[Gender-Specific Sports Medicine].

INTRODUCTION: Sports medicine, as a classical cross-sectional subject, includes diverse topics which show gender-specific differences and thus require a differentiated consideration. Evidence-based research exists in the field of musculoskeletal medicine, for example, in relation to cruciate ligament injuries or concussions. Marked differences in trainability (both muscular and cardiac or pulmonary) are also emerging. Pregnancy and sport is also a topic of increasing interest. Close interdisciplinary care of female athletes, knowledge of physiological changes during pregnancy and contraindications to sports activity (especially with higher intensity) are essential here. Aspects in the field of internal sports medicine with gender differences are topics like iron deficiency or the relative energy deficit (RED-S). There are also sex and gender differences with implications for preventative aspects such as the annual screening examination (so called 'preparticipation screening').

Health problems occurring in national-level female soccer players are different between leagues and throughout the season: a 6-month prospective cohort study.

Objectives: This study investigated the prevalence and severity of health problems in national-level female soccer players with respect to league and seasonality. Methods: In a prospective cohort study, 46 female soccer players aged 22.8±3.9 years playing in the three highest leagues in Switzerland were surveyed biweekly using the Oslo Sports Trauma Research Centre health problem (OSTRC-H) questionnaire. All definitions and measures followed the OSTRC-H-specific recommendations. The 6-month observation period included parts of the off-season and one half of the match season. Results: The average 2-weekly health problem prevalence was 37.3% (illnesses: 8.8%; sudden onset injuries-both acute and repetitive mechanisms: 19.7%; repetitive gradual onset injuries: 12.4%) and 25.1% for substantial problems as defined in the OSTRC-H context (7.3%; 12.0% and 7.3%, respectively). The absolute injury rates amounted to 148 injuries per 100 players per half season, of which 96 injuries per 100 players per half season were substantial. Female players in the 2nd and 3rd highest national leagues showed more gradual onset injuries (p<0.001) and fewer illnesses than those in the top league (p<0.05). At the same time, there were no league-specific differences in sudden onset injuries. Such injuries had a higher cumulative severity score than gradual onset injuries. Among sudden onset injuries, the ankle was the most affected body part, while the thigh was affected by for gradual onset injuries. The average 2-weekly health problem prevalence values steadily increased during the match season. Conclusion: Among national-level female soccer players, the risk of health problems is relatively high and differs between leagues and across seasons.

Sport and exercise recommendations for pregnant athletes: a systematic scoping review.

Objectives: To analyse the available evidence and identify gaps in current knowledge regarding physical activity volume and intensity and their effects on pregnancy outcomes in female athletes. Design: Scoping review. Data sources: A structured literature search of three electronic databases (Embase, PubMed and Web of Science) was conducted on 25 February 2022, and a rerun search was conducted on 8 September 2022. Eligibility criteria: Studies were eligible if they contained information on the relevant population (ie, elite or competitive amateur female athletes), intervention/exposure (ie, minimum of 10 hours of sport per week) and fetal and maternal outcomes. Eligible comparators included female recreational athletes and pregnant non-exercisers. Risk of bias: The risk of bias was evaluated with the National Institutes of Health (National Heart, Lung and Blood Institute) quality assessment tool. Results: The results revealed a discrepancy between the number of original research papers and the number of reviews and recommendations derived from them. The identified studies focused primarily on pregnant recreational athletes. Sixteen clinical studies met the inclusion criteria. No adverse effects on maternal or fetal outcomes were reported. Only during performance tests involving acute intensive exercise with the mother exercising at more than 90% of her maximal heart rate did some fetuses experience decelerations in heart rate. Summary/conclusion: A lack of high-quality studies and direct evidence on pregnant elite and competitive amateur female athletes is evident. Further prospective observational cohort studies are needed using new monitoring methods (eg, non-invasive, wireless monitoring systems) aiming to gain a broader understanding of the stress tolerance of pregnant athletes and fetuses during exercise. Following that, interventional studies with stress tests in laboratory settings should be conducted. Therefore, technology plays a decisive role in gaining new knowledge and providing evidence-based recommendations on this topic. PROSPERO registration number: CRD42022309541.