The UK Sports Institute believes that if we want to improve the conditions for girls and women in sport, we need to learn from the past.
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Female athletes suffer certain sports injuries more frequently than male athletes, but that should not be the case.
“It is important to consider biological differences between men and women when it comes to performance or injury outcomes, but it’s only one piece of the puzzle,” says Dr Victoria Downie, a performance scientist within the UK Sports Institute’s [UKSI] Performance Innovation Team. She is telling the Leaders Performance Institute about elements of her team’s research into female athlete injury occurrence.
“I started to explore how we as an institute could better understand all the factors which are impacting how women are training, competing and performing, how they feel, and their whole experience of being women in elite sport,” adds Downie, who has spent time immersed in different Olympic and Paralympic sports in order to better understand their challenges and opportunities. “It’s easy to underestimate the impact of simply spending time listening to athletes. That goes for men and women but perhaps more for female athletes who feel historically as if they haven’t had much of a voice.”
Female athlete health and wellbeing has long been a priority for the UKSI. In February, through the prestigious British Academy Innovation Fellowships scheme, the Institute partnered with the University of Nottingham to launch a research project calling upon former UK Sport-funded female athletes who have retired within the last five years. The purpose is to interview these former athletes and explore how women’s sporting environments – their social and cultural context when training and competing – influenced their experiences of both minor and major injuries.
“We asked women to talk about their experience of injury while doing their sport and all the factors that may have influenced that experience.”
The gendered environment
The research project is being led by Dr Stephanie Coen, an Associate Professor of Geography at the University of Nottingham. “You may be wondering what a geographer has to do with this type of work, but my speciality within Geography is Health Geography,” she tells the Leaders Performance Institute.
“Broadly, I’m interested in how our environments influence our health and, within that, my interest has been around gender differences in physical activity.”
In 2021, Coen published a paper with Joanne Parsons at the University of Manitoba and Sheree Bekker at the University of Bath entitled ‘Anterior cruciate ligament injury: towards a gendered environmental approach’.
“My foray into sport was prompted by my previous work on how environments, like the gym, shape the gendered nature of physical activity,” says Coen, who explains that her collaboration with Parsons and Bekker happened “by chance”. In 2017, she was approached by Parsons, a clinician, and four years later their paper with Bekker would provoke a response in the sports world “that exceeded our wildest expectations”.
One of the key elements of the paper was to challenge the focus on the clinical and biological in female athlete injury occurrence. “The current medical paradigm puts the focus of injury within the female body – menstrual cycles, anatomy, biomechanics, all of those things – whereas the gendered environmental approach asks us to take a wider lens. It’s not that the biological lens doesn’t matter, but the gendered environment approach asks us to think beyond the individual body to how we can change the gendered conditions of sport in ways that might reduce injury risk.”
The myth of the ‘ideal female athlete’
Female athlete ACL injuries provide an illustrative example of the impact of the gendered environment. Downie says: “When this is discussed in the media, there is talk about women having more ACL injuries because of their biomechanics, because whilst they’ve got their period, their muscles are a bit more relaxed.” She is not dismissive of those factors, but the UKSI has long sought to look beyond such internal factors.
“One example that’s come out of our work is that women in sport often talk about feeling as if they need to show they are strong or not complaining,” says Downie. “That is a factor that could be leading women to not report that they are feeling a niggle or they feel that they need to train through the niggle to show they are strong – ‘I don’t want to be the one that misses training today’ – and it could be a factor that delays their diagnosis.”
“This inherent belief is embedded in history. For example, women were only allowed to run the Olympic marathon for the first time in 1984. Before that, people thought women weren’t strong enough, weren’t brave enough. There has been a huge shift in these beliefs over the last 40 years, but it is not a long time in the grand scheme of things. These beliefs are still in play and through this work we are hoping to highlight these factors.”
There is also the challenge presented by what Coen and Downie call the perception of the “ideal female athlete.” “This is the kind of wider social norm that prescribes the social and physical qualities that the ‘ideal’ female athlete embodies,” says Coen. “That might seem abstract, but actually, in the women’s experiences, this kind of ideal really did function as a barrier to women feeling as if they could voice health and injury concerns because if they maybe asked too many questions, maybe they’re being too direct or too assertive and that might contravene the ideal of being soft, nice, polite and agreeable. The ideal of the female athlete can have quite a tangible material impact on the everyday experiences of women athletes with ramifications for how they went about tending health and injury concerns.”
The drive to better understand these concerns fuels the entire project. “It’s about understanding that these sorts of social norms and taken-for-granted ways of doing things become part and parcel of the sport environment,” adds Coen. “These social and cultural aspects are an untapped opportunity for reducing women’s injury risk. If we can make them visible, we can change them. And this puts us in a position to improve outcomes more widely for girls and women in sport.”
The research-to-practice gap
Coen’s academic work made her a natural fit for the UKSI. “We always look outside the Institute for people who are working outside of elite sport on areas that interest us,” says Downie. “We put together an application for a British Academy Innovation Fellowship and we won the award, which meant that we have Steph for the whole year.”
Coen has taken on the duties of interviewing the retired athletes who were encouraged to come forward for the project. “I feel so lucky and privileged to have this opportunity,” she says. “I went to my first Performance Innovation Team meeting in the spring and I’ve been blown away by the creativity and excitement in the room.
“When we published the gendered environmental approach to ACL injury it was a conceptual paper, an idea. By partnering with the UKSI and Vic we’ve been able to move this idea into something that can have a tangible impact for women in sport. That research-to-practice gap is something that often feels very wide in academia and I feel like in this work we’re actually closing this gap in real time.
“It shows there’s leadership at the UKSI that’s really trying to push forward in a substantial way for female athletes.”
Downie’s excitement is palpable with a Summer Olympics and Paralympics year approaching. “This work has not happened overnight,” she says. “We’re in a place now where we can share this and start to have some impact. Paris is less than a year away but we can see some tangible impact going into the next cycle.”
Progress is being made at Manchester United and World Rugby – in traditionally male dominated sports – but there are not always opportunities for all in women’s sport.
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Polly Bancroft serves as the Head of Women’s Football at WSL [Women’s Super League] club Manchester United. She is discussing her 18 years working in the women’s game, which have taken in roles at the Football Association, Brighton & Hove Albion and Uefa.
Of her experience working for Uefa, the European football confederation, which is headquartered in Nyon, Switzerland, Bancroft adds: “I think having experienced living in Switzerland and working across Europe with many different cultures, I think understanding different approaches to time, decision making, and hierarchy were just integral to my career.
“And I think learning to work with people from different backgrounds around sometimes very challenging topics but maintaining those relationships has been really important to me.”
Bancroft was speaking at a recent Keiser Webinar entitled Leading Women: Building Perception and Driving Opportunity. She was joined online by Nicky Ponsford, the Head of Women’s High Performance at World Rugby and, in front of a virtual audience drawn from coaches and practitioners from across the globe, the duo discussed the challenges of creating, scaling and sustaining a high performance infrastructure in women’s sport.
“I was lucky in my very first role that I had a line manager who always gave me the chance to learn and the chance to make mistakes. That’s something that I’ve tried to take with me throughout my journey,” Ponsford says of her time at the RFU [Rugby Football Union] where she served as Head of Performance for women – a role she filled for two decades as the game continued to grow exponentially.
“But I can’t do it all by myself. I need other people, need collaboration, need to work with others. [I learned] that politics are real in sport and that you have to learn how to work the politics.”
Bancroft and Ponsford, as leaders with female-focused leadership roles, are proof that steps are being taken in traditionally male-dominated sports, but neither is happy to rest on their laurels.
Here are six steps towards ensuring that progress is both scalable and sustainable.
During her time at the RFU, Ponsford oversaw the establishment of a women’s performance management group that was designed to have a “direct voice to the RFU management board.” It does not mean that the issues facing women’s rugby, from the transition to professionalism (ongoing since 2019) to the question of maternity leave, are instantly solved, but the right people are being asked the right questions. If you have men’s and women’s teams, it is important to grant both access to the necessary expertise or resource. “We’ve expanded our governance model in that we now have two different bodies overseeing women’s football at Manchester United,” says Bancroft. “We have a technical football board and a commercial working group as well. That falls under a women’s executive leadership team.” The intention is clear: “This new governance structure brings in members of the leadership team in legal, finance, communications, operations, football and marketing. We’ve got the key heads of football across the business that work on men’s, women’s, boys’ academy, girls’ academy and we’re using the very best expertise at the club and channelling it into the women’s game.”
What is the right pathway for the female version of your sport? Equity does not mean that women’s and men’s sport should be treated the same way. The challenges are often different and female sport must take its own path if the girls and women involved are to thrive with the right support. For example, English rugby removed promotion and relegation from Women’s Premiership Rugby during Ponsford’s tenure at the RFU. “[Previously] everyone had the chance to get to the top, but in terms of driving standards and driving a league that we wanted to get to, it wasn’t going to work,” she says. “Pushing that through, getting what we needed for the women’s game, was really important.”
“Nicky and I come from male-dominated sports,” says Bancroft. “Here at Manchester United, the club have operated men’s football for over 145 years and the women’s team has been reborn and we’re now into our sixth season. So my approach has been to blend that knowledge and experience of that 145-year history with collaboration and the bespoke nature of the demands and requirements of the women’s game. One part of that is through developing our own performance framework. With myself and the Head Coach, Marc Skinner, we’ve worked on this framework that is around learning and embracing the journey that learning gives you.” The framework is then split into “feelings and operations”. Bancroft continues: “From a feeling perspective, we want people to feel energised, we want them to feel included, and we want them to feel playful.” The idea is to promote creativity on and off the field. In terms of operations, the club wants to equip players to manage themselves and communicate effectively. There is also an emphasis on “finding solutions” and “seeking ownership”. “We want players to identify challenges and find solutions. Similarly, in the staffing environment, there might be a certain challenge or blocker that we’re coming up against. Let’s not sit back and complain about it. Let’s try and work out some solutions.”
What structures are in place in your environment to enable players, coaches and staff to take interpersonal risks? Ponsford argues that the creation of psychological safety goes hand in hand with developing a culture that encourages people to come forward with ideas. “While some may talk lots during meetings, there needs to be another mechanism for people to come forward, another time for people to share so that everybody has that opportunity,” she says. Ponsford has an open door policy so that “people can come forward with thoughts, people can come forward with ideas, and [know] that they get discussed, they get picked up, and they don’t get ignored.”
Manchester United use individual development plans for players and appraisals for staff to assist development, commit to goals and track progress. “We’re also really encouraging of staff and players to talk to their peers, talk to their friends about strengths and weaknesses. We also do different personality tests that can highlight certain blind spots, which I’ve found to be helpful personally,” says Bancroft. Some people at the club keep diaries, some meditate, and all players are encouraged to better understand their triggers and habits while also being accepting and kinder to themselves.
Bancroft explains that she and Manchester United have benefited from pioneering research into female athletes. She cites one report in particular, which was born from a collaboration between Dr Emma Ross of health and fitness consultancy the Well HQ and the WSL. It helped the club to shape their best practice. “We invited in some guest speakers, particularly around the menstrual cycle and the pelvic floor, we discussed kit options with our kit manufacturer, we’ve done some education with staff, we’ve done some education with players – I’ve learned some stuff about the menstrual cycle as well – it was a fascinating exercise to go through; that even as a woman I didn’t know everything there was yet about the cycle.” Such conversations need to be normalised.
