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  • Writer's pictureMicaela Zettel, PT, MScPT, MCISc AHCP SEM, BScHK(hons),

Supporting the Female Athlete: What is Female Sports Medicine?

Updated: Feb 13, 2021

What is an athlete? 

“a person who is proficient in sports and other forms of physical exercise”. - merriam webster 

What is sports medicine? 

“a field of medicine concerned with the prevention and treatment of injuries and disorders that are related to participation in sports.” - merriam webster

What is Female Sports Medicine? There’s no clear definition out there……So I’ll give you one: “a field of medicine concerned with the prevention and treatment of injuries and disorders that are related to participation in sports for female athletes”. In my opinion, as someone who is passionate about contributing to the field of female sports medicine, anyone working with female athletes (doctors, physiotherapists, chiropractors, massage therapists, coaches, personal trainers, strength coaches, etc) must have an understanding of the unique needs of female athletes. “Given the lack of research on elite female athletes, this is challenging at present. This limits the ability to adopt an evidence-informed approach when working in female sports, and as such, we are likely failing to maximize the performance potential of female athletes” (Emmonds et al, 2019). While we wait for this research to be done, we must work together to support our female athletes, with the knowledge that we do have about their systems, hormones, movement needs, changes they undergo throughout different stages in life, and the specific mindset challenges they face. This is all part of a holistic approach to support our female athletes. 

Most or all of our treatment concepts and interventions, training methods and performance information comes from research done on elite male athletes,  yet we know that there are female-specific factors and considerations  that must be understood and integrated into their care. Emmonds et al outlines a clear example of these types of considerations:. 

 “ it is known that estrogen concentrations fluctuate throughout the menstrual cycle and estrogen has measurable effects on muscle function and tendon and ligament strength. Estrogen and relaxin concentrations have been reported to peak during the luteal phase of the menstrual cycle, potentially increasing anterior cruciate ligament (ACL) injury risk. Similarly, fluctuations in estrogen and progesterone concentrations during different stages of the menstrual cycle may affect temperature regulation, central nervous system fatigue, substrate metabolism, and overall exercise performance. Therefore, female athletes may require different performance, nutritional, recovery, and injury prevention strategies in comparison to male athletes.” (2019). 

If you work with female athletes, you should be familiar with their unique needs. If you aren’t  h, I would encourage you to get familiar. I’m going to highlight a point made and discuss it a little further. We hear a lot about how youth female athletes are at a higher risk of ACL tears and so we focus on strengthening - which is important - BUT what if it’s more than that? What if we need to be doing something different? What if we need to be providing education and intervention in a different body system? ay their metabolism? Or their hormones? Or tailor the training we are doing with their growth and their hormonal development? There are many questions to ask and answers that need to be found to best support our female athletes. 

If you work with female athletes, these are topics that I think you must have a good understanding of or, at minimum, be aware of so that you can get someone involved who does have this knowledge -  a team approach. I don’t have all the answers and info, and neither do you - and that’s okay. I have created a list to get you thinking about what female athletes need. This list comes from what I have found through my own practice, research and working with other team members in caring for female athletes. 

The list (it’s not exhaustive I’m sure, if you have something to add I encourage you to message me and let me know!): 

  • Hormones and how they affect performance, recovery and injury risk at multiple different points in the menstrual cycle and life (think puberty, pre/post-partum and menopause). 

  • Metabolism and common issues that arise with female athletes at various points in their lives, and what to do about it, signs and symptoms that their metabolism is suffering (think iron deficiency, RED-S (Relative Energy Deficiency in Sport), trying to eat like a male and expecting the same results, what factors affect their metabolism, etc). Learn more about RED-S. Learn more about iron deficiency.

  • Movement patterns that female athletes tend to adopt that do not serve them well, why these start, why they need to be improved and how to do this. If you work with female athletes at any age and you are not talking about their bathroom habits and their pelvic floor, then you are doing them a disservice. If you can’t talk about it, then work with someone who can (ahem, refer them to me, fellow colleagues - I’d be happy to collaborate with you!). 

  • How the core works - and during the different parts of a female athlete’s life, how it changes, why it changes and how education, training and intervention can support them through these changes. If you are using an approach that has been researched on men only - think again…….please!!!  Learn about some of the issues female athletes experience with their core and training.

  • How the female athlete’s brain works - why it’s different and how you can empower them in their recovery, training, and performance - at multiple stages in life. 

  • Current health information pertaining to females - not sticking with what has always been done. Please stop prescribing hormonal birth control to treat hormonal imbalances and PMS symptoms. When we know better we need to do better - and we know better now. For the record - I am pro birth control and choice, but let’s look at what type of birth control we are using with a critical lens and ask some important questions; there are more options out there than you might think. Learn more about hormones: What is "normal". Hormones: What is "abnormal".

  • If you coach, treat, or train youth female athletes, you need to have an understanding of the various changes their bodies are going through (hormones, developing breasts, and the pelvis changes shape) - these all affect their ability to move and execute the skills you want them to. Again - if you don’t feel comfortable, it’s out of your comfort zone - HIT ME UP! I’m here to work with you. 

I want better information and support for our female athletes throughout their lives. This is how I’m going to start. I have a vision where female sports medicine is a division of medicine, a special division on its own, and we have evidence informed information to support what we know and do. For now, I will keep educating female athletes, sharing my clinical insights and experience and working to empower females in their health and performance. 

As always, I’m here to help. If you have questions, reach out to me via email or social media and check out my YouTube channel for more information.



  1. Emmonds, S., Heyward, O. & Jones, B. The Challenge of Applying and Undertaking Research in Female Sport. Sports Med - Open 5, 51 (2019).

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