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Purpose: To examine the impact of oral contraceptive (OC) phases on performance, physiological, and subjective responses to prolonged, intensive exercise when carbohydrate (CHO) stores are reduced. Methods: Ten well-trained female cyclists using monophasic OC completed 4 identical trials (>150 min) under conditions of in-trial 60-g·h−1 CHO supplementation (CHO+) or placebo (CHO−) during the sugar- (SUG) and active-pill (ACT) phases of their OC cycle. Each trial comprised two 400-kcal time trials (TT) separated by 1 hour of submaximal cycling at first ventilatory threshold. Results: Change in completion time from TT1 to TT2 was minimized in CHO+ compared with CHO− (4.06 [2.55] vs 6.08 [5.33] min; P =.019, effect size = −0.36). An interaction effect of OC and CHO was observed for time to complete TT (P =.006), mean TT power (P =.002), mean TT heart rate (P =.002), and posttrial emotional balance (P =.020) and negative emotional state (P =.033). In ACT, mean TT power and heart rate were higher in CHO+ when compared with CHO−, resulting in faster TTs in CHO+ and improved posttrial emotional well-being. When CHO was not supplemented, TT power and heart rate were higher in SUG when compared with ACT, resulting in faster TTs in SUG and improved posttrial emotional balance. Conclusion: CHO depletion during ACT negatively influenced TT performance and emotional well-being when compared with SUG. Irrespective of OC pill phase, CHO supplementation should be prioritized to sustain performance and improve postexercise recovery–stress balance. [ABSTRACT FROM AUTHOR]

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.

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]

This study investigated the impact of menstrual cycle (MC) phases and resistance training (RT) on muscle cross-sectional area (CSA) in two MCs utilizing a within-subject design. Twenty women with regular MCs had their legs randomly allocated to either the control (CON) or RT condition, which included 16 training sessions over two MCs. CSA, estradiol (E2), and progesterone (P4) were assessed during the menstruation (M), ovulation (O), and luteal (L) phases in the first (M1, O1, L1) and second (M2, O2, L2) MCs and at the beginning of the third MC (M3). P4 values were significantly higher during the luteal phase than during menstruation (P < 0.0001) and ovulation (P < 0.0001). No significant differences in E2 concentrations were observed between the MC phases (P = 0.08). For the RT condition, the CSA showed significant increases at O2, L2, and M3 compared to baseline (M1) (all P < 0.0001). No significant changes were observed for the CON condition during the two MCs (P > 0.05). However, RT condition showed a significant change in average CSA across two MCs. Additionally, individual analyses revealed that 19 participants showed variation in CSA above or below the minimum detectable difference during the two MCs. These findings suggest that changes in muscle CSA observed during two MCs may not be exclusively attributed to RT. [ABSTRACT FROM AUTHOR]

BACKGROUND: Trunk muscle thickness and brightness are associated with injuries. OBJECTIVE: This study compared trunk muscle thickness and brightness between female college athletes with and without history of low back pain. METHODS: 15 sprinters, 22 volleyball-, and 18 basketball players, all females, were included. The participants were grouped based on the presence of low back pain. Short-axis ultrasound images of the rectus abdominis, external oblique, internal oblique, transverse abdominis, and lumbar multifidus were obtained. The muscle brightness was calculated after selecting the region of interest for each muscle. Muscle thickness and brightness in both groups were compared. RESULTS: In sprinters, the right lumbar multifidus thickness was significantly thinner in the low back pain group (24.66 ± 2.98 mm) than in the healthy group (28.13 ± 2.84 mm). Volleyball and basketball players showed no significant differences in muscle thickness between the two groups for any muscle type. In volleyball players, the right transverse abdominis thickness is inclined toward thinness in the low back pain group than in the healthy group, but the difference was not significant. In all sports, there were no significant differences in muscle brightness between the two groups. CONCLUSIONS: Low back pain in female college athletes may not be related to trunk muscle thickness and brightness. [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]

Objectives: We aim to investigate the accuracy of shear-wave elastography (SWE) in diagnosing patellar tendinopathy in female volleyball and basketball players. In addition, we compared different parts of the patellar tendon and investigated the effects of different knee angles on elastography measurements. Methods: This cross-sectional case–control study evaluated 63 female athletes from professional basketball and volleyball teams (NCT06199583). Patellar tendinopathy diagnoses were made using clinical and ultrasonographic criteria. SWE measurements were taken at 30-degree knee flexion and extension. Rectangular regions of interest boxes were placed in three different parts of the tendon (proximal, middle, distal). The global SWE value was calculated by taking the mean of measurements in the three parts. Receiver operating characteristic (ROC) curves were used to identify significant cutoff points for SWE, and 2 × 2 tables were generated to determine sensitivity and specificity. Results: Thirteen (20.6%) of the 63 athletes were diagnosed with patellar tendinopathy. The ROC curves have identified different cutoff scores for SWE measurements. The SWE score of 130.75 from the proximal part showed the highest sensitivity of 89% and specificity of 80% (p < 0.001) with a 4.45 likelihood ratio at the 30-degree knee flexion. The likelihood ratio is 1.5 at a 30-degree angle and 1.65 at a 0-degree angle when measuring the entire tendon, whereas other portions indicate a ratio ranging from 1.12 to 1.73. Conclusions: Shear-wave elastography is a reliable evaluation method for diagnosing patellar tendinopathy. It has more accuracy when applied to the proximal part and at 30-degree knee flexion compared to measurements taken at knee extension and other parts of the tendon. [ABSTRACT FROM AUTHOR]

Female soccer players report that the menstrual cycle (MC) can negatively impact sporting performance, with barriers identified in communicating their MC experiences to coaches and support staff. Whilst research is growing, there are few studies exploring the coaching staff perspective in soccer, and none from those at the youth level. The aim was to explore soccer coaches' awareness, perceptions and experiences of the MC and the perceived impact on performance. Thirteen coaches (female n = 4; male n = 9, aged 33 ± 9 years) from Scottish elite adult and youth soccer participated in individual semi-structured interviews (average interview time 39 ± 11 min). Interviews were audio recorded and transcribed verbatim, with reflexive thematic analysis (RTA) performed. RTA generated three key themes from 232 meaning units: environment and culture, coach–athlete dynamic, and coach support and education. Coaches perceived a societal culture of the MC being hidden, or taboo, with similar barriers noted within the club environment. Coaches were often embarrassed to discuss the MC with players and believed players were embarrassed. Communication differed depending on the coach–athlete relationship, with trust and familiarity cited as improving comfort in communication. Coach awareness and understanding of the MC both generally and within a sporting context influenced their perceived ability to communicate and support players. Findings highlight the need to support coaches by providing MC education, and practical guidance on how to support players' health and wellbeing. Improved confidence in communication should allow players to feel supported and normalise conversations about the MC. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate (1) if there are differences in training load and intensity between the different training days within a microcycle and (2) if training load and intensity within the different training days are stable over the course of a season. Data were collected over a full season from a team in the women's premier division in Norway. External load (total distance, high-speed-running distance, sprint distance, and the combined number of accelerations and decelerations [ACCDEC]) was assessed using a 10-Hz GPS system with a built-in accelerometer. Internal load was assessed through session rating of perceived exertion, which was multiplied with session duration (session rating of perceived exertion-load). Training days were classified in relation to their proximity to the upcoming match day (MD): MD − 4, MD − 3, MD − 2, and MD − 1. Contents on these days were standardized according to a weekly periodization model followed by the coaching staff. Differences between training days were analyzed using a linear mixed-effects model. All training days were significantly different from each other across multiple variables. ACCDEC values were highest on MD − 4 (147.5 [13.0] ACCDEC count), and all distance variables were highest on MD − 3. All measures of training load were significantly reduced from MD − 3 to MD − 2 (effect size [ES] = 1.0–4.1) and from MD − 2 to MD − 1 (ES = 1.6-4.3). A significant negative effect across the season was observed for session rating of perceived exertion-load and ACCDEC (ES = 0.8–2.1). These results provide evidence that elite female football teams can be successful in differentiating training load between training days when implementing a weekly periodization approach. [ABSTRACT FROM AUTHOR]

It is known that female athletes are at risk for eating disorders. It is thought that factors such as pressure and stress experienced by professional athletes may affect emotional eating and body appreciation. In this context, the aim of this study was to evaluate the emotional eating and body appreciation of professional Turkish female athletes. A total of 265 professional female athletes were categorized according to their sport types and nationality. Emotional eating was found to be higher and body appreciation to be lower in athletes competing at the national level. The results of the hierarchical regression analysis, which included variables such as age, body mass index, professional sports background, national level, and sport type show that the most effective factor in explaining emotional eating in professional female athletes is body appreciation. The present study findings support that professional female athletes are at risk in terms of emotional eating and body appreciation. In addition, emotional eating scores were found to be higher and body appreciation scores were lower in national athletes. Psychological factors such as intense stress and pressure have an impact on the eating behavior and body appreciation of national athletes. These results suggest that athletes should be evaluated by nutritionists, doctors, and psychologists from a multidisciplinary perspective. [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. [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]

Youth soccer participation, particularly among females, continues to grow worldwide. With the high incidence of sport-related concussion (SRC) in soccer, it is important to investigate if SRC occurs disproportionally by positions. Our hypothesis was to see no positional differences in SRCs, SRC-related characteristics, and outcomes among in female youth soccer athletes. Data were prospectively collected from participants at a single sports medicine institution between August 2015-April 2021. Female participants aged 8–18 diagnosed with SRC sustained during an organized soccer practice, scrimmage, or game were separated into 4 groups based on position: Forward, Midfielder, Defender, and Goalkeeper. Demographics, medical history, injury-related details, and outcomes were reviewed. A chi-square test or Fisher's exact test was used for categorical variables. Continuous variables were compared with Mann-Whitney or Kruskal-Wallis test. Two hundred fourteen participants were included: 52 Forwards, 65 Midfielders, 63 Defenders, and 34 Goalkeepers. There were no significant differences between the groups in age, race, ethnicity, or previous concussion history. Differences in mechanism existed with Goalkeepers most commonly reporting Head to Body Part. Goalkeepers, which make up 1/11 of the total positions on the field, had a significantly higher proportion of SRCs compared to Field Positions. (9.1% vs 15.9%) At 3-month post-enrollment, there were no significant differences in reported symptoms or return-to-play between the different positions. In youth female soccer players, goalkeepers sustained a higher proportion of sport-related concussions compared to field players based upon the composition of a soccer team. The mechanism of injury also differed among the different soccer positions. However, no differences in concussion characteristics, outcomes, or RTP were seen across the different soccer positions. [ABSTRACT FROM AUTHOR]

To describe the epidemiology of injuries in sub-elite female Australian Football (AF). Prospective cohort. 424 athletes were tracked across a 12-match season. Injury characteristics (location, severity, mechanism) were reported. Injury incidence (injuries per 1000 h) and injury burden (days absent per 1000 h) were calculated. Severity was considered as the number of days missed between injury onset and return to full training. Incidence was compared using incidence rate ratios, and severity using a Mann–Whitney U test. Total injury incidence was 10.8 (95 % confidence interval [CI] = 9.0, 12.8) injuries per 1000 h. Match incidence was 34.6 (95 % CI = 28.0, 42.4) injuries per 1000 h. Ankle sprain injuries (2.2 per 1000 h, 95 % CI = 1.4, 3.1) and concussion (1.6 per 1000 h, 95 % CI = 1.0, 2.5) injuries were the most frequent, followed by anterior cruciate ligament (ACL) injuries (0.9 per 1000 h, 95 % CI = 0.4, 1.6). ACL (40.4 days per 1000 h, 95 % CI = 36.9, 44.1), ankle sprain injuries (31.4 per 1000 h, 95 % CI = 28.4, 34.7), and concussion (19.9 per 1000 h, 95 % CI = 17.5, 22.5) injuries were also the most burdensome. There were 78 mild, 34 moderate, and 21 severe injuries. ACL injuries were the most severe injury (56.0 [77.0] in-season days missed). This research describes the first large-scale injury profile of sub-elite female AF, reporting time-loss measures of incidence and burden for many injury types. Ankle sprain injuries, concussions, and ACL injuries are common and burdensome, and should be prioritised for prevention. [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]

Purpose: Athletes struggle with bone stress injuries despite the many risk factors reported in previous studies. However, the relationship between body weight measurement frequency and risk of stress fractures has yet to be investigated. Thus, the purpose of this study is to seek the link between body weight measurement frequency and the occurrence of stress fractures. Method: This cross-sectional study included female athletes who were requested to fill out an anonymous online survey regarding their personal background, including the history of amenorrhea and stress fractures. In addition, the frequency at which they measured their body weight and composition and whether they had to report the same to their coaches and seniors were asked. Results: A total of 172 collegiate female athletes for 28 different types of sports participated in this study. Among the included athletes, 35.7% had a history of amenorrhea, whereas 29.7% had a history of stress fractures. A total of 57.0% of the athletes answered that in their team, they measure their body weight on a regular basis, and 33.1% of the athletes answered that they reported the data to their coaches. Logistic regression analysis revealed that those who measured their body weight at least once a day had a higher risk of sustaining stress fractures than did those who measured their body weight less than once a day (OR = 2.36, 95% CI 1.06–5.27, p = .04). Conclusion: Body weight measurement frequency was associated with the risk of stress fractures in female collegiate athletes. [ABSTRACT FROM AUTHOR]

Background: Patient sex is known to affect patient outcomes in sports medicine. Historically, many studies on athletes have focused on male athletes and been generalized to female athletes. Hypothesis: Studies with female first or senior authors will isolate female athletes as study participants more frequently than studies with male first or senior authors. Study Design: Systematic review; Level of evidence, 4. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols, original research studies published between 2017 and 2021 that analyzed athletes were systematically screened from the 6 top sports medicine journals (British Journal of Sports Medicine ; Arthroscopy: The Journal of Arthroscopic and Related Surgery ; Knee Surgery, Sports Traumatology, Arthroscopy ; American Journal of Sports Medicine ; Orthopaedic Journal of Sports Medicine ; Sports Health: A Multidisciplinary Approach). Articles were included for analysis if they met the following criteria: (1) original sports medicine research study, (2) analysis involving athletes, and (3) inclusion of ≥10 participants. Exclusion criteria included (1) review articles of any type and (2) cadaveric studies. The determination of author sex was completed using the name-to-gender assignment algorithm Genderize.io (https://genderize.io/). Results: A total of 1146 studies were included in quantitative analysis. There were 246 studies with a female first author (21.5%) and 191 studies with a female senior author (16.7%). When looking at all authors (first, senior, and intermediate), 19.9% were female. Female first authors were over 4 times more likely to isolate female athletes in clinical research than male first authors (17.5% vs 3.8%, respectively; P <.001). Female senior authors were approximately twice as likely to isolate female athletes compared with male senior authors (11.5% vs 5.8%, respectively; P <.001). Conclusion: Female first authors were significantly more likely to perform research isolating female athletes. While improving the frequency of female athlete research is multifactorial, increasing the number of female researchers may have a direct effect on improving gender equality in sports medicine research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the acute effect of low, moderate, or high doses of taurine on anaerobic and physiological performance in female rugby players. A total of 16 sub-elite female rugby athletes (21.3 ± 1.5 yr, 168.0 ± 4.9 cm, 62.1 ± 3.5 kg mean ± SD) participated in this research. Following familiarization, participants attended 4 successive tests separated by 72 h in a randomized, counter-balanced, crossover research design. Following an over night fast, participants completed a 5-min 60 Watt warm-up followed by a 30-s Wingate anaerobic test on a cycle ergometer after ingestion of either 2 g taurine (LOWTAU), 4 g (MODTAU), 6 g (HIGHTAU) or placebo (PLA) 1 h before the test. Peak (PP) and mean power (MP) along with heart rate (HR), rating of perceived exertion (RPE), capillary lactate and blood glucose were measured. LOWTAU did not affect PP, MP, HR, lactate and glucose compared to PLA (p > 0.05), while MODTAU improved MP and HIGHTAU improved PP and MP compared to PLA and LOWTAU (p < 0.05). MODTAU and HIGHTAU had little effect on HR, blood lactate and glucose (p > 0.05). A single dose of taurine (MODTAU or HIGHTAU) 1 h prior to competition or training would provide an ergogenic effect on subsequent power output. [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]

A 21-year-old African American Division 1 female sprinter presented with 3-weeks history of right great toe and forefoot pain, fatigue, and a 30-day continuous menstrual cycle despite implanted etonogestrel (Nexplanon) inserted 3 years prior. An magnetic resonance imagine (MRI) identified likely stress fracture of the second metatarsal base with a diffusely low T1 signal indicating hyperactive red marrow. Due to persistent pain, a follow-up MRI was ordered 6 months later and indicated serous atrophy of the bone marrow, prompting a further metabolic workup notable for triglycerides exceeding 4000 mg/dL and a hemoglobin A1c of 10.9%. This case highlights the manifestation of a rare congenital lipodystrophy that initially presented as a relatively classic stress fracture and metrorrhagia in a female athlete. [ABSTRACT FROM AUTHOR]

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.

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.

Purpose: The 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. Methods: The 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. Results: 51.8% 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 < 0.05). Weight loss during secondary sexual characteristics did not affect current menstrual cycle. There was no significant difference in competition results due to the experience of weight loss during junior high school (χ2 = 4.485, df = 3, n.s.). Conclusions: These findings suggest that weight loss during the growth spurt phase may adversely impact normal development. It also suggested that weight loss during the junior high school years may not be a strategy to bring about better competition results. These observations indicate the need for education on appropriate class selection and weight control for junior athletes in weight class competitions. [ABSTRACT FROM AUTHOR]

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]

Introduction and hypothesis: Stress urinary incontinence (SUI) is defined as involuntary leakage of urine on physical effort and is prevalent among power- and weightlifters. However, there is scant knowledge on treatment options for this population. The aim of this pilot study was to evaluate the potential outcomes and feasibility of a pelvic floor muscle training (PFMT) program on SUI in nulliparous female power- and weightlifters. Methods: This was a case-series study, including one weightlifter and two powerlifters aged 21–32 years. The participants conducted 12 weeks of PFMT at home, with weekly follow-up by a physiotherapist. Change in total score of the International Consensus of Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was the primary outcome. Secondary outcome was perceived change assessed by the Patient Global Impression of Improvement (PGI-I) Scale and impact on sport participation. PFM strength, endurance, and resting pressure was measured using vaginal manometry. Feasibility was evaluated as adherence to training and self-efficacy (Self Efficacy Scale for Practicing Pelvic Floor Exercises). Results: One athlete reduced their ICIQ-UI-SF score and experienced improvement in symptoms. One athlete reported no change, and one reported a worsening of symptoms. All three participants improved PFM strength and endurance, completed the testing, and 12 weeks of PFMT, but adherence varied between 40 and 80%. Participants reported a lack of time and energy and forgetting to perform the exercises, as reasons for low adherence. Conclusion: There were varying effects of a 12-week PFMT program on SUI in three strength athletes. The results can create the basis for a future randomized controlled trial. [ABSTRACT FROM AUTHOR]

There is currently an underrepresentation of sports science research focused on the female athlete, specifically in the context of Gaelic football. The aims of this study are to (a) compare the strength characteristics of elite and subelite players and (b) establish normative-based values and percentile scores for the strength characteristics of female Gaelic football players. Ninety-two female Gaelic football players were recruited for this study and subsequently categorized as elite (intercounty n = 30, age; 25.1 ± 5.3 years, stature; 1.69 ± 0.06 m, mass; 69.5 ± 5.9 kg) or subelite (club n = 62, age; 25.4 ± 6.8 years, stature; 1.66 ± 0.06 m, mass; 65.1 ± 8.9 kg). The physical strength characteristics of the subjects were assessed through the isometric midthigh pull (IMTP), countermovement jump (CMJ), and 10-5 repeated jump test. Statistically significant differences were found in the physical strength characteristics between the groups with elite players demonstrating greater peak force (large effect), relative peak force (moderate effect), and reactive strength index (large effect). Statistically significant differences were also observed for key CMJ phase characteristics with elite players producing greater RSImod (moderate effect), jump height (large effect), and propulsion peak power (large effect) than subelite players. This study demonstrated that there are moderate to large differences between playing standards with elite players displaying superior reactive-, explosive-, and maximal-strength than their subelite counterparts. The strength characteristics evaluated in this study may be used in conjunction with other performance indices to distinguish between elite and subelite playing standards in female Gaelic football players. [ABSTRACT FROM AUTHOR]

Background: Problematic low energy availability (EA) is the underlying culprit of relative energy deficiency in sport (REDs), and its consequences have been suggested tobe exacerbatedwhen accompanied by lowcarbohydrate(CHO) intakes. Objectives: This study compared dietary intake, nutrition status and occurrence of REDs symptoms in groups of female athletes, displaying different patterns of EA and CHO intake. Methods: Female 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 <30 kcal/kg fat free mass, and SCHO patterns characterised by CHO intake ≥3.0 and LCHO <3.0 g/kg body weight for most of the registered days. Body composition was measured with dual energy x-ray absorptiometry, resting metabolic rate with indirect calorimetry and serum blood samples were collected for evaluation of nutrition status. Behavioural risk factors and self-reported symptoms of REDs were assessed with the Low Energy Availability in Females Questionnaire, Eating Disorder Examination Questionnaire Short (EDE-QS), Exercise Addiction Inventory, and Muscle Dysmorphic Disorder Inventory. Results: In total, 36.6% were categorised as SEA + SCHO, of which 5/16 were ball sport, 7/10 endurance, 1/7 aesthetic, 2/5 weight-class, and 0/3 weight-class athletes. Of LEA + LCHO athletes (19.5% of all), 50% came from ball sports. Aesthetic and endurance athletes reported the greatest training demands, with weekly training hours higher for aesthetic compared to ball sports (13.1 ± 5.7 vs. 6.7 ± 3.4 h, p = 0.012). Two LEA + LCHO and one SEA + LCHO athlete exceeded the EDE-QS cutoff. LEA + LCHO evaluated their sleep and energy levels as worse, and both LEA groups rated their recovery as worse compared to SEA + SCHO. Conclusion: Repeated exposures to LEA and LCHO are associated with a cluster of negative implications in female athletes. In terms of nutrition strategies, sufficient EA and CHO intakes appear to be pivotal in preventing REDs. [ABSTRACT FROM AUTHOR]

Purpose: Short periods of reduced energy availability are commonly undertaken by athletes to decrease body mass, possibly improve the power-to-mass ratio, and enhance physical performance. Our primary aim was to investigate the impact of 10 d of low energy availability (LEA) followed by 2 d of optimal energy availability (OEA) on physical performance parameters in trained females. Second, physiological markers at the whole-body and molecular level related to performance were evaluated. Methods: Thirty young trained eumenorrheic females were matched in pairs based on training history and randomized to a 10-d intervention period of LEA (25 kcalfat⋅free mass (FFM)-1⋅d-1) or OEA (50 kcal⋅FFM-1⋅d-1) along with supervised exercise training. Before the intervention, participants underwent a 5-d run-in period with OEA + supervised exercise training. After the LEA intervention, 2 d of recovery with OEA was completed. Participants underwent muscle biopsies, blood sampling, physical performance tests, body composition measurements, and resting metabolic rate measurements. A linear mixed model was used with group and time as fixed effects and subject as random effects. Results: Compared with OEA, LEA resulted in reduced body mass, muscle glycogen content, repeated sprint ability, 4-min time-trial performance, and rate of force development of the knee extensors (absolute values; P < 0.05). Two days of recovery restored 4-min time-trial performance and partly restored repeated sprint ability, but performance remained inferior to the OEA group. When the performance data were expressed relative to body mass, LEA did not enhance performance. Conclusions: Ten days of LEA resulted in impaired performance (absolute values), with concomitant reductions in muscle glycogen. Two days of recovery with OEA partially restored these impairments, although physical performance (absolute values) was still inferior to being in OEA. Our findings do not support the thesis that LEA giving rise to small reductions in body mass improves the power-to-mass ratio and thus increases physical performance. [ABSTRACT FROM AUTHOR]

The rise in participation in sports, like women's cricket, is linked with increased injury risk. Providing high-level longitudinal data is the first step in implementing evidence-based injury prevention strategies. Prospective cohort study. This cohort study aims to describe the injury profiles in sub-elite women's cricket in South Africa during the 2022/23 season. Injuries were prospectively recorded using injury surveillance questionnaires, injury surveillance database, and logbooks completed by each team's medical staff. Injury rates were investigated for match and training days, body region, player role, nature, and activity at the time of injury. Three teams with a total of 44 players (20.86 ± 1.6 years) were included in the study. Injury incidence was 85.23 per 1000 player match days, 15.91 for match time-loss and 69.32 for non-time-loss, with 2.95% of players unavailable for match selection on any day. Fast bowlers had the highest injury incidence. Fielding caused 46.67% of all injuries. Injury incidence was higher in training than in matches. The wrist/hand had the highest injury incidence and caused the most match time-loss. This study provides valuable insights regarding the current injury rates in sub-elite female cricket players. • Injury incidence at sub-elite women's cricket appears lower than elite levels. • Time-loss injuries were higher in training compared to matches. • The most time-loss injuries occurred in the lower leg and ankle. • Fast bowlers had the highest muscle-related injuries. • Wrist and hand injuries caused the most matches missed. [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]

To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season. Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,' Ober's, Ely's tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups. During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: −10.6°; 95% confidence interval: −16.5, −4.6; p < 0.01) and lower hip abduction strength (mean difference: −4.7% of body weight; 95% confidence interval: −9.2, −0.3; p = 0.04). Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing. [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]

Bone stress injuries (BSIs) are common among athletes and have high rates of recurrence. However, risk factors for multiple or recurrent BSIs remain understudied. Thus, we aimed to explore whether energy availability, menstrual function, measures of bone health, and a modified Female Athlete Triad Cumulative Risk Assessment (CRA) tool are associated with a history of multiple BSIs. We enrolled 51 female runners (ages 18–36 years) with history of ≤1 BSI (controls; n = 31) or ≥3 BSIs (multiBSI; n = 20) in this cross-sectional study. We measured lumbar spine, total hip, and femoral neck areal bone mineral density by dual-energy X-ray absorptiometry, bone material strength index using impact microindentation, and volumetric bone mineral density, microarchitecture, and estimated strength by high-resolution peripheral quantitative computed tomography. Participants completed questionnaires regarding medical history, low-energy fracture history, and disordered eating attitudes. Compared with controls, multiBSI had greater incidence of prior low-energy fractures (55% vs. 16%, p =.005) and higher modified Triad CRA scores (2.90 ± 2.05 vs. 1.84 ± 1.59, p =.04). Those with multiBSI had higher Eating Disorder Examination Questionnaire (0.92 ± 1.03 vs. 0.46 ± 0.49, p =.04) scores and a greater percentage difference between lowest and highest body mass at their current height (15.5% ± 6.5% vs. 11.5% ± 4.9% p =.02). These preliminary findings indicate that women with a history of multiple BSIs suffered more prior low-energy fractures and have greater historical and current estimates of energy deficit compared with controls. Our results provide strong rationale for future studies to examine whether subclinical indicators of energy deficit contribute to risk for multiple BSIs in female runners. [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

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.

The growth of investment in women's cricket has led to the development of new professional pathways. However, there is lack of specific evidence to support the development of these athletes. This study aimed to take a first step in understanding the participation histories of female cricketers selected into English women's professional academies. 84 players completed the Participation History Questionnaire (PHQ) to capture details of activities engaged in across development, including milestones, cricket activity, and engagement in other sport activities. There were relative age effects where players' birthdate distributions differed from national norms (X2 = 8.451, p =.003, V = 0.227), and more players than expected attended independent schools (X2 = 7.980, p =.005, V = 0.232). Participants engaged in cricket informally before coach led training, have siblings (particularly brothers) interested in cricket and often played boy's cricket before engaging in the girl's or women's game. Developmental activities were characterised by early engagement, high levels of diversification, and very low levels of play compared to high levels of formal practice and match play. These findings have implications for the advancement of talent identification and development policies and processes in women's cricket. [ABSTRACT FROM AUTHOR]

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]

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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]

The menstrual cycle is one of the most fundamental differences between men and women and is capable of influencing the performance, well-being and health of female athletes. Despite increasing research, the influence of the menstrual cycle on athletic performance is still largely a mystery and highly individual. This in turn increases the importance of effective communication between coaches and female athletes. The purpose of this study is to analyse the existing communication behaviour of coaches as perceived by female athletes, as well as their willingness to communicate about the menstrual cycle. Therefore, we developed an online questionnaire addressed to female sports club athletes (n = 1195). Questions about the coach's thematisation of the menstrual cycle and the female athlete's willingness to communicate served as dependent variables. Ordinary least squares regressions were conducted for both dependent constructs. We found that communication behaviour depends on coaches' age, type of sport and training frequency. Communication willingness depends on the gender of the coach, athletes' age, type of sport, training frequency and perception of cycle-related performance fluctuations. Overall, the results of our study also show a large gap between desire and reality-even in 2022 coaches rarely talk about the menstrual cycle, although a large proportion of female athletes would be willing to do so. Both coaches and athletes should be empowered to communicate more openly about menstrual cycle. Improving communication skills on both sides may also improve the coach-athlete relationship. [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]

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]