Objective: This study aimed to gather and represent experts’ perspectives on the gender- and/or sex-specific factors relevant to injury risk for female/woman/girl athletes. Methods: Mixed-methods concept mapping study. Sixty-six experts including cisgendered (1) athlete/coach/carers, (2) clinicians, (3) sports science/high-performance professional, (4) administrators and (5) researchers brainstormed statements to a prompt (‘What gender-specific and/or sex-specific factors do you think contribute to injury risk among female, woman and girl athletes?’) before thematically sorting and rating the statements/factors for importance and modifiability (5-point Likert scales). Results: Ten clusters were constructed from 101 unique statements/factors. The clusters (number of statements) include: (1) Inequitable organisational funding and support (n=17); (2) Athletes’ lack of, and access to, resources (n=7); (3) Lack of knowledge and expertise among support staff (n=6); (4) Lack of evidence for, and implementation of gender and sex-appropriate injury prevention (n=20); (5) Sex-related factor s (n=14); (6) Gendered health (n=8); (7) Gendered expectations to conform to athletic ideals and norms (n=10); (8) Gendered harassment (interpersonal violence) and social biases (n=9); (9) Gendered sport environment (7); (10) Gendered communication (n=3). Lack of knowledge and expertise among support staff was deemed the most important and modifiable cluster to address gender- and/or sex-specific factors relevant to injury prevention for female/woman/girl athletes. Conclusion: Ten gender- and/or sex-specific clusters, ranging from organisational to biological considerations and societal influences, were defined that could impact female/woman/girl athlete injury risk factors. Advancing stronger evidence for gender and sex appropriate injury prevention is urgently needed.

Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The recovery process of the abdominal muscles following childbirth is not well understood. This study aimed to demonstrate the changes in the thickness and contractile function of abdominal muscles during the first six months postpartum. Nine perinatal and 15 nulliparous females participated. The thicknesses and contraction/relaxation thickness ratios of the rectus abdominis (RA), external abdominal oblique (EO), internal abdominal oblique (IO), and transverse abdominis (TrA) were measured using ultrasound images from 36–39 weeks’ gestation until six months postpartum. The RA, IO, and TrA muscles were thinner in perinatal females than controls at 36–39 weeks of gestation (4.8 vs. 9.47 mm (RA), 5.45 vs. 7.73 mm (IO), 2.56 vs. 3.38 mm (TrA), respectively). The thinner IO muscle persisted for six months after delivery. The decreased TrA thickness ratio persisted until four months post-delivery. Abdominal muscle thickness and contractile function decreased in the postpartum period. Therefore, abdominal muscle exercises might help prevent postpartum symptoms; however, because deterioration of muscle function is significant in the first four months, careful attention should be paid to exercise intensity. The study limitation was a relatively small sample size, thus future studies should involve more participants.

Objectives: To evaluate the difference between female and male sports medicine physicians regarding disrespectful attitudes and sexual harassment perceived from athletes, coaches, physicians, athletic trainers (ATs) and organisations/administrations. Methods and study design: anonymous survey was distributed to sports medicine physicians practicing in 51 countries. χ² analysis was used to detect differences between female and male sports medicine physicians and logistic regression analysis was used to determine the independent variables that affect disrespectful attitudes and sexual harassment from sports participants. Results: 1193 sports medicine physicians (31.9% female) participated from 51 countries. The survey revealed that female physicians, compared with male physicians, perceive significantly more disrespect or have their judgement questioned more by the following categories: male and female athletes, male and female coaches, female physicians with more years of experience, male physicians (regardless of years of experience), male and female ATs and organisation/administrations (all p<0.05). The only category where the frequency of disrespect was perceived equally by male and female physicians was during their interactions with female physicians who have the same or lesser years of experience. Female sports medicine physicians noted more sexual harassment than male physicians during interactions with male athletes, coaches, ATs and physicians (all p<0.001). In the logistic regression, gender was a related factor for perceiving disrespect, especially from male coaches (OR=2.01) and physicians with more years of experience (OR=2.18). Conclusions: Female sports medicine physicians around the world experience disrespectful attitudes, questioning of their judgement and are sexually harassed significantly more often than male counterparts.

Many elite female athletes struggle to maintain performance while transitioning from high school to university-level (senior) sports. This study explores factors of body composition that influenced performance in elite junior female track and field athletes transitioning to the senior division. Forty-two elite female track and field athletes, ranked among the top 100 in Japan, were enrolled in this study. Whole-body mode dual-energy X-ray absorptiometry scans were performed during the post-season of 2016 and 2017. Athletes’ performances were assessed using the International Association of Athletics Federation scoring system. Relationships between changes in performance and those in body composition were investigated. There were significant negative correlations between changes in performance and fat mass (FM), and percentage FM (FM%). This was seen in total body and lower extremities, and not in the trunk and upper extremities. In addition, there was a positive correlation between changes in performance and percentage lean mass (LM%). However, there were no correlations between changes in performance and LM and total mass. Elite female track and field athletes transitioning to senior division should decrease their FM and FM% and increase LM%, to sustain or improve performance. It is also more important to monitor changes in body composition than body mass.