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Hunter SK, Senefeld JW. Sex differences in human performance. J Physiol 2024; 602:4129-4156. [PMID: 39106346 DOI: 10.1113/jp284198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 07/08/2024] [Indexed: 08/09/2024] Open
Abstract
Sex as a biological variable is an underappreciated aspect of biomedical research, with its importance emerging in more recent years. This review assesses the current understanding of sex differences in human physical performance. Males outperform females in many physical capacities because they are faster, stronger and more powerful, particularly after male puberty. This review highlights key sex differences in physiological and anatomical systems (generally conferred via sex steroids and puberty) that contribute to these sex differences in human physical performance. Specifically, we address the effects of the primary sex steroids that affect human physical development, discuss insight gained from an observational study of 'real-world data' and elite athletes, and highlight the key physiological mechanisms that contribute to sex differences in several aspects of physical performance. Physiological mechanisms discussed include those for the varying magnitude of the sex differences in performance involving: (1) absolute muscular strength and power; (2) fatigability of limb muscles as a measure of relative performance; and (3) maximal aerobic power and endurance. The profound sex-based differences in human performance involving strength, power, speed and endurance, and that are largely attributable to the direct and indirect effects of sex-steroid hormones, sex chromosomes and epigenetics, provide a scientific rationale and framework for policy decisions on sex-based categories in sports during puberty and adulthood. Finally, we highlight the sex bias and problem in human performance research of insufficient studies and information on females across many areas of biology and physiology, creating knowledge gaps and opportunities for high-impact studies.
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Affiliation(s)
- Sandra K Hunter
- Movement Science Program, School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathon W Senefeld
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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2
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King DA, Hume PA, Clark TN. Match Injury Incidence for a New Zealand Amateur Domestic Female Soccer Team over Two Consecutive Seasons. Sports (Basel) 2024; 12:216. [PMID: 39195592 PMCID: PMC11359641 DOI: 10.3390/sports12080216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 07/29/2024] [Accepted: 08/07/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE To determine the match injury incidence for a New Zealand amateur domestic female soccer team over two consecutive seasons. METHODS A descriptive, epidemiological observational study was conducted to determine match injury incidence for 49 players over two domestic seasons. Match exposure and injury burden were calculated. RESULTS A total of 84 match-related injuries resulted in a match injury incidence of 145.5 (95% confidence interval (CI): 117.4 to 180.1) per 1000 match h. Attackers had a higher incidence of injuries for total (200.0 per 1000 match h) and missed matches (152.4 per 1000 match h). The lower limbs had the highest injury incidence (105.6 per 1000 match h), with ankle injury being the most reported (43.3 per 1000 match h) lower limb injury. Over three quarters (75.3%) of the injuries recorded were missed match injuries. Sprains/strains were the most recorded total (86.6 per 1000 match h) injury type. Fractures were recorded as having the highest mean injury burden (68.7 ± 70.4 days). DISCUSSION Historically, there was a paucity of injury burden data for female football; however, the data presented within this study can be utilised to support the identification of injury patterns and areas to be included within injury reduction programmes.
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Affiliation(s)
- Doug A. King
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland 1142, New Zealand
- School of Science and Technology, University of New England, Armidale 2351, Australia
- Wolfson Research Institute for Health and Wellbeing, Department of Sport and Exercise Sciences, Durham University, Durham DH1 3LE, UK
| | - Patria A. Hume
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland 1142, New Zealand
- Technology and Policy Lab, Law School, The University of Western Australia, Perth 6009, Australia
| | - Trevor N. Clark
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
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3
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Wakefield-Scurr J, St John E, Bibby K, Renwick N, Smith N, Hobbs S, Brown N. Insights into breast health issues in women's rugby. Eur J Sport Sci 2024. [PMID: 38952063 DOI: 10.1002/ejsc.12128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 07/03/2024]
Abstract
World RugbyTM supports dedicated women's welfare, injury surveillance and medical/technical interventions, yet breast health has received limited attention. This article aims to provide insights into breast health issues in rugby, including breast impacts and injuries. We discuss how breast anatomy and position may be problematic in rugby. Breast volume relates to body size, which may be increasing in women's rugby, suggesting increased breast surface area and mass, potentially increasing injury risk. Breast health issues in rugby have been reported previously, with 58% of contact footballers (including rugby) experiencing breast injuries. There are damaging effects related to these breast health issues, with breast impacts often causing pain and swelling. Breast impacts may lead to haematomas, cysts and fat necrosis which can calcify over time making them difficult to distinguish from breast carcinoma, causing further investigation and anxiety. In sport, poor bra fit and insufficient support are associated with pain, skin strain and performance decrements. This article reports the potential implications of these breast health issues on performance in rugby. Recent breast-related projects supported by rugby communities may address recommendations identified in the literature for robust breast injury classifications, updated injury surveillance systems and prospective data collection on breast injury prevalence, severity and impact in rugby. These data should inform breast injury care pathways and intervention research, including evidence-based bra design. Understanding the implications of breast impacts on tissue properties, health and wellbeing is vital. Finally, data should inform rugby-specific breast education, raising awareness of this aspect of athlete health.
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Affiliation(s)
- Joanna Wakefield-Scurr
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Edward St John
- Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - Kilian Bibby
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Nichola Renwick
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Neal Smith
- Centre for Health and Applied Sport and Exercise Research, University of Chichester, Chichester, UK
| | - Samantha Hobbs
- Centre for Health and Applied Sport and Exercise Research, University of Chichester, Chichester, UK
| | - Nicola Brown
- Faculty of Sport, Technology and Health Sciences, St Mary's University Twickenham, Twickenham, UK
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de Jager E, Willemsen M, Kempe M, Janssen I. Breaking barriers: Exploring female-specific health challenges affecting performance in an elite multisport training environment. J Sci Med Sport 2024; 27:466-471. [PMID: 38734513 DOI: 10.1016/j.jsams.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Female-specific issues, such as breast injuries, pelvic floor dysfunctions, saddle sores, and menstrual symptoms, can significantly impact female athletes. This study examined the prevalence, perceived impact on performance, and role of the support staff in addressing and managing these issues in elite athletes based at a multisport training centre. DESIGN Anonymous online questionnaire. METHODS A total of 180 female athletes from various sport disciplines at the Dutch Olympic Training Centre were invited to participate in the study. An anonymous, 39-item questionnaire was developed and hosted on Qualtrics collecting data on respondents' characteristics, breast injuries, pelvic floor dysfunctions, saddle sores, menstrual symptoms, contraceptive use, and communication about these issues. RESULTS A total of 105 valid responses were analysed. The findings revealed that athletes regularly experience breast injuries (15.2 %), urinary incontinence (29.5 %), other pelvic floor problems (21.0 %), saddle sores (65.7 %), and menstrual cycle-related symptoms, with negative performance effects. Communication with support staff remained limited, with only 23.8 % of athletes discussing any of these issues, often due to concerns about understanding, shame, or a lack of opportunity for easy communication. CONCLUSIONS The findings underscore the crucial role of creating a supportive environment, promoting early intervention, and utilising multisport centres to comprehensively address these concerns, emphasising the need for open communication, education, and support to enhance female athletes' performance and well-being.
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Affiliation(s)
- Eline de Jager
- Sport Science and Innovation, National Sports Centre Papendal, the Netherlands; Medical Faculty, Rijksuniversiteit Groningen, the Netherlands.
| | - Maaike Willemsen
- Sport Science and Innovation, National Sports Centre Papendal, the Netherlands
| | - Matthias Kempe
- Medical Faculty, Rijksuniversiteit Groningen, the Netherlands
| | - Ina Janssen
- Sport Science and Innovation, National Sports Centre Papendal, the Netherlands
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5
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Kipp S, Leahy MG, Sheel AW. Sports Bra Restriction on Respiratory Mechanics during Exercise. Med Sci Sports Exerc 2024; 56:1168-1176. [PMID: 38350462 DOI: 10.1249/mss.0000000000003403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE We set out to understand how underband tightness or pressure of a sports bra relates to respiratory function and the mechanical work of breathing ( during exercise. Our secondary purpose was to quantify the effects of underband pressure on O 2 during submaximal running. METHODS Nine highly trained female runners with normal pulmonary function completed maximal and submaximal running in three levels of underband restriction: loose, self-selected, and tight. RESULTS During maximal exercise, we observed a significantly greater during the tight condition (350 ± 78 J·min -1 ) compared with the loose condition (301 ± 78 J·min -1 ; P < 0.05), and a 5% increase in minute ventilation ( ) during the tight condition compared with the loose condition ( P < 0.05). The pattern of breathing also differed between the two conditions; the greater maximal during the tight condition was achieved by a higher breathing frequency (57 ± 6 vs. 52 ± 7 breaths·min -1 ; P < 0.05), despite tidal volume being significantly lower in the tight condition compared with the loose condition (1.97 ± 0.20 vs. 2.05 ± 0.23 L; P < 0.05). During steady-state submaximal running, O 2 increased 1.3 ± 1.1% (range: -0.3 to 3.2%, P < 0.05) in the tight condition compared with the loose condition. CONCLUSIONS Respiratory function may become compromised by the pressure exerted by the underband of a sports bra when women self-select their bra size. In the current study, loosening the underband pressure resulted in a decreased work of breathing, changed the ventilatory breathing pattern to deeper, less frequent breaths, and decreased submaximal oxygen uptake (improved running economy). Our findings suggest sports bra underbands can impair breathing mechanics during exercise and influence whole-body metabolic rate.
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Affiliation(s)
- Shalaya Kipp
- School of Kinesiology, University of British Columbia, Vancouver, BC, CANADA
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6
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Wakefield-Scurr J, Jones M, Jones B, Whatling E, Mehta R. Hidden support for the lionesses: a breast/bra intervention. Res Sports Med 2024:1-9. [PMID: 38771254 DOI: 10.1080/15438627.2024.2357761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
Despite health and performance benefits of appropriate breast support in sport, elite women athletes' knowledge of breasts/bras is poor leading to poor bra choices, breast pain and performance decrements. This multiphase intervention assessed breast/bra issues and preferences, individually prescribed sports bras and evaluated outcomes for the England Senior Women footballers. Breast/bra workshops were delivered to England players; all 36 completed pre-intervention surveys and breast/bra assessments, before being prescribed bras six weeks before European and World Championships (2022, 2023). 24 players completed post-intervention surveys. Pre-intervention outcomes identified poor knowledge, poor bra fit, many bra issues, and cultural sensitivities. Breast pain was prevalent (61%), with 25% reporting clinically significant breast pain. Post-intervention, players reported significant improvements with prescribed sports bras. 91% reported improvements in knowledge and benefiting from the intervention. This successful intervention provided an evidence-base for ongoing breast health initiatives with England Teams, plus roll-out to all levels of women's football.
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Affiliation(s)
- Joanna Wakefield-Scurr
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Melissa Jones
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Brogan Jones
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | | | - Ritan Mehta
- Physiotherapy, Football Association Ltd, London, UK
- Centre for Sport and Exercise Medicine, Queen Mary University of London, London, UK
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Christopher SM, Donnelly G, Brockwell E, Bo K, Davenport MH, De Vivo M, Dufour S, Forner L, Mills H, Moore IS, Olson A, Deering RE. Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement. Br J Sports Med 2024; 58:299-312. [PMID: 38148108 DOI: 10.1136/bjsports-2023-107489] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/28/2023]
Abstract
Female athletes have identified a lack of guidance as a barrier to successfully returning to running postpartum, and existing guidelines are vague. Our aim was to define the current practice of determining postpartum run-readiness through a consensus survey of international clinicians and exercise professionals in postpartum exercise to assist clinicians and inform sport policy changes.A three-round Delphi approach was used to gain international consensus from clinicians and exercise professionals on run-readiness postpartum. Professionals who work with postpartum runners participated in an online survey to answer open-ended questions about the following postpartum return-to-running topics: definitions (runner and postpartum), key biopsychosocial milestones that runners need to meet, recommended screening, timeline to initiate running, support items, education topics and factors that contribute to advising against running. Consensus was defined as ≥75% participant agreement.One hundred and eighteen professionals participated in round I, 107 participated in round II (response rate 90.6%) and 95 participated in round III (response rate 80.5%). Responses indicated that, following a minimum 3-week period of rest and recovery, an individualised timeline and gradual return to running progression can be considered. Screening for medical and psychological concerns, current physical capacity, and prior training history is recommended prior to a return to running.This study proposes recommendations for the initial guidance on return-to-running postpartum, framed in the context of current research and consensus from professionals. Future research is needed to strengthen and validate specific recommendations and develop guidelines for best practice when returning-to-running after childbirth.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Rehabilitation Sciences, Doctor of Physical Therapy, Tufts University, Seattle, Washington, USA
- Elon University, Elon, North Carolina, USA
| | - Gráinne Donnelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Kari Bo
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marlize De Vivo
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
- Active Pregnancy Foundation, None, UK
| | - Sinead Dufour
- The World of my Baby (WOMB), Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada
| | - Lori Forner
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Mills
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Rita E Deering
- Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Haworth L, Aitkenhead R, Grecic D, Chohan A. Understanding experience, knowledge and perceived challenges related to bra fit for sports participation: a scoping review. Res Sports Med 2024; 32:302-315. [PMID: 35856556 DOI: 10.1080/15438627.2022.2102922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
Abstract
The breasts are reported as the fourth largest barrier to participation in physical activity (PA). This scoping review provides a comprehensive understanding of experiences, knowledge and challenges relating to bra fit and sports participation. The search strategy was adopted by the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) guidelines and multiple databases were searched. All research was in English and within the last 20 years. Exclusion criteria excluded reviews, male participants and the inability to locate or access full-text articles. The JBI critical appraisal tool assessed methodological quality. Twenty-three studies were included. Key themes from the studies are breast motion during PA, sports bra design, perceived barriers to participation in PA and education/knowledge of breast support and bra fit. Increasing breast support reduces breast movement during PA yet breast motion and bra fit are still the most common breast concerns for females. This is likely influenced by poor breast knowledge, leading to poor breast support choices. Future research should explore to what extent breast motion, knowledge and bra fit influences sport participation, and this research should include a more diverse range of adult ages, cup sizes, ethnicities and PA levels to provide a wider understanding.
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Affiliation(s)
- Lauren Haworth
- Allied Health Professions Research Unit, University of Central Lancashire, Preston, UK
- Research Centre for Applied Sport Physical Activity and Performance, University of Central Lancashire, Preston, UK
| | - Robyn Aitkenhead
- Research Centre for Applied Sport Physical Activity and Performance, University of Central Lancashire, Preston, UK
| | - David Grecic
- Research Centre for Applied Sport Physical Activity and Performance, University of Central Lancashire, Preston, UK
| | - Ambreen Chohan
- Allied Health Professions Research Unit, University of Central Lancashire, Preston, UK
- Research Centre for Applied Sport Physical Activity and Performance, University of Central Lancashire, Preston, UK
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Wakefield-Scurr J, Sanchez A, Jones M, Hockley L, Biswas A, Johnson F, Roberts E. A multi-phase intervention study of sports bra prescription for elite UK female athletes preparing for the Tokyo Olympics and Paralympics. Res Sports Med 2024; 32:186-200. [PMID: 35711113 DOI: 10.1080/15438627.2022.2090254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/13/2022] [Indexed: 10/18/2022]
Abstract
Athletes report poor breast/bra knowledge, breast pain, sports bras causing lacerations and chafing, negatively affecting sports performance. No bra interventions to address these issues are reported. Working with 142 UK female athletes preparing for Tokyo Olympics/Paralympics (27 sports), this multi-phase intervention assessed breast/bra knowledge, preferences, issues via surveys and breast/bra assessments. Data were used to develop two sports bras. A total of 112 athletes were prescribed one of the new bras through individual assessments. After four weeks, wear athletes completed evaluations. Pre-intervention breast/bra knowledge was low (83% ≤average), multiple breast/bra issues were reported and most athletes wore ill-fitting, loose bras, offering limited support. Post-intervention, 63% reported improved knowledge and 97% reported their prescribed bra as better than their original bra. Eighty-seven per cent reported benefitting from this intervention, with 17% reporting improved performance. This intervention effectively assessed sports bra needs, developed and implemented solutions, which improved knowledge and potentially performance for some UK athletes.
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Affiliation(s)
- Joanna Wakefield-Scurr
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Amy Sanchez
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Melissa Jones
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Louisa Hockley
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Anita Biswas
- English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, UK
| | - Fiona Johnson
- English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, UK
| | - Emily Roberts
- Innovation Department, Clover Global Limited, Kowloon, Hong Kong
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10
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Stevenson NG, Harris R, Montag J, Stay S, K Panagodage Perera N. The development and test-retest reliability of the periodic health evaluation for female athletes (PHE FA) survey. PHYSICIAN SPORTSMED 2023; 51:615-620. [PMID: 36545815 DOI: 10.1080/00913847.2022.2158386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To develop and assess the test-retest reliability of a survey exploring Australian high-performance female athlete's perspectives toward the periodic health evaluation and their perceived health needs. METHODS A structured three-phase method for survey development was used to develop the periodic health evaluation for female athletes (PHE FA) survey. Initially, a literature review and gap analysis was performed to identify themes and questions (Phase 1). Survey questions were developed covering demographic information (n = 9); sports-related medical screening (n = 19) and health needs and information (n = 7) (Phase 2). Test-retest reliability of the survey was then assessed (Phase 3). The survey was administered to a purposeful sample of seven high-performance level female athletes who completed the survey, on two separate occasions, 3 weeks apart via Checkbox© survey software (Checkbox Technology Inc., San Francisco, CA). Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). RESULTS The mean age of the athletes was 29 years (SD 4 years, range 24-34 years). All were able-bodied athletes and 71% participated in team sports. Eighty-six percent of athletes have competed in world championships and 71% were Olympians. The average ICC of all items was 0.998 (95% CI 0.997-0.998, p = 0.000) demonstrating excellent consistency of measures between the two time points.All the athletes preferred a Sport and Exercise Medicine Physician to conduct their PHE and 86% preferred a female doctor. The key topics of interest were pelvic floor health including incontinence (100%); fertility (86%); pregnancy (71%); and mental and emotional wellbeing (71%). Face-to-face education was the preferred option to receive health information. CONCLUSIONS The PHE FA survey was co-created with an athlete and other key stakeholders. Excellent consistency of measures between the two time points was indicated by the high test-retest reliability of the PHE FA survey. Data collected using the PHE FA survey can contribute to informed evidence-based policies, and processes to support the health and wellbeing of female athletes.
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Affiliation(s)
| | - Rachel Harris
- Female Performance & Health Initiative, The Australian Institute of Sport, Bruce, Australia
| | | | - Sharon Stay
- Performance Health Deptartment, Queensland Academy of Sport, Brisbane, Australia
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Baxter CR, Crittenden TA, Dean NR. Self-reported breast size, exercise habits and BREAST-Q data - an international cross-sectional study of community runners. JPRAS Open 2023; 37:92-101. [PMID: 37457991 PMCID: PMC10339238 DOI: 10.1016/j.jpra.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Women with larger breasts tend not to participate in high-intensity exercise and exercise less frequently. This study investigates how breast size impacts exercise habits and how breast reduction surgery changes women's participation in recreational exercise. Recruitment was generated via parkrun Limited (Richmond, UK), an organization offering weekly community-based runs. Female parkrun members aged over 18 years with no history of breast cancer were invited to complete a survey, including questions about their exercise habits, breast size, any breast alteration surgery, and BREAST-Q questionnaires. A total of 1987 women completed the survey, including 56 women who had undergone breast reduction. Results demonstrate that women with bigger breasts believe that reducing their breast size would improve their exercise performance and participation and that their breast size significantly impacts their type of exercise. Women who had undergone breast reduction reported increased overall frequency, enjoyment, and willingness to exercise in a group. Additionally, women that have undergone breast reduction report higher BREAST-Q scores than their non-surgical counterparts. This study supports the existing literature that breast size can impact exercise habits and demonstrates that women who have undergone breast reduction participate in healthier lifestyle practices. We suggest that if breast size impacts women's participation in sport and fitness, health practitioners and policymakers should advocate for better access to reduction mammoplasty in the publicly funded health sector.
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Affiliation(s)
- Claire R. Baxter
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia
| | - Tamara A. Crittenden
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Nicola R. Dean
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, South Australia, Australia
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Wakefield-Scurr J, Sanchez A, Jones M. A multi-stage intervention assessing, advising and customising sports bras for elite female British athletes. Res Sports Med 2023; 31:703-718. [PMID: 35164611 DOI: 10.1080/15438627.2022.2038162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
Abstract
Appropriate breast support is recommended in sport; however, what constitutes appropriate support is complex, individual and often sports specific, particularly in elite sport given the wear duration. This intervention educated, assessed and advised elite British female athletes on breasts and bras; those with unresolved issues engaged in bespoke bra interventions. Following educational workshops (n = 80), breast/bra surveys (n = 60), individual bra assessments (n = 37); a rower, shooter, and hockey player participated in the bespoke bra intervention. Eighty-three per cent of athletes rated their breast/bra knowledge as ≤average. Fifty-one per cent experienced breast pain, affecting performance for 29%; seven used medication and one surgery to relieve symptoms. In individual bra assessments most wore ill-fitting, unsupportive bras and wanted bra advice. Bespoke bra interventions eliminated breast pain: for the rower, improved breast position and spine rotation; for the shooter, repositioned tissue and improved performance; and for the hockey player, accommodated smart devices. Whilst bespoke bra development is challenging, most elite athlete breast/bra issues are resolved via education, advice and fitting.
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Affiliation(s)
- Joanna Wakefield-Scurr
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Amy Sanchez
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Melissa Jones
- Research Group in Breast Health, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
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Powell DW, Fong HB, Nelson AK. Increasing breast support is associated with altered knee joint stiffness and contributing knee joint biomechanics during treadmill running. Front Sports Act Living 2023; 5:1113952. [PMID: 37152112 PMCID: PMC10160436 DOI: 10.3389/fspor.2023.1113952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/20/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Greater breast support has been associated with improved running performance as measured by oxygen cost and running economy. Several candidate mechanisms have been proposed to underlie breast support-related improvements in running performance including increased knee joint stiffness. Greater knee joint stiffness has been associated with improved running performance (speed and metabolic cost), though the influence of breast support on knee joint stiffness has not been previously investigated. Therefore, the purpose of this study was to investigate the influence of increasing breast support on knee joint stiffness and its constituent components during treadmill running. Methods Thirteen recreational runners performed a 3-min running bout at their preferred running velocity in each of three breast support conditions: bare chested (CON), low support (LOW) and high support (HIGH) sports bras. Three-dimensional kinematics and ground reaction forces were collected simultaneously using a 10-camera motion capture system (240 Hz, Qualisys Inc.) and instrumented treadmill (1,200 Hz, Bertec Inc.). Visual3D (C-Motion Inc.) was used to calculate knee joint excursions, moments, powers and work while custom software (MATLAB) was used to calculate knee joint stiffness and breast displacements during the stance phase of running in each experimental condition. A series of 1 × 3 repeated measures analysis of covariance with post-hoc t-tests was used to evaluate the effect of breast support on knee joint biomechanics during treadmill running. Results Increasing levels of breast support were associated with greater knee joint stiffness (p = 0.002) as a result of smaller knee flexion excursions (p < 0.001). Increases in knee extension power (p = 0.010) were observed with increasing levels of breast support while no differences were observed in knee extension moments (p = 0.202) or work (p = 0.104). Conclusion Greater breast support is associated with increased knee joint stiffness resulting from smaller joint excursions. These findings may provide insight into the biomechanical mechanisms underlying previously reported improvements in running performance including reduced oxygen consumption and greater running economy.
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Affiliation(s)
- Douglas W. Powell
- Breast Biomechanics Research Center, College of Health Sciences, University of Memphis, Memphis, TN, United States
- Department of Orthopedic Surgery & Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, United States
- Correspondence: Douglas W. Powell
| | - Hailey B. Fong
- Breast Biomechanics Research Center, College of Health Sciences, University of Memphis, Memphis, TN, United States
| | - Alexis K. Nelson
- Department of Biomedical Sciences, University of Tennessee Health Science Center, Memphis, TN, United States
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Ten questions in sports engineering: technology in elite women’s football. SPORTS ENGINEERING 2022. [PMCID: PMC9667860 DOI: 10.1007/s12283-022-00384-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of technology in football is increasing, although, products predominantly focus on men’s football in performance, safety, comfort, and fit considerations. A recent scoping review identified just 32 published scientific articles on technology in women’s football, despite demands of those playing/working in the women’s game increasing. We wish to highlight the progressions made so far and barriers remaining in the elite women’s football technology to shed a light on this topic and prod researchers and manufacturers to help support the evolution of women’s-football-focussed technological considerations. The ten questions presented in this paper address the generic question on whether women’s specific tailoring is needed (Question 1) as well as addressing specific questions on football technology and engineering, such as the progressions made and ongoing issues in the following areas: football kits, religious considerations (hijab designs), sports bras, football boots, balls, football pitches, performance tracking devices, menstrual cycle tracking devices (Question 2–10). It is evidence that certain areas have received more attention than others and with these ten questions we hope to steer readers towards research and engineering gaps for future work.
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Fong HB, Powell DW. Greater Breast Support Is Associated With Reduced Oxygen Consumption and Greater Running Economy During a Treadmill Running Task. Front Sports Act Living 2022; 4:902276. [PMID: 35774380 PMCID: PMC9237383 DOI: 10.3389/fspor.2022.902276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Breast pain is a major barrier to running for women. While breast support through the use of sports bras reduces breast-related discomfort, the effect of breast support on running performance is less understood. Therefore, the purpose of the current study was to evaluate the effect of greater breast support on oxygen consumption and running economy during a treadmill running task. Methods Fifteen female recreational runners performed a 10-min treadmill running task at their preferred running speed in each of two sports bra conditions: low support and high support. Participants ran on an instrumented treadmill (1,200 Hz, Bertec) while indirect calorimetry was performed using a metabolic measurement system (100 Hz, TrueOne, ParvoMedics). Average VO2 (absolute and relative) from the third to 10th minutes was used to evaluate oxygen consumption. Running economy was calculated as the distance traveled per liter of oxygen consumed. Paired samples t-tests were used to compare mean oxygen consumption and running economy values between breast support conditions. Correlation analysis was performed to evaluate the relationship between breast size and change in running performance. Results Greater breast support was associated with reductions in absolute (p < 0.001) and relative oxygen consumption (p < 0.001; LOW: 30.9 ± 7.1 ml/kg/min; HIGH: 28.7 ± 6.7 ml/kg/min). Greater breast support was associated with increases in running economy (p < 0.001; LOW: 88.6 ± 29.1 m/L O2; HIGH: 95.2 ± 31.1 m/L O2). No changes in temporospatial characteristics of running were observed including cadence (p = 0.149), step length (p = 0.300) or ground contact time (p = 0.151). Strong positive linear correlations were observed between the change in running performance metrics and breast size (Oxygen Consumption: p < 0.001, r = 0.770; Relative Oxygen Consumption: p < 0.001, r = 0769; Running Economy: p < 0.001, r = 0.807). Conclusions Greater breast support was associated with reduced oxygen consumption and increased running economy. These findings demonstrate that greater breast support is not only associated with improved comfort but also improved running performance.
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Coltman CE, Brisbine BR, Molloy RH, Steele JR. Effect of Torso and Breast Characteristics on the Perceived Fit of Body Armour Systems Among Female Soldiers: Implications for Body Armour Sizing and Design. Front Sports Act Living 2022; 4:821210. [PMID: 35356093 PMCID: PMC8959632 DOI: 10.3389/fspor.2022.821210] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to provide normative data characterising the torsos and breasts of female soldiers and to determine which torso and breast anthropometric measurements contributed to reports of poor body armour fit. Ninety-seven female Australian Army soldiers completed a questionnaire about their experience with current-issue body armour, including perceptions of fit. Participants also attended a single testing session where we took a three-dimensional scan of their breasts and torso and collected several anthropometric measurements to characterise their torso size and shape. Sixteen of the 22 breast and torso measurements collected were significantly related to the perceived fit of current-issue body armour systems. To improve perceptions of fit for female soldiers and, in turn, reduce movement interference, discomfort, and barriers to occupational performance, future body armour systems should cater to the wide range of female breast and torso shapes and sizes.
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Affiliation(s)
- Celeste E. Coltman
- Faculty of Health, University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
- *Correspondence: Celeste E. Coltman
| | - Brooke R. Brisbine
- Faculty of Health, University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Richard H. Molloy
- Human Systems Integration, Land Division, Defence Science and Technology Group, Department of Defence, Melbourne, VIC, Australia
| | - Julie R. Steele
- Biomechanics Research Laboratory, University of Wollongong, NSW, Australia
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17
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Nolan D, Elliott-Sale KJ, Egan B. Prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifting and rugby. PHYSICIAN SPORTSMED 2022; 51:217-222. [PMID: 34991413 DOI: 10.1080/00913847.2021.2024774] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The prevalence of hormonal contraceptive (HC) use and the associated symptomology of use or nonuse are under-studied in athletic populations, and in particular, in strength and collision sports. This study aimed to investigate the prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifters and rugby players. METHODS Competitive female powerlifters and rugby players (aged ≥18 y), representing a strength and a collision sport respectively, completed an anonymous online questionnaire for the purpose of assessing self-reported prevalence of HC use, and symptoms of the menstrual cycle and HC use. Athletes were categorized by sport (powerlifters, n = 149; rugby players, n = 135) in order to conduct a stratified analysis. For open-ended questions, a content analysis was conducted to categorize responses, and frequency analyses were performed. RESULTS Current HC use was reported by 51.1% of athletes, with similar prevalence for the two sports (powerlifting, 48.3% vs. rugby, 54.1%, P = 0.34). Side effects of the menstrual cycle were reported in 83.5% of non-HC users, with the most common being unspecified cramping (42.4%), headache/migraine (24.5%), and fatigue (24.5%). Side effects were reported in 40.0% of HC users, with the most common being mood changes (17.9%), stomach pain (8.3%) and headaches/migraines (6.9%). CONCLUSION A large proportion of HC users and nonusers in this study experience negative side effects of HC use and the menstrual cycle, respectively. The symptoms experienced by both groups are wide-ranging, with a high degree of variation between individuals. The negative side-effects experienced by HC users and nonusers may have an influence on athletic performance, and this requires future investigation.
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Affiliation(s)
- David Nolan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | | | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.,Florida Institute for Human and Machine Cognition, Pensacola, FL, USA
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18
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Bye T, Martin R. Static postural differences between male and female equestrian riders on a riding simulator. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep210003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study aimed to compare static posture of male and female riders on a riding simulator. Ten female and five male riders underwent a 5 min standardised exercise programme on the simulator, they were then videoed for 10 s from each the left, right, and rear views whilst stationary on the simulator. Two-dimensional kinematic analysis of the videos showed that male riders had a more neutrally positioned pelvis in the sagittal plane (median left: 6.47°, right: 5.24°) with females demonstrating a posterior pelvic tilt (L: 14.04°, R: 13.55°). Females showed significantly greater pelvic obliquity (median female: 1.99°, male: 0.73°), trunk lean (F: 1.60°, M: 0.43°), and shoulder tilt (F: 1.79°, M: 0.57°) in the frontal plane, demonstrating an overall greater postural asymmetry. Previous studies of elite riders have shown a more anteriorly rotated pelvis to be more desirable. Symmetry of riding position is favourable as it allows movements to be performed with ease and ensures even force distribution through the saddle to the horse. Male riders may therefore have a biomechanical advantage over females when it comes to maintaining a desirable riding position. This research should now be extended to study riders on the horse in motion.
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Affiliation(s)
- T.L. Bye
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
- School of Sport, Health and Exercise Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, United Kingdom
| | - R. Martin
- University Centre Bishop Burton, York Road, Bishop Burton, East Yorkshire, HU17 8QG, United Kingdom
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Burbage J, Rawcliffe AJ, Saunders S, Corfield L, Izard R. The incidence of breast health issues and the efficacy of a sports bra fit and issue service in British Army recruits. ERGONOMICS 2021; 64:1052-1061. [PMID: 33709872 DOI: 10.1080/00140139.2021.1895324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Increasing retention of female recruits throughout Basic Training (BT) is a key priority for the British Army. The aims of this study were two-fold; (i) quantify breast health issues and sports bra usage within female British Army recruits, and (ii) assess the influence of professionally fitted sports bras on breast health and bra fit issues across 13 weeks of BT. A survey was completed by 246 female recruits that identified the incidence of breast health issues during BT. Subsequently, 33 female recruits were provided with professionally fitted sports bras during Week-1 of BT. Recruits completed a survey in Week-1 (Pre) and Week-13 (Post). There was a high incidence of bra issues during BT, which did not reduce following the implementation of professionally fitted sports bras. The authors recommend further research into the specific functional requirements of breast support relative to the demands of BT and the needs of the female recruit. Practitioner Summary: The British Army have a duty of care to ensure female recruits are equipped sufficiently for the demands of training. Despite the implementation of a sports bra fitting and issue service bra fit issues remained high. Further research into the specific functional requirements of breast support during training is recommended. Abbreviations: BT: Basic Training; ATR(W): Army Training Regiment Winchester; ATC(P): Army Training Centre Pirbright; BMI: Body Mass Index; NRS: Numeric Rating Scale; FET: Fisher's Exact Test.
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Affiliation(s)
- Jenny Burbage
- School of Sport, Health and Exercise Science, University of Portsmouth, Hampshire, UK
| | - Alex J Rawcliffe
- Department of Occupational Medicine, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Uphaven, UK
| | - Samantha Saunders
- Human Performance, Defence Security Analysis, Defence Science and Technology Laboratory, Porton Down, UK
| | - Louise Corfield
- Department of Occupational Medicine, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Uphaven, UK
| | - Rachel Izard
- Science and Technology Commissioning, Defence Science and Technology, Ministry of Defence, Salisbury, UK
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Abstract
More systematic breast biomechanics research and better translation of the research outcomes are necessary to provide information upon which to design better sports bras and to develop effective evidence-based strategies to alleviate exercise-induced breast pain for women who want to participate in physical activity in comfort.
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Affiliation(s)
- Deirdre E McGhee
- Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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21
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Brisbine BR, Steele JR, Phillips EJ, McGhee DE. Breast and torso characteristics of female contact football players: implications for the design of sports bras and breast protection. ERGONOMICS 2020; 63:850-863. [PMID: 32301393 DOI: 10.1080/00140139.2020.1757161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to provide normative data characterising the breast size, breast position and torso size of female contact football players. 117 AFL, Rugby League, Rugby Union and Rugby 7s players attended a single testing session where a three-dimensional scan was taken of their naked breasts and torso. Dimensions relevant to the design of sports bras and breast protective equipment were then calculated from the scans. Several breast and torso characteristics of female contact football athletes differed to measurements reported for females in the general population and amongst the contact football codes. Designers and manufacturers of sports bras or breast protective equipment should consider the specific breast and torso dimensions of female contact football players to maximise the fit, comfort and efficacy of these garments. Practitioner summary: Using three-dimensional scanning, this study characterised the breast and torso size and shape of 117 female contact football players. These normative data should be used to improve the fit and comfort of sports bras and breast protective equipment for female contact football players.
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Affiliation(s)
- Brooke R Brisbine
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
- Applied Technology and Innovation, Australian Institute of Sport, Canberra, Australia
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
| | - Elissa J Phillips
- Performance People and Teams, Australian Institute of Sport, Canberra, Australia
| | - Deirdre E McGhee
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
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