March 8, 2025
The dialogue surrounding female participation in sport is in constant change, evolving as research continues to develop and provide further information on how an inclusive environment impacts an athlete’s continued involvement past adolescence.
In recent years, research has created space for sport medicine and science professionals, coaches, parents and athletes to discuss the importance of education regarding female participation in sport and the various factors involved.
Understanding the influence of the menstrual cycle and being aware of how physiological differences can impact injury risk are a couple valuable topics to consider.
There is no one approach to coaching that can equally accommodate both male and female athlete requirements, so education in both is key.
By the age of 16, five in ten girls are no longer involved in sport and participate at lower rates than boys, according to statistics from the Canadian Women & Sport Rally Report 2024. In addition, the dropout rate for women in sport increases after the age 16 and continues late into teen years. More than one in five young women leave sport at this point, although recently there has been a notable increase in the number of female athletes continuing their pursuit of sport into adulthood.
Closing the gap seen in sport participation and research is complicated, but there are an innumerable number of individuals working behind the scenes to achieve a future where there is equality in sport education.
The influence of physiology
Following adolescence, young girls often have to adjust to changes in how their bodies move and according to sport physiotherapist Kelsi Hilderman, it can be challenging. She states that females have different physiology, anatomy and hormone profiles, which causes them to move differently and this translates into different risks of injury than seen in male athletes.
Physiotherapists such as Hilderman work to inform individuals on why there is a recurrence of certain injuries in female athletes and the importance of understanding the cause.
“Some [risk of injury] is based on moving differently and so because of [women’s] anatomy, wider hips, muscle bulk and even neuromuscular, they have different ways that their brain controls their muscles…so all those things sort of combined, contribute to that increase risk in injury.”
She states that typically women will experience lower body injury such as problems with ACLs, patellofemoral pain and stress fractures.
That understanding of different injury risk can allow coaches to build a toolbox of information that can benefit female athletes through modified training. Hilderman encourages coaches to be open to assistance while making the transition.
“Be willing to seek out information and bring someone in when you are not quite sure how to modify your training to get the most of your athletes, but also to help with injury prevention that we know is higher with female athletes.”
The science behind supporting female athletes
Much like the body it studies, the sport science and medical field is in constant fluctuation.
Up until recently, research lacked proper gender-diversity, which left female athletes following guidelines that were created from male-based research and thus a gap developed.
“In a lot of scientific research, we know that females are significantly under-represented and so this data gap, specifically in [physiotherapy] has been looked into and studied a lot this past five to ten years to see where we are at and to know where we need to improve,” shared Hilderman. “There is some research out there and in a lot of that research quality is an issue. So, it has been really challenging for researchers out there who are trying to create protocols for female athletes.”
According to Hilderman, the lack of quality in current research stems from studies not accounting for and properly tracking hormone levels and the differences in women’s menstrual cycle.
With that, individualism has become a driving force in accommodating the needs of athletes during active training and while in recovery.
“It always has to be individualized, because women experience the different jumps and valleys of those hormones differently,” said Hilderman.
Regardless of what the research and protocols reflect, Hilderman centres her practice on the overarching influence of individual experience. She suggests that her athletes track their cycle and encourage them to delve deeper by tracking their sleep quality, motivation, mood and reaction time for at least three months.
By tracking this information, athletes become more in tune with their cycle, which allows them to consider energy level and symptoms prior to a training session or competition. As Hilderman states, athletes knowing about their cycle and how it affects them throughout the month puts them in control.
The value of that internal awareness is something sport nutritionist Heather Hynes echoes to athletes as well.
“Being able to track [their cycle] and know what normal is, is so helpful,” said Hynes. “The science is all over the place so there aren’t specific recommendations that would fit for every single person. I would say that biggest thing is that everyone is unique.”
Consistent with what is outlined in the Rally Report, the menstrual cycle is one of many factors that can influence how female athletes engage in sport and focusing on an individual’s needs is key to creating an inclusive environment.
Working with the science given
The recommended daily values once suggested in sport nutrition have undergone positive change over the years, now encouraging less restriction and more autonomy in choice of diet.
Although guidelines have modernized, the science that they are developed from continue to lack proper gender diversity. Like the field of physiology, sport nutrition research is often compiled from male-based studies.
“All of the recommendations that you see published in sport nutrition, whether it is carbohydrate requirements during exercise, or carbohydrate and protein requirements in recovery, that is based on males,” said Hynes.
The current era of sport medicine and science research has left individuals like Hynes and Hilderman to take information that is available and make it applicable to female athletes.
“There are well documented [forms of] information that do know about the two main hormones that fluctuate in your cycle – estrogen and progesterone – and how they can affect things like muscle building, endurance and recovery. We just don’t have the research right now to apply it to sport,” shared Hilderman when asked about the influence of the menstrual cycle on training.
With that knowledge of how estrogen and progesterone play a role in menstruation, Hilderman will inform her athletes that when estrogen is high, individuals are typically more motivated, mentally resilient and able to build muscle better. That knowledge can allow athletes to determine a training schedule that works best with their bodies and start a conversation with their coach.
When possible, both Hilderman and Hynes take the science that is published and use it as building block in their practice.
“There is still a lot of work to do, not only in the sport science, sport medicine field, but in a lot of scientific research where females are severely underrepresented” said Hilderman.
The value of nutrition
Proper nutrition plays a valuable role in an athlete’s energy level and their ability to perform at the level they desire.
Macronutrient intake during in-season months when an athlete’s energy expenditure is higher, needs to be met with an equal increase in the energy that is taken in via food.
According to Hilderman, low energy can affect things like recovery and performance, bone density, as well as how an athlete adapts to training sessions. In addition, risk of injury will go up.
“We can identify during in-season months, your body needs more energy. There are just so many more stressors from other places, we want to make sure that we are getting that [energy] in with food,” said Hynes.
Coaches often inquire about the role they can play in their athletes’ nutrition and Hynes asserts that there is no need for athletes to track what they are eating or changes in body composition. She states that there are other signs that coaches and athletes can watch for to make sure the body is getting enough.
“You’ve got to look for those small signs. Maybe the athlete’s mood is changing a bit, or an athlete is changing their attendance and maybe losing their desire to want to train hard, or the athlete doesn’t look like they are having fun anymore.”
Those indications of malnutrition can signify other underlying issues that may go unaddressed. For example, when a female athlete overextends their available energy, they can experience a loss of their menstrual cycle.
“Your body will downregulate the menstrual cycle, it’s almost like it goes into survival mode. When that happens you get disfunction of your menstrual cycle, which means you get disfunction of the fluctuating hormones and we know that those hormones affect many different systems in your body,” said Hilderman.
“That is not something that we want to be seeing, definitely not something we want to be seeing long term,” added Hynes.
Individualism is the basis to how Hynes guides athletes through their nutrition, whether male or female. She encourages athletes to eat what their bodies crave during certain times of their menstrual cycle and works with athletes to find the best way to fuel their individual body.
“I think that the biggest thing for [athletes] to understand is that the process requires energy and if they are finding certain times of the day, or certain days of the month, they have less energy or motivation to train, to really kind of figure out what is going on and why they might feel like that,” said Hynes. “It is never black and white. I think when you are talking about any type of science, it is never black and white because it is always changing.”
Continuing Women in Sport Education:
Coaching Female Athletes – Nutrition, the Menstrual Cycle and performance. Your Questions Answered! (March 26)
Following previous workshops on coaching female athletes presented by Canadian Sport Centre Saskatchewan, Heather and Kelsi will be answering questions on the role that nutrition can play in helping performance during the menstrual cycle. Registration and more information.
Canadian Women & Sport – Body Confidence in Sport Webinar (March 20)
Sask Sport will be hosting a webinar featuring guest speaker, Dr. Eva Pila, who will navigate how psychosocial body experiences, such as body image concerns and weight stigma, impact quality participation in physical activity. Registration and more information.
Women and Girls in Sport Resource Kit Development (ongoing)
Sask Sport has hired Spark Solutions to develop a resource kit to support the development of girls and women to become and stay involved in sport in Saskatchewan. If you’ve got a program or initiative that you would like to share about, please fill out the survey.