Research on the science of sport is heavily skewed towards male athletes, finds a review of hundreds of sports-medicine studies1. The imbalance leaves large gaps in knowledge about female sports and sport-related injuries.
A review of this type is long overdue, says Willie Stewart, a neuroscientist at the University of Glasgow, UK, who studies concussion. “It reflects the general neglect of female sport.”
Researchers reviewed 669 studies published between 2017 and 2021 in six leading sports-science journals. They wanted to put some numbers to their observations that there were many more studies on male sports compared with female sports. “We wanted to quantify these discrepancies in the current sports-medicine research to show that there is a need for female-athlete centred research, especially as we continue to learn how females experience different injuries than males across many sports,” says co-author Meghan Bishop, a surgeon at the Rothman Orthopaedic Institute in Philadelphia, Pennsylvania.
Just 9% of the studies focused exclusively on female athletes, whereas 71% focused only on male athletes. “While stark, these results were not particularly surprising,” says Bishop. The starkest comparison between sexes, she adds, was in baseball and softball, with 91% of studies focusing on male players and only 5% focusing on female players.
The disparity, Bishop says, is for several reasons, from financial incentives to the availability of data in public databases and an over-representation of male researchers in the studies’ leaders. Bishop says that more female orthopaedic surgeons could help redress the balance.
Michael Grey, a neuroscientist at the University of East Anglia in Norwich, UK, who specializes in sports injuries, says he isn’t sure that a lack of female surgeons is the problem, but agrees that funding is a big driver. “People focus on men’s sport because that’s where the money is. Not only in the sport itself but in the research,” he says. “And it shouldn’t be that way.”
There has been a slight improvement in the past few years, the study shows. The proportion of studies that focused solely on women or girls, or included both male and female athletes, has started to increase gradually over the past few years (see ‘Slow progress’). This change is partly because of greater awareness of the issue in researchers, and partly because some funding agencies, such as the US National Institutes of Health (NIH) require the clinical studies they fund to include data on different sexes, Stewart says.
“I’m excited to see studies on female athletes being represented in the literature,” says Martina Anto-Ocrah, an epidemiologist at the University of Pittsburgh in Pennsylvania. “It will be great to see more rigorous studies that connect studies of this nature to female injuries, treatment options, interventions and recovery.”
Grey says that a lack of data on female athletes leads to inappropriate extrapolation, especially in his area of research. “We know that certainly with respect to concussions, the protective elements of the brain are different in women and men,” he adds. “We must be studying women and cannot be extrapolating from men to women. That’s just wrong.”