Overview
The women’s game has grown exponentially over the past decade and the demands on players have significantly increased, both on and off the pitch. It is critical that the support surrounding female athletes evolves.
It is for this reason that FIFA has embarked on the FIFA Female Health Project, an all-encompassing overview of the female athlete and the environment and support that she needs in order to perform at her best.
Current research was reviewed and compiled to develop educational resources to support member associations, players, coaches, multidisciplinary teams (MDTs – including sports scientists, nutritionists, strength and conditioning professionals, psychologists, medical staff, etc.)
How to train and prepare female athletes and to provide the holistic support they need
STRENGTH AND CONDITIONING
As the physical match demands of the women’s game continue to evolve, it is incumbent upon the scientific community to fully embrace and understand the nuances of the female game and provide valid and reliable recommendations to the broader football community.
RECOVERY
The increasing physical demands and density of match play in the women’s game has meant that recovery is of paramount importance. There is evidence to suggest that women have greater resistance to fatigue and a superior ability to recover metabolically than men during repeated, maximal-intensity intermittent sprinting, as well as between repeated high-intensity sessions.
NUTRITION AND HYDRATION
Player performance and training adaptations are linked to the adequate and periodised intake of energy and macronutrients. The focus for players should first be on the quantity and quality of nutrients, protein and fats to optimally fuel for and recover from training and match play.
SLEEP
It is important to identify individual players who have sleep disruption and to provide support in developing individual routines in an attempt to improve sleep quality and, ultimately, improve recovery aiming to enhance performance.
INJURY REDUCTION AND MOVEMENT
As the women’s game continues to grow, it is essential to consider the psychological and sociological influences women encounter and manage. It is equally important to examine how these factors interact with physical development and game demands, affecting skill development and injury risk.
PERFORMANCE WELL-BEING
A well-being ecosystem for women’s football that will support the sustainability of the game and broaden the life skills of the players is critical to their well-being, longevity, and performance.
Case Study
Below is a case study of a women’s national team that takes account of the health, well-being and performance of female players in the national-team programme. All identification markers have been removed.
- Senior womenʼs national national-team programme: the majority of players had no female health, well-being and performance education
- MDT: doctor, coach, assistant coach, physio, sports scientist, etc.
- Sanitary products available, waste disposal is adequate, no funds for blood testing or sleep monitoring and a limited nutrition budget
- A female sports scientist was chosen to be the female health, well-being and performance lead
- She started reviewing female health well-being and performance resources that were available and developed a journey for education for all team members (players and all staff)
- The female health, well-being and performance lead customised the material provided to meet the needs of their environment
- The female health, well-being and performance lead delivered education to the rest of the MDT and players
- Follow-up resources were shared with the MDT and players
- Ongoing education and support for the MDT and player
- Players completed a short questionnaire (including questions related to mental health history and current status, hormonal contraception and symptoms)
- A couple of potential medical concerns were flagged to the doctor for follow-up, who liaised with the players and referred back to the rest of the MDT when required
- A plan was put in place for ongoing screening and refinement of player symptom management
- Players were educated on the importance of why and how to track their cycles (both endogenous and exogenous)
- Some players took a few months to get into the regular habit, but good compliance was achieved by having the female health, well-being and performance lead monitoring this
- The female health, well-being and performance lead regularly updated the MDT on any observable patterns or concerns (e.g. significant changes in cycles) and identified when a player may be entering a historically problematic phase
- The female health, well-being and performance lead works with the MDT to support the players on an individual basis to proactively manage symptoms and work with the playersʼ cycles
- Players are involved in this process and are empowered to be proactive to support their cycles and implement this approach with their club and national teams
13 tips to keep top of mind
Female health and performance education should be made accessible to everyone involved in the women’s game. This should not be restricted to players and medical or female staff.
Through education, players should be encouraged to take ownership of their health, performance and well-being.
Female health should not be regarded as a barrier to exercise, nor should it be a topic that cannot be discussed. A safe space for communication around female health should be created. We must normalise the conversation.
Players should be encouraged to track their cycles and learn more about their own bodies and should be educated on what is normal and when something may be untoward.
An optimal strength and conditioning programme should embrace an individualised and sport-specific approach and should consider the athlete’s training age, maturation status, skill level, current level of play, strength imbalances or weaknesses, menstrual status and injury history.
Education is key to helping the players understand the recovery process and has an impact on behaviour change to make the right choices at the optimal time.
It is necessary to ensure players are educated on the fundamentals of recovery, encompassing nutrition, hydration and sleep.
Players should be encouraged to be consistent and develop a bedtime routine, including powering down screens, ensuring the bedroom is optimal for sleep (such as temperature, black-out curtains, comfortable bed, mattress, pillow and bedding, lavender aroma/oil, no bright light/TV/phone), avoiding caffeine and relaxing the mind.
Players should be provided with simple education on fuelling for, and recovery from, training and matches. It should be noted that nutritional and hydration needs may change due to fluctuations in oestrogen and progesterone levels (whether natural or synthetic).
Navigating puberty can be challenging for players and their coaching staff. This is an essential part of development, and specific support and education are needed, particularly as it is more common for people to turn away from sport during this time.
Family planning, pregnancy and parenthood should be normalised. Sports organisations, coaches, staff and players need to work together to create an environment where pregnancy and being a parent are valued, celebrated and appropriately supported.
Menopause is not a disease and does not require treatment unless symptoms affect the quality of life.
Consideration should be given to female-specific requirements, including having toilet access, adequate sanitary facilities (e.g. bins and handwash), access to menstrual hygiene products, clothing to allow for potential leakage and access to well-fitting sports bras.
FIFA’s aim is to optimise every female footballer’s health, well-being and performance and to improve knowledge of women and girls in football at every level of the game.
Sarai Bareman, Chief Womenʼs Football Officer