Why we need to talk about periods, breasts and injuries in women’s sport

Women’s sport is having a huge summer coming to an end.

But away from the drama and excitement on the pitch, there is also a scientific revolution taking place.

Teams of scientists are looking into the unique ways that elite sport affects the female body, including how breasts affect running but the right sports bra might give you the edge, how the menstrual cycle might affect performance, and what functions period trackers might perform, and why are some injuries more likely to occur and what can be avoided?

Bring your memory to the iconic scene from the 2022 European Championships final.

Lioness Chloe Kelly scored the winning goal against Germany in extra time at Wembley.

In the ensuing euphoria, she whipped off her England shirt showing the world her sports bra.

What facts about her breasts are:

• Breasts can bounce an average of 11, 000 times in a football match
• Without proper support, an average bounce is 8 cm (3 in).
• They can move with up to 5G of force, which is equivalent to Formula 1 driver’s experience.

Laboratory experiments – using motion sensors on the chest – have revealed how a shifting mass of breast tissue alters the movement of the rest of the body, and in turn, sporting performance.

Compensating for bouncing breasts by restricting the movement of your upper body alters the positioning of the pelvis and shortens the length of each stride. Sports bras are a form of performance gear because they are not just for comfort or fashion.

According to Prof. Wakefield-Scurr, “we actually observed that a decrease in stride length resulted in a four centimeter decrease in stride length.”

“If you lost four centimetres every step in a marathon, it adds up to a mile”.

The body is clearly affected by the menstrual cycle, which can lead to fatigue, headaches, and cramps as well as having an impact on mood, sleep, and emotions.

But Calli Hauger-Thackery, a distance runner who has represented Team GB at the Olympics, says talking about its sporting impact is “still so taboo and it shouldn’t be, because we’re struggling with it”.

Calli says she always notices the difference in her body in the lead up to her period.

She claims that her legs are extremely fatigued, and that she feels like she’s almost running through mud at times.

Being on her period causes anxiety, “especially when I’ve got big races coming up,” according to Calli’s menstruation tracker, which indicates that she “lives.”

Oestrogen and progesterone, two hormones, are the rhythmic oscillations that control the menstrual cycle. But how big an impact can that have on athletic performance?

The Manchester Metropolitan University professor, who is a specialist in female endocrinology and exercise physiology, says, “It’s very individual and there’s a lot of nuance here. It’s not quite as simple as saying that the menstrual cycle affects performance.”

Every day during the menstrual cycle, she says, “Competitions, personal bests, world records, everything has been set, won, and lost.”

Understanding the physiological changes that hormones have throughout the body, the difficulty of performing while experiencing symptoms, the psychological effects of your period-related anxiety, and general opinions about all of the above are necessary to determine whether the menstrual cycle affects sporting ability.

There is no “phase where you’re going to win or you’re going to lose,” according to Prof. Elliott-Sale, but in theory the hormones oestrogen and progesterone could alter body parts like bone, muscle, or heart.

“What we don’t yet understand is: Does that have a big enough effect to really impact performance”? she asserts.

The professor goes on to say that poor sleep, fatigue, and cramping would have a “very reasonable conclusion” and that dread and anxiety were “absolutely tangible things” for athletes in their era who are performing in front of large crowds.

Manchester Metropolitan University has collaborated with Sale Sharks Women, a rugby union team.

I got to know former England rugby player and all-time top scorer Katy Daley-McLean.

The team are having open discussions around periods to help them understand the impact that menstruation can have, and how to plan for it. Daley-McLean recommends taking ibuprofen three days before bed, instead of thinking, “I can’t do anything about it.”

A change in the risk of some injuries has become a more significant issue as women’s sport has received more attention.

The anterior cruciate ligament (ACL), a portion of the knee that connects the upper and lower legs together, has received the most attention. Injuries can be brutal and take a year to recover from.

According to Dr. Thomas Dos’Santos, a researcher at Manchester Metropolitan University, the risk is three to eight times greater in women than men, depending on the sport.

He claims that there is “no simple answer” to explaining the higher risk for women.

Partly it could be down to differences in anatomy. Women’s hips mean that the top of the thigh bone moves in a wider direction, which affects the angle at which the lower leg connects with the knee, potentially causing greater risk.

According to him, “there could be an increased risk of injury, theoretically,” because of elevated oestrogen levels prior to ovulation, which could alter the properties of ligaments, making them slightly more stretchy.

However, Dr. Dos’Santos contends that considering how women still receive the same level of support and strength training as men, it is crucial to consider other aspects of the body.

He compares it to ballet, where dancers do receive good quality training. According to Dr. Dos’Santos, “the]difference in] incidence rates is essentially trivial between men and women.”

By teaching female athletes to move in subtly different ways, research has been done to determine whether it is possible to reduce the risk of ACL injuries.

But there is a risk of lessening performance, and some techniques that put strain on the ACL – like dropping the shoulder to deceive a defender before bursting off in another direction – are the necessary moves in sports like football.

Katy Daley-McLean at Sale Sharks Women still has a lot of work to do, despite the fact that there are still many unanswered questions.

She recalls that all the hypotheses about how her body would behave were based on information provided by male rugby players when she first received her first cap in 2007.

“We were literally treated as mini-men”, Daley-McLean recalls.

Girls and women no longer feel like outsiders in sport, she claims, which encourages continued advancement of women’s performance at the highest level.

“It’s awesome, it’s something to be celebrated because, according to the statistics, one of the biggest reasons young girls leave sports is body image, which is caused by periods and not having the appropriate sports bra, which is so easily sorted.