“FEMALES ARE NOT SMALL MEN”

We have:

• More essential fat

• Most of lean mass in lower body

• Greater proportion of type 1 endurance muscle fibres

• Smaller heart and lungs and lower O2 carrying capacity

• Good fat-burners, great for endurance but struggle at times when access to carbohydrates are needed for intense efforts

• Struggle to lose weight vs males

• Paleo, keto etc diets – males thrive but often less succesful in females

• Sweat later and sweat less - struggle to acclimatise to heat in comparison to males

FEMALE RUNNERS

•Motivation for many women to run

is in an attempt to lose weight

•Steady state running has been

shown to not be the most effective

way to achieve this

•Interval running and HIIT are more

effective

•During exercise females utilise

more fat but in recovery females

burn an increased proportion of

carbs

•Great nutrition post training is

required

•Stress -> impacts ability to lose

weight

THE MENSTRUAL CYCLE

MENSTRUAL CYCLE GUIDELINES

• Peak bone mass reached at approximately 18 years age

• Periods should commence by 15 yrs age

➢ Much harder to get period if under 55kgs

➢ Poor starting point for bone health if no period by 15

➢ Within 2 years of menarchy beginning periods should be regular

➢ Loss of period for 1 -2 months is not normal

• Must ask about menstrual cycle in all exercising females – not just elite level

athletes!

AMMENORHEA/OLIGOMENORHEA

• Inadequate energy intake – reproduction and growth are the two systems that are compromised as other systems are essential for survival

• 1 month low energy availability can cause menstrual cycle disturbance

• 20-30% of energy deficit is enough to cause menstrual disturbance

• Not just about weight – deceiving, don’t have to have dramatic weight loss, don’t need to be “skinny”

• Significant issue particularly in our development runners

• Orthorexia = obsession with healthy eating

• More causes of ammenorhea than just LEA – ie polycystic ovaries, stress

Only need to miss 2 -3 menstrual cycles before negative impacts on bone health

➢ Significant impact on runners

MENSTRUAL CYCLE AND PERFORMANCE

Increased length of time of amenorhea

➢ Increased reduction in velocity

➢ Increased reduction in performance

Luteal phase

• Heat feels hotter

• Decreased ability to cool yourself

• Decreased ability to achieve intense efforts

Cramping and GI issues

• Can reduce stomach cramps by planning 5-7days before menstrual cycle begins

• Magnesium, omega 3 fatty acids, low dose aspirin

Headaches

• Menstrual headaches or migraines when estrogen levels change (drop)

• Eat nitric oxide rich foods – beets, pomengranate, watermelon, spinach in days leading up to it

• These foods promote dilatation which help reduce the severity of the shift

HORMONE EFFECTS

Progesterone:

• Increases protein catabolism

• Increases respiration rate

• Altered thermoregulation - sweat thresholds, higher resting core temperature,

issues offloading head post exercise

Estrogen

• Increases fluid retention

• Alteration in carbohydrate metabolism (enhances gylcogen sparing)

• Greater capacity for burning fat (during exercise)

HOLISTIC HEALTH CARE

1. First point of call

1. Early detection

2. Onward referral

STRENGTH TRAINING IN RUNNERS

• Evidence showing benefits of strength training for running athletes in injury

prevention

• Convincing runners of this is biggest challenge

• Running biomechanics

• Gait retraining

• Altering biomechanics-> altered loads -> train to cope with increased loads

• If you don’t strength train expect to lose atleast 3% of muscle mass per decade

after age 30

• Variety is key to keeping muscles stimulated and strong

RESEARCH, STRENGTH TRAINING & INJURIES

• 80% of running injuries are load related

• Either improve load management or improve the bodies ability to cope with load

• Eccentric training can reduce hamstring injuries by 70% in ALL athletes (85% in

those with previous hamstring injuries)

• Strength training:

• Could prevent up to 50% of overuse injuries

• Increase running economy

• Improves endurance performance

• Reduces energy cost of locomotion

• Is effective across age and gender

STRENGTH TRAINING IN RUNNERS

Achieves 3 significant goals:

1.Reduces injury risk

2.Helps you run faster

3.Improves running economy

STRENGTH BENCHMARKS

Leg press

• 1.25-1.5 x body weight

Knee extension

• 20 – 35 kgs

Calf raises

• Up to 50% of BW (or 50kgs)

MOBILITY & RUNNING

• Simply tight or tight & weak

• Capacity

• Muscle overload

• Self management strategies

• Break cycle

• Activation, endurance, strength, mobility

PERFORMANCE AND STRENGTH

Menstrual cycle approximately 28 days

Follicular phase – day 1 of period to mid cycle

➢ Strength focus gains

Luteal phase – mid cycle to day before period begins

➢ Harder to hit high intensities

➢ Harder to recover from hard exercise

➢ Maintenance focus – running and strength

FOLLICULAR PHASE TRAINING WINS

WORKING WITH THE MENSTRUAL CYCLE

NUTRITION & THE MENSTRUAL CYCLE

• Average female population struggle to meet calcium and iron requirements let

alone our female athletes

• Heavy menstrual bleeding

➢ More likely to be iron deficient

➢ If taking iron supplements timing is crucial

• Importance in females of protein consumption within 20 minutes post training

➢ Essential for muscle repair and also to reduce the signalling to store body fat

➢ Carbohydrates and protein post exercise for recovery

• Progesterone is catabolic:

➢In luteal phase even more important that protein is consumed asap post

training

RESOURCES

FITR

• Free Ap designed in UK for female athletes

• Track menstrual cycles

• Track symptoms suffered throughout cycle

• Tips on nutrition, recovery, training intensities and injury prevention

www.fuelaoteroa.co.nz

• Great resource for young female athletes

MENOPAUSE IN FEMALE ATHLETES

• Estrogen and progesterone diminish

• Exercise feels harder due to a number of changes

• Lose aerobic fitness

• Decrease in muscle strength

• Decreased muscle bulk (replaced with fat)

• Decreased bone mineral density

• Weight gain

• Less temperature tolerance – pre cooling required

• Greater sensitivity to carbohydrates – more blood sugar swings and less need for carbohydrates overall

• Use protein less effectively

• Less power production – must train this to prevent muscle loss and weakness

• Decreased balance > 40 yrs

IAAF

• International athletic federation guidelines Current attempt is to reduce “allowed” testosterone levels in female athletes in 800m - 1500m

• <5 nMol/L for a continuous period of 6 months prior to competing

• Testosterone performance enhancing effects – bone, muscle, oxygen carrying capacity

• Normal female athletes 1.2 – 1.8

• Females with polycystic ovaries – up to approx 3.8

• DSD females – XY chromosome > 5

• Take medication to lower testosterone levels but still have advantages of having had high testosterone

• Future – DSD and trans females will most likely be excluded from competing as females

➢Potential for alternate category

ACKNOWLEDGMENTS

Stacy Sims, physiologist, Mount Maunganui

Alison Heather, Otago University

WHISPA group, HPSNZ

REFERENCES

Strength training for middle and long distance performance, Berryman et al.

International journal of sports physiology and performance. 2018, 13, 57-63

The effectiveness of exercise interventions to prevent sports injuries: a systematic

review and meta-analysis of randomised controlled trials, Lauersen et al, British

journal of sports medicine. 2013. D:10,1136/bjsports-2013-092538

Resistance training in musculoskeletal rehabilitation: a systematic review, Kristensen

& Franklyn-Miller, British journal of sports medicine 46,10

ROAR: How to match your food and fitness to your unique female physiology for

optimum performance, great heatlh and a strong, lean body for life. Stacy Sims,

Selene Yeager.

EXAMPLES OF DYSFUNCTION

“ We run away from weakness and towards strength”

➢ Ie quadicep dominant females – postures, “dormant buttock syndrome”

➢ Poor gluteal activation and strength

➢ Poor hip control

➢ Altered biomechanics which further increase load on anterior and medial knee

such as increased vertical oscillation

➢ Examples are PFJ frequency of injuries such as anterior knee pain