Female athletes: managing risk and maximizing benefit

Hormonal contraception for female athletes presents special needs and concerns

PURPOSE

Oral contraceptives (OCs) are commonly used by female athletes raising concerns regarding the possible adverse effects of OCs on physical performance, musculoskeletal injuries, and bone density. We aimed to review all current studies on the physiological effects of OCs in physically active women.

MATERIALS AND METHODS

A review of literature in electronic search in PubMed and Google Scholar databases from December 2002 to December 2022 using relevant keywords. The reference lists of the articles found eligible were also reviewed.

RESULTS

Out of 344 articles in the initial database, 54 clinical studies were eligible for inclusion in our literature review. OCs are used by about two-thirds of female athletes. Current research suggests that OCs' effects on endurance performance and muscle strength are mostly reassuring. OCs do not seem to have a major negative impact on bone health or sports injuries. In fact, new data suggests that they may even significantly reduce the risk of anterior cruciate ligament (ACL) injury.

CONCLUSIONS

OCs can be safely used by young female athletes, who may also benefit from better menstrual cycle control. OCs offer newly realised protection from ACL injuries. The use of OCs must be carefully individualised according to their preferences, expectations, and experience.

The Underlying Mechanisms of Sports Injuries in Paralympic Goalball: A Mixed-Method Study

OBJECTIVE

Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport goalball, but the mechanisms behind have not been explored. The aims of this study are to (1) quantitatively analyze goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, (2) qualitatively explain the differences between both games, and (3) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball.

DESIGN

This is a mixed-method study. Injury incidence rates were analyzed from data collected during the 2012 and 2016 Paralympic Games. Then, semistructured interviews of games participants qualitatively explored injury mechanisms and prevention opportunities.

RESULTS

A reduction of injuries occurred from 2012 (incidence rate, 19.5; 95% confidence interval, 12.5-26.5) to 2016 (incidence rate: 5.6; 95% confidence interval, 1.7-9.5). In both games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared with males ( P = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse, and poor physical conditioning. The differences between the two games were explained by equipment, environment, and preparations.

CONCLUSIONS

The result from this study indicates that injuries in goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context develop prevention measures.

The link between the range of rapid weight loss and physical conditions of elite wrestlers during competition under the morning weigh-in rule

BACKGROUND

Amateur wrestlers have often undergone rapid weight loss (RWL) to win their matches. On January 1, 2018, the rule of weigh-in was changed and weight category increased. The study aimed to determine the prevalence of wrestlers undergoing RWL under the new rule of morning weigh-in before the tournament and examine the relationship between the range of RWL and physical conditions.

METHODS

Male (N.=204) and female (N.=50) wrestlers participating in the National Wrestling Championship completed a questionnaire about weight reduction methods and their physical condition.

RESULTS

Among 159 participants exceeding their weight class one-week before competition, 36% of males and 44% of females exceeded their weight class by 0.0-4.9% (requiring small RWL); 30% of males and 6% of females exceeded by 5.0-10.0% (requiring large RWL), but neither males nor females were over 10.0% above required weight. In males, there was a moderate negative correlation between excess rates of body mass one-week before competition and their physical condition (r=-0.330 to -0.467, P<0.05) on the first day of the competition; however, no significant correlation was found in the females. Comparing physical condition according to the range of RWL, there were significantly lower scores in the large RWL group (≥4.9%) than the small RWL group (<4.9%) in males.

CONCLUSIONS

We found that RWL≤5% is most appropriate to ensure better physical condition of wrestlers on competition day.