Gender-specific supportive environment key to cutting female athletes’ injury risks
Among other things, this should be free of body shaming, idealised body types, and gendered norms, says the world’s first Consensus Statement on this topic
BMJ Group
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
● Implementation and enforcement of rules/policies that penalise unlawful head/body contact
● Mandatory injury management across all sports to prevent concussion
● All child and teen ice hockey players to wear mouthguards
● All cyclists, skiers, snowboarders, skateboarders, horseriders to wear helmets
● Neckguards/protectors to be worn for collision/contact ice sports
“We recognise that these recommendations must be responsive to diverse contexts, including uniqueness in experiences, expertise, geography, culture, healthcare access, sport structure, level of participation and sociocultural considerations,” says the Statement.
But it concludes: “To bolster female/women/girl athlete health and safety, every person (at all levels of sport participation and in their own specific context) can, and should, take responsibility to carefully consider and action these recommendations.”
Journal
British Journal of Sports Medicine
Subject of Research
People
Article Title
Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: International Olympic Committee (IOC) consensus meeting held in Lausanne, Switzerland, 2025
Article Publication Date
2-Dec-2025
Global study backs mandatory strength warm-ups for female athletes
La Trobe University
Routine strength exercise warm-ups should be mandated to reduce leg injuries in female athletes across all ages and levels of competitive sport, according to a new set of global recommendations co-led by La Trobe University, the University of Calgary and supported by the International Olympic Committee (IOC).
Published in the British Journal of Sports Medicine, the Female, woman, girl Athlete Injury pRevention (FAIR) Consensus Statement offers 56 practical recommendations to reduce injury risk and improve safety.
The recommendations span policy reform, training, personal protective equipment, secondary prevention, implementation strategies and the creation of gender/sex-specific supportive sport environments.
Co-author Professor Kay Crossley, Director of La Trobe University’s Sports and Exercise Medicine Research Centre, said the FAIR recommendations offered a roadmap for athletes, parents, coaches and sports administrators, which could be adapted to different settings and cultures.
“This world-leading initiative recognises the unique injury risks faced by female athletes and provides clear, actionable guidance for everyone involved in sport, from grassroots to elite levels,” Professor Crossley said.
Recommendations include:
Mandated sport-specific strength, balance and control (neuromuscular) exercises for a minimum of 10 minutes, twice a week to prevent first-time and repeat leg injuries.
Enforced fair play by disallowing dangerous contact to reduce injuries of all kinds.
Knee braces should not be used to prevent first-time knee injuries, including anterior cruciate tears. Semi-rigid ankle braces should be used to prevent first-time and repeat sprains.
Mandated mouthguards in collision sports to prevent concussion and dental injuries.
Encouragement of properly fitted sports bras to reduce breast discomfort and skin irritation.
Shared responsibility among sport partners for creating spaces where female, woman and girl athletes’ safety and wellbeing is front of mind and non-negotiable.
Create safe spaces free from body shaming, idealised body types and gendered norms.
Estimates suggest only 22 per cent of Australian women aged 15 years and over participated in a sport-related activity at least once a week. Women and girls often face gendered barriers in sport that can affect their safety, participation and performance.
“The rates of sport participation and injuries in girls’ sport are increasing and many girls that get injured from sport don’t return,” said co-author Professor Carolyn Emery, from the University of Calgary’s Sport Injury Prevention Research Centre.
Dr Jane Thornton, IOC’s Director of Health, Medicine and Science said the mandate of the Department is to promote and protect athlete health, in sport and through sport. Convening consensus meetings to produce global recommendations for injury and illness prevention such as the FAIR recommendations are a priority for the IOC.
“There is a significant data gap in terms of how female athlete health data are collected and represented in research and policy. Injury and illness rates are disproportionately high and female athlete health has risen to be among the top five priorities for international sport federations.”
Professor Crossley said many females, women and girls trained and competed in environments that were not set up for their success.
“Targeted action is needed to educate sports partners and improve access to injury-prevention programs, good sporting facilities and resources that are supported by sufficient funding.
“The FAIR Consensus helps address this gap by offering tools to protect female, woman and girl athletes’ health, extend careers and promote lifelong participation. We all have a role to play in creating safer, more inclusive sports environments where women and girls can thrive.”
Note to editors:
The FAIR Consensus followed an eight-step hybrid method. 109 authors from six continents conducted seven evidence reviews (systematic, scoping and concept mapping), synthesizing over 600 studies involving more than 600,000 participants. They reviewed evidence on injury prevention strategies, and modifiable risk factors for lower and upper extremity injuries, concussions, and spine, chest, abdominal and pelvic injuries and/or pain. These projects underpinned draft recommendations subsequently voted on by a Steering Committee of 24 experts and an External Advisory Committee of eight women with lived experience as athletes, coaches, and practitioners, including Olympians Paralympians, and representatives from low- and middle-income countries. Consensus was defined as ‘critical to include’ (≥70% scored recommendation as 7–9 [9-point Likert scale, 1=not important; 9=critically important] AND ≤15% scored recommendation as 1–3).
Journal
British Journal of Sports Medicine
Method of Research
Meta-analysis
Subject of Research
People
Article Title
Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: International Olympic Committee (IOC) consensus meeting held in Lausanne, Switzerland, 2025
Article Publication Date
2-Dec-2025
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