The Female Runner: Gender Specifics

An Analysis of Running Impact on Different Surfaces for Injury Prevention

The impact that occurs on the runner's foot when it lands on the ground depends on numerous factors: footwear, running technique, foot strike and landing pattern, among others. However, the surface is a decisive factor that can be selected by the runner to improve their sports practice, thereby avoiding injuries. This study aimed to assess the number and magnitude of accelerations in impact (produced by the runner when their foot strikes the ground) on three different surfaces (grass, synthetic track, and concrete) in order to know how to prevent injuries. Thirty amateur runners (age 22.6 ± 2.43 years) participated in the study. They had to run consecutively on three different surfaces at the same speed, with a three axis-accelerometer placed on the sacrum and wearing their own shoes. The results showed that the running impacts differed based on the type of surface. Higher mean acceleration (MA) and mean peak acceleration (PA) in the impacts were observed on concrete compared to the other two surfaces. There were small differences for MA: 1.35 ± 0.1 g (concrete) vs. 1.30 ± 0.1 g (synthetic track) SD: 0.43 (0.33, 0.54) and 1.30 ± 0.1 g (grass) SD: 0.36 (0.25, 0.46), and small differences for PA: 3.90 ± 0.55 g (concrete) vs. 3.68 ± 0.45 g (synthetic track) SD 0.42 (0.21, 0.64) and 3.76 ± 0.48 g (grass) SD 0.27 (0.05, 0.48), implying that greater impacts were produced on concrete compared to synthetic track and grass. The number of peaks of 4 to 5 g of total acceleration was greater for concrete, showing small differences from synthetic track: SD 0.23 (-0.45, 0.9). Additionally, the number of steps was higher on synthetic track (34.90 ± 2.67), and small differences were shown compared with concrete (33.37 ± 2.95) SD 0.30 (-0.25, 0.85) and with grass (35.60 ± 3.94) SD 0.36 (-0.19, 0.91). These results may indicate a change in technique based on the terrain. Given the increasing popularity of running, participants must be trained to withstand the accelerations in impact that occur on different surfaces in order to prevent injuries.

Downhill Sections Are Crucial for Performance in Trail Running Ultramarathons-A Pacing Strategy Analysis

Trail running is an increasingly popular discipline, especially over long-distance races (>42.195 km). Pacing strategy, i.e., how athletes modulate running speed for managing their energies during a race, appears to have a significant impact on overall performance. The aims of this study were to investigate whether performance level, terrain (i.e., uphill or downhill) and race stage affect pacing strategy and whether any interactions between these factors are evident. Race data from four race courses, with multiple editions (total races = 16), were retrieved from their respective events websites. A linear mixed effect model was applied to the full dataset, as well as to two subgroups of the top 10 male and female finishers, to assess potential differences in pacing strategy (i.e., investigated in terms of relative speed). Better finishers (i.e., athletes ranking in the best positions) tend to run downhill sections at higher relative speeds and uphill sections at lower relative speeds than slower counterparts (p < 0.001). In the later race stages, the relative speed decrease is larger in downhill sections than in uphill ones (p < 0.001) and in downhill sections, slower finishers perform systematically worse than faster ones, but the performance difference (i.e., between slower and faster finishers) becomes significantly larger in the later race stages (p < 0.001). Among elite athletes, no difference in pacing strategy between faster and slower finishers was found (p > 0.05). Both men (p < 0.001) and women (p < 0.001), in the later race stages, slow down more in downhill sections than in uphill ones. Moreover, elite women tend to slow down more than men (p < 0.001) in the later race stages, regardless of the terrain, in contrast to previous studies focusing on road ultramarathons. In conclusion, running downhill sections at higher relative speeds, most likely due to less accentuated fatigue effects, as well as minimizing performance decrease in the later race stages in downhill sections, appears to be a hallmark of the better finishers.

Sex Differences in Training Behaviors of 10 km to Ultra-Endurance Runners (Part A)-Results from the NURMI Study (Step 2)

Training for running events is fundamental for successful participation in various running events such as 10 km, half-marathon, marathon, or ultra-marathon distances. Training behaviors are likely based on runner motivations and social constraints, particularly for females. Participants completed a questionnaire following a cross-sectional approach, including questions on sociodemographics, general training behaviors, and periodization training strategies. The final sample included 245 participants (141 females, 104 males), mostly from Germany (72%), Austria (18%), and Switzerland (5%), with a median age of 39 years (IQR 17) and a BMI of 21.7 kg/m² (IQR 3.5). Males more often trained alone and independently, whereas females were most likely to follow an external resource (p = 0.037). Non-parametric ANOVA revealed significant training differences between sexes in daily training mileages and durations at each phase and stage (p < 0.05) as well as in weekly training mileages and durations for general basic training and race-specific training (p < 0.05). Critical sex differences in training behaviors may arise from physiological differences and social expectations, which may be related to the distances they prefer to race at as well as their motivations for running and racing. This study provides a wide overview of training behaviors for endurance runners or professionals guiding healthy running performance.

The Female Athlete Triad-the impact of running and type of diet on the regularity of the menstrual cycle assessed for recreational runners

Background

The Female Athlete Triad (FAT) included three interrelated conditions including disordered eating, amenorrhea, and osteoporosis. The American College of Sports Medicine updated the definition of FAT to reflect the interdependence of low energy availability with or without eating disorders. The main aim of the study was to assess the impact of recreational running on potential disturbances in the regularity of women's menstrual cycles. Additionally, this work compared differences in the menstrual cycle between women runners and women who did not regularly practice sports. The respondents were also asked about the type of diet they consumed.

Methods

A total of 360 women took part in the research. This group included 217 runners and 143 control. The authors' questionnaire was used in the research.

Results

When compared to the control group, the runners had an increased frequency of menstrual cycles of <24 days (10.14% vs. 3.50%), fewer typical cycles of 25-31 days (75.58% vs. 86.71%), had fewer regular cycles per year (9.62 vs. 11.22), shorter duration of bleeding (4.79 vs. 5.27 days), and an increased frequency of painless menstruation (23.96% vs. 7.69%). A positive predictor of menstrual cycle disorders was the use of a 'special diet' (R:1.67; 95% C:0.47-2.87).

Conclusions

The runners had shorter and less regular monthly cycles and shorter and more often painless menstrual bleeding when compared to the control group. The frequency of menstrual disorders in runners was increased by following a 'special diet'. The frequency of menstrual cycle disorders in runners, however, did not differ significantly from the control group.

Vascular Function in Norwegian Female Elite Runners: A Cross-Sectional, Controlled Study

In general, aerobic exercise has a positive impact on the vascular system, but the syndrome of relative energy-deficiency in sports (RED-S) makes this impact less clear for the athlete. The present cross-sectional controlled study aimed to investigate the vascular function in female elite long-distance runners, compared to inactive women. Sixteen female elite long-distance runners and seventeen healthy controls were recruited. Assessments of vascular function and morphology included endothelial function, evaluated by flow-mediated dilatation (FMD), vascular stiffness, evaluated with pulse wave velocity (PWV), carotid artery reactivity (CAR %), and carotid intima-media thickness (cIMT). Blood samples included hormone analyses, metabolic parameters, lipids, and biomarkers reflecting endothelial activation. RED-S risk was assessed through the low energy availability in female questionnaire (LEAF-Q), and body composition was measured by dual-energy X-ray absorptiometry (DXA). We found no significant differences in brachial FMD, PWV, CAR %, cIMT, or biomarkers reflecting endothelial activation between the two groups. Forty-four percent of the runners had a LEAF-Q score consistent with being at risk of RED-S. Runners showed significantly higher HDL-cholesterol and insulin sensitivity compared to controls. In conclusion, Norwegian female elite runners had an as good vascular function and morphology as inactive women of the same age.

Even Pacing Is Associated with Faster Finishing Times in Ultramarathon Distance Trail Running-The "Ultra-Trail du Mont Blanc" 2008-2019

In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. This study investigated the effects of age, sex, and performance level on pacing in the UTMB^® (Ultra-trail du Mont Blanc) and aimed to verify previous findings obtained in the research on other running disciplines and other ultramarathon races. Data from the UTMB^® from 2008 to 2019 for 13,829 race results (12,681 men and 1148 women) were analyzed. A general linear model (two-way analysis of variance (ANOVA)) was applied to identify a sex, age group, and interaction effect in pace average and pace variation. A univariate model (one-way ANOVA) was used to identify a sex effect for age, pace average, and pace variation for the fastest men and women. In our study, pace average and a steadier pace were positively correlated. Even pacing throughout the UTMB^® correlated with faster finishing times. The average pace depended significantly on sex and age group. When considering the top five athletes in each age group, sex and age group also had significant effects on pace variation. The fastest women were older than the fastest men, and the fastest men were faster than the fastest women. Women had a higher pace variation than men. In male competitors, younger age may be advantageous for a successful finish of the UTMB^®. Faster male runners seemed to be younger in ultramarathon trail running with large changes in altitude when compared to other distances and terrains.

Perceptions of risk for stress fractures: A qualitative study of female runners with and without stress fracture histories

OBJECTIVES

To gain insight into perceived factors related to bone health and stress fracture (SF) prevention for female runners and to understand their experiences within the medical community.

DESIGN

Cohort qualitative study.

SETTING

University health system.

PARTICIPANTS

Forty female runners, 20 who had SF histories and 20 age-and-running-distance matched women without SF.

MAIN OUTCOME MEASURES

Women participated in audiotaped qualitative semi-structured interviews. For women with a SF history, questions sought their perspectives on factors that they felt contributed to SF, experiences with the medical community, and changes made post SF. For women without a SF history, questions sought perspectives on factors felt important to perceived running-related bone health.

RESULTS

Six themes emerged; 1) Previous/Recurrent Musculoskeletal Injuries, 2) Activity Patterns and Training Regimens, 3) Nutrition, 4) Prevention and Intervention, 5) Pain, and 6) Mindset. Within these themes, between group differences are characterized by differences in knowledge and/or application of knowledge for health and wellness. Compared to women without SF, women with SF histories increased training load more quickly, had poorer nutrition, performed less cross-training, and kept running despite pain.

CONCLUSIONS

More education is needed for female runners to decrease risks for SF.

Influence of speed and heel-to-toe drop in running shoes for female recreational runners: A cross-sectional study

In recent years, the popularity of running has boomed and the number of women runners has risen sharply. However, little research has been conducted into the running cycle as concerns female runners. The aim of this study is to analyse, in women runners, the relationships between spatiotemporal parameters in the running cycle, the heel drop in running shoes and a progressive increase in training speed, when running on a treadmill.Thirty-eight female runners were recruited from the Malaga University Athletics Club and Nerja Athletics Club. All were at least 18 years old, recreationally active (3-4 running sessions per week) and able to run 5 km in less than 25 min. Their running performance on a treadmill was recorded and spatiotemporal parameters assessed using the OptoGait system.As the running speed increased (8-12-15 km/h) the spatiotemporal parameters of the running cycle altered: the flight time increased (P < .001) and the contact time decreased (P = .05). Heel drop (4-12 mm) was not significantly associated with any of the parameters (phase 1: P = .198; phase 2: P = .191; phase 3: P = .242).A progressive increase in training speed on a treadmill directly influences the spatiotemporal parameters of the running cycle in women runners.

The 5- or 10-km Marikenloop Run: A Prospective Study of the Etiology of Running-Related Injuries in Women

Study Design Prospective cohort. Background The popularity of running events is still growing, particularly among women; however, little is known about the risk factors for running-related injuries in female runners. Objectives The aims of this study were to determine the incidence and characteristics (site and recurrence) of running-related injuries and to identify specific risk factors for running-related injuries among female runners training for a 5- or 10-km race. Methods Four hundred thirty-five women registered for the Marikenloop run of 5 or 10 km were recruited. Follow-up data were collected over 12 weeks using questionnaires, starting 8 weeks before the event and ending 4 weeks after the event. Two orthopaedic tests (navicular drop test and extension of the first metatarsophalangeal joint) were performed in the 8 weeks before the event. Running-related injuries, defined as running-related pain of the lower back and/or the lower extremity that restricted running for at least 1 day, were assessed at 1-, 2-, and 3-month follow-ups. Results Of 417 female runners with follow-up data (96%), 93 runners (22.3%) reported 109 running-related injuries, mainly of the hip/groin, knee, and lower leg. Multivariable Cox regression analysis showed that a weekly training distance of more than 30 km (hazard ratio = 3.28; 95% confidence interval [CI]: 1.23, 8.75) and a previous running injury longer than 12 months prior (hazard ratio = 1.88; 95% CI: 1.03, 3.45) were associated with the occurrence of running-related injuries. Conclusion Hip/groin, knee, and lower-leg injuries were common among female runners. Only weekly training distance (greater than 30 km) and previous running injury (greater than 12 months prior) were associated with running-related injuries in female runners training for a 5- or 10-km event. Level of Evidence Etiology, 2b. J Orthop Sports Phys Ther 2016;46(6):462-470. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6402.

The effects of gait retraining in runners with patellofemoral pain: A randomized trial

BACKGROUND

Running popularity has increased resulting in a concomitant increase in running-related injuries with patellofemoral pain most commonly reported. The purpose of this study was to determine whether gait retraining by modifying footstrike patterns from rearfoot strike to forefoot strike reduces patellofemoral pain and improves associated biomechanical measures, and whether the modification influences risk of ankle injuries.

METHODS

Sixteen subjects (n=16) were randomly placed in the control (n=8) or experimental (n=8) group. The experimental group performed eight gait retraining running sessions over two weeks where footstrike pattern was switched from rearfoot strike to forefoot strike, while the control group performed running sessions with no intervention. Variables were recorded pre-, post-, and one-month post-running trials.

FINDINGS

Knee pain was significantly reduced post-retraining (P<0.05; effect size=0.294) and one-month follow-up (P<0.05; effect size=0.294). Knee abduction was significantly improved post-retraining (P<0.05; effect size=0.291) and one-month follow-up (P<0.05; effect size=0.291). Ankle flexion was significantly different post-retraining (P<0.05; effect size=0.547), as well as ankle range of motion post-retraining (P<0.05; effect size=0.425) and one-month follow-up (P<0.05; effect size=0.425).

INTERPRETATION

Findings suggest running with a forefoot strike pattern leads to reduced knee pain, and should be considered a possible strategy for management of patellofemoral pain in recreational runners. This trial is registered at the US National Institutes of Health (clinicaltrials.gov) #NCT02567123.

Performance and Age of the Fastest Female and Male 100-KM Ultramarathoners Worldwide From 1960 to 2012

The purpose of this cross-sectional study was to investigate the change in 100-km running performance and in the age of peak performance for 100-km ultramarathoners. Age and running speed of the annual fastest women and men in all 100-km ultramarathons held worldwide between 1960 and 2012 were analyzed in 148,017 finishes with 18,998 women and 129,019 men using single, multivariate, and nonlinear regressions. Running speed of the annual fastest men increased from 8.67 to 15.65 km.h(-1) and from 8.06 to 13.22 km.h(-1) for the annual fastest women. For the annual 10 fastest men, running speed increased from 10.23 ± 1.22 to 15.05 ± 0.29 km.h(-1) (p < 0.0001) and for the annual 10 fastest women from 7.18 ± 1.54 to 13.03 ± 0.18 km.h(-1) (p < 0.0001). The sex difference decreased from 56.1 to 16.3% for the annual fastest finishers (p < 0.0001) and from 46.7 ± 8.7% to 14.0 ± 1.2% for the annual 10 fastest finishers (p < 0.0001). The age of the annual fastest men increased from 29 to 40 years (p = 0.025). For the annual fastest women, the age remained unchanged at 35.0 ± 9.7 years (p = 0.469). For the annual 10 fastest women and men, the age remained unchanged at 34.9 ± 3.2 (p = 0.902) and 34.5 ± 2.5 years (p = 0.064), respectively. To summarize, 100-km ultramarathoners became faster, the sex difference in performance decreased but the age of the fastest finishers remained unchanged at ∼ 35 years. For athletes and coaches to plan a career as 100-km ultramarathoner, the age of the fastest female and male 100-km ultramarathoners remained unchanged at ∼ 35 years between 1960 and 2012 although the runners improved their performance over time.

Injuries in runners; a systematic review on risk factors and sex differences

BACKGROUND

The popularity of running continues to increase, which means that the incidence of running-related injuries will probably also continue to increase. Little is known about risk factors for running injuries and whether they are sex-specific.

OBJECTIVES

The aim of this study was to review information about risk factors and sex-specific differences for running-induced injuries in adults.

SEARCH STRATEGY

The databases PubMed, EMBASE, CINAHL and Psych-INFO were searched for relevant articles.

SELECTION CRITERIA

Longitudinal cohort studies with a minimal follow-up of 1 month that investigated the association between risk factors (personal factors, running/training factors and/or health and lifestyle factors) and the occurrence of lower limb injuries in runners were included.

DATA COLLECTION AND ANALYSIS

Two reviewers' independently selected relevant articles from those identified by the systematic search and assessed the risk of bias of the included studies. The strength of the evidence was determined using a best-evidence rating system. Sex differences in risk were determined by calculating the sex ratio for risk factors (the risk factor for women divided by the risk factor for men).

MAIN RESULTS

Of 400 articles retrieved, 15 longitudinal studies were included, of which 11 were considered high-quality studies and 4 moderate-quality studies. Overall, women were at lower risk than men for sustaining running-related injuries. Strong and moderate evidence was found that a history of previous injury and of having used orthotics/inserts was associated with an increased risk of running injuries. Age, previous sports activity, running on a concrete surface, participating in a marathon, weekly running distance (30-39 miles) and wearing running shoes for 4 to 6 months were associated with a greater risk of injury in women than in men. A history of previous injuries, having a running experience of 0-2 years, restarting running, weekly running distance (20-29 miles) and having a running distance of more than 40 miles per week were associated with a greater risk of running-related injury in men than in women.

CONCLUSIONS

Previous injury and use of orthotic/inserts are risk factors for running injuries. There appeared to be differences in the risk profile of men and women, but as few studies presented results for men and women separately, the results should be interpreted with caution. Further research should attempt to minimize methodological bias by paying attention to recall bias for running injuries, follow-up time, and the participation rate of the identified target group.

Performance differences between sexes in 50-mile to 3,100-mile ultramarathons

Anecdotal reports have assumed that women would be able to outrun men in long-distance running. The aim of this study was to test this assumption by investigating the changes in performance difference between sexes in the best ultramarathoners in 50-mile, 100-mile, 200-mile, 1,000-mile, and 3,100-mile events held worldwide between 1971 and 2012. The sex differences in running speed for the fastest runners ever were analyzed using one-way analysis of variance with subsequent Tukey–Kramer posthoc analysis. Changes in sex difference in running speed of the annual fastest were analyzed using linear and nonlinear regression analyses, correlation analyses, and mixed-effects regression analyses. The fastest men ever were faster than the fastest women ever in 50-mile (17.5%), 100-mile (17.4%), 200-mile (9.7%), 1,000-mile (20.2%), and 3,100-mile (18.6%) events. For the ten fastest finishers ever, men were faster than women in 50-mile (17.1%±1.9%), 100-mile (19.2%±1.5%), and 1,000-mile (16.7%±1.6%) events. No correlation existed between sex difference and running speed for the fastest ever (r²=0.0039, P=0.91) and the ten fastest ever (r²=0.15, P=0.74) for all distances. For the annual fastest, the sex difference in running speed decreased linearly in 50-mile events from 14.6% to 8.9%, remained unchanged in 100-mile (18.0%±8.4%) and 1,000-mile (13.7%±9.1%) events, and increased in 3,100-mile events from 12.5% to 16.9%. For the annual ten fastest runners, the performance difference between sexes decreased linearly in 50-mile events from 31.6%±3.6% to 8.9%±1.8% and in 100-mile events from 26.0%±4.4% to 24.7%±0.9%. To summarize, the fastest men were ~17%–20% faster than the fastest women for all distances from 50 miles to 3,100 miles. The linear decrease in sex difference for 50-mile and 100-mile events may suggest that women are reducing the sex gap for these distances.

[Sport and urinary incontinence in women]

Women are more attentive to their physical appearance and a quarter of French women use to practice a regular physical activity. Benefits of sport on general health are recognized. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. In literature, intensive exercise is a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hyperpressure, inherent with certain activities, and excess capacity of sphincters. Some sports are more risky than others, and high-level sportswomen are the most exposed. Health professionals must invest in information, screening, prevention, counseling and treatment track athletes So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic and monitoring of sportswomen. Better information is needed because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge and to improve the management of these patients.

Swimming performances in long distance open-water events with and without wetsuit

Background

Existing literature showed improved swimming performances for swimmers wearing wetsuits competing under standardized conditions in races held in pools on short to middle distances. Data about the influence of wetsuits on swimming performances in long and ultra-long open-water swimming races are missing. It is unknown whether the benefit of wearing wetsuits is comparable in men and women. The aim of this study was to investigate the influence of wearing a wetsuit on open-water swimming performances at the 26.4 km ‘Marathon Swim in Lake Zurich’ in Lake Zurich, Switzerland, and the 3.8 km Lake Ontario Swim Team-Race (LOST-Race) in Lake Ontario, Canada.

Methods

Race times of the fastest female and male swimmers competing with and without wetsuit were compared using multi-level regression analyses and analysis of variance.

Results

In the ‘Marathon Swim’ in Lake Zurich, wearing a wetsuit had no effect on race time regarding the gender where athletes wearing a wetsuit were not faster than athletes without wetsuit. However, the ten fastest men wearing a wetsuit (410.6 ± 26.7 min) were faster (32.7%, p < 0.01) than the ten fastest women without wetsuit (544.9 ± 81.3 min). In the ‘LOST-Race’, the top ten men wearing a wetsuit (51.7 ± 2.5 min) were faster (13.2%, p < 0.01) than the top ten women wearing a wetsuit (58.5 ± 3.2 min). Additionally, the top ten men without wetsuit (52.1 ± 2.4 min) were faster (19.6%, p < 0.01) than the top ten women without wetsuit (62.3 ± 2.5 min). The top ten women wearing a wetsuit (58.5 ± 3.2 min) were faster (6.5%, p < 0.01) than top ten women without a wetsuit (62.3 ± 25 min).

Conclusions

These results suggest that wearing a wetsuit had a positive influence on swimming speed for both women and men but the benefit of the use of wetsuits seemed to depend on additional factors (i.e. race distance). Women seemed to benefit more from wearing wetsuits than men in longer open-water ultra-distance swimming races.

Preventing urinary incontinence in women

PURPOSE OF REVIEW

This review examines the evidence to date, analyzes specific risk factors and assesses the ability to prevent urinary incontinence in women, while providing clinical recommendations. More extraordinary risk factors such as ethnicity and race, mixed and fecal incontinence, iatrogenic and neurogenic factors should be discussed in a follow-up report.

RECENT FINDINGS

Studies have revealed that certain factors place women at risk for developing urinary incontinence, including age, obesity, diabetes, pregnancy and delivery, high-impact physical exercise factors and estrogen deficiency.

SUMMARY

Healthcare providers should screen women who are at risk for developing urinary incontinence and institute specific interventions, specifically behavioral and even rehabilitative techniques, to prevent this prevalent and distressing condition.

Sex differences in 24-hour ultra-marathon performance--a retrospective data analysis from 1977 to 2012

OBJECTIVES

This study examined the changes in running performance and the sex differences between women and men in 24-hour ultra-marathons held worldwide from 1977 to 2012.

METHOD

Changes in running speed and ages of the fastest 24-hour ultra-marathoners were determined using single- and multi-level regression analyses.

RESULTS

From 1977 to 2012, the sex differences in 24-hour ultra-marathon performance were 4.6±0.5% for all women and men, 13.3% for the annual fastest finishers, 12.9±0.8% for the top 10 and 12.2±0.4% for the top 100 finishers. Over time, the sex differences decreased for the annual fastest finishers to 17%, for the annual 10 fastest finishers to 11.3±2.2% and for the annual 100 fastest finishers to 14.2±1.8%. For the annual fastest men, the age of peak running speed increased from 23 years (1977) to 53 years (2012). For the annual 10 and 100 fastest men, the ages of peak running speed were unchanged at 40.9±2.5 and 44.4±1.1 years, respectively. For women, the ages of the annual fastest, the annual 10 fastest and the annual 100 fastest remained unchanged at 43.0±6.1, 43.2±2.6 and 43.8±0.8 years, respectively.

CONCLUSION

The gap between the annual top, annual top 10 and annual top 100 female and male 24-hour ultra-marathoners decreased over the last 35 years; however, it seems unlikely that women will outrun men in 24-hour ultra-marathons in the near future. The fastest 24-hour ultra-marathoners worldwide achieved their peak performance at the age of master athletes (>35 years).

Analysis of 10 km swimming performance of elite male and female open-water swimmers

This study investigated trends in performance and sex difference in swimming speed of elite open-water swimmers at FINA 10 km competitions (i.e. World Cup races, European Championships, World Championships and Olympic Games). Swimming speed and sex difference in swimming speed of the fastest and the top ten women and men per event competing at 10 km open-water races between 2008 and 2012 were analysed using single and multi-level regression analyses. A total of 2,591 swimmers (i.e. 1,120 women and 1,471 men) finished 47 races. Swimming speed of the fastest women (1.35 ± 0.9 m/s) and men (1.45 ± 0.10 m/s) showed no changes across years. The mean sex difference in swimming speed for the fastest swimmers was 6.8 ± 2.5%. Swimming speed of the top ten female swimmers per event was 1.34 ± 0.09 m/s and remained stable across the years. The top ten male swimmers per event showed a significant decrease in swimming speed over time, even though swimming speed in the first race (i.e. January 2008, 1.40 ± 0.0 m/s) was slower than the swimming speed in the last race (i.e. October 2012, 1.50 ± 0.0 m/s) (P < 0.05). To summarize, swimming performances remained stable for the fastest elite open-water swimmers at 10 km FINA competitions between 2008 and 2012, while performances of the top ten men tended to decrease. The sex difference in swimming speed in elite ultra-swimmers (~7%) appeared smaller compared to other ultra-distance disciplines such as running. Further studies should examine how body shape and physiology of elite open-water ultra-distance swimmers influence performances.

Sex difference in open-water ultra-swim performance in the longest freshwater lake swim in Europe

This study examined participation and performance trends in the 26.4-km open-water ultra-swim "Marathon Swim in Lake Zurich," Switzerland. A total of 461 athletes (157 women and 304 men) finished the race between 1987 and 2011. The mean age of the finishers during the studied period was 32.0 ± 6.5 years for men and 30.9 ± 7.2 years for women. The mean age of finishers and the age of winners increased significantly across years for both sexes (p < 0.01). The winner times were significantly lower for men (403 ± 43 minutes) compared with women (452 ± 63 minutes) (p < 0.01). In contrast, the mean swimming time of the finishers did not differ between men (530 ± 39 minutes) and women (567 ± 71 minutes) (p > 0.05). The swimming time performance remained stable (p > 0.05) for both sexes across years. A higher age was associated with an increased risk for not finishing the race (odds ratio = 0.93, p = 0.045). Swim time was negatively associated with water temperature in the top 3 swimmers (ß = -9.87, p = 0.025). These results show that open-water ultra-swimming performance of elite swimmers over 26.4 km in a freshwater lake is affected by age, sex, and water temperature. The sex difference in open-water ultra-swimming performance (approximately 11.5%) remained unchanged these last 25 years. It seems unlikely that elite female swimmers will achieve the same performance of elite male swimmers competing in open-water ultra-swimming in water of approximately 20 °C. Anthropometric and physiological characteristics such as skeletal muscle mass and thermoregulation need additional investigations in female and male open-water ultra-swimmers.

Finisher and performance trends in female and male mountain ultramarathoners by age group

Background

This study examined changes according to age group in the number of finishers and running times for athletes in female and male mountain ultramarathoners competing in the 78 km Swiss Alpine Marathon, the largest mountain ultramarathon in Europe and held in high alpine terrain.

Methods

The association between age and performance was investigated using analysis of variance and both single and multilevel regression analyses.

Results

Between 1998 and 2011, a total of 1,781 women and 12,198 men finished the Swiss Alpine Marathon. The number of female finishers increased (r² = 0.64, P = 0.001), whereas the number of male finishers (r² = 0.18, P = 0.15) showed no change. The annual top ten men became older and slower, whereas the annual top ten women became older but not slower. Regarding the number of finishers in the age groups, the number of female finishers decreased in the age group 18–24 years, whereas the number of finishers increased in the age groups 30–34, 40–44, 45–49, 50–54, 55–59, 60–64, and 70–74 years. In the age groups 25–29 and 35–39 years, the number of finishers showed no changes across the years. In the age group 70–74 years, the increase in number of finishers was linear. For all other age groups, the increase was exponential. For men, the number of finishers decreased in the age groups 18–24, 25–29, 30–34, and 35–39 years. In the age groups 40–44, 45–49, 50–54, 55–59, 60–64, 70–74, and 75–79 years, the number of finishers increased. In the age group 40–44 years, the increase was linear. For all other age groups, the increase was exponential. Female finishers in the age group 40–44 years became faster over time. For men, finishers in the age groups 18–24, 25–29, 30–34, 40–44, and 45–49 years became slower.

Conclusion

The number of women older than 30 years and men older than 40 years increased in the Swiss Alpine Marathon. Performance improved in women aged 40–44 years but decreased in male runners aged 18–49 years.

Increase in finishers and improvement of performance of masters runners in the Marathon des Sables

Aim

The aim of the study was to examine finisher and performance trends of ultrarunners in the Marathon des Sables, the world’s largest multistage ultramarathon.

Methods

The age and running speed was analyzed for 6945 finishes of 909 women and 6036 men between 2003 and 2012 at the Marathon des Sables covering about 240 km in the Moroccan desert.

Results

The number of finishes increased significantly for both women and men from 2003–2012. The annual number of finishes increased in age groups: 30–34 years (r² = 0.50; P = 0.021), 45–49 years (r² = 0.81; P = 0.0004), and 50–54 years (r² = 0.46; P = 0.029) for women and in all age groups older than 35 years for men (35–39 years: r² = 0.64, P = 0.0054; 40–44 years: r² = 0.67, P = 0.0036; 45–49 years: r² = 0.77, P = 0.0007; 50–54 years: r² = 0.72, P = 0.0018; 55–59 years: r² = 0.42, P = 0.041; and 60–64 years: r² = 0.67, P = 0.0038). The fastest running speed was achieved by runners in the age group of 35–39 years for both sexes. The mean age of overall finishers was 41.0 ± 9.1 years for women and 41.3 ± 9.5 years for men. For men, running speed improved for athletes in the age group of 35–39 years (r² = 0.44; P = 0.036) and of 40–44 years (r² = 0.51; P = 0.019), while it decreased for athletes in the age group of 30–34 years (r² = 0.66, P = 0.0039). For women, running speed remained stable during the study period for athletes in all age groups.

Conclusion

These data suggest that the number of finishers of masters runners older than 40 years increased for both sexes at the Marathon des Sables, as has been previously observed for single-stage ultramarathons. In contrast to women, men aged 35 to 44 years improved running speed during the study period. Future studies are needed to investigate the reasons for the growing numbers of masters athletes in endurance sports and their improvement in performance.

Participation and performance trends in multistage ultramarathons-the 'Marathon des Sables' 2003-2012

BACKGROUND

The purpose of this study was to investigate participation and performance changes in the multistage ultramarathon 'Marathon des Sables' from 2003 to 2012.

METHODS

Participation and performance trends in the four- or six-stage running event covering approximately 250 km were analyzed with special emphasis on the nationality and age of the athletes. The relations between gender, age, and nationality of finishers and performance were investigated using regression analyses and analysis of variance.

RESULTS

Between 2003 and 2012, a number of 7,275 athletes with 938 women (12.9%) and 6,337 men (87.1%) finished the Marathon des Sables. The finisher rate in both women (r2 = 0.62) and men (r2 = 0.60) increased across years (p < 0.01). Men were significantly (p < 0.01) faster than women for overall finishers (5.9 ± 1.6 km·h-1 versus 5.1 ± 1.3 km·h-1) and for the top three finishers (12.2 ± 0.4 km·h-1 versus 8.3 ± 0.6 km·h-1). The gender difference in running speed of the top three athletes decreased (r2 = 0.72; p < 0.01) from 39.5% in 2003 to 24.1% in 2012 with a mean gender difference of 31.7 ± 2.0%. In men, Moroccans won nine of ten competitions, and one edition was won by a Jordanian athlete. In women, eight races were won by Europeans (France five, Luxembourg two, and Spain one, respectively), and two events were won by Moroccan runners.

CONCLUSIONS

The finisher rate in the Marathon des Sables increased this last decade. Men were significantly faster than women with a higher gender difference in performance compared to previous reports. Social or cultural inhibitions may determine the outcome in this event. Future studies need to investigate participation trends regarding nationalities and socioeconomic background, as well as the motivation to compete in ultramarathons.

Age and sex interactions in mountain ultramarathon running - the Swiss Alpine Marathon

Background

The aims of the study were to examine the (a) participation, (b) difference in running times between the sexes, and (c) age-related decline in the running times of ultramarathoner women and men competing in the Swiss Alpine Marathon from 1998 to 2011.

Methods

The ultramarathoners competing in the Swiss Alpine Marathon were analyzed in terms of participation, difference in running times between the sexes, age of the fastest runners, and age-related decline in the fastest running times. The race covers a distance of 78 km, with a total altitude change of approximately 2260 m. A total of 12,194 men and 1781 women finished the race between 1998 and 2011.

Results

Women’s participation increased from approximately 10% in 1998 to approximately 16% in 2011 (r² = 0.57; P = 0.001), but participation remained unchanged in men (r² = 0.17; P > 0.05). Over the years, the top ten women showed no change in running times (r² = 0.02; P > 0.05), whereas the top ten men’s running times increased (r² = 0.46; P < 0.01). The age for peak running times increased over time both for the top ten women (r² = 0.58; P < 0.01) and for the top ten men (r² = 0.40; P = 0.01).

Conclusion

Among the top women, participation increased, the age for peak running times increased, and the running times remained unchanged. Among the men, however, the participation remained steady, and both the peak running-time age and the running times increased.

Best performances by men and women open-water swimmers during the 'English Channel Swim' from 1900 to 2010

Little research has examined ultra-endurance swimming performances. The 'English Channel Swim', where swimmers have to cover a distance of 32 km between England and France represents a unique long-distance, open-water, sea-swimming challenge, and each year swimmers from all over the world try to succeed in this challenge. The best times in minutes and the nationality of successful men and women swimmers were analysed from 1900 to 2010. A total of 1,533 swimmers (455 women and 1,078 men) from more than 40 countries have successfully completed the 'English Channel Swim'. Great Britain was the country most represented, with 38% of the total, followed by the United States with 20%. Swim speed has increased progressively for both sexes (P < 0.001) but was lower for women than for men (0.68 ± 0.15 m · s⁻¹ vs 0.71 ± 0.16 m · s⁻¹ respectively, P < 0.01). However, the best annual performances did not differ between the sexes (men: 0.89 ± 0.20 m · s⁻¹; women: 0.84 ± 0.18 m · s⁻¹, P > 0.05). The results suggest that the performance of women open-water ultra-distance swimmers may be similar to that of men. Further studies investigating anthropometrical and physiological characteristics of open-water ultra-swimmers are needed to compare men's and women's open-water ultra-swim performances.

Understanding stress urinary incontinence

Underreported and undertreated, stress urinary incontinence leads to decreased quality of life in sufferers and financial burdens for both the patient and the healthcare industry. Nurse practitioners should understand their role in identifying, diagnosing, and treating the condition.

Pharmacologic treatment of knee osteoarthritis in athletic women

There is a greater incidence of anterior cruciate ligament tears due to noncontact sports injuries in women compared with men. Anterior cruciate ligament tears are associated with accelerated development of knee osteoarthritis (OA), which is also more prevalent in women than in men. This article considers therapeutic modalities that are best suited for athletic women with knee OA. Clinical data on the safety and efficacy of pharmacotherapies for knee OA, including acetaminophen, oral nonsteroidal anti-inflammatory drugs (NSAIDs), and topical NSAIDs, are discussed, with attention paid to special considerations for women who participate in athletic activity. Adverse events associated with the use of acetaminophen and oral NSAIDs place potential limits on the dose and duration of therapy and may be of greater concern in female athletes than in other patient groups. Topical NSAIDs, which effect relief through the same mechanism of action as oral NSAIDs, produce dramatically lower systemic NSAID exposure compared with oral NSAIDs and are associated with a lower incidence of systemic adverse events. These findings, along with additional future studies, may have particular relevance to the choice of the most effective treatment options for athletic women with OA of the knee.

The female athlete triad and endothelial dysfunction

A tremendous increase in the number of female athletes of all ages and abilities has occurred in the past 35 years. In general, sports and athletic competition produce healthier and happier women. However, explosion in participation has revealed clear gender-specific injuries and medical conditions unique to the female athlete. This article focuses on the latest advances in our knowledge of the female athlete triad and the relationship between athletic-associated amenorrhea and endothelial dysfunction. Treatment of vascular dysfunction with folic acid is also discussed.