special considerations when working w/ female athletes

seasons of a woman's body

puberty -> reproductive years and pregnancy -> perimenopause -> menopause -> postmenopause

*non-linear

ovulatory phase/follicular phase

low hormone phase (day 1 - ovulation)

- better tolerance to stress/heavier loads

- improved CNS control

- harder to build muscle

luteal phase

high hormone phase (ovulation - menstruation)

- higher levels of inflammation, temperature and cortisol

- build tissue; IMPORTANT to eat more and meet exercise intensity

- increased estrogen = easier to build muscle

- harder to hit high intensities and harder to recover

puberty onset

- pelvis widens/Q angle increases

- quad dominant which leads to a higher ACL risk 3:1 to men

female athlete triad

menstrual dysfunction, low energy availability, decreased BMD

LEA (low energy availability)

caused by low fueling especially carbs

- can result in RED-S if prolonged

sx:

- performance decreases, bone health decreases, irregular period, immunity drops, GI distress, coordination issues

RED-S

relative energy deficiency that affects metabolic rate, menstrual function, bone health, immunity, protein synthesis, CV and psychological health

PT considerations for teenage female athletes

- posterior chain strengthening

- lateral movements

- encourage strength training

- discuss fueling

- suggest tracking menstrual cycle

- avoid masculinization

oral contraceptives can lead to

higher level of inflammation and oxidation

- lower VO2

current ACOG pregnancy exercise guidelines

- 30+ min of moderate PA most if not all days

- 85% maxHR or 7/10 RPE for 4-5 hrs to avoid complications like diabetes

- supine should be cautioned or avoided in 2nd or 3rd trimester

- avoid exercise that will raise body core temp >102

- avoid ballistic movements for joint safety

- avoid contact sports

PT consideration's for pregnancy

goal: maintain fitness level

- listen to your body

- anemia sx due to placenta demands

different trimester considerations

1st: higher risk for miscarriage

2nd: energy improves, miscarriage decreases, urinary incontinence sx, 15% increase in HR, decreased lung volume

3rd: COG changes, weight gain

average age perimenopause

35-55 y/o

average duration of perimenopause

10 years

average age of menopause

52 y/o