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Observations About Sports Injury Surveillance and Sports Medicine Psychology among Female Athletes

Diane M. Wiese-Bjornstal, Ayanna N. Franklin, Tara N. Dooley, Monique A. Foster, and James B. Winges

Injuries contrast with the overwhelmingly positive benefits of sports participation for female athletes, with estimates of a third or more of all female athletes sustaining injury in any given season. Media headlines convey the impression that female athletes are more vulnerable to sports injuries than male athletes are. This observation led to our first purpose, which was to use evidence from the sports injury surveillance literature to examine the facts about female athlete risks of injury and compare these risks to those of male athletes. In light of Gill and Kamphoff’s (2010) observation that we largely ignore or underrepresent female experiences in the sport and exercise psychology literature, our second purpose was to highlight examples of the psychological, behavioral, and social aspects of female athletes’ injury experiences, and provide comparisons to male experiences within this realm of sports medicine psychology. These evidence-based observations guide our concluding recommendations for injury reporting, prevention, and rehabilitation roles of those in the media and sports professions.

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Preferential Quadriceps Activation in Female Athletes With Incremental Increases in Landing Intensity

Kevin R. Ford, Gregory D. Myer, Laura C. Schmitt, Timothy L. Uhl, and Timothy E. Hewett

The purpose of this study was to identify alterations in preparatory muscle activation patterns across different drop heights in female athletes. Sixteen female high school volleyball players performed the drop vertical jump from three different drop heights. Surface electromyography of the quadriceps and hamstrings were collected during the movement trials. As the drop height increased, muscle activation of the quadriceps during preparatory phase also increased (p < .05). However, the hamstrings activation showed no similar increases relative to drop height. Female athletes appear to preferentially rely on increased quadriceps activation, without an increase in hamstrings activation, with increased plyometric intensity. The resultant decreased activation ratio of the hamstrings relative to quadriceps before landing may represent altered dynamic knee stability and may contribute to the increased risk of ACL injury in female athletes.

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Physique Anxiety and Disordered Eating Correlates in Female Athletes: Differences in Team and Individual Sports

Anne M. Haase

As female athletes participating in physique-salient sports report similar levels of social physique anxiety (SPA) and disordered eating symptoms compared with those in nonphysique salient sports, alternative factors contributing to disordered eating require consideration, specifically participation in sport type (team vs. individual). This study examined SPA and disordered eating correlates in female athletes (N= 137) in two sport types (team sports and individual sports). Individual sport athletes exhibited higher SPA, F(1, 135) = 22.03, p< .001; dieting, Brown and Forsythe’s F(1, 57.05) = 43.79, p< .001; and bulimic behavior, Brown and Forsythe’s F(1, 59.92) = 13.45, p= .001 than team sport athletes. SPA and sport type together predicted 44% of dieting and 22% of bulimic symptom variance, suggesting that individual-sport athletes with higher SPA experienced greater disordered eating. Involvement in individual sports where physique is more open to social evaluation may contribute to dieting and bulimic symptoms among female athletes.

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Sports and Male Domination: The Female Athlete as Contested Ideological Terrain

Michael A. Messner

This paper explores the historical and ideological meanings of organized sports for the politics of gender relations. After outlining a theory for building a historically grounded understanding of sport, culture, and ideology, the paper argues that organized sports have come to serve as a primary institutional means for bolstering a challenged and faltering ideology of male superiority in the 20th century. Increasing female athleticism represents a genuine quest by women for equality, control of their own bodies, and self-definition, and as such represents a challenge to the ideological basis of male domination. Yet this quest for equality is not without contradictions and ambiguities. The socially constructed meanings surrounding physiological differences between the sexes, the present “male” structure of organized sports, and the media framing of the female athlete all threaten to subvert any counter-hegemonic potential posed by female athletes. In short, the female athlete—and her body—has become a contested ideological terrain.

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Nutritional Recommendations for Synchronized Swimming

Sherry Robertson, Dan Benardot, and Margo Mountjoy

The sport of synchronized swimming is unique, because it combines speed, power, and endurance with precise synchronized movements and high-risk acrobatic maneuvers. Athletes must train and compete while spending a great amount of time underwater, upside down, and without the luxury of easily available oxygen. This review assesses the scientific evidence with respect to the physiological demands, energy expenditure, and body composition in these athletes. The role of appropriate energy requirements and guidelines for carbohydrate, protein, fat, and micronutrients for elite synchronized swimmers are reviewed. Because of the aesthetic nature of the sport, which prioritizes leanness, the risks of energy and macronutrient deficiencies are of significant concern. Relative Energy Deficiency in Sport and disordered eating/eating disorders are also of concern for these female athletes. An approach to the healthy management of body composition in synchronized swimming is outlined. Synchronized swimmers should be encouraged to consume a well-balanced diet with sufficient energy to meet demands and to time the intake of carbohydrate, protein, and fat to optimize performance and body composition. Micronutrients of concern for this female athlete population include iron, calcium, and vitamin D. This article reviews the physiological demands of synchronized swimming and makes nutritional recommendations for recovery, training, and competition to help optimize athletic performance and to reduce risks for weight-related medical issues that are of particular concern for elite synchronized swimmers.

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Disorders of the Female Athlete Triad among Collegiate Athletes

Katherine A. Beals and Melinda M. Manore

This study examined the prevalence of and relationship between the disorders of the female athlete triad in collegiate athletes participating in aesthetic, endurance, or team/anaerobic sports. Participants were 425 female collegiate athletes from 7 universities across the United States. Disordered eating, menstrual dysfunction, and musculoskeletal injuries were assessed by a health/medical, dieting and menstrual history questionnaire, the Eating Attitudes Test (EAT-26), and the Eating Disorder Inventory Body Dissatisfaction Subscale (EDI-BD). The percentage of athletes reporting a clinical diagnosis of anorexia and bulimia nervosa was 3.3% and 2.3%, respectively; mean (±SD) EAT and EDI-BD scores were 10.6 ± 9.6 and 9.8 ± 7.6, respectively. The percentage of athletes with scores indicating “at-risk” behavior for an eating disorder were 15.2% using the EAT-26 and 32.4% using the EDI-BD. A similar percentage of athletes in aesthetic, endurance, and team/anaerobic sports reported a clinical diagnosis of anorexia or bulimia. However, athletes in aesthetic sports scored higher on the EAT-26 (13.5 ± 10.9) than athletes in endurance (10.0 ± 9.3) or team/anaerobic sports (9.9 ± 9.0, p < .02); and more athletes in aesthetic versus endurance or team/anaerobic sports scored above the EAT-26 cut-off score of 20 (p < .01). Menstrual irregularity was reported by 31% of the athletes not using oral contraceptives, and there were no group differences in the prevalence of self-reported menstrual irregularity. Muscle and bone injuries sustained during the collegiate career were reported by 65.9% and 34.3% of athletes, respectively, and more athletes in aesthetic versus endurance and team/anaerobic sports reported muscle (p = .005) and/or bone injuries (p < .001). Athletes “at risk” for eating disorders more frequently reported menstrual irregularity (p = .004) and sustained more bone injuries (p = .003) during their collegiate career. These data indicate that while the prevalence of clinical eating disorders is low in female collegiate athletes, many are “at risk” for an eating disorder, which places them at increased risk for menstrual irregularity and bone injuries.

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The Coaching Needs of High Performance Female Athletes within the Coach-Athlete Dyad

Leanne Norman

Within the research literature there is little work that has examined how coaches (and coaching) can positively influence female athletes’ continued participation and development in performance sport. One barrier that has been recently cited that prevents more women from progressing in sport is the inability of coaches to understand how to engage their female athletes. With this in mind, utilising a phenomenological approach, the current study focused on the coaching preferences of female athletes within the elite coach-athlete dyad. Through interviews with 27 current high performance female athletes, four major coaching needs were found. These were: to be supported as a person as well a performer, coaching to be a joint endeavour, the need for positive communication, and recognition of the salience of gender within the coach-athlete dyad. The findings highlight the complexities and contradictions that are inherent within such a relationship, but ultimately provide evidence that the relational expertise of coaches is at the forefront of these women’s coaching needs. The present study also demonstrates that gender is a salient influence on the coach-athlete relationship. Such findings hold practical significance through demonstrating the need for gender-responsive coaching practitioners.

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Behavioral, Psychological, and Physical Characteristics of Female Athletes with Subclinical Eating Disorders

Katherine A. Beals and Melinda M. Manore

The purpose of this study was to delineate and further define the behavioral, psychological, and physical characteristics of female athletes with subclinical eating disorders. Subjects consisted of 24 athletes with subclinical eating disorders (SCED) and 24 control athletes. Group classification was determined by scores on the Eating Disorder Inventory (EDI), the Body Shape Questionnaire (BSQ), and a symptom checklist for eating disorders (EDI-SC). Characteristics representative of the female athletes with subclinical eating disorders were derived from an extensive health and dieting history questionnaire and an in-depth interview (the Eating Disorder Examination). Energy intake and expenditure (kcal/d) were estimated using 7-day weighed food records and activity logs. The characteristics most common in the female athletes with subclinical eating disorders included: (a) preoccupation with food, energy intake, and body weight; (b) distorted body image and body weight dissatisfaction; (c) undue influence of body weight on self-evaluation; (d) intense fear of gaining weight even though at or slightly below (-5%) normal weight; (e) attempts to lose weight using one or more pathogenic weight control methods; (g) food intake governed by strict dietary rules, accompanied by extreme feelings of guilt and self-hatred upon breaking a rule; (h) absence of medical disorder to explain energy restriction, weight loss, or maintenance of low body weight; and (i) menstrual dysfunction. Awareness of these characteristics may aid in more timely identification and treatment of female athletes with disordered eating patterns and, perhaps, prevent the development of more serious, clinical eating disorders.

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Media Coverage of the Female Athlete Before, during, and after Title IX: Sports Illustrated Revisited

Mary Jo Kane

This study examined the impact of Title IX on media coverage given to female athletes to determine if there has been a shift away from negative social stereotypes traditionally associated with women’s sports participation toward a more socially accepting view of the female athlete. A content analysis of feature articles within 1,228 issues of Sports Illustrated was undertaken for the years 1964-1987. These represented three 8-year time spans before (1964-71), during (1972-79), and after (1980-87) Title IX. In order to assess whether attitudes have changed toward female athletes as related to a Title IX timeline, amount and type of coverage were considered. Chi-square analyses revealed mixed results. There was a significant increase in the proportion of coverage given to women in athletic (e.g., professional golfer) versus nonathletic (e.g., swimsuit model) roles. However, feature articles about female athletes gave significantly more coverage to women in "sex-appropriate" sports such as tennis versus "sex-inappropriate" sports such as rugby, regardless of the Title IX time frame. Results are discussed in terms of challenging current beliefs that women’s athletics have gained widespread social acceptance following the enactment of Tide IX. Implications for practitioners and academics within sport management are presented.

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Disordered Eating in Female Collegiate Athletes and Collegiate Females in an Advanced Program of Study: A Preliminary Investigation

Candi D. Ashley, Joe F. Smith, James B. Robinson, and Mark T. Richardson

The purpose of this study was to use the Eating Disorders Inventory-2 (EDI-2) to compare disordered eating pathology between female intercollegiate athletes and a control group of nonathletic subjects enrolled in an advanced program of study. Analysis of variance (ANOVA) procedures revealed no significant difference (NSD) (p > .05) between any of the athletic groups or the control group on any EDI-2 subscale, and there was no significant difference between “lean” sports, other sports, and the control group. There was also NSD on EDI-2 subscale scores on the basis of age. African Americans had significantly lower scores on the Body Dissatisfaction and Impulse Regulation subscales than white Americans. Chi-square analysis revealed NSD between any groups in percentage of respondents scoring above anorexic norms. The results did not indicate a greater amount of disordered eating in female athletes compared to nonathlete controls.