The Female Athlete
“That time of the month”, “girl problems”, “woman’s issues”… whatever you want to call it, it happens, and its effect on female athletes training, recovery and chance of injury is very real. Within this article I’m going to touch base on what the menstrual cycle is, its effect on sport and exercise performance and training.
What is the Menstrual cycle?
The menstrual cycle occurs in reproductive aged females, lasting on average 28 days (give or take 7), consisting of three distinct phases; days 1-9 the follicular phase, when oestrogen and progesterone are low and when menses (your period) occurs; days 10-14 ovulatory phase, where oestrogen is high and progesterone is low and days 15-28 luteal phase, where oestrogen and progesterone are high.
The Female Athlete
With the onset of puberty in young females it is thought that the large fluctuations of the hormones oestrogen and progesterone may alter the neuromuscular system, leading to potential alterations in the way muscles activate. Although these alterations are all well stated within research, from an injury prevention stand point, it is still widely unknown if women are being trained or are training optimally for performance and injury prevention.
Why is it important to know about the menstrual cycle and its effect on exercising and training?
During each phase of the menstrual cycle there are apparent structural changes that occur within the muscle, as well as changes in tendon and ligament laxity. This is typically demonstrated in research investigating anterior cruciate ligament injuries (ACL) with women suffering up to eight times the amount of injuries than their male counterparts.
During the different phases of the menstrual cycle significant changes in the strength, aerobic performance, anaerobic performance and fatigue of a female athlete occurs.
In the earlier phases of the menstrual cycle (when oestrogen levels are high and progesterone levels are low), the maximal force you can produce is higher, indicating that 1 rep max will increase and therefore is a good time to optimise strength training. However, research has shown that this is also the time when injuries are most likely to occur as tendon laxity increases, indicating a link between oestrogen peaks and alteration in the tissue properties within the body.
During the later phase of the menstrual cycle (when both oestrogen and progesterone levels are high), the maximal force you can produce is thought to be lower and levels of fatigue greater. This means that you may be feeling more tired and sluggish and training feels significantly more challenging. However, this is when there is a lower risk of sustaining an injury.
Studies have previously investigated exercise interventions focusing on developing muscular strength of the knee stabilisers and proprioception. However, although these are positive interventions, the menstrual cycle is typically overlooked.
A common method used for reducing injury risk in female athletes is the use of hormonal contraceptives with the most common type being in the form of the oral contraceptive pill, more commonly known as ‘the pill’. It works by supressing the natural fluctuation of the hormones oestrogen and progesterone to prevent ovulation from occurring. This in turn means that the changes that would have occurred to the tissue properties in the body no longer happen, potentially reducing the risk of injury. Although this may be seen as a positive, there are also negative side effects that come with using hormonal contraception that may affect athletic performance such as: weight gain, alterations in mood and irregular periods. However, there is also evidence that using hormonal contraceptives doesn't affect performance at all, highlighting that there needs to be further research conducted in the area of female physiology.
Overall, if you’re not using hormonal contraceptives it is worth tracking your menstrual cycle to get the most out of your training and optimise your performance.
This can be done using a wide range of apps such as Fitbit, Clue and many more.
Whether it be a sporting injury or some other form of injury. I have gained practical experience in a clinic setting and also in an elite sport setting. This means I can offer you an in-depth, personalised rehabilitation programme and also provide a personalised training programme to further improve performance to help you achieve your goals.
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