An investigation into the body model sports science built for itself in the lab, and what changes when a gap in knowledge stops being called out and starts being funded.
On Tuesday evenings, about ten of us run along the river, paired off for the first four miles, at a pace that lets you finish a sentence every so often, then takes it back. The same person has been next to me for three years. Twenty-nine years old, a shorter stride than mine and a quicker one, and in her pocket a training plan I gave her: printed, folded in quarters, Thursday’s intervals circled in pen.
I’d copied that plan from a training manual I loved. The footnotes sit at the bottom of the page, in a typeface small enough to discourage anyone from reading them, and I opened them late. They said the protocols had been validated on groups of twenty or thirty subjects, mostly men, nearly all college students measured over a few winter weeks.
I’d handed her a translation and called it a plan.
Described by Analogy
For most of the twentieth century, sports physiology didn’t describe the human body — it described a human body. The one easiest to recruit on a campus, fit inside an oxygen mask, and put back on a treadmill the following week under the exact same hormonal conditions. Thresholds, recovery windows, rehydration strategies, load-adaptation curves — all of it was calibrated on that subject. Then the numbers were extended to every other body by proportion: take the recommendation, scale the values down for mass and height, and hand it over.
That subject is male. And analogy is an excellent rhetorical tool and a mediocre clinical one.
According to a report from Femtech Insider, less than 10% of research in sports science and sports medicine focuses exclusively on women, and that share hasn’t moved in a decade. The same report cites a 2025 analysis of nearly 1,500 studies published in three major journals in the field: fewer than 6% had accounted for participants’ menstrual cycle phase in the research design. It also notes that female athletes suffer ACL injuries at a rate two to eight times higher than men playing the same sports.
Every volleyball and women’s soccer coach knows that ACL number. They talk about it the way people talk about the weather — something that happens, an anatomical fact of life. But a fact of life that repeats with that kind of regularity has measurable causes, and causes only get measured if someone decides to fund the measuring.
Half the people training have spent decades following instructions written with someone else in mind.
From Talking Point to Infrastructure
The gap has been called out for a long time, and calling it out costs nothing. It fits neatly into a conference panel, a line in a press release, an end-of-season comment after the injury has already happened. It produces instant agreement and zero operational consequence. What’s new starts where the talking stops.
In February, Boston saw the opening of the Women’s Health, Sports & Performance Institute, a facility built around female athlete health that combines research, education, and clinical care. Behind it sits an investment of more than $50 million, led by co-founders David and Jane Ott and Clara Wu Tsai. The institute is co-founded by Kathryn Ackerman, a sports medicine physician and researcher who built her career on female athlete health and founded the Female Athlete Conference, and it’s a member institution and research partner of the Wu Tsai Human Performance Alliance, a $220 million scientific alliance.
Ackerman has said she felt those gaps first as an athlete, on her own body, and spent the years since — as a clinician, as a researcher — trying to close them. She’s also pointed out that the healthcare system we move through was built to someone else’s measurements, and that two generations have passed since American law opened college sports to girls.
An investment alone guarantees little on the level of scientific truth. But it does one concrete, checkable thing: it turns an acknowledged problem into a line item, a street address, salaries for researchers that someone will still have to pay next year. A claim written in an op-ed can be retracted. A lab with bills to pay keeps producing data even after the topic stops being fashionable.
What a Pipeline of Research, Practitioners, and Care Produces
Under one roof: a physiology lab, metabolic testing, an experimental-grade kitchen, 3D movement analysis, equipment for bone density and blood biomarkers. The institute’s stated focus areas span the full life course, pregnancy and postpartum, sex-based differences and the effect of the menstrual cycle on performance strategy, sports endocrinology and bone metabolism, injury prevention and recovery. REDs shows up too — Relative Energy Deficiency in Sport, the condition that damages hormones, bones, the immune system, and mood when intake stays chronically below output.
Put that way, it reads like a catalog of specialties. The difference is on the building’s second floor, the education floor, aimed at athletes, coaches, clinicians, and family caregivers together. That’s the part that’s usually missing. A researcher publishes in a specialist journal, and a small-town coach will never open it. The gap between the two is measured in years. The institute treats knowledge translation itself as an object of study, and names the lag between research and clinical practice as one of the problems it’s trying to shorten.
Then there’s the third piece: actual care, the clinic. The partnership with Boston’s medical system puts sports medicine, endocrinology, rehab, nutrition, and mental health on one team, built on the idea that performance and health have to be read together. Anyone who trains seriously knows how rare that is. Usually everyone watches their own piece of the puzzle, and the athlete is the only person in the room holding the whole picture together.
When that chain works, a question raised in a Monday clinic visit can become an experimental design, then material for coaches, then a change to a training plan like the one I folded into quarters. It becomes possible to build training around hormonal cycles instead of ignoring them. And movement starts to carry the same precision we expect from a therapy — one where generic advice counts for little and what matters is the exact dosage of exercise.
What We Still Don’t Know, Said in Full
An institute opening is a promise, and promises get judged years later. The share of research dedicated to female athletes has stayed flat for an entire decade, and one building in Boston won’t move it alone. It would take dozens of research groups changing method at once, public funders who stop treating that variable as a nuisance.
Behind the gap sits a reason that’s less noble and more practical. Studying female athletes costs more: a physiology that shifts across the month means more blood draws, more sessions, bigger samples, calendars that get complicated fast. No one excluded anyone by decree. It just took decades of convenience — measuring whichever subject was most “stable” and available.
There’s also a risk running the other way, and it deserves mentioning. Once hormones enter the public conversation around training, they become a convenient explanation for everything: the off day, the bad race, the knee that gives out, the week of bad sleep. Biological determinism has a lazy kind of appeal. Knowledge done well hands athletes and coaching staffs more room to maneuver, anziché a new, well-documented excuse.
And there’s still the physical distance between a lab in Massachusetts and a riverside path on a Tuesday evening. The first to benefit will be elite athletes, as always. My training partner will see those results in a few years, diluted into an article, a coaching course, a footnote finally written about her.
Thursday, we’re back on the river. The plan is still the same one, folded in quarters in a back pocket, the pen circle still around the intervals. One day there’ll be a version written with her in mind. Until then, we run, and we wait for it.