In “The Female Athlete: Overdue for Change,” we discussed that so much of the research we have for female athlete comes from treating “females as small males” (Sims, 2019) instead of actually focusing research on the female athlete. This has not served the female athlete community well, and there is a need for change. The female athlete is unique and there is no one-size-fits-all when it comes to treating them. This is largely due to the fact that every body is different, every hormone level and range for normal is different, and every cycle is different from woman to woman.
As a result of identifying this need for change, we brought together female athletes from within our community and a panel of experts in sports medicine, which included Stacey Dault, DO, Chrissy Barth, MS, RDN, RYT, Sara Gagliano, PT, DPT, CLT-UE, Carrie Yaeger, PT, DPT, PRPC, and Angela Breitmeyer, PsyD. At this unique event, we explored the best ways to care for the female athlete. Here is what we learned:
Treating the Whole Athlete: Stacey Dault, DO
Stacey Dault, DO, stressed the need to get the whole picture of the athlete – life, habits, stressors, specifics of sport – in order to best treat the female athlete. Part of the whole picture is the menstrual cycle. Your cycle can tell your physician a lot. Any changes in length or any new symptoms can indicate something else going on- either nutritionally, physically, or emotionally. Because your cycle is completely different from any other woman’s cycle, it is important to note that tracking your cycle is beneficial (& why getting on birth control just to try and ‘normalize’ your cycle is not always the best answer), not only for you, but also for your physician. It can help give a clear picture of what is going on and how to best treat based on your individual, specific needs.
Because everything is unique to you, treat choosing your physician the same. Having a provider that will advocate for your health and performance rather than overlook an issue because it seems “normal” is a game changer in the long run. This goes hand in hand with understanding your own cycles. If you are tracking the nuances of your own body, you can find out quickly what you need and find a provider who will fulfill that for you. Seek out someone who will put you on track to be the best athlete you can be.
The Importance of Gut Health: Chrissy Barth, MS, RDN, RYT
Current research is trending to highlight the importance of gut health. Chrissy Barth, MS, RDN, RYT, advocated that gut health impacts the health of all other systems of the body. As a dietician, Barth utilizes blood tests to identify nutritional deficiencies in order to tailor individualized supplements to athletes. While multivitamins, omega-3, and vitamin D are recommended for most, finding which individualized supplements are needed can help to maximize athletic performance or aid in other areas of life.
Alongside supplementation is looking at nutrition. Athletes of different ages have different nutritional needs. In their 20s, they reach peak bone mass and muscle mass, so, as athletes approach 30, bone density begins to weaken. Eating foods that are high in calcium, vitamin D and vitamin K, as well as adequate amounts of protein, is important for performance. As the athlete approaches 40, muscle mass begins to decrease as well, so increasing protein intake as well as eating anti-inflammatory foods, like fruits, vegetables, garlic, ginger, and turmeric is essential.
Overall, taking a holistic approach to wellness is important. Pay attention to stress, honor cravings, and eat whole foods.
Taking Care of the Pelvic Floor: Sara Gagliano, PT, DPT, CLT-UE and Carrie Yeager, PT, DPT, PRPC
What is the pelvic floor? It is important to note that both men and women have pelvic floors, but each gender has different musculature that makes it up. Spooner therapists, Sara Gagliano, PT, DPT, CLT-UE, and Carrie Yaeger, PT, DPT, PRPC, guided the audience through what makes up the female pelvic floor and how and when dysfunction can occur.
The female pelvic floor is composed of 12 muscles that locally support urinary, sexual, or bowel functions. Alongside this, it also acts as a puzzle piece that connects and transmits force between the lower and upper bodies. As if it was not doing enough, the pelvic floor also is a major stabilizer of the entire pelvis and trunk and works with the abdominal muscles, lower back muscles, and diaphragm for support. It is a complicated network of musculature, but it is a key component of overall health.
Pelvic floor dysfunction can happen at any age and stage of life. With dysfunction, weakness in the musculature is approached in two ways: truly weak or functionally weak. Truly weak muscles are too mobile and cannot contract. Functionally weak muscles are too tight and restricted, which can be painful and impact function. Either type of pelvic floor dysfunction can be triggered by irregular cycles and hormonal changes, birth, post-partum hormonal changes, surgery, any endocrine disorder, menopausal hormone changes, or breathing incorrectly while lifting or moving.
In the case of pregnancy and birth, it can take up to 10-12 weeks post-delivery to return to sport. Pelvic floor therapy can be beneficial in this transition but is just as important to note that it is not just post-partum females that may need to seek out care from a pelvic floor therapist. Both Carrie and Sara strongly emphasized to advocate for proper treatment and that leaking is never normal. If you are leaking, speak to a pelvic floor therapist or a physician.
The Connection Between Mind and Body: Angela Breitmeyer, PsyD, CMPC
Our minds and our bodies are interconnected. Angela Breitmeyer, PsyD, CMPC, illustrated how, when we are physically sick, we don’t feel mentally 100% either. The same can be said for injuries, not matching performance expectations, and retiring from sport. In those moments where athletic identity may waver, mindfulness comes into play. Breitmeyer noted that the mind controls the body, so it is important to learn strategies to control the mind.
For adolescent athletes, social media plays a role as a pressure and a stressor. Being mindful of its presence and influence can change one’s outlook. For the athlete that is at the end of her athletic career, there is a period of grief. Finding ways to honor your athletic self and find athletic outlets is important. For the injured athlete, seeing time away from sport as time to get mentally stronger can be a positive turn on something that is emotionally impactful.
Learning how to talk to yourself in and out of sport is essential. When you are going into a new skill, your self-talk should be instructional. While performing previously learned skills, your self-talk should be motivational. Breitmeyer emphasized that if your self-talk “is not instructional or motivational, it is detrimental.” Be in the present moment, recognize your strengths, and show compassion to yourself.
What’s Next?
The female athlete is strong and unique. She requires care that reflects those qualities and more open discussion about how to best serve her. This is why it is important for there to be more research for individualized care as well as for the athlete to advocate for herself to be treated by providers who want to see her succeed.
Our specialty trained pelvic floor specialists will perform a whole-body evaluation, including the pelvic floor, to address all your needs and to help you return to your desired level of function and achieve your goals. Our focus is on positive outcomes and a positive patient experience. Your health and quality of life are what’s most important to us. Schedule an appointment or complimentary assessment.
References:
- Sims, S. (2019, June). Women are Not Small Men: a paradigm shift in the science of nutrition [Video].
TED Conferences. https://www.ted.com/talks/stacy_sims_women_are_not_small_men_a_paradigm_shift_in_the_science_of_nutrition