BJSM e-edition: Female athlete health








Several of the BJSM editorial team attended the excellent 2019 Isokinetic Conference in London this past April. One inspiring session at the conference focused specifically on the latest research in female sport. We heard a call for an increase in the number of published female-specific sports research studies. As the old saying goes “Men are from Mars, Women are from Venus”, therefore if we have gender differences we need to review the effectiveness of interventions (e.g. prevention programs) and whether they differ between the genders. This was discussed on the BJSM podcast last year by Jacky Forsyth and is included below in this e-edition.

Given the additional excitement generated by this year’s FIFA women’s world cup we have included some of the most recent papers on concussion and ACL risks in female athletes. We highlight the inspirational BJSM interview with the first ever female to run the prestigious Boston marathon – Kathrine Switzer. This e-edition includes the most recent updates on relative energy deficiency syndrome (RED-S) and reinforces some of the great research published in last year’s physical activity during pregnancy edition of BJSM.

It would be remiss of us not to mention that our female athlete edition also features some of the leading talent in the sports medicine research space. Highlighting the work of great female researchers such as Dr. Kathryn Ackerman and Dr. Margie Davenport is always a pleasure. When it comes to the female athlete there cannot be many better conferences than the BJSM approved Biennial International Female Athlete Conference held recently in Boston, USA. It may be worth adding the webpage to your diary to keep abreast of updates on the next one. With great guests such as Dr. Cheri Blauet and Dr. Kirsty Elliot-Sale, it’s sure to attract even more than the 450 registrants who attended this year! For more information click here.

We want to be sure that researchers and readers, know we have heard the call for more gender specific research in sports medicine. As a journal leading the way in our field we certainly look forward to publishing new evidence on gender specific differences in the elite sporting environment. If you want to join the debate, tweet us @BJSM_BMJ.

If you have ideas or want to suggest topics for future editions, we are keen to serve you, our audience. Please get in touch by using the #BJSMOnlineEdition on Facebook, Twitter or Instagram to let us know your thoughts. Also, don’t forget to download the BJSM App on iOS and Android. The App remains a convenient way to see all the latest podcasts, blogs and other BJSM content in one place.

We hope you enjoy these supplementary BJSM editions and wish you a physically active day!

— Your BJSM online editors

BJSM Online: The female athlete



Empowering female athletes in 2019
Kathrine Switzer


Katherine Switzer discusses her participation in the Boston marathon and her fight for female
representation across elite sport

In 1967, 20-year-old Kathrine Switzer became the first woman to complete the all-male Boston Marathon as an official entrant. She managed to fight off a race official who tried to force her from the course after only several kilometres, and made history as she crossed the finish line four hours later. Empowered by her experience, Kathrine became determined to create change for all women and has dedicated her career to advancing women’s sport, health and equality.

ORIGINAL ARTICLE (Journal of Adolescent Health)

The Influence of the Breast on Sport and Exercise Participation in School Girls in the United Kingdom
Joanna Scurr, Nicola Brown, Jenny Smith, et al.


Too many rib ticklers? Injuries in Australian women’s cricket
Nirmala Kanthi Panagodage Perera


Body Composition Periodization and Performance

@YLMSportScience featuring a paper from Stellingwerff (2017) found in the International Journal of Sport Nutrition and Exercise Metabolism.


SmartHER: Female Athlete Health at the English Institute of Sport (EIS)

Emma Ross and Richard Burden of the EIS Physiology team speak about the work they are doing around female athlete health to encourage athletes, coaches and support staff to open up the conversation and consider female physiology and psychology in training, recovery, nutrition and the coaching environment, in order to improve the health and performance outcomes for female athletes.


We need to talk about ‘manels’: the problem of implicit gender bias in sport and exercise medicine
Sheree Bekker, Osman H Ahmed, Ummukulthoum Bakare, et al.

ORIGINAL ARTICLE (European Journal of Applied Physiology)

Prevalence and Perceived Side Effects of Hormonal Contraceptive Use and the Menstrual Cycle in Elite Athletes
Daniel Martin, Craig Sale, Simon B. Cooper, Kirsty J. Elliott-Sale


Female athletes’ knowledge of the menstrual cycle and hormonal contraception

@clareMINAHAN and @brianna_larsen


Research imbalance: Sport and Exercise in Women versus Men

Jacky Forsyth (@JackyForsyth) is a senior lecturer at Staffordshire University. She is a lead organiser of the Women in Sport and Exercise Conference. In this podcast reviews the difference in the amount of research done on exercise in women compared to exercise in men, and why we need to correct this imbalance.


The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes
Georgie Bruinvels, Richard Burden, Nicola Brown, at al.

EDITORIAL (The Physician and Sportsmedicine)

Pelvic floor muscle function and urinary incontinence in the female athlete
Ellen K. Casey & Kate Temme


Risk Factors for ACL Injuries & how to prevent them


ORIGINAL RESEARCH (International Journal of Sports Medicine)

A Reliable Video-based ACL Injury Screening Tool for Female Team Sport Athletes

Simon Tarsha & Craig Sheridan

REDS (Relative Energy Deficiency Syndrome)


Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport
Kathryn E Ackerman, Bryan Holtzman, Katherine M Cooper, et al.


IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update
Margo Mountjoy, Jorunn Kaiander Sundgot-Borgen, Louise M Burke, Kathryn E Ackerman, Cheri Blauwet, Naama Constantini, Constance Lebrun, Bronwen Lundy, Anna Katarina Melin, Nanna L Meyer, Roberta T Sherman, Adam S Tenforde, Monica Klungland Torstveit, Richard Budgett


Clinical tips from Dr. Kathryn Ackerman on how to manage athletes with low energy availability

Dr. Kathryn Ackerman talks about the hot topic of energy availability in sport giving us clinical tips to manage athletes we suspect might be at risk of the consequences of low energy availability. Kathryn’s research focuses on the Female Athlete Triad and the various aspects of Relative Energy in Deficiency in Sport.


Relative energy deficiency in sport (RED-S)
Siobhan M Statuta, Irfan M Asif, Jonathan A Drezner


Relative energy deficiency in sport: an infographic guide

Nicola Keay, Alan Rankin

ORIGINAL ARTICLE (Scandinavian Journal of Sports Medicine and Sciences in Sports)

Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes
Emily M. Brook Adam S. Tenforde Elizabeth M. Broad, et al.


The IOC relative energy deficiency in sport clinical assessment tool (RED-S CAT) FREE
Margo Mountjoy, Jorunn Sundgot-Borgen, Louise Burke, et al.


Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes
Monica Klungland Torstveit, Ida Lysdahl Fahrenholtz, Mia Beck Lichtenstein, et al.


Energy Availability Concept


Hormone Cycles and Performance

Further discussion with Dr. ‘Kate’ Ackerman, MD, MPH, as she presents current research and hypotheses related to hormone cycles and athletic performance, during Boston Children’s Hospital Sports Medicine Division Female Athlete Conference.

ORIGINAL ARTICLE (International Journal of Sport Nutrition and Exercise Metabolism)

Characterization of Risk Quantification Differences Using Female Athlete Triad Cumulative Risk Assessment and Relative Energy Deficiency in Sport Clinical Assessment Tool
Bryan Holtzman, Adam S. Tenforde, Allyson L. Parziale, Kathryn E. Ackerman

EDITORIAL (Clinics in Sports Medicine)

Female Athlete Triad: Future Directions for Energy Availability and Eating Disorder Research and Practice
Nancy I.Williams, Siobhan M.Statuta, Ashley Austin

Pregnancy and Exercise


Physical activity for pregnant women


2019 Canadian guideline for physical activity throughout pregnancy
Michelle F Mottola, Margie H Davenport, Stephanie-May Ruchat, et al.


Do female elite athletes experience more complicated childbirth than non-athletes? A case–control study
Thorgerdur Sigurdardottir, Thora Steingrimsdottir, Reynir Tomas Geirsson, et al.


Bumping up physical activity throughout pregnancy

Fewer than 15% of women achieve the minimum recommendation of 150 min per week of moderate-intensity physical activity throughout their pregnancy. Meeting the recommendation can reduce the risk of pregnancy-related illness such as depression by at least 25%, and the risk of developing gestational diabetes, hypertension and preeclampsia by 40%. Dr. Margie Davenport addresses common misconceptions regarding physical activity during pregnancy and explains the new 2019 Canadian guidelines for physical activity throughout pregnancy.

ORIGINAL RESEARCH (Medicine & Science in Sport & Exercise

Effects of Aerobic Exercise during Pregnancy on One-Month Infant Neuromotor Skills
Amy McMillan, Linda May, Georgeanna Gaines, et al.

ORIGINAL RESEARCH (Medicine & Science in Sport & Exercise

Effects of Aerobic Exercise during Pregnancy on One-Month Infant Neuromotor Skills
Amy McMillan, Linda May, Georgeanna Gaines, et al.


Considerations to guide return to postnatal running

Tom Goom, Gráinne Donnelly & Emma Brockwell


It’s time to treat exercise in pregnancy as therapy
Gregory Davies & Raul Artal


Physical activity in pregnancy—what, when, how and why to be active: Prof Greg Whyte, OBE

Professor Greg Whyte, one of the world’s most respected and renowned Sport & Exercise Scientists. Greg combines his academic position at Liverpool John Moores University with both public & private work around the UK, and is a hugely respected scientist and voice, with expertise in a wide range of domains. Not content with overseeing breathtaking Sport Relief challenges and helping to raise >£30m for charity, he has recently published a book titled ‘Bump It Up’, focused on advice for pregnant women.

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