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The notable gaps in understanding and knowledge stem from the lack of research into female athletes, with studies seen by the English Institute of Sport [EIS] suggesting that as little as 3% of sports performance research has looked at training, recovery and the general wellbeing of female competitors.
“The majority of research findings in sports performance are only applicable to male athletes,” observes EIS.
“If we could adjust training, recovery, nutrition and the environment to account for specific female physiology and genetic profile, you could guarantee better performance outcomes for female health, wellbeing and performance.”
In its quest to optimise female-specific factors around training and performance, EIS has rolled out its SmartHER campaign.
It says: “We want to create a place where it’s absolutely vital, in the pursuit of world class performance, to have the best evidence, insight and culture to ensure we have informed and open conversations about anything and everything that might help female athletes fulfil their performance potential.”
The Leaders Performance Institute spoke to Dr Emma Ross, EIS Co-Head of Physiology, to explore how SmartHer is already benefiting the female athletes who enter its high performance system. “We know there are gaps and these gaps are quite big,” she begins, “but that provides us with an amazing opportunity to improve performance and wellbeing. That’s what is truly motivating us.”
Understanding the fundamentals of female athletes
Ross admits that the workshops arranged by SmartHER refreshed even her knowledge of basic biology and have proven useful in dispelling common misconceptions around female athletes and their menstrual cycle. She says: “While a female athlete cannot be defined by the fact that she has a menstrual cycle, her fluctuating hormones really do have a massive impact on the things that she does, whether that would be motivation to train, mood and emotion, ability to adapt to a certain training stimulus, how she might communicate or be communicated to.
“All of those things might be affected by these powerful hormones that fluctuate through a female’s physiology over the course of a month. Understanding the basic biology of females is a good starting point for us and, in doing that, we really understand the gaps in terms of the data that’s collected in sport.
“Scientific research either tends to just look at men or at females in one specific point in their menstrual cycle when their key hormones are quite low and so they closely resemble male athletes. There’s very little research that takes into account what a female looks like in terms of this intervention or outcome measure when she’s in different phases of her menstrual cycle.”
This deficit, Ross explains, has also affected the medicine. She says: “They’re now finding that there are medical treatments, which at certain times in the menstrual cycle, have the opposite effect or increase the propensity for illness – because the clinical trials were all done on men.”
The opportunity for Ross, EIS and SmartHER is to work with athletes on an individual basis. “We can really tune into what works and what doesn’t work across one individual’s menstrual cycle; does this athlete get clumsy at a specific time in their cycle; does the way we communicate with them need to be different at different times.
“But the privilege of working in high performance sport is that you get to try and understand that with your athletes in a close-knit way.”
“Pennies started to drop”
SmartHER’s first big action came in the form of four workshops, held throughout 2018 and attended by 120 staff. “We went out to coaches and sports science practitioners first and we just gave them a bit of a 101 in female biology because when you start to talk to people about a topic like this, pennies start to drop,” says Ross.
“A coach might say ‘OK, so you’re saying that hormones can affect coordination; that makes sense. Is that a time when I should be training skill or not skill training?’ Those pennies start dropping and you do start to have open conversation. ‘If my athlete is on the pill does her physiology look like this or does it look different?’”
SmartHER is trying to change the landscape. “You’ve got a lot of male coaches in sport and I think that creates an environment where it’s slightly more difficult to approach some of these topics,” observes Ross. “Not that this means anyone is unwilling.
“We did those workshops with the coaches, then practitioners, and then, on the back of that, we’re now going out to the athletes because ultimately what we want to happen is that everybody has the same conversation in a really impactful way and pennies drop all over the place.
“They go back to their sports and have really impactful conversations. The great thing is that the people pass on this information and education are people that work in our system. So rather than being heavy science, it becomes a very context-driven conversation. We’re working with doctors, physios, physiologists and athletes on a daily basis – it’s their job to talk in a way that coaches and athletes understand.”
The athletes represented stage two. “We wanted the athletes there without the coaches because we wanted to offer them a really safe space for having conversations,” says Ross. “Then they will feel more confident with their new knowledge going back to talk to their coaches or whoever they feel might be appropriate.
“What we don’t want to happen in this situation is that everyone just walks back to their sport and says ‘I suppose we’d better talk about the menstrual cycle again’. We want it to be part and parcel of the performance conversation that goes on.”
Progress will inevitably be gradual. “At the moment it’s going to have to be a bit clumsy and we’re going to have to get over some of the stigma attached to talking about periods,” admits Ross. “A female athlete probably wouldn’t think to say to their coach that this is a long training session and there may be a point in the middle where I need to go to the toilet because I’m on my period and need to change my sanitary protection – that feels like the weirdest conversation in the world right now.”
Yet it is a crucial step in taking these conversations away from the realms of the medical. “Female athletes need to know how much their physiology can influence their opportunity to recover, train or perform better. Sometimes these conversations don’t happen unless it becomes more medicalised.
“We want to make it so that female physiology and psychology – all the elements of the female athlete – become part of the intuitive process, the problem-solving around performance. We want to give these people the information they need to make it really intuitive so that when it’s appropriate it can be part of the performance conversation. When a coach and athlete work together, the coach will look at the athlete and say they’re not moving in the same way and maybe I need to give them a different training session.
“Additionally, if we’re trying to work out why an athlete is currently injured, we want it to be in the mind of the physios, doctors, and coaches to go to the athlete routinely at different phases of her menstrual cycle rather than just thinking they can’t figure it out. We want it to be part of the problem-solving culture of supporting athletes.”
The mental aspects of SmartHER are equally important. “I think we’re making strong strides towards creating a psychologically safe space. In terms of the female athlete that’s really important, whether that’s being comfortable to talk about pelvic floor dysfunction or the menstrual cycle or whether it’s just accommodating the different communication needs or motivation techniques of different individuals.
“There’s research that shows that females and males are fundamentally different in how they think; women are more empathetic and men are more process-driven. There are differences and you need to have a safe space where you’re willing to be flexible and accommodating of individual needs.”
Examples of miscommunication abound. “If you ask any coach about their communication and motivation techniques their responses will be highly individualised,” admits Ross, but, “some of the feedback we’ve had from coaches who may have worked with male groups before and the female groups, they would try to motivate the female group in similar ways and it fell on deaf ears and they couldn’t figure out why.”
One coach told his female athletes to be ‘more aggressive’ and they didn’t respond as they thought they might – like a male athlete. “He ultimately figured out that what really motivated this group was their teammates. They were really collegiate in their approach,” says Ross.
“I’m not saying that’s how all female athletes will think and one size does not fit all, but a coach has a group of female athletes who have an emotional response to a decision you’ve made as a coach and you think ‘they’re just emotional women’ then you’ve lost them. You’ve lost the room and you can’t ask them to give 100% in training and they might not be 100% convinced.
“But if you tap into what they need as individuals then suddenly you’ve got a group of really engaged athletes. We are in the business of motivating athletes and there’s a lot of things to unpick in how we communicate.”
Ideally, EIS want to be discussing all of the above at the entry point for the athletes on their programmes. “It can also be as simple as wearing the right-fitting bra,” she adds. “We want all of that to be part of the initial conversation so that it’s part of the norm and that’s the place that we’re trying to reach.”
SmartHER is a work in progress and there is a deficit in research and practical application but therein lies an opportunity for EIS to be nimble. “There’s a group of researchers out there doing amazing work in this area but there’s not millions of them so we can really connect with them and take the science that’s being done in universities around the country and really help translate that into practice quicker and more effectively than trying to tackle broader areas.”
Ross says the opportunities are exciting: “Especially when you find opportunity in a place you hadn’t considered.”
It is the least female athletes deserve.
International Women’s Day on 8 March 2019 saw Leaders welcome over 250 sport business executives to Facebook’s offices in London and New York, to recognise and celebrate the talented women who are driving the sports industry forward. The agenda was designed to champion diversity in the workplace and inspire a new generation of sports execs. To learn more about Leaders Meet: Women in Sport click here.