Female sport in Australia has never had more visibility — AFLW crowds keep growing, Super Netball remains one of the best domestic competitions in the world, and the Matildas' popularity has pulled a whole generation of girls into club sport. But the science and support systems around female athletes are still catching up. For decades, most sports science research was conducted on men and simply applied to women, which means a lot of "standard" training advice was never actually built for female physiology in the first place.

Three areas matter enormously and deserve straight talk: strength training, the menstrual cycle, and injury risk — particularly the ACL.

Strength Training Isn't Optional

There's a persistent myth that female athletes should prioritize cardio and "toning" over heavy resistance work. That thinking is outdated and, frankly, counterproductive. Strength training builds the tendon, ligament, and muscular resilience that protects joints under the explosive, cutting, and landing forces sport demands. It also directly improves speed, power, and durability across a season.

One of the clearest findings in the research is a structural gap, not a biological one: female athletes are less likely than male athletes to have a dedicated strength and conditioning program or a certified strength coach guiding their training. That's a resource and access problem, not a reflection of what female bodies can handle. Closing that gap — through compound lifts, plyometrics, and progressive overload — is one of the most effective things a female athlete can do for both performance and injury prevention.

Training Around the Menstrual Cycle: What the Science Actually Shows

"Cycle syncing" your workouts has become popular advice — train harder in the follicular phase, back off in the luteal phase, and so on. It's an appealing idea, but it's important to separate what's trendy from what's proven.

The current weight of evidence is fairly clear: menstrual cycle phase does not meaningfully affect strength, muscle growth, or training adaptations. A 2023 umbrella review of the existing research found no consistent effect of cycle phase on strength performance or hypertrophy, and a randomized controlled trial reached the same conclusion for training-induced muscle gains. Some studies do report a small performance dip during menstruation itself, but findings are inconsistent, and much of the earlier research supporting "phase-based programming" was low quality.

That doesn't mean the cycle is irrelevant — it means the relationship is more individual than the popular narrative suggests. What's worth paying attention to:

Symptoms, not the calendar, should drive adjustments. Fatigue, cramping, sleep disruption, and mood shifts are real and can affect a session — but they vary hugely between individuals and even between cycles for the same person.
Injury risk may fluctuate. Some research points to increased injury susceptibility around the late follicular phase, though the mechanisms are still being studied.
The bigger levers are the boring ones. Sleep, nutrition, hydration, and stress management have a far larger, more consistent impact on training outcomes than cycle phase does.

The practical takeaway: track how you feel, adjust intensity or volume when your body signals it, but don't feel obligated to overhaul a training plan around a rigid cycle-based template — the evidence doesn't require it.

The ACL Problem in Female Athletes

This is where the sex-based gap in sports medicine is most stark — and it's especially relevant here, given how many Australian girls and women play the sports where the risk is highest. Depending on the study and sport, female athletes face somewhere between two and eight times the rate of ACL injury compared to their male counterparts, with the sharpest disparities showing up in sports involving cutting and pivoting.

Netball, one of the most widely played sports by women and girls in Australia, is a standout example. Australian netball data has reported ACL injury rates as high as 17–22%, driven largely by the sport's one-step landing rule, which forces players to decelerate and pivot on a single planted foot. In AFLW, the numbers are just as striking: accounting for exposure, female AFL players face roughly six times the ACL injury risk of male players, and ACL injuries are consistently the AFLW's biggest single cause of missed matches after concussion. Data from the Australian Institute of Sport's High Performance Sports System tells a similar story, with the large majority of tracked ACL injuries occurring in female athletes across netball, basketball, and field hockey.

Some of this gap reflects genuine sex differences:

Landing mechanics. Female athletes more often land in a more upright position with straighter hips and knees, increasing knee valgus (inward collapse) and shear force on the ACL.
Ligament and joint characteristics. Research suggests female ACLs may be less stiff, weaker, and subject to greater knee laxity, with some evidence of a slower biological repair response to ligament stress.
Hormonal influence. Estrogen and other reproductive hormones affect ligament tissue properties, though this remains an active area of research rather than a settled mechanism.

But it's worth being cautious about numbers, too. A recent Harvard-led analysis pointed out that a lot of the "injury rate" statistics compare male and female teams unevenly — smaller female rosters, less depth, and different exposure-time calculations can inflate the apparent gap. The disparity is real, but its size is genuinely debated in the literature.

What's not debated is that prevention works. Structured neuromuscular training programs — focused on landing mechanics, hip and core strength, and controlled deceleration — have consistently been shown to reduce non-contact ACL injury risk. Yet in one survey of female university athletes, the vast majority had never participated in one, despite nearly all of them saying they'd be willing to. For netballers and AFLW hopefuls in particular, this is exactly the kind of program that turns a high-risk sport into a manageable one.

The Common Thread

Strength training, cycle awareness, and injury prevention aren't three separate issues — they're connected. Athletes with better-developed strength and neuromuscular control land more safely and recover more consistently, regardless of where they are in their cycle. The biggest barrier isn't female physiology — it's that female athletes have historically had less access to the coaching, research, and prevention programs built around it.

That's changing, slowly. The more this research reaches the athletes who need it, the more that gap closes.

Ready to Train Smarter and Reduce Your Injury Risk?

Whether you're managing an injury, or wanting to ensure you are performing at your best, Excelsior Sports Therapy can help. Book an appointment today and take the guesswork out of your training.

References

Colenso-Semple, L.M., D'Souza, A.C., Elliott-Sale, K.J., & Phillips, S.M. (2023). Current evidence shows no influence of women's menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Frontiers in Sports and Active Living, 5, 1054542.
McNulty, K.L., Elliott-Sale, K.J., Dolan, E., et al. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Medicine, 50(10), 1813–1827.
Blagrove, R.C., Bruinvels, G., & Pedlar, C.R. (2020). Variations in strength-related measures during the menstrual cycle in eumenorrheic women: a systematic review and meta-analysis. Journal of Science and Medicine in Sport, 23(12), 1220–1227.
Duehring, M.D., et al., as cited in: Current and Future Trends in Strength and Conditioning for Female Athletes. (2022). International Journal of Environmental Research and Public Health, 19(5), 2687.
An examination of current practices and gender differences in strength and conditioning in a sample of varsity high school athletic programs. (2011). Journal of Strength and Conditioning Research (via PubMed).
Bekker, S., Richardson, S.S., et al. (2024/2025). Limitations of athlete-exposures as a construct for comparisons of injury rates by gender/sex: a narrative review. British Journal of Sports Medicine (via PubMed, PMC).
Harvard GenderSci Lab. (2024). Real reason ACL injury rate is higher for women athletes. Harvard Gazette; commentary via University of Bath press release.
Prodromos, C.C., et al. (2007), as cited in: Comparison of ACL injury rate by level of competition and sex. PMC (ID: PMC6604059).
Anterior cruciate ligament injuries in netball: the elephant in the room – Part 2. British Orthopaedic Association / Royal College of Surgeons.
Anterior Cruciate Ligament Injury Prevention Programs in Welsh Netball: A Survey of Knowledge, Implementation and Barriers Amongst Players and Coaches. PMC (ID: PMC11179151).
Anterior Cruciate Ligament Injuries in Australian Football. (2021). Open Access Journal of Sports Medicine (Dove Medical Press).
AFL and AFLW injury reports (2023 season data). AFL.com.au.
Anterior cruciate ligament injury occurrence, return to sport and subsequent injury in the Australian High Performance Sports System: A 5-year retrospective analysis. ScienceDirect / Journal of Science and Medicine in Sport.
Familial Predisposition to Anterior Cruciate Ligament Injury in Australian Rules Footballers. PMC (ID: PMC11613231).
Sports injury in Australia, Netball. Australian Institute of Health and Welfare (AIHW).
A Pilot Survey Study of Anterior Cruciate Ligament Injuries in Female University Athletes. PMC (ID: PMC11242743).

Training Smarter: What Every Female Athlete Should Know About Strength, Cycles, and Injury Risk