Creating a safe, gender-specific, supportive environment—one that is free of body shaming and idealised female forms, for example—is key to minimising female athletes' future risks of injury and protecting their health, emphasises the Female/woman/girl Athlete Injury pRevention (FAIR) Consensus Statement—the first of its kind—published online in the British Journal of Sports Medicine.
Women and girls have increasingly been taking part in sports, which has led to a concomitant rise in their risk of injury. But how best to minimise this risk has been hampered by a lack of comprehensive and practical gender-specific evidence.
In a bid to tackle this knowledge gap and both promote and protect female athletes' health, the International Olympic Committee convened a panel of sports and exercise specialists from around the globe to draw up a series of workable recommendations, with the aim of informing current policy and practice and guiding future avenues of research.
The 56 recommendations in the Statement are based on syntheses of the best available evidence, combined with the lived experiences of athletes, as well as those involved in regulation, policy, practice, professional and personal support, to span the 'whole sports system'.
The recommendations, which range from universal to sport specific, also include primary injury prevention strategies; policy, rules, and legislation; personal protective equipment; training; secondary injury prevention; modifiable risk factors; and approaches to diversity and inclusion.
"Injury prevention strategies cannot work if female/women/girl athletes do not have access to resources, knowledge or training/competition environments that support implementation of best practice injury prevention, health, and performance strategies that consider their needs," says the Statement.
"The FAIR recommendations to facilitate a supportive environment include creating equitable funding and resource allocation (eg, injury prevention implementation, equipment, coach/support staff, gender/sex-preferred uniforms and surveillance systems with female/woman/girl-specific health codes) and access to expertise and knowledge through education, targeted research and hiring practices," it continues.
Everyone who works in sport needs to be involved, urges the Statement.
"Recommendations such as 'Create safe spaces free from body shaming or promoting ideal body types, or gendered norms' might appear sensible, but they are NOT always part of female/woman/athletes' reality. They should be front-of-mind and non-negotiable. At all levels of sport, responsibility must be taken for actions that can influence female/woman/girl athlete health," it emphasises.
Other related recommendations include creating and enforcing gender based policies and procedures to tackle interpersonal violence and harassment, and fostering a non-judgmental culture in which issues, such as pregnancy, bone health, and breast care can be discussed and accommodated.
Policies to address unconscious and explicit social and cultural biases against women and girls' sports participation and health are also essential, it says.
Lifelong injury prevention needs to start early to forge good preventive behaviours. And it needs to be a collaborative effort between athletes, coaches, and practitioners, and be evidence based, says the Statement.
Other key recommendations include:
● Mandatory neuromuscular training warm-ups for all sports and all ages to ward off first and recurrent leg injuries, lasting a minimum of 10 minutes, twice a week
