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The Rugby Players Association's (RPA) podcast returns! Join us to talk about the work of the RPA, and the wider sports agenda.
Hello, and welcome to this month's edition of the RPA, the player's voice podcast. This month, we're joined by Great Britain 7 star, Eloise Hayward. In the last 6 months, Eloise's work has been published into the International Journal of Environmental Research and Public Health entitled role of the menstrual cycle on performance and injury risk. We're here to chat all things about this to to discover what she has learned from this process. So, Eloise, a star at the beginning.
Ste:Eloise, tell us what made you, you know, want to research and undertake stuff in this sort of area?
Eloise:It's sort of an area I've had an interest in since I was probably about 16 to be honest. I remember having conversations with teachers at school saying, you know, ACL injuries are massive in women's sport. Why aren't they research more? And then it wasn't until I was doing my degree in biomedical science that I had a lot of friends around me in the rugby scene, in the football scene, tear their ACLs like myself. I've suffered with ligament injuries in my ankle, just surrounded by female athletes at the top of their game, have no reason to be injured and they are having catastrophic catastrophic injuries.
Eloise:That was difficult. And I thought there's more research that needs to be done. I was Googling, I was asking questions to physios and they weren't educated enough. We weren't educated enough as players. And I thought, well, if no one's going to do it, then I might as well take the research on myself.
Eloise:And that's sort of where it went from there. I always had an interest in the impacts of the menstrual cycle on athletic performance and injuries in female athletes, specifically, you know, rugby and football. I guess that's the sport I play. So, I thought, why not apply it to myself? And yeah.
Eloise:And that's where the paper came from.
Ste:So tell us just to break it down. How, you know, what were the the basic findings? What what did you discover as part of the dissertation?
Eloise:Yeah. So we found, gosh, it was quite a lot. So I break it down into I break it down into topics, into categories. So I look at the psychological effect, the performance effect and the nutritional effect because I thought that was something that's never really been looked upon before. And we found well, I found that there was over half of our population.
Eloise:So my study group had sustained an injury whilst on the menstrual cycle. And injury. We categorise that as anything from ligament injury, bone break, concussion, muscle injury. So we're talking, you know, if you've torn your ankle, if you've torn your ACL, you've done your meniscus, anything like that. And over half of it, half of the population group had sustained energy boss on the menstrual cycle.
Eloise:So I did it all on a on a on a form basis, on a questionnaire. I hand it all out to every single PWR club. There was asked a girl that I knew in every single club if they could drop it in the group chat. And then I was playing rugby league at the time as well. So I dropped into all the Super League group chats as well.
Eloise:And we got there was a bit of a basis. You had to be 18 years old. You had to be playing in the Super League or the PWR. And even better if you could specialise that you were an international rugby player. So we had international 7s players, international 15s players.
Eloise:So this is coming from top flight women's rugby. And I had over 300 respondents. And yeah, the significance of the fact that we had over half of the study group sustained an injury. And then we dove deeper into the psychological side. So we looked at the effects of white shorts, for example, the IRF, you'd no longer play in white shorts for the women.
Eloise:And there's a significance of 54% of women found that they were psychologically affected whilst on the menstrual cycle whilst playing rugby. Whether that came from pulling out tackles, having lower confidence, lower self esteem, just felt like they went with it. They had a bit of a fog. Or they just had an awareness of the kit they were in and how they felt. So I left people questions were yes, no or they were they were closed questions.
Eloise:But there was always an additional comments box at the end of each one so people could just kind of tell me what sort of injuries they sustained or if they had anything else they wanted to talk about. And some of the comments came across the lack of awareness from staff. So, one of my main questions was sort of around comfortability. So how do you feel to discuss with staff that you're on your menstrual cycle and you're sort of struggling? And it was about 80% said they just wouldn't, they wouldn't bother saying anything.
Eloise:And that was striking because I just thought, okay, maybe that's just a me thing, maybe it's just a personal thing, you know, maybe I wouldn't speak to staff. I mean, since doing this paper, I'm now like, oh, I will shout, you know, from the rooftops and stuff like, look, this is going on, This is crap. But yeah, previously before doing my study, I would have been one of those things like, well, I'm not going to mention staff. It doesn't make a difference. I said, okay, but if you were to speak to staff, who would you speak to?
Eloise:And majority of respondents said it would have a female member of staff and it was normally a physio, an S&C or a manager. And then they'd probably try and get them to feed it into male head coaches. And that was a that was a part about education is the fact that as female athletes, we aren't educated. So one of the questions majority of respondents again said they felt they weren't educated enough. And when asked where it came from, self research or school.
Eloise:And I'm sorry but the education you get at school is it's not gonna it's nothing to do with your athletic performance it's a very basic idea
Ste:What surprised you the most in it and is there anything that maybe you couldn't investigate that, couldn't investigate further at this time that maybe you thought maybe, you know, in the future that you might like to pick up again?
Eloise:Yeah, definitely. So, I looked into sort of training adaptions that could happen. So one of the biggest points of the research was that Chelsea won Super Club. I mean, I'm an outfit. I'm an avid Chelsea fan.
Eloise:So for me, that was pretty good. They heard in their Super League wins, FA Cup wins, the Cup wins, that amazing league run that we had to the Fitr app, which is an app to track a menstrual cycle. All staff have access to it as well. So you can log how you're feeling, you can log your symptoms, your eating, your training. It's kind of a good way to just keep an eye on you.
Eloise:All staff have access to it. And you can see sort of how a player is progressing. It's okay. Their menstrual cycle is not as usual as you know what's going on. You could check-in with players, that sort of stuff.
Eloise:You can adapt their training. So if one player maybe was a little bit off the boil, it's like, look, don't do extra scrimmaging today. Go have a nap. It was really good. Same for the US National Women's Football Team.
Eloise:So when they won the World Cup in 2019, they dedicated their win to the fact that they were menstrual cycle tracking and profiling their players, their squad. So they were able to know when to push players, when to make players recover better, what to do and how to sort of adapt around squads. Now I know football squads are a lot smaller than rugby squads. There's what an average 40 of us in a squad and 20 of them. So it's easier to keep 9 footballers than there is rugby players and they've got a hell of a lot more stuff.
Eloise:But I thought that's probably something we could try and introduce into the women's premiership or if we start at the top and we go say, you know, international women's rugby, whether that's we start in the sevens where it's a smaller group of us or you start in the fifteens where you have the resources. If you could look at into training adaptions, you know, you make it a building that profile on players and say, this is her, you know, her average period, her average cycle. Okay, these are her average symptoms. Okay, what's going on today? And maybe check-in with the player.
Eloise:I'm not feeling too good. Okay, let's maybe rein you in. Let's pull you back. Like if you were to go to a physio in the morning of camp and say that my hamstrings is feeling a bit niggly today, then you're probably going to be managed in training. But it's so taboo to go to your physio in the beginning of the morning and say, do you know what, my period is killing me, I'm not sure how much I can give you today.
Eloise:You just wouldn't say it. And even if you did, your physio would be like, all right, cool. Yeah. You do you. You do you.
Eloise:And it's like you have to self manage these sort of things. And I mean, that's a big overview. There probably is a lot of physios who would know what to do. But I think the lack of education we have from a professional athlete point of view, it's not the best. That's definitely something I'd like to look into further is what adaptions can be put into place.
Eloise:Is that people's gym programming? Is that people's training adaptions? Is that just building menstrual cycle profiling? And you can go down a rabbit hole. Like I'd love to look into writing a second paper on adaptions you can do.
Eloise:And at the end of my paper, I wrote the conclusions, my sort of advice so far of what I could give, what I'm educated enough to give from my research and my findings. But there was definitely a rabbit hole and something that I find interesting that we couldn't touch base on so much. And I'd love to probably do further research on it. But the effects of the menstrual cycle and concussion, that was that was big. And that's something that I'd like to look into next is, you know, does does getting a concussion interrupt a menstrual cycle, which then can impact injuries in the future?
Eloise:Because I know people who have had concussions, they've come back, they've even made, you know, often comments saying, you know, my period's a bit messed up. You think nothing of it as a player? Oh, I think nothing of it. And then they go and get injured. Post concussion, you think it's not coincidental enough.
Eloise:There's too many people for it to be coincidental. So, yeah, that was sort of sort of the case, I think. Yeah. That would be what I'd like to look into.
Ste:I mean, this is probably a broader broader point. Obviously, there's just a lack of research when it comes to what are your feelings towards this, but there's a lack of research in general when it comes to women in sport and sport science, you know, just what are your initial thoughts from this really?
Eloise:Do you know what? I was so surprised when I started fine. So at first I was thinking about doing, you know, systematic review. I thought, yeah, this would be banging. Could not find enough papers.
Eloise:That's why I had to move to primary research and write my own paper. So at first it was it was really annoying because I think I didn't realize the sort of laid back attitude we have towards it. You know, you could be at training and you're warming up whatever and, you know, the app as girls obviously was warming up. And someone said, oh, you know, so so should I reach out? You're like, oh, no way.
Eloise:So what you did this weekend? Like, we just drop it into conversation. You just think that would never happen anywhere else. That would just never happen. And when it happened in the men's game, it was a big deal.
Eloise:When Entevac missed out on the World Cup, it was huge. When the suffering captain, when he did his ACL, massive news. If you were to see superstars like Anton DuPont do his ACL, I think it would be headline news and it would be, you know, how do we prevent this in the men's game? Funny enough, we have I think in women's top quartile alone, there was 67 ACL injuries last season. 6 coming from Arsenal.
Eloise:Like 1 club alone had 6. We missed out in the World Cup with our captain, with Vallejo Williamson, without our golden boot winner Beth Meade and yet nothing was sort of yeah. It was it was mainstream news and it was, you know, I was gutting, you know, she's done her ACL. Oh, not another one, you know? And that's sort of the the mindset we had to it.
Eloise:So then when I started, you know, doing all my research and looking at these papers, it was baffling to me that most of the research for female athletes in performance sport was based on male data. It was all based on their data. It was all based on their knee strength, their testing, their that. But we're so biologically different to men. We've got different hip angles, knee angles.
Eloise:We've got a menstrual cycle. Like we've got hormones fluctuating around our body that causes ligament laxity and calcium density to be pulled out of bones. It just baffled me when I was writing my introduction and I was having to say, like, most data at the minute is based on men. So, you know, this is one of one of the first papers to involve female data and actual firsthand primary data from female athletes. There's been there's been one that's just just before mine, which was based on footballers, but that was a very small pool.
Eloise:It was about 11 players from the WSL. And it was more interview based. 1 maybe a little bit more in-depth because you got to have an interview. It'd be a bit more personal but small pool. So you can't really say your findings are significant.
Eloise:Whereas this we had, you know, a massive pool, massive sampling, but we need further research. It doesn't end here. I think one paper isn't gonna isn't going to fix the issue. So, yeah, definitely looking forward to seeing what the PFA leads back at. I think it's FIFPRO.
Eloise:Yeah. Nike. So I'm yeah, I'm interested in seeing what what comes out of that. I mean, I live near Leeds, so hopefully you might see if I can go and get them.
Ste:They just
Eloise:have words.
Ste:What, I mean, is the is the findings in any way changed how the world changed the way you prepare as an athlete? Like
Eloise:all. Yeah. Yeah, definitely. I think it's definitely changed the way I approach training. Like I said before, I was definitely one of these players who sort of viewed Metro cycles as a taboo.
Eloise:You know, some brought up the change room, but like, okay, moving on. So, you know, so I just sort of whisked start around. So throwing myself into my paper was really good to push me out my own comfort zone. But, yeah, it's definitely changed the way I prepare or I train in general. So before it would be a case of, you know, I've got a speed session to do and it's it's heavy today.
Eloise:I go for like, I'm firing on all cylinders. Okay. Well, why not find all cylinders? You're like, well, what stage am I cycling at? You know, have a little look and you're like, okay, that's why.
Eloise:Let's rain it in a little bit today so I can fire again tomorrow. Or it would be a case of, okay, let's warm up a little bit. Let's thoroughly warm up today. Let's pull all the activation out, everything. Let's get the rehab in, make sure nothing goes.
Eloise:And if mid session it's like, no, you're seriously not firing. It's not okay. Having that I don't know that emotional maturity to be like, look, pull yourself out. You're not going to be Superman by doing a session. Just pull yourself out.
Eloise:I think that's something that maybe matured in me is because when I was younger, I definitely would be like, oh, what the hell? And just kind of cracked on a bit. Like, you know, I need to get through this and grit and bear my teeth. And don't get me wrong. There are times where you need to to push through because if you're going to face your menstrual cycle in World Cup finals and things like that, you're definitely going to push yourself through.
Eloise:But I think adrenaline is going to get you through that than doing a speed session on a Tuesday. But there's a slight difference in maybe the event. But yeah, it's definitely changed the way that I approach training and matches for sure, making sure I'm I'm fully prepared and I'm fully just aware. Yeah, definitely.
Ste:And you spoke earlier about the education side of things and how people just aren't educated on this but what what what what's in your opinion anyway what what can what more could be done to empower women to learn about or to well to empower women about their menstrual cycle and the ways of raise awareness when it comes to training and match play and things like that is it Yeah. What what
Eloise:do you think? Yeah. So that's a good one. I think as as women, we're aware that it's a topic we probably should talk about. We just don't talk about it.
Eloise:It's something, you know, you should do something and you just don't do anything about it. I think it's just having that confidence to sort of spark conversations within your club, within your national team, spark conversations with other players, maybe ask what they need in that moment. Maybe just having that sort of education of, look, this is how your menstrual cycle can impact you. Let's talk about it. Let's actually discuss how people feel because menstrual cycle is so individualized.
Eloise:They're so different. And I can't sit here and say there's a one size fits all because it's not a given generalized opinion. But every player is going to be different to another one, especially those who take contraception and things like that. Everyone's going to be looking different. But I genuinely believe that at the start of the season we have to do a, you know, our gambling talks, our drugs talks, supplements, etc.
Eloise:Maybe if in the PWR or things like that, we can slot in an education slot of this talk about your mental cycle, even if it's a 50 minute presentation on here's some things you could do or here's some things you should be aware of. I think a lot more people, it would spark them to do a bit more self research or even just kind of be a little bit more aware of what's going on in their own body. But it's just definitely just speaking about it and making it's making sure it's not a taboo topic. Having coaching staff who are approachable and saying, yeah, okay. Like, I'm happy to be quite with you.
Eloise:Because that was one of the massive things is people, most athletes didn't want to be deemed as weak. They're not a session because of symptoms or, you not be able to come to training because of symptoms or things like that or not feel like they're firing. Right. It's a macho culture. I get it.
Eloise:We play a contact sport. We play rugby. I understand. But there's a difference between looking weak, not training well and getting injured. There's a massive difference.
Eloise:So if you can open up those lines of conversations, whether it's between medical staff and players or actual coaching staff and players, like one of the massive things I found was, is that 88% of female top flight sports. So we're looking at rugby, football, basketball, AFL. They're all run by male head coaches.
Ste:So does
Eloise:that vary anyway of just just not knowing, you know, and that's not not the male head coaches thoughts at all because they just they never experienced. They just don't know. Yeah, they've not experienced it. They've never even considered it as something they probably need educating on because they're too busy looking at, you know, tactical maps and training maps and things like this and sessions that you know, it's at 1% that they probably never looked at. But if teams are dedicating World Cups to it and Super League titles and FA Cups, then it's probably something we should look into.
Ste:I think you just alluded to it there but then is there you know what what how do you think sporting you know organizations clubs programs things like that could adjust to you know your in light of your findings you know would you recommend I guess it's a more generalized thing here, but would you recommend certain things for certain clubs or programs to do straight away or the near future or anything like that?
Eloise:Yeah. Definitely. I think it's I think it would be good for just for for clubs to get straight into the whole menstrual cycle monitoring and profiling our players. Like I know we have a lot of players coming in and out a lot through extended squads or going to 6 Nations, Pac four, etcetera. And our players are coming in and out.
Eloise:But I know as a general, most clubs now we do a wellness in the morning or training, etcetera. And there is a question in there that says, you know, are you on your period? What day are you on? But like what then is the use of that data? Are we constantly tracking it?
Eloise:Are we then saying, oh, you know what, she's off from usual. Like maybe we should check-in like, you know, because that as a female athlete, that is the first warning sign that's like getting in your car and, you know, get a warning on your dashboard. Something going on in your menstrual cycle is the first warning sign. It's the first sign of, okay, injury is going to happen here or something's going on that we need to check. So if you can start to build this data of metro cycle monitoring and profiling and I'm not saying it's on the staff.
Eloise:I think as players we should probably take a lot of ownership and say, look, we'll monitor our own and we'll flag if something's wrong. Completely fine. The squads of us that massive and stuff not at the time of the resources. But I think that's probably the first place to start is where, you know, okay, what's she looking like? What's going on?
Eloise:Can we help in any way? Because we have the medical resources to be like, oh, okay, are you lacking an eye? And what's your diet looking like? Are you eating? Are you fueled?
Eloise:And just then probably having the I don't really know how to phrase it, but yeah, the ability to turn around and say, I need my training adapted today. Which is something so difficult. Like even I I will struggle myself after doing all this research, going up to staff and saying, I probably need to take it easy in the gym today. And if you kind of say it to an SSC, they normally kind of go, oh, why you're like, oh, my mental, you know, my period. They're like, all right, definitely.
Eloise:Fair enough. Fair enough. So that makes sense. He's get it. Like, if you just got to put yourself back in the gym one day, don't feel ashamed that you could do what's best for you in your performance.
Eloise:But yeah, those would be the top sort of three things for me is education, menstrual cycle profiling slash monitoring and just any form of training adaption.
Ste:Do you reckon we'll ever get to a place where coaches and SNC SNC coaches and head coaches don't consider it a a taboo subject?
Eloise:I'd like to hope so. I'd like to hope we get there. I think we're moving towards it. I think we're moving more towards a bit more of an open society within sport in general. I think thanks to the lionesses and what they've done for football, I think that is having a knock on effect to the rest of us in other sports.
Eloise:So I think, yeah, the ACL research going on right now, whether they're looking into the metro cycle as well, I actually don't know, but I know obviously they're looking into ACLs. So hopefully they'll touch a topic on that. Yeah, I'd like to think so. Like I know, for example, the world's women, they have Jo Perkins, their head of physio, and she's really, really big into looking at metro cycles and pelvic floor, that sort of stuff. So I think if we can get more staff on board with that, the better.
Eloise:It's just winning over the staff to convince them that this is the 1% that probably could make a difference in a Premiership final or World Cup final. Yeah. It's probably just convincing them sometimes. Maybe looking at the athlete well-being and injury prevention is as good as looking at rehab plans when they are injured. Like why not try and prevent it before it happens?
Ste:How does it feel to be a published writer in the International Journal of I'm going to write down the International Journal of Environmental Research and Public Health. Fancy title.
Eloise:But how
Ste:does it how did it feel to first see that when it first published?
Eloise:It was quite surreal, to be honest. I'd never really wrote a paper with the intention of being published. I just sort of wrote the paper because I had to do my dissertation and I wanted to do something I was interested in. It wasn't until my this tutor said to me, this is actually quite good. I mean, it was the actually that got me that that solid for me is that this is actually quite good.
Eloise:And so that's the actual thing. But it was such a timely topic that at the time when I was writing, obviously, they wouldn't send Donnar ACL, definitely did Donnar ACL, Xavier Harrison did Donnar ACL. These big names in women's football, women's rugby were injured. And just as we got published, some Kurt did our ACL. So I I was like, look, this is timely, this is a timely topic.
Eloise:And, yeah, that was it. We sort of went for publication and got it first time just because they were like, there's no there's no research in it currently. So it's one of the one of the main papers we actually were given top 10 most read paper in I think in January or February. So we were actually top 10 which is really cool. Getting emails like that and getting my, you get a stipulation of publication.
Eloise:This is in my room, in my drawer somewhere. And yeah, baffling. It's just never really something you, you set out to achieve. I think I've always liked science and things like that. To be a published author in science is now like, that's pretty cool.
Eloise:That's pretty cool. Can add that to the add that to the CV. So yeah, it's, it's, it's really good. It's just nice to know that. So making a difference and now it's how can I actually use that published paper to have an impact on women's sports?
Eloise:I think this is just a start. I either want to write more papers or make sure that the knowledge is out there from the paper. If I can simplify it in any way, shape or form and make sure that other athletes are educated, then 100%.
Ste:And then to to wrap it off, just I was wondering, you know, from a friend perspective, you know, what have your teammates' friends been like since since it was published at the the the, you know, what's their reaction been to it?
Eloise:Just think I'm a big nerd. Just think of a big nerd. They're like, oh, you should do more kicking practice or something. No, they they've been really supportive, like heavily supportive and really a lot, you know, a lot of them are Reddit and my friends play, play all over. So I've got football friends in the WSL, football rugby friends in the premiership and the championship.
Eloise:And loads of them have read it and said, do you know what? This has seriously changed my perspective. And it sort of opened up conversations with me, I think. And then a bit more that they feel they can have those conversations with me and come to me for advice. I had a friend of mine who plays Fassenbiller.
Eloise:She was away in Scotland camp and they were playing some European qualifiers and checked some money. She's like, I'm going to something like I'm panicking up. We're playing a big game today. I'm panicking. I was like, okay, fine.
Eloise:Talk to me. What's up? And we went through and she's like, Oh, okay, I feel better. I was like, Well, there you go. Then welcome to my good casting service.
Eloise:Apparently, I'm back
Ste:to the TV. No, I'm sorry.
Eloise:Yeah. I might be running business. But yeah, everyone's been supportive and I think it has opened up that line of communication with friends and people feel like I have those conversations with me. I've had multiple conversations at training with players in the changing rooms at the at the lunch, you know, at dinner tables, at training people sort of said to me, you know, it's really cool. I've read, read and draft your paper or things like this.
Eloise:You know, can I ask you about this? Can I ask you about this statistic? And I'm like, I'll happily have this conversation with people because me, like I said, it's a topic that just needs just needs talking about. It needs inflating. But, yeah, everyone's been so supportive and really, really good.
Ste:And then lastly, Louise, I think you alluded to this right at the start, but what what's next for for you and and and and Bill, particularly for this research? What what yeah. What's on what's on the agenda next? Yeah.
Eloise:It's probably just, at the minute keep pushing the research that I've already done, seeing the impact I can try and make in the women's game currently and seeing if I can. Yeah, Get it, get it out there. I get all my facts out there and all my research out there and and hopefully see if I can continue and write more and find out more. I think this is this is going to be an ongoing project for for many years. I don't think in my playing career we're probably going to get an answer to it.
Eloise:But I hope for generations, but only we can make the game a safer place and a more stable sort of environment where people can openly talk about these sort of things. And we can go on and win gold medals in World Cups and Olympic Games without sort of the worry of periods and injuries and missing out on selections and stuff due to it. So, yeah, definitely, definitely more research, more being a nerd.
Ste:Being a nerd all the way
Eloise:because this is amazing.
Ste:Thank you so much for your time, Eloise. We'll put a link for your research paper in the bio for the podcast, so make sure you go check that out if you fancy a good read. Thank you so much for your time again and thank you for listening to the RPA for Players Voice podcast. If you've got a topic that you want to talk about ahead of the upcoming 2024, 25 season, then please do let us know using the hashtag the player's voice. See you now.
Ste:Bye bye.