Y’all. This is big. Recently the International Olympic Committee (IOC) published an expert consensus statement focusing on the specific health needs athletic females (bio-sex) (Moore et al, 2022). The authors identified 10 female athlete health domains to prioritize in research. The domains will assist with consistency of research classification, communication, and reporting: menstrual and gynecological health; preconception and assisted reproduction; pregnancy; postpartum; menopause; breast health; pelvic floor health; breast feeding, parenting and caregiving; mental health and sport environments. In addition, they hoped to foster investigation of how these variables may impact sports participation and performance. Conversely, how sports participation may influence these unique health needs.

See domains and definitions below from Moore et al, 2022.

This is such big news….folks are front loading future research with imperatives from the tippy top of athleticism. It will take time, but it gives us all rallying points to be sure we are on the same page- moving the conversation forward with collective intention.

Meet Me at the Rallying Point

In 2020, I began a collaboration with Chris Napier PT, PhD at the SFU Run Lab, with the intention of filling large gaps in the literature on some of these female athlete health domains (D-PR, D-PO, D-PF, and D-ME). While some of our results challenged my own biases, some of the results were novel! Offering new information to help fine tune our thought processes on how sport and female athlete health domains interact.

One of the strengths of our study was that we recruited for a running study first, then offered pelvic health surveys second. This limited participant selection bias, meaning folks chose to join the study as a runner, not as someone who runs AND has pelvic health challenges. The goal was to get a broader sampling of runners and get a clearer picture of prevalence of a variety of pelvic health needs in the recreational female runner population. In addition, we surveyed for a spectrum of pelvic health need across the lifespan not just urinary incontinence. That’s where some of the novel magic happened!

Check out study details below, followed by links to our published abstracts in open access journals. We looked at associations in the data between the above noted health domains, demographics, running history and volume, and kinematic and kinetic variables in a convenience sample of recreational female runners.

Take a Peek: Methods

Eighty-eight healthy recreational female runners (biologic female sex at birth) free of musculoskeletal pain who ran at least 1x/week for > 3 months were recruited from the local community for an instrumented biomechanical treadmill study. After data collection, they were invited to complete a series of surveys and screened for additional criteria. Runners <18 years-old, currently pregnant or <12 months from a delivery, breastfeeding, with an acute urinary tract, bladder, or vaginal infection, diabetes or neurological disease, or using diuretics were excluded. Sixty- six participants met additional criteria and volunteered to completed surveys.

Participants were provided a standardized shoe with insole-embedded inertial measurement units capturing peak resultant acceleration at initial contact (PRA-IC) as they ran on a treadmill at three speeds (2.5, 3.0, 3.5 m/s). Afterward, participants self-reported running mileage and experience, obstetrical history, hormonal status, and pelvic health symptomatology via a modified Epidemiology of Prolapse and Incontinence Questionnaire and the Queensland Pelvic Floor Questionnaire.

In addition, we asked questions regarding symptom behavior during running in the same 4 pelvic health domains captured by the Queensland (Urinary, Bowel, Prolapse, and Sexual Health). Currently, there are no validated measures specific to pelvic health in athletic populations, however the IOC consensus statement specifically suggested the Queensland because it asked questions in multiple pelvic health domains (Moore et al, 2022).

Take a Peek: Results

Now onto some of our results! See below links to 4 published abstracts of our 7 peer reviewed platform and poster presentations shared at state, national, and international conferences! Go Team (they are amazing*)! For now, I am sharing abstract links (you will need to scroll within the article to the Abstract# or page# indicated in the citation). Throw thoughts or questions below in the comments or send me an email!

Abstracts can only capture preliminary findings and snapshots of components of the study. Manuscripts are in process with the hope of creating a fuller picture of the data and contribute to filling gaps in the literature! I will be following up with more blogs, videos, and social media posts more specifically on our results soon! Stay tuned!

The Abstracts

Wiebe JW, Nguyen A, Huang MH, LaCross J, Fridman L, Tran N, Napier C. Prevalence of Pelvic Health Dysfunction and Help-Seeking Behavior Among Recreational Female Runners. [Abstract 41246]. In: Academy of Pelvic Health Physical Therapy. 2024 Combined Sections Meeting Platforms and Posters. J Womens Pelvic Health Phys Ther. 2024;48(1):47-71.

Wiebe J, Huang M, LaCross J, Nguyen A, Fridman L, Tran N, Napier C. Dyspareunia in recreational female runners: investigating obstetrical and running habit characteristics [Abstract page 3] In: Lamvu G. Abstracts from the International Pelvic Pain Society (IPPS) annual scientific meeting on pelvic pain 2023. Pain Rep. 2024;9(3):e1150. Published 2024 May 15.

Wiebe J,LaCross J, Huang M, Nguyen A, Fridman L, Tran N, Napier C. Prevalence of Pelvic Health Symptoms Associated with Pelvic Floor Overactivity in Recreational Female Runners [Abstract 093]. In: American Academy of Sports Physical Therapy Poster Presentation Abstracts. JOSPT Open 2024;2(4):CSM31-CSM79.

Wiebe J, Huang M, LaCross J, Nguyen A, Fridman L, Tran N, Napier C. Dyspareunia Associated with Peak Resultant Acceleration in Recreational Female Runners. [Abstract 084]. In: American Academy of Sports Physical Therapy Poster Presentation Abstracts. JOSPT Open 2024;2(4):CSM31-CSM79.

The Team

*The Team: Jennifer LaCross, PT, DPT, PhD, WCS, ATC; Min Huang, PT, PhD; Anna Nguyen, PT, DPT; Lauren Fridman; Nicolas Tran; Chris Napier, PT, PhD.

Don’t wanna miss a post? Want updates on events and discounts on online course products ? Join my newsletter here. Find me on the socials: Instagram, Facebook, Twitter, and YouTube.

References

Moore IS, Crossley KM, Bo K, et al. Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. Br J Sports Med. 2023;57(18):1164-1174. doi:10.1136/bjsports-2022-106620