Optimising Training for Women in Sport

For many years, sports science and training programs were largely designed around male physiology, leaving female athletes underrepresented in research. This created gaps in our understanding of how women train, recover, and respond to exercise.

Female-specific training helps bridge this gap by recognising the unique hormonal, physiological, and musculoskeletal needs of women. With evidence-informed training approaches, female athletes can reduce injury risk, improve performance, and feel stronger and more confident in their movement and sport.

Why Female-Specific Training is Essential

Women have unique physiological characteristics that influence how our bodies respond to exercise.

These include:

• Hormonal fluctuations: Oestrogen and progesterone levels change across the menstrual cycle, affecting strength, endurance, ligament stability, and recovery. For instance, during the follicular phase, rising oestrogen may enhance strength and power but also increase ligament laxity, potentially raising ACL injury risk. Conversely, the luteal phase may reduce energy availability and endurance due to progesterone effects. Adjusting training load and intensity according to these phases can help optimise performance and reduce injury risk.

• Bone health and stress fracture risk: Women are at higher risk of bone density loss, particularly if they experience irregular menstrual cycles, a hallmark of Relative Energy Deficiency in Sport (RED-S). Maintaining adequate nutrition and weight-bearing exercise is key to long-term skeletal health.

• Pelvic floor and core strength: are vital for stability, power, and injury prevention. Weak or underactive muscles particularly after childbirth can lead to incontinence, pelvic organ prolapse, and reduced athletic performance.

Menstrual Cycle Considerations in Training

Understanding an athlete’s menstrual cycle is crucial for tailoring training programs:

1. Follicular Phase (Day 1–14): Rising oestrogen promotes strength and recovery. This phase is ideal for higher-intensity training and power-based exercises.

2. Ovulatory Phase (Around Day 14): Peak oestrogen may increase ligament laxity. Emphasis on stability and controlled strength work can reduce injury risk.

3. Luteal Phase (Day 15–28): Progesterone dominates, potentially reducing endurance and increasing fatigue. Focus on moderate-intensity training and recovery strategies.

4. Amenorrhea or irregular cycles: May indicate low energy availability or RED-S, requiring careful assessment and collaboration with various health practitioners including a women’s health physio, GP, dietitian or naturopath.

Postpartum Athlete Considerations

With proper guidance, women can safely return to pre-pregnancy performance levels and beyond. Pregnancy and childbirth bring significant changes to the pelvic floor, core muscles, and musculoskeletal system.

Women’s health physiotherapists focus on:

• Pelvic floor rehabilitation: Ensuring proper activation and strength to prevent dysfunction during high-impact sports.

• Abdominal and core retraining: Restoring functional strength after diastasis recti (abdominal separation).

• Gradual return to training: Considering ligament laxity from pregnancy hormones and fatigue from caring for a newborn.

• Load management: Modifying intensity, duration, and type of exercise to account for postpartum recovery and breastfeeding energy demands.

Understanding RED-S (Relative Energy Deficiency in Sport)

RED-S occurs when energy intake is insufficient for the demands of training and daily life, negatively affecting multiple body systems:

• Hormonal: Menstrual disturbances, reduced fertility, altered metabolism

• Skeletal: Low bone mineral density, increased stress fracture risk

• Cardiovascular and metabolic: Fatigue, reduced endurance, impaired recovery

• Psychological: Mood disturbances and disordered eating

Women’s health physiotherapists are key in early detection, working with athletes, coaches, and dietitians to optimise energy intake, bone health, and training strategies.

Strategies for Female-Specific Training

1. Individualised assessments: Evaluate menstrual cycle, bone density, pelvic floor, core strength, postpartum status, and previous injuries.

2. Strength and conditioning: Focus on multi-planar movements, core and glute activation, and progressive overload to reduce injury risk.

3. Cycle- and postpartum-informed load management: Adjust training intensity, recovery, and nutrition according to menstrual phase, postpartum recovery, and breastfeeding demands.

4. Education and empowerment: Teach athletes to monitor energy intake, recognise RED-S symptoms, understand their own physiology, and return safely after pregnancy.

5. Collaborative care: Integrate physiotherapists, dieticians, sports medicine doctors, and coaches to provide holistic support.

Key Takeaways

Female athletes deserve training programs that are evidence-informed, physiologically appropriate, and tailored to their needs. By understanding hormonal influences, menstrual cycle phases, postpartum recovery, pelvic floor and core health, bone density considerations, and RED-S, athletes, coaches, and physiotherapists can work together to:

• Improve performance

• Prevent injuries

• Support long-term health and well-being

Ready to optimise your training safely and effectively? Book a personalised assessment with our women’s health physiotherapist at Kaylana Wellness Collective, Hurstville and start training smarter, not harder.

Disclaimer:
The information shared in this blog is intended for educational purposes only and should not replace individual medical or health advice. Every person and athlete is different, and training recommendations should be tailored to your individual needs, goals, and medical history. If you are experiencing pain, injury, or specific health concerns, please consult your physiotherapist, doctor, or qualified health professional before commencing or modifying exercise or training programs.