The 2019 Biennial International Female Athlete Conference Proceedings

Summaries Presentations: Day 1, Track 1 Hormonal contraceptive use in elite female athletes Kirsty Elliott-Sale, PhD, FHEA; ClareMinahan, PhD; Brianna Larsen, PhD Hormonal contraceptives (HC) are used by many female athletes; a study of 430 elite female athletes found that 49.5% were using HCs and 69.8% had used HCs at some point in time (Martin, Sale, Cooper, & Elliott-Sale, 2018). Drs. Elliott-Sale, Minahan, and Larsen are researchers with a common interest in human performance and the effect of hormones on elite female performance. Numerous physiologic systems that may affect athletic performance—for better or worse—can be altered by this systemic administration of exogenous hormones. The most common observed effects of HC use were changes in the menstrual cycle, including regulating periods, reducing menstrual symptoms, and altering menstrual cycles by causing cessation of periods or less frequent periods (Martin et al., 2018). Australian female athletes ages 16 and older were surveyed for their knowledge about the menstrual cycle and combined oral contraceptive (COC) use. This study found that these athletes possessed poor knowledge about how COC affects physiology; yet nearly 50% of the athletes surveyed used COC (Larsen, Morris, Quinn, Osborne, & Minahan, 2020). Overall, HC have few proven effects on athletic performance; larger, more well-controlled studies on specific HC formulations are needed; and athletes should consider their health and goals when selecting a contraceptive method. The female athlete and the ACL: How, why, and psychological implications for recovery and return to sport Melissa Christino, MD; Corinna Franklin, MD; Cordelia W Carter, MD Drs. Christino, Franklin, and Carter are orthopedic surgeons dedicated to improving outcomes for female athletes. Dr. Christino is a member of the Female Athlete Program at Boston Children’s Hospital; Dr. Franklin directs the Female Initiative: Evaluation and Rehabilitation Care Excellence (FIERCE) program for female athletes at Shriners Hospitals for Children; and Dr. Carter is the director of the Women’s Sports Center at NYULangone Medical Center. Female athletes are more likely to sustain ACL injuries than their male counterparts, and these ACL injuries have longlasting effects on quality of life irrespective of surgery (Arendt, Agel, & Dick, 1999; Beynnon et al., 2014). Numerous etiologies for this increased risk for injury have been proposed, including smaller ACLs compared to males, changing hormonalmilieus, and greater Q angles inwomen thanmen (“The Female ACL,” 2016). Modifiable risk factors include neuromuscular control and biomechanics. Prevention programs targeting these modifiable risk factors have reduced ACL injury incidence. A study conducted on 600 Italian soccer players found that the athletes who participated in balance and proprioceptive training for 20minutes per day had a lower incidence ofACL injuries compared to controls (Caraffa, Cerulli, Projetti, & Rizzo, 1996). A neuromuscular and proprioceptive program implemented in 1041 female youth soccer players decreased the incidence of ACL injuries by 88% in the first season and 74% in the second season in comparison to controls (Mandelbaum et al., 2005). When an ACL injury occurs, surgical intervention is often indicated. Children and adolescents are skeletally immature, and the level of skeletal immaturity dictates the type of procedure used to carry out the repair. Athletes who sustain ACL injuries are at risk for profound psychological sequelae, including increased anger and depression and decreased self-esteem (Brewer & Cornelius, 2010; Mainwaring, Hutchison, Bisschop, Comper, & Richards, 2010). Athletes frequently fear reinjury WSPAJ Vol. 29, No. 2, 2021 164 2019 Female Athlete Conference Unauthenticated | Downloaded 03/21/22 06:32 AM UTC when returning to sport; unfortunately, this fear seems to be implicated in higher rates of reinjury after return to sport (Tagesson & Kvist, 2016). What we know and what we don’t know about female athletes and head injuries