Attitudes And Practices Of Elite Strength Coaches Towards Sex-specific Needs In International Women's Rugby Union

Abstract

The Female Athlete Triad is a well-established medical condition marked by low energy availability, low bone density, and menstrual disturbance, resulting in negative health outcomes that range from mild to severe. Substantial research on the Triad has been conducted in samples of high-level female athletes, but less is known about the risk of the Triad among recreationally active females. PURPOSE: To compare the prevalence of the Triad in competitive and recreationally active females. METHODS: 652 premenopausal females (26±7.3 yrs) completed an electronic survey. Individuals were included if they performed at least 75 min of vigorous aerobic activity, 150 min of moderate aerobic activity, or two days of resistance training per week. Participants self-selected as a competitive athlete (CA; n=131) of any level (i.e., amateur, professional) or recreationally active athlete (RA; n=521) and reported diagnosis of medical conditions associated with the Triad. The Low Energy Availability Questionnaire (LEAF-Q) screened for Triad risk by assessing injuries, gastrointestinal (GI) and menstrual function with a total score of ≥8 considered at risk for the Triad. Physical activity in the last 7 days was reported using the International Physical Activity Questionnaire (IPAQ). RESULTS:The LEAF-Q assessed 44% of participants to be at risk for the Triad, with no difference between CA and RA (p=.762). When examining the LEAF-Q subscales, no group differences in GI function (p=.753) or menstrual function (p=.445) were noted, but CA had a higher injury score than RA (p=.031). Self-reported rates of disordered eating (15% vs 14%) and stress fracture (21% vs 20%) diagnosis did not differ between CA and RA. CA reported a higher diagnosis rate of low bone mineral density (4% vs 1%) and oligo/amenorrhea (11% vs <5%) compared to RA. No significant differences were found between CA and RA when comparing body mass index (BMI) (p=.143) or total weekly minutes of physical activity (p=.190). CONCLUSIONS: Physically active females are at a high risk of the Triad, regardless of their athlete status, total volume of physical activity, or BMI. Therefore, future Triad research should include recreationally active women. Development of a quick screening tool is urgently needed to identify active women at risk for the Triad.

Examining the coach–athlete relationship for facilitators and barriers to healthy sport participation for cyclically menstruating athletes: A systematic review

“…27,29 Overall, coaches, as well, considered their own knowledge of the menstrual cycle to be poor. 39,51,52 They perceived the menstrual cycle to be a complicated topic and were unclear about the impact of training on the menstrual cycle and vice versa. 24,30,41,52 Sports scientists, nutritionists and physiotherapists, however, were more aware of how their respective domains interacted with menstrual function.…”

“…39,51,52 They perceived the menstrual cycle to be a complicated topic and were unclear about the impact of training on the menstrual cycle and vice versa. 24,30,41,52 Sports scientists, nutritionists and physiotherapists, however, were more aware of how their respective domains interacted with menstrual function. 26,36 In addition to finding their own knowledge of the menstrual cycle to be poor, athletes and coaches perceived others' knowledge to be insufficient as well.…”

“…32 Situations where coaches had modified or adapted training routines based on the athletes' needs served to increase their willingness for more open communication. 36,52 Athletes also reported that attending formal education sessions had helped them open up and seek support from their coaches. 41 Coaches noted that approaching athletes with menstrual tracking information and performance implications of their symptoms was conducive to more open communication regarding the menstrual cycle.…”

“…Most athletes and coaches recognised the need to improve their own knowledge of menstrual function, menstrual symptoms, and their impact on athletic performance. 24,28,30,32,33,41,52 Athletes expressed a desire to see more research and data, as well as multi-disciplinary collaboration between coaches and other staff, to improve the quality and quantity of communication around the topic. 28 Athletes indicated the need for early and more personal communication from their coaches as well.…”

“…28 Among all groups of athletes and coaches, there was a recognition that their clubs, organisations, and sport associations must improve their support through formal education and knowledge-sharing opportunities and expert-led discussions. 25,30,41,49,52…”