Keywords: collegiate athlete, female athlete, performance level, survey

The roles of 17β estradiol (E2) and progesterone (P4), the primary female sex hormones, are pivotal in regulating various aspects of metabolism. E2 influences food intake, energy expenditure, adipose tissue distribution, and insulin sensitivity across multiple tissues. Meanwhile, P4 impacts energy expenditure, electrolyte balance, amino acid oxidation, muscle protein synthesis, and glucose metabolism. The interactions between these hormones affect macronutrient utilization, both at rest and during exercise. Acknowledging the need to incorporate sex hormone perturbations in research, this paper explores the current landscape of study design and menstrual cycle tracking for female-specific sport research. It emphasizes the importance of standardization in terminology, hormone phases, reference values, and affordable hormone detection methods to advance our understanding of how the menstrual cycle influences female athletes.

PurposeThe facile manipulation of body weight in junior athletes has the potential to pose significant risks to their lifelong health. In judo, which is a weight class sport, pre-competition weight loss is widespread even among juniors, but information on the current situation is scarce, especially for female athletes, for whom it is important to provide adequate nutrition and enhance bone mass during the growth period, and the details of the current situation are not clear. Therefore, the purpose of this study was to determine the actual weight loss during the growth period in junior female judo athletes and its subsequent impact on their health.MethodsThe survey was a cross-sectional survey of junior female judo athletes in Japan using a questionnaire. Participants were asked to respond via an online questionnaire about their weight, height, weight loss experience, menstruation, competition results, and other lifestyle.Results51.8% of subjects experienced weight loss for competition during their junior high school years (ages 12–15). Those who experienced weight loss during secondary sexual characteristics were found to be significantly shorter in current height than those who did not (p

BackgroundProblematic low energy availability (EA) is the underlying culprit of relative energy deficiency in sport (REDs), and its consequences have been suggested to be exacerbated when accompanied by low carbohydrate (CHO) intakes.ObjectivesThis study compared dietary intake, nutrition status and occurrence of REDs symptoms in groups of female athletes, displaying different patterns of EA and CHO intake.MethodsFemale athletes (n = 41, median age 20.4 years) from various sports weighed and recorded their food intake and training for 7 consecutive days via a photo-assisted mobile application. Participants were divided into four groups based on patterns of EA and CHO intakes: sufficient to optimal EA and sufficient to optimal CHO intake (SEA + SCHO), SEA and low CHO intake (SEA + LCHO), low energy availability and SCHO (LEA + SCHO), and LEA and LCHO (LEA + LCHO). SEA patterns were characterised by EA ≥30 and LEA by EA

Introduction: Canoe slalom is a physically very demanding discipline, in which body constitution, body composition, and relative strength are significant factors in high performance. Although anthropometric and strength parameters are relatively well-studied in male athletes, there is a lack of evidence for any conclusions in women. Therefore, the objective of this study was to determine the morphology and upper-limb strength parameters of female canoe slalom paddlers and identify whether morphological differences exist between performance groups. Methods: Altogether, 63 female competitors of the 2023 ICF Canoe Slalom World Cup (n = 29) and 2023 ICF Canoe Slalom World Ranking Competition (n = 34) in Prague (Czech Republic) were examined with a battery of anthropometric tests, segmental bioimpedance analysis, and handgrip strength test. The athletes were divided into groups according to age and performance: elite athletes belonging to the world top 10 according to the ICF World Ranking (WORLD, n = 7), international-level athletes competing during the World Cup (ELITE, n = 22), international-level junior athletes competing in the World Ranking Race (JUNIOR, n = 17), and other lower performance-level athletes competing in the World Ranking Race (REST, n = 17). Results: Female slalom paddlers are, in general, of average body height (~165 cm), lower body mass (~60 kg), BMI (~22 kg/m2), and body fat (~20%) and without exceptional anthropometric dimensions and proportions. However, differences were detected when performance was factored in. Female paddlers belonging to the world TOP 10 have the largest circumferences of arms and forearms, and their somatotype is more mesomorphic, with a lower proportion of total body fat and a higher proportion of muscle mass. In addition, the WORLD group differs significantly in upper-limb strength. Discussion: The results shows the significance of muscular strength and power for canoe slalom athletes and the importance of well-developed musculature in operating the boat in the unstable environment. Being a successful female canoe slalom athlete requires a well-developed musculature, maximizing strength capabilities while maintaining a low body weight through limited hypertrophy of the lower limbs and a low level of body fat. [ABSTRACT FROM AUTHOR]

Background: Running-related injuries (RRI) are common among adolescent runners; however, our understanding of RRI risk factors in this population is limited. Sleep, stress, and fatigue are risk factors in other youth sports but have not been studied in high school runners. This study prospectively assessed the effect of changes in sleep duration and quality, stress, and fatigue on RRI among high school cross country runners. Hypothesis: Less and poorer quality sleep and greater stress and fatigue, compared with the previous week, would be associated with RRI. Study Design: Prospective, observational study. Level of Evidence: Level 2b. Methods: Runners completed a preseason demographics and injury history survey and daily surveys regarding sleep duration and quality, stress, fatigue, and current RRI. Values were summed within each week, and change scores were calculated relative to the previous week. Runners completing ≥75% of daily surveys were analyzed; sensitivity analyses for those completing ≥50% and ≥90% were also conducted. Generalized estimating equations assessed the association between change in each predictor, including its interaction with sex, and RRI, controlling for year in school, previous RRI, and repeated observations. Results: A total of 434 runners enrolled in the study; 161 (37%) completed ≥75% of daily surveys. No associations between change in sleep duration, sleep quality, or fatigue and RRI were observed (P values ≥0.24). A significant change in stress × sex interaction with RRI was observed (P < 0.01). Associations among boys (P = 0.06) and girls (P = 0.07) were marginally significant. Sensitivity results were similar. Conclusion: Short-term changes in sleep duration, quality, and fatigue were not associated with RRI, but a significant interaction between change in stress and sex suggests that stress may influence RRI risk in high school cross country runners. Clinical Relevance: Large changes in stress levels should be monitored throughout the season, as these changes may precede RRI occurrence in this population. [ABSTRACT FROM AUTHOR]

Ensuring proper energy, nutrient intake, and sleep is vital for athlete health and competitiveness. Despite previous studies investigating the nutrient intake among top-level collegiate female athletes in Japan, the status of snack consumption remains unclear. This study addressed this gap by surveying 70 top-level female university athletes. The survey included a self-administered diet history questionnaire, a qualitative food intake frequency survey, and a survey on snack and dietary supplement use. The results revealed a low frequency of snack intake (2.1 ± 2.3 days/week), with 55.7% of athletes reporting snack consumption. The energy intake in the snack-intake group was significantly higher than that in the without-snack-intake group (31.5 ± 10.0 vs. 26.6 ± 9.92 kcal/kg of BM, p = 0.047). Similarly, carbohydrate intake was significantly higher in the snack-intake group than in the without-snack-intake group (4.84 ± 1.71 vs. 3.96 ± 1.65 g/kg of BM/day, p = 0.035). However, neither group reached the recommended value of 5–8 g/kg of BM/day during the medium training period. Overall, this study emphasizes inadequate energy intake even among athletes with a high snack intake frequency, highlighting the necessity to enhance overall food consumption and underscoring the importance of nutritional education for incorporating appropriate complementary meals to improve performance. [ABSTRACT FROM AUTHOR]

Background: There has been little focus on concussions in youth lacrosse players in the United States. Purpose: To provide a descriptive analysis of the epidemiology and incidence of concussions in youth lacrosse and compare the results with well-documented analyses of concussions in youth American football. Study Design: Descriptive epidemiology study. Methods: Data on concussions in pediatric patients playing lacrosse from 2006 to 2019 were collected using the National Electronic Injury Surveillance System (NEISS). Weighted calculations and combined participation data obtained from membership in USA Lacrosse were used to estimate injury incidence. A comparison dataset was created using the NEISS data on youth football-related concussions. The cause of concussion was categorized into player-to-player, player-to-stick, player-to-ball, or player-to-ground contact. Results: A total of 37,974 concussion injuries related to lacrosse were identified in players with a mean age of 14.5 ± 3.5 years; 70% of concussions occurred in boys. National participation in lacrosse increased from 2006 to 2011 by a mean of 10.3% annually, followed by a lower annual growth rate of 2.5% from 2012 to 2019. The overall incidence of concussion injuries increased over the study period (r = 0.314), with the incidence rate in boys being greater than that of girls from 2009 to 2013. The most common cause of concussion was player-to-ground contact for boys and player-to-ball or player-to-stick contact for girls. The mean annual concussion incidences in youth lacrosse and youth football were 443 and 355 per 100,000 participants, respectively. Conclusion: Over the study period, 16% of lacrosse injuries were diagnosed as concussions, a higher mean annual incidence per 100,000 participants than that of youth football (443 vs 355). The cause of concussion was different based on sex, with higher rates of player-to-ball or player-to-stick contact in female players versus player-to-ground contact in male players. [ABSTRACT FROM AUTHOR]

Background: Previous studies have attempted to determine if certain risk factors can predict the occurrence of a lateral ankle sprain (LAS) in female soccer players. Unfortunately, there is limited evidence with regard to risk factors associated with an LAS in female soccer players. Purpose: To identify intrinsic risk factors for an LAS among young female soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: Participants were 161 young female soccer players in Japan who were evaluated for LAS risk factors during a preseason medical assessment. The assessment included anthropometric, joint laxity, joint range of motion, muscle flexibility, muscle strength, and balance measurements. Each athlete's history of LASs was also collected. The participants were monitored during a single-yearseason for LASs, as diagnosed by physicians. Results: There were 26 instances of an LAS in 25 players (15.5%) during the season. Injured players were significantly more likely to have sustained a previous ankle sprain (P =.045) and demonstrated significantly worse balance than their peers without an LAS during the double- and single-leg balance tests (P =.008 for both). Athletes with lower hamstring-to-quadriceps muscle strength ratios were also significantly more likely to sustain an LAS (P =.02). Conclusion: Poor balance, a low hamstring-to-quadriceps ratio, and a history of ankle sprains were associated with an increased risk of LASs in young female soccer players in the current study. These findings may be useful for developing a program to prevent LASs in this population. [ABSTRACT FROM AUTHOR]

Background: The menstrual cycle and its impact on training and performance are of growing interest. However, evidence is lacking whether periodized exercise based on the menstrual cycle is beneficial. The primary purpose of this proposed randomized, controlled trial, the IMPACT study, is to evaluate the effect of exercise periodization during different phases of the menstrual cycle, i.e., comparing follicular phase-based and luteal phase-based training with regular training during the menstrual cycle on physical performance in well-trained women. Methods: Healthy, well-trained, eumenorrheic women between 18 and 35 years (n = 120) will be recruited and first assessed for physical performance during a run-in menstrual cycle at different cycle phases and then randomized to three different interventions: follicular phase-based training, luteal phase-based training, or regular training during three menstrual cycles. The training intervention will consist of high-intensity spinning classes followed by strength training. The menstrual cycle phases will be determined by serum hormone analysis throughout the intervention period. Assessment of aerobic performance (primary outcome) and muscle strength, body composition, and blood markers will be performed at baseline and at the end of the intervention. Discussion: With a robust methodology, this study has the potential to provide evidence of the differential effects of exercise periodization during different phases of the menstrual cycle in female athletes. Trial registration: ClinicalTrials.gov NCT05697263. Registered on 25 January 2023 Key message: • The menstrual cycle has the potential to affect sporting performance in female athletes. Female athletes do perceive the impact of the menstrual cycle on physical performance. • This randomized, controlled trial will provide evidence of any differential effects of exercise periodization during different phases of the menstrual cycle in female athletes. • The results of this study might lead to new training recommendations given to exercising women. [ABSTRACT FROM AUTHOR]

Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women: An Experimental Crossover Study. Med. Sci. Sports Exerc., Vol. 56, No. 1, pp. 37-43, 2024. Introduction/Purpose: Heavy lifting may produce strain on the pelvic floor muscles (PFM) due to high increases in intra-abdominal pressure, but knowledge of the impact of weightlifting on the PFM is lacking. Therefore, this study aimed to investigate acute effects of heavy weightlifting on the PFM in strength-trained women and whether general strength in whole-body exercises correlated to PFM strength. Methods: Forty-seven nulliparous women between 18 and 35 yr who regularly performed weightlifting and were able to lift their own body weight ( 1.2 in back squat and 1.5 in deadlift were included in this experimental crossover study. They participated in baseline evaluations (questionnaire/measurements of background characteristics and pelvic floor disorders, one-repetition maximum (1RM) tests in back squat and deadlift) and one test day where they were randomized to start with 60 min of weightlifting (four sets of four repetitions at 75%–85% of 1RM in back squat and deadlift) or seated rest of 60 min. Vaginal pressure measurements of PFM resting pressure, strength, and endurance and surface electromyography measurements of PFM resting activity were performed before/after weightlifting and rest. Results: No statistically significant differences were found when comparing the change in PFM resting pressure, strength, endurance, and resting activity after heavy weightlifting and rest. There were no statistically significant correlations between PFM strength and maximum (1RM) or relative strength (1RM/bodyweight) in either back squat or deadlift. Conclusions: Our results imply that heavy weightlifting is well tolerated by the PFM in short term among young, nulliparous, and strength-trained women. Strength in whole-body exercises was not correlated to PFM strength. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate change in bone mineral density (BMD), BMD percentile (BMDp), lean mass (LM), fat-free mass index, body fat percentage (BF%), and muscle size (mCSA) and quality (EI) in collegiate female gymnasts over a competitive season and characterize the impact of menarche on changes. Twenty gymnasts completed a validated survey to assess age of menarche. Body composition was assessed via whole-body dual-energy X-ray absorptiometry scans at pre- and postseason. mCSA and EI were determined from a panoramic ultrasound scan of the vastus lateralis. Pre- to postseason changes were evaluated using paired sample t tests, and strength of relationships between were analyzed via bivariate correlations and linear regression. Significant losses in body fat percentage (Δ -1.1 ± 1.9%; p =.022) and EI (Δ -5.0 ± 5.8 a.u.; p =.002) were observed. No significant changes were observed in BMDp, mCSA, BMD, LM, or fat-free mass index (p =.310–.869). Age of menarche (15.4 ± 1.5 years) was negatively correlated with Δ BMDp (r = −.454; p =.044) and Δ mCSA (r = −.658; p =.002), explaining 21% and 43% of variation in Δ BMDp and Δ mCSA, respectively. Positive outcomes of gymnastics training, such as gains in LM and mCSA, may be attenuated by delayed menarche, suggested by increased EI and decreased body fat percentage, despite no changes in mCSA or overall LM. These findings may indicate a higher priority of fat utilization within the muscle over muscle and bone growth. Considering menarche as a significant predictor for Δ mCSA, this lack of increase (despite improved EI), may signify increased injury risk resulting from team-specific training style or insufficient energy intake to support appropriate muscle growth. [ABSTRACT FROM AUTHOR]

Background: Approximately 1 in 4 athletes returning to sports will sustain a second anterior cruciate ligament (ACL) injury. Psychological factors related to kinesiophobia, confidence, and psychological readiness are associated with second ACL injury; however, the evidence is conflicting. Hypothesis: Athletes who sustain a second ACL injury (ie, graft rupture or contralateral ACL rupture) within 2 years of ACL reconstruction (ACLR) would have greater kinesiophobia, less confidence, and lower psychological readiness prior to return to sport (RTS) compared with athletes who do not sustain a second ACL injury. Study Design: Secondary analysis of a prospective randomized trial. Level of Evidence: Level 3. Methods: A total of 39 female Level I/II athletes completed the following measures after postoperative rehabilitation and a 10-session RTS and second ACL injury prevention program: ACL Return to Sport after Injury (ACL-RSI) scale, the 11-item Tampa Scale of Kinesiophobia (TSK-11), and question 3 on the Knee injury and Osteoarthritis Outcome Score (KOOS) quality of life (QoL) subscale. Athletes were dichotomized based on whether they sustained a second ACL injury within 2 years of ACLR or not. Independent t tests determined group differences in TSK-11, KOOS-QoL, ACL-RSI, and the 3 individual components of the ACL-RSI (ie, emotions, confidence, risk appraisal). Results: Nine athletes sustained a second ACL injury (4 graft ruptures and 5 contralateral ACL ruptures). The group that sustained a second ACL injury had higher scores on the ACL-RSI (P = 0.03), higher on the risk appraisal questions of the ACL-RSI (P < 0.01), and met RTS criteria sooner than athletes who did not (P = 0.04). All second ACL injuries occurred in athletes who underwent primary ACLR with hamstring tendon autografts. Conclusion: Athletes who sustained a second ACL within 2 years of ACLR had a more positive psychological outlook, higher scores on the specific questions related to the risk appraisal construct of the ACL-RSI, and met RTS criteria sooner than athletes who did not sustain a second ACL injury. Clinical Relevance: Counseling athletes about delaying RTS to reduce the risk of second ACL injury may be especially important in athletes who display high psychological readiness and meet RTS criteria sooner. [ABSTRACT FROM AUTHOR]

Relative age effects (RAEs) are commonly associated with advantages for older athletes. However, a variety of benefits attributed to 'advantage reversals' have been observed among relatively younger professional athletes. Considering psychosocial development as a proposed mechanism, the purpose of this study was twofold: (1) To explore an association between developmental assets (i.e., facilitators of positive youth development [PYD]) and RAEs; (2) To assess whether overall developmental asset levels are protective against sport dropout. The Developmental Assets Profile© was distributed to members of a one-year cohort of post-adolescent, female soccer players from Ontario, Canada. The presence of differences between groups of relatively older (H1; n = 64) and younger (H2; n = 57) participants and developmental asset scales were assessed using discriminant analysis. A binary logistic regression was conducted to assess whether overall developmental asset levels are protective against sport dropout, with consideration of relevant factors. Findings suggest that relatively younger, female players score higher in two internal categories: commitment to learning and positive values. The overall developmental asset scores were not found to be protective against dropout. This study provides preliminary, albeit cautious, support that 'advantage reversals' may be in part associated with enhanced PYD resulting from developmental sport experiences. [ABSTRACT FROM AUTHOR]

Over the past ten years there has been a dramatic rise in female sport participation and accompanying female professional national leagues across multiple sports, yet research has not followed suit. Although there are known variations between female and male physiology, training protocols in female sport are predominantly underpinned by research undertaken in male athletes. The hormonal variability experienced by women across the menstrual cycle, as well as the menstrual cycle variability between women, may contribute to the complexity of conducting rigorous physiological studies, leading to a paucity of robust sports-specific research that can be confidently applied to female athletes. Moreover, barriers exist in female sport that potentially limit the ability to conduct research, including the lack of full-time programs and limited resources. Recently, there has been increased interest in the potential effects of fluctuations in the female sex hormones, progesterone and oestrogen, on sport performance across different phases of the menstrual cycle. However, current research evaluating the menstrual cycle and physical performance (such as strength, speed, aerobic fitness, and athletes' perception of their performance) have shown inconsistent results. Additionally, methodological design across studies has shown little consistency, making it difficult to draw firm conclusions, which potentially prevents female athletes optimising their physical and sporting performance. It further impacts coaches and sports science researchers in their ability to provide appropriate training recommendations and educational opportunities. It is important to progress in female athlete research with an understanding of how the unique physiology of female athletes may influence their ability to physically perform in their respective sport, which requires representation in sports science research. This paper will provide an overview on current evidence and limitations within menstrual cycle research and provide considerations and directions for future research in this space within team sports. [ABSTRACT FROM AUTHOR]

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Purpose: The female athlete triad is a condition of low energy availability, menstrual dysfunction, and low bone mineral density familiar to dancers and weight-class athletes. This study investigated the prevalence of the female athlete triad components and risk factors. The elements and risk factors were discussed in light of the sources of nutritional information and factors that affected the daily dietary intake of female athletes and dancers. Materials and Methods: Fifty-four (54) female athletes and dancers (18.96 ± 3.49 years old) answered a survey questionnaire about years of formal dance or sports training, sources of nutritional information, factors that affected their daily food choices, menstrual history, and injury history. Energy availability was estimated using the Low Energy Availability in Females Questionnaire (LEAF-Q; MELIN et al., 2014). Results and Conclusion: Twenty-one participants (38.90 %) had a risk of low energy availability, while 28 participants (51.90 %) had menstrual dysfunction. Twenty participants (37%) had a history of musculoskeletal injuries. The mean body mass index was 20.46 ± 4.08, and the mean percent body fat was 18.19 ± 5.73%. The primary sources of nutritional information were coaches, peers, and magazines. Personal preference, convenience, and parents were the main factors that affected daily food choices. The prevalence of the Female Athlete Triad components and risk factors was relatively high. The presence of the components and risk-factors should alarm coaches, trainers, and parents for further tests and proper intervention measures. [ABSTRACT FROM AUTHOR]

Much study focuses on the effects of unavoidable injuries in sparring (i.e. contact injuries). However, the majority of martial arts injuries occur during training, rather than competition. Many common martial arts injuries, from ligament tears to ankle sprains, could be prevented with appropriate prehabilitation. With an emphasis on tradition, recreational martial arts clubs have not yet widely adopted modern prehabilitation exercises, which are particularly crucial given the higher rates of preventable injuries in the female athlete and national efforts to increase participation of women in sport. We reviewed the literature to identify injury prevalence and mechanism in martial arts striking sports (MASS). Given the lack of data on female martial artists, we also reviewed common injuries in female athletes engaging in high impact sport. We then identified sport-specific evidence-based interventions using a combination of literature review and Physiotec exercise video library and filtered this through the constraints of recreational martial arts environments to develop a cohesive, useable prehabilitation programme for MASS. We propose a programme of 12 exercises for injury prevention in martial arts striking sports (MASS-12). We emphasise the importance of biomechanical retraining to ameliorate the heightened risk in the female athlete while targeting common injuries across all sexes in martial arts. Hip-knee-ankle alignment is key to injury prevention in MASS, while improved injury surveillance across recreational MASS is needed for future intervention. [ABSTRACT FROM AUTHOR]

Women’s wrestling is actively practiced in many countries. While severe spinal injuries pose a threat to an athlete’s career and health, research on severe spinal injuries in female wrestlers remains limited. The aim of this study was to investigate the characteristics of severe spinal injuries and post-injury management in Korean female wrestlers. We enrolled 54 female wrestlers participating in the national team selection competition. Interviews were conducted to examine the characteristics of spinal injuries that resulted in a time loss of more than three weeks from training throughout their athletic careers and their post-injury management practices. Approximately 46% of participants experienced severe spinal injuries, and 52% faced re-injuries during their wrestling careers. These injuries predominantly occurred during technical training due to overuse during tackling and standing attacks. The most frequent injuries were lumbosacral disc injuries (72%) and cervical disc injuries (20%), with 36% requiring surgery. Nearly half of the injured athletes received specialized rehabilitation, yet roughly 76% resumed training without medical clearance. Athletes injured during their student years were notably less likely to receive specialized rehabilitation compared with those injured during their professional careers (p = 0.011). On average, athletes returned to play within 2.7 to 3.0 months. Spinal injury characteristics and post-injury management were not significantly different between the light- and heavyweight classes. While Korean female wrestlers are at a high risk of experiencing severe spinal injuries and re-injuries during their careers, appropriate post-injury management is often lacking, highlighting the need for proactive intervention by healthcare professionals to prevent recurrent spinal injuries in female wrestlers and to ensure safe return to training.

Introduction: Canoe slalom is a physically very demanding discipline, in which body constitution, body composition, and relative strength are significant factors in high performance. Although anthropometric and strength parameters are relatively well-studied in male athletes, there is a lack of evidence for any conclusions in women. Therefore, the objective of this study was to determine the morphology and upper-limb strength parameters of female canoe slalom paddlers and identify whether morphological differences exist between performance groups.Methods: Altogether, 63 female competitors of the 2023 ICF Canoe Slalom World Cup (n = 29) and 2023 ICF Canoe Slalom World Ranking Competition (n = 34) in Prague (Czech Republic) were examined with a battery of anthropometric tests, segmental bioimpedance analysis, and handgrip strength test. The athletes were divided into groups according to age and performance: elite athletes belonging to the world top 10 according to the ICF World Ranking (WORLD, n = 7), international-level athletes competing during the World Cup (ELITE, n = 22), international-level junior athletes competing in the World Ranking Race (JUNIOR, n = 17), and other lower performance-level athletes competing in the World Ranking Race (REST, n = 17).Results: Female slalom paddlers are, in general, of average body height (∼165 cm), lower body mass (∼60 kg), BMI (∼22 kg/m2), and body fat (∼20%) and without exceptional anthropometric dimensions and proportions. However, differences were detected when performance was factored in. Female paddlers belonging to the world TOP 10 have the largest circumferences of arms and forearms, and their somatotype is more mesomorphic, with a lower proportion of total body fat and a higher proportion of muscle mass. In addition, the WORLD group differs significantly in upper-limb strength.Discussion: The results shows the significance of muscular strength and power for canoe slalom athletes and the importance of well-developed musculature in operating the boat in the unstable environment. Being a successful female canoe slalom athlete requires a well-developed musculature, maximizing strength capabilities while maintaining a low body weight through limited hypertrophy of the lower limbs and a low level of body fat.

RED-S is a contraindication for women in the sport. The purpose of the exercise was originally getting results in the form of a healthy and a fit body, but the female athletes when exercise is done with intensity is too high then suffered great mental distress that would arise RED-S disease include anorexia nervosa, amenorrhea, and osteoporosis. This study aims to identify the RED-S in women swimmer athletes. The results showed that the identification of RED-S in the women swimmer athlete is as follows: In objective based on the control of anorexia nervosa in detail that there were 26 (100%) athletes who entered in categories of anorexia nervosa. While the detailed control of amenorrhoea that there are 25 (96.15%) athletes who fall into the category of secondary amenorrhoea and 1 (3.85%) athletes who fall into the category of primary amenorrhoea. Then in the control of Osteoporosis in detail there are 0 (0%) athletes who fall into the category of high osteoporosis, 12 (46.15%) athletes who fall into the category of moderate osteoporosis, and 14 (53.85%) athletes who fall into the category of low osteoporosis. In Subjective based on the tendency of the RED-S, as many as three athletes (11.54 %) were in the category of very high, 3 athletes (11.54 %) were in the high category, 13 athletes (50.00%) were in the category of being, 5 athletes (19.23 %) were categorized as low, and 1 athlete (3.85%) were categorized as very low. While based on the RED-S risk factors, as many as four athletes (15.38%) were in the category of very high, 5 athletes (19.23%) were in the high category, 12 athletes (46.15%) were in the category medium, 2 athletes (7.69 %) were included in the low category, and 3 athletes (11.54%) were in the category of very low. Keywords: RED-S, Female Athlete, Swimmer.

The aim of this cross-sectional study was to examine relationships of external load variables between beach and indoor volleyball amongst individual positions on the team. The movements of eight beach and fourteen indoor female volleyball players were recorded during elite playoff matches; in total, 2,336 three-dimensional trajectories were analyzed. Time-outs and intervals between rallies or sets were excluded from active play time. In both beach and indoor volleyball, 80% of rallies lasted up to 10 s, and players covered 4.5 to 10 m of court during 60% of rally play. Differences in dependent variables of external load were found between independent variables of sports and player positions (p < 0.05). The distance covered in beach volleyball rallies and Player Load™ parameters was significantly higher by up to 23%. The unstable court surface with sand in beach volleyball elevated explosive Player Load™ (accelerations in all three orthogonal planes of motion higher than 3.5 m/s3) in beach volleyball players compared to those of players on stable flooring in indoor. While beach volleyball blocker and defender positions showed no significant difference in parameters between each other, they differed in all parameters when compared to player positions in indoor volleyball. Indoor blocker and libero reached higher loads than setter, outside and opposite positions in various parameters. Factors that influence external load include the larger relative court areas covered by each player in beach volleyball, complexity of players’ roles, and game strategy. This data adds to the knowledge of elite match demands in female volleyball. Specified agility-drill distances and times are essential for training optimization and must be supported by scientific observation. Researchers, coaches, and conditioning specialists should find this helpful for achieving a higher degree of training regulation.