Training and Game-Day Considerations to Optimise Performance and Reduce Injury Risk
Female athletes experience natural hormonal fluctuations throughout the menstrual cycle that can influence strength, energy availability, recovery, ligament properties, and perceived exertion. While every athlete responds differently, understanding these physiological changes allows coaches, athletes, and allied health professionals to better periodise training and manage performance demands (Elliott-Sale et al., 2021).
For footballers in particular—where performance depends on repeated sprinting, cutting, jumping, and high neuromuscular demand—aligning training considerations with menstrual cycle phases can help optimise training quality, reduce injury risk, and improve recovery.
It is important to emphasise that cycle-based periodisation should be individualised, as symptoms and performance responses vary between athletes.
Understanding the Menstrual Cycle
A typical menstrual cycle lasts approximately 21–35 days and is divided into four main phases:
- Menstrual phase
- Follicular phase
- Ovulation
- Luteal phase
These phases are characterised by changes in oestrogen and progesterone, hormones that influence muscle function, metabolism, ligament stiffness, and thermoregulation (McNulty et al., 2020).
Tracking menstrual cycles through apps or athlete monitoring systems can help identify patterns in fatigue, performance, and injury risk.
Phase 1: Menstrual Phase (Days 1–5)
Hormonal Profile
- Low oestrogen
- Low progesterone
This phase begins on the first day of menstruation.
Common Symptoms
Athletes may experience:
- Fatigue
- Cramps
- Lower energy levels
- Reduced motivation
- Headaches or back pain
However, many athletes are still capable of training effectively during this phase.
Training Considerations
Training should remain flexible and symptom-guided.
Recommended focus:
- Lower intensity technical work
- Mobility and recovery sessions
- Light strength training if tolerated
- Skill development
Athletes without symptoms may train normally.
For symptomatic athletes, adjusting load may improve comfort and training quality.
Game-Day Considerations
Athletes competing during menstruation may benefit from:
- Adequate hydration
- Iron-rich nutrition
- Anti-inflammatory nutrition strategies
- Effective pain management strategies if required
Open communication between athletes and support staff helps ensure appropriate adjustments.
Phase 2: Follicular Phase (Days 6–13)
Hormonal Profile
- Rising oestrogen
- Low progesterone
The follicular phase is often associated with improved training capacity.
Research suggests this phase may be favourable for strength development due to the anabolic effects of oestrogen on muscle tissue (Sung et al., 2014).
Performance Characteristics
Athletes may experience:
- Increased energy levels
- Improved recovery
- Higher motivation
- Better tolerance to high training loads
Training Priorities
This phase is often ideal for high-intensity training blocks.
Recommended focus:
- Strength development
- Power training
- High-speed running
- Sprint training
- High-intensity conditioning
For footballers, this may include:
- Acceleration drills
- Change-of-direction training
- Plyometrics
- Strength sessions focusing on posterior chain development
High-quality training sessions during this phase may produce strong adaptations.
Phase 3: Ovulation (Around Day 14)
Hormonal Profile
- Peak oestrogen
- Rising progesterone
Ovulation represents the transition between follicular and luteal phases.
Performance Considerations
Some research suggests potential increases in:
- Power output
- Neuromuscular performance
However, some studies also indicate that increased oestrogen may influence ligament laxity, potentially affecting joint stability (Herzberg et al., 2017).
Injury Risk Considerations
There is some evidence suggesting increased ACL injury incidence around ovulation, although findings remain mixed.
Given this possibility, maintaining strong neuromuscular control and proper landing mechanics is particularly important during this phase.
Training Focus
Athletes may still tolerate high-intensity training but should emphasise:
- Movement quality
- Landing control
- Strength training
- Agility drills with strong technique
Proper warm-ups and neuromuscular preparation become especially important.
Phase 4: Luteal Phase (Days 15–28)
Hormonal Profile
- Elevated progesterone
- Moderate oestrogen
This phase can affect metabolism, thermoregulation, and perceived fatigue.
Common Symptoms
Some athletes may experience:
- Increased fatigue
- Higher perceived exertion
- Reduced heat tolerance
- Premenstrual symptoms (PMS)
These responses vary significantly between individuals.
Training Considerations
Training may need to shift slightly toward:
- Moderate intensity work
- Tactical and technical training
- Controlled conditioning sessions
Strength training can still be performed but may require slightly lower volumes depending on athlete response.
Recovery Focus
During the luteal phase, athletes may benefit from prioritising:
- Sleep
- Hydration
- Nutrient timing
- Stress management
Maintaining recovery quality can help offset fatigue and maintain performance.
Game-Day Considerations for Female Footballers
Match-day performance is influenced by multiple factors including:
- Hydration status
- Energy availability
- Sleep quality
- Psychological readiness
Menstrual cycle phase is only one part of this equation.
Key strategies for female footballers include:
Fueling
Adequate carbohydrate intake supports repeated sprint performance and endurance during matches.
Hydration
Progesterone increases core body temperature during the luteal phase, making hydration particularly important.
Warm-Up Preparation
Neuromuscular warm-ups help improve movement control and reduce injury risk.
Programs such as FIFA 11+ have demonstrated significant reductions in injury rates when implemented consistently.
Recovery
Post-match recovery should prioritise:
- Protein intake
- Carbohydrate replenishment
- Sleep
- Active recovery strategies
Individual Variability in Female Athletes
One of the most important concepts in menstrual cycle periodisation is individual variability.
Athletes respond differently to hormonal fluctuations.
Some athletes experience minimal symptoms, while others may notice significant changes in:
- Energy levels
- Strength
- Recovery
- Mood
Tracking tools such as:
- menstrual tracking apps
- wellness questionnaires
- training monitoring systems
can help identify individual patterns.
This information allows training programs to be adjusted to suit the athlete.
The Role of Allied Health in Female Athlete Management
Supporting female footballers effectively often requires a multidisciplinary approach.
Allied health professionals play an important role in optimising training, reducing injury risk, and supporting long-term athlete development.
Physiotherapy
Physiotherapists assist with:
- Injury assessment and treatment
- Movement screening
- ACL injury prevention programs
- Return-to-sport rehabilitation
Exercise Physiology
Exercise physiologists design strength and conditioning programs tailored to the athlete’s needs.
This includes:
- neuromuscular training
- strength development
- load monitoring
- rehabilitation following injury
Dietetics
Dietitians help athletes optimise fueling strategies for training and recovery.
They also support athletes at risk of Relative Energy Deficiency in Sport (RED-S).
Integrated Performance Support
Combining physiotherapy, strength training, and nutrition allows athletes to receive comprehensive care.
Supporting Female Footballers at Changez Health and Fitness Daisy Hill
At Changez Health and Fitness Daisy Hill, female athletes benefit from a collaborative allied health environment designed to optimise performance and support injury prevention.
Our services include:
- Physiotherapy for injury management and rehabilitation
- Exercise physiology for strength and conditioning
- Dietetics for performance nutrition
- Personal training in a fully equipped gym environment
By integrating these services, we help footballers:
- Build strength and resilience
- Reduce injury risk
- Improve recovery
- Return to sport safely following injury
Whether athletes are managing training loads, recovering from injury, or preparing for competition, the Changez team provides evidence-based support tailored to the individual athlete.
If you or your daughter plays football and wants to train smarter, reduce injury risk, or optimise performance, the allied health team at Changez Health and Fitness Daisy Hill can help.
References
Elliott-Sale, K. J., Minahan, C. L., De Jonge, X., Ackerman, K. E., Sipilä, S., Constantini, N., Lebrun, C., Hackney, A., & McNulty, K. L. (2021). Methodological considerations for studies in sport and exercise science with women as participants. Sports Medicine, 51(5), 843–861.
Herzberg, S. D., Motu’apuaka, M. L., Lambert, W., Fu, R., Brady, J., Guise, J., & Sutton, K. M. (2017). The effect of menstrual cycle and contraceptives on ACL injuries and laxity. Sports Medicine, 47(11), 2397–2412.
McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020). The effects of menstrual cycle phase on exercise performance in women. Sports Medicine, 50(10), 1813–1827.
Sung, E., Han, A., Hinrichs, T., Vorgerd, M., Manchado, C., & Platen, P. (2014). Effects of follicular versus luteal phase-based strength training in young women. SpringerPlus, 3, 668.
