Encouraging Women in Sport and Physical Activity Across the Life course.
October in Scotland is spectacular – the landscape glows with colour from the changing leaves on the trees, the heather blooming on the hills, the stormy pink sunsets, and if you’re lucky – you may even catch a glimpse of the northern lights – also locally known as the Mirrie Dancers. It’s a wonderful time of the year to take time to get outside and move! October is also an important month for promoting and raising awareness for women in sport. It’s Breast Cancer Awareness month; Menopause Awareness month; the Active Scotland Division of the Scottish Government have the ‘Scottish Women and Girls in Sport Week’ to encourage all women and girls to get active (see the hashtag: #shecanshewill) and a new Physical Activity For Health National Framework has just been launched.
Figure 1: Physical activity for health: framework for Scotland (available at: https://www.gov.scot/publications/physical-activity-health-framework/pages/1/ and https://www.actify.org.uk/scotlandsnationalframework)
The focus for The Wellbeing Edit this month is women in sport and physical activity across the lifecourse. Unlike previous Edits, I am not writing this one alone! I am joined by one of my dearest pals, Laraine Adams. I first met Laraine more than ten years ago when we were brought together in Wales to do a promotional trip for Gore Tex and Mountain Equipment. We spent a week together up to our knees in fresh snow climbing the 14 highest peaks in Wales, getting our photos taken, and just generally having a great time in the hills. The main highlight of most promotional trips is all the free kit you get to take home – but for this particular trip, of a group of about ten, Laraine and I were the only women participants, and so, we also took home what has turned out to be a very long friendship. Since then, we’ve been on adventures of epic proportions all over Scotland, the Lake District and the Alps. I have lost count of the times Laraine has convinced me to run the West Highland Way and do other very long distance and potentially questionable events! In more recent years, we have both scaled things back substantially – not least because we are getting older, but for me – I have had a lot of ill health and injury, and for Laraine, her experience with perimenopause. Before we get into that though, I’ll rewind to the start of the female life course.
Figure 2: With Laraine at the finish of the 85km Hoka Highland Fling Ultramarathon
Early and teenage years
Taking part in sport and physical activity is linked to many factors, and for children and teenagers, having some sort of family connection and encouragement can be crucial to being encouraged to participate. Some may only have the opportunity to do so when at school, during PE classes, and at after-schools groups and clubs – assuming they have access to these. Outside of this, if the family network is not engaged in some sort of sport or physical activity, there is a chance that the child will not have the opportunity to take part either.
The Daily Mile is a great example of how schools and communities can be encouraged to support children to be active outside of school in a way that is accessible and low-cost. It is a great initiative that can embed healthy lifestyle practices at a young age – which can then filter into the teenage and early adult years.
Figure 3: The Daily Mile (available at: https://thedailymile.co.uk/)
Evidence shows that perception of fitness and links with being physically fit lead to active adolescents who are more likely to be active adults. This is particularly important because it is the teenage age-group when we really see a dip in girls taking part in sport (WHO, 2022). While there is an increase in the number of teenage girls taking part, and teams like the Lionesses play a pivotal role in this continuing trend, there remains a huge gap between boys and girls who play a lot of sports. There are however, efforts to address this, a recent example, from the West Lothian Cycle Circuit who run a weekly youths and women’s sessions from building confidence to more serious development. Aligned with the recently published Scottish Cycling Women and Girls Strategy. We have amazing cycling facilities in Scotland, and young women are such important parts of this overall story, and potentially international success.
Figure 4: Scottish Cycling Strategy for Women and Girls (available at: https://scottishcycling.org.uk/news/scottish-cycling-launches-women-girls-strategy/)
Adulthood and beyond
Moving into the adult years, and things can become complicated. Decreasing participation is reported to be associated with events such as marriage; childbirth (younger women); decreasing health (older women). Increased participation is often associated with events such as retirement; death of spouse (mid-age women). Stressful events are reported to cause a change in levels of physical activity engagement (for example, divorce) and this can be either way – an increase or a decrease. A complex list of things that can vary from one individual to another, and certainly will also include micro and macro level variations for each individual. As someone who develops interventions to support people to move more, I am acutely aware of the complexities of individual lives and how lives vary across the course of the day, never mind the week, month, or even year. I also see how difficult it can be for people to add more into their lives – and often hear about lack of time for doing things like going for a run, or to the swimming pool, or to an exercise class. There is also a cost associated with most of these things, and if someone has children or someone they care for, there may then be other financial commitments that take priority over sport or physical activity. On a positive, many women do find an activity or whole selection of activities they love when they move into their adult years and many do carry this forward for the rest of their lives. However, the likelihood of being able to participate at the same level for the rest of their lives may not be so straightforward. I know that ill health after Covid, which turned into long Covid, forced me to make big changes to my training. The mental side of this has perhaps been the most difficult – in my mind I am still training for an extreme ironman – the reality is, I am nowhere near training at this level! Another huge event for women, is the menopause. We’ll cover that later in the article, before that it is important to explore the perimenopause stage.
Perimenopause
Perimenopause has received substantially less airtime than the menopause – certainly this has been my experience, with much of the research and industry information coming through there does seem to be a focus on menopause. Given this topic is not my area of expertise, I can’t comment on why this is – and it is fair to assume I may have missed something. Enter Laraine, whose experience is documented below, in her own words.
As a childless 42-year-old woman, there has been very little to impact my ability to participate in exercise since I discovered the joy of running in my early thirties. I’ve battled the odd injury and occasional work/life lethargy which would lead me to reduce or abandon regular running altogether for some periods during the last decade or so but generally I’ve been able to run as and when I’ve wanted. However, over the last couple of years it’s been increasingly difficult to enjoy running the way I did. I’ve never been fast, but I’ve had good endurance and enjoyed marathon and ultra-marathon training, but since the age of 39, I’ve struggled with many of the typical symptoms of perimenopause, such as aching joints (particularly my hips), insomnia, anxiety, brain fog, clumsiness and fatigue which made simply getting up in the morning and showering before work an achievement, let alone running long miles.
When looking on the internet for guidance, there are many articles telling you how to exercise in your perimenopausal years, but most of these articles are around the importance of perimenopausal women weightlifting and the important of strengthening bones and muscles. My frustration came from not seeing a way to continue in a sport I loved, I wanted answers on to how still enjoy running, rather than give it up altogether.
A pivotal moment for me was finding a social media group called Girls That Jeff (GTJ), which advocates using a run/walk method. The premise is simple; you run for short periods of time such as 30, 60 or 90 seconds and follow this with a 30 second purposeful walk interval. These intervals can be adapted to suit your personal preferences, but you start the intervals from the beginning of your run, rather than just when you get tired and need to walk. This method reduces fatigue and stress on the body, and it’s provided me with a way to continue with a sport I love and gain a lot from, both physically and mentally. Having a space to share my perimenopausal struggles in a running context with others has also helped.
However, this is just one method (which is often viewed as ‘cheating’ or ‘not real running’) in one sport. Could more be done to help perimenopausal women understand how to adapt their chosen sport or method of exercise, rather than feeling it’s time to give up?
Laraine’s experience has been key in prompting me to consider developing my own research which looks at female participation – and we are hoping to put together a project, partnering with The National Trust, to further explore the context of physical activity during perimenopause, and to develop strategies to support women to continue to participate in activities they enjoy.
Menopause
Menopause, normally beginning during the ‘mid-life’ years is experienced by all women, with 8 in 10 experiencing symptoms that can have significant effect on lifestyles including impacting physical activity engagement, and up to 30% reporting being less active during menopause. My colleagues, Professor Ailsa Niven and Dr Claire Fitzsimons, along with Professor Nanette Mutrie, Dr Divya Sivaramakrishnan, Dr Tessa Strain, and Janis Reid recently worked with the Scottish Action for Mental Health (SAMH) to explore experiences of women during the menopause life stage and show the extent of menopausal symptoms and how they are related to mental wellbeing and physical activity. This piece of work has been hugely impactful, and presented crucial findings about how to support women through this stage of life, highlighting the important role that physical activity can have. The report proposed nine key recommendations including: normalising menopause; highlighting the mental, physical, and social wellbeing benefits of taking part in regular physical activity during menopause; and awareness raising including provision of tools and resources, support for healthcare professionals, and learning materials. The overarching message being that continuing, or starting, to engage with sport and physical activity during menopause can be hugely beneficial for all women. This work continues, and we are currently working on a systematic review on ‘Effectiveness of physical activity-based interventions to improve mental health outcomes among women in menopausal life stages’ which will be published in the future, all being well.
Figure 5: From ‘Moving Through Menopause’; SAMH; pg31
Death of a spouse
One major life event that I haven’t covered in this edition of the Edit is death of a spouse. I had planned to, however, on hearing Tina Adams story my feeling was this is such an important and completely lifechanging part of life that it was important to share Tina’s experience as a standalone piece. I felt that so many women would benefit from what is such an important piece of writing. Please see here for the full piece.
