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Over the past three years, some of the biggest news in women’s sport has exposed abusive coaching practices. Some (though certainly not all) of that malpractice is due to a lack of knowledge about how to keep young female athletes healthy and performing their best—largely because so much of the research used to inform training strategies is based on men.
A new project at Stanford University is among the initiatives looking to change that story. FASTR (Female Athlete Science and Translational Research) launched in January, with a team of physicians and researchers seeking to close the gender gap in sports science research and working on better ways to get that information into the hands of athletes, coaches, parents, and their health-care providers.
“Some of the challenges with the research right now is that it’s not always getting disseminated to the eyes, ears, hands of the athletes who need to hear it the most—as well as the coaches and the parents,” says Emily Kraus, a clinical assistant professor of orthopedic surgery and FASTR’s director. “As a physician, I think that it’s so important that they’re all hearing the same information.”
The program’s pilot study is focusing on educating high school distance runners about the Female Athlete Triad and bone stress injuries (the Female Athlete Triad is a syndrome of three interrelated conditions: low energy availability with or without disordered eating, menstrual disturbances and amenorrhea, and impaired bone health like stress fractures). FASTR is creating five educational videos based on the latest research, delivered by role model athletes who can share their own experiences.
Megan Roche, a five-time U.S. trail-running champion who received her medical degree at Stanford in 2018, is FASTR’s lead researcher. She’s also completing a Ph.D. in epidemiology with a focus on bone health in athletes and genetic predictors of sports injury. She believes that the more female athletes know about proper fueling at a far younger age, the longer their athletic careers will stretch—and hearing these messages from athletes they may look up to could make them more powerful.
“If we talk about this as researchers, it might not have as much impact as it would have coming from role models,” Roche says. “We want to make sure it’s scientifically backed information and have top athletes translate what that means to them. It’s a good combination to hear from athletes who have gone through some of these trials and tribulations.”
Some of the women involved in the project include Kate Courtney, a pro cross-country mountain bike racer; Latoya Shauntay Snell, an ultrarunner, chef, and advocate; Rebecca Mehra, a pro middle-distance track and field athlete; and Amelia Boone, an ultrarunner, obstacle racing world champion, and lawyer.
The pilot study will go on to measure whether the videos made a difference in the high school distance runners’ knowledge about the triad, their body image, self-compassion, and perspective on longevity in the sport.
“Knowledge is power,” Kraus says. “With it, you can advocate for yourself. You can say, ‘Hey coach, I lost my period. Maybe it’s because I’m overtraining.’ Then the coach can also become a safe person to talk to about this, changing that culture and the dynamic between coach and athlete. The more we talk about it and take away some of the stigma of these conversations, the easier it will get.”
Some of the lessons will center on why it’s important for young athletic girls to fuel properly, how bodies will look and develop differently, and why a normal menstrual cycle is essential to maintain. FASTR will also help educate coaches, team captains, and parents.
“It’s a challenge for me clinically, especially with coaches who have had more birthdays. The traditional approaches to coaching may have been based on anecdotal experiences and they are finding that isn’t the right approach for all athletes,” Kraus says.
It’s critical to link these topics, like fueling and the menstrual cycle, to how they improve health, performance, and longevity for female runners.
“All coaches want their athletes to perform well,” Roche says. “It will be more motivating for coaches to create that kind of environment if we can, whenever possible, put it under the lens of performance.”
Mental health will also be a factor in the FASTR portfolio of research and education, recognizing that it, too, is a big part of athletes’ overall well-being and that girls may not know how to ask for the help they need.
“We’re realizing and appreciating how important it is and the interplay—the underlying anxiety or depression and the relationship it can have to underfueling,” Kraus says.
FASTR is also collaborating closely with the Female Athlete Program at Boston Children’s Hospital. The overall goal is to help more women become lifelong athletes and have the knowledge they need to stick with it through the many stages of changes, successes, and failures.
“I think the idea is that we focus on a broad range of ages throughout sport—high school athletes, college athletes, post-collegiate, post-menopausal athletes,” Roche says. “It is exciting to see female athletes represented in research across those age ranges, as well as diversity across different backgrounds, different sports, and really building the female athlete.”