Women’s Health & Performance · Evidence Review

Female athletes are more visible. Female-specific injury evidence is still incomplete.

A practical review of the 2025 IOC FAIR consensus and the evidence limitations behind injury-prevention recommendations for female, woman and girl athletes.

Updated August 2026Evidence type: IOC consensus + systematic/scoping reviews
Bottom line

The FAIR initiative assembled a large international evidence program, but fewer than 40% of studies informing the consensus provided female-specific or sex-disaggregated data. That limits certainty when recommendations are translated to diverse female athlete populations.

Evidence program

The 2025 Female/woman/girl Athlete Injury pRevention (FAIR) IOC consensus used five systematic reviews, one scoping review and a mixed-methods concept-mapping study. The consensus involved 109 authors from six continents and addressed prevention strategies, modifiable risk factors and implementation.

Key finding for research quality

Across the evidence reviews, female-specific data were often missing. The consensus reports relatively few studies with female/woman/girl-specific or disaggregated data, which required some recommendations to draw on aggregate or male-only evidence. The authors identify this as a contributor to limited high-certainty evidence.

Why this matters

  • Female athletes are not one homogeneous population; age, sport, competitive level, impairment status, geography and other factors may modify risk.
  • Evidence from mixed or male-dominant samples may not answer female-specific questions when sex- or gender-related mechanisms matter.
  • Para athletes and other equity-deserving groups remain particularly underrepresented.
  • Implementation research is also important: an intervention can be efficacious yet fail if it is not adopted or sustained in real sporting environments.

What it does not mean

The evidence gap does not mean that existing injury-prevention strategies are useless for female athletes. It means confidence should reflect the actual population studied, and recommendations should not be framed as more female-specific than the underlying evidence allows.

Coaching application

Programming for female athletes should use the best available evidence while avoiding unsupported assumptions based on sex alone. Individual history, sport demands, training exposure, symptoms, menstrual/reproductive health when relevant, injury history and athlete preference remain important context.

7PRIME interpretation: Evidence-based practice includes knowing where the evidence is thin. Uncertainty should change the confidence of a recommendation, not be hidden by confident language.

Primary sources

British Journal of Sports Medicine — IOC FAIR consensus ↗

BJSM Editorial — Road to FAIR: where are all the female, woman and girl athletes? ↗