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The female athlete
  1. C Doyle
  1. Senior Physiotherapist, Hôpital La Musse, 27180 Saint Sébastien de Morsent, Normandie, France;

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    Mary Lloyd Ireland and Aurelia Nattiv. London: Harcourt Publishers Limited, 2002, £48.00, pp 803, hardcover. ISBN 0721680291

    This book is a very informative source, both from a practical point of view with its sports medicine content, and also from an educational angle with information on the psychosocial aspects of the female athlete, which are very relevant and are not often included in general sports medicine texts.

    The book presents sex differences in injury occurrence and gives effective advice on prevention and injury management. It is targeted mainly at sports medicine professionals, but also significant sections are relevant to coaches, trainers, administrators, and, in some part, the athletes themselves and their families.

    The organisation is logical, with the content divided into sections including firstly historical, psychosocial, and performance issues followed by chapters on female specific and general medical conditions, and finally sections dealing with orthopaedic, rehabilitation, and sport specific conditions. The chapters are well written and easy to read, with a considerable level of research literature and statistical data discussed within most. The presentation of the text is clear with good use of tables, figures, and other visual representation of information.

    The initial section gives a good historical background to female sports participation and explores psychosocial and performance issues and how they relate to the athlete and those working with her. This is important in knowing how to create a successful working relationship by understanding the subtle differences in dealing with female rather than male athletes. This is particularly well explained. There could be more information included here, for example on race, class, and sexuality as such subjects are rarely broached in this type of literature and would improve the knowledge of those caring for the athlete.

    The following section covers in great detail problems associated with nutrition, menstrual dysfunctions, and other obstetric and gynaecological issues including pregnancy as well as general medical conditions. Despite some repetition of information, there are very good chapters covering the female athlete triad and the sequelae of disordered eating, with pragmatic advice on recognising symptoms of these conditions. The chapter on the physically challenged athlete supplies detailed information on some of the unique problems faced by this group of sportswomen, about which there is very little written and will considerably enhance the knowledge of the non-expert reader.

    The orthopaedic section includes all the major injuries usually seen, with relevant female specific information and advice. The chapters on stress fractures, knee, and shoulder injuries are particularly clearly written and presented. There could be a greater contribution, where appropriate, from relevant sports rehabilitation specialists to discuss the specifics of certain aspects of treatment in addition to the surgical or bracing procedures. For example, the foot and ankle chapter could be expanded with the views of a podiatrist on both assessment and management.

    The following section on rehabilitation provides a general approach, giving advice on sport specific rehabilitation programmes, upper and lower limb rehabilitation, strength training and evaluation, and proprioception. Some parts of this section are excellent, with detailed practical advice and evidence based research included, particularly in the upper limb rehabilitation and strength evaluation chapters. However, others are a little basic with insufficient detail and evidence given from research literature. This could be improved by lengthening this section, with more practically orientated information provided.

    The final section on sport specific conditions gives a good account of injury type and incidence in a wide variety of sports, including data on some that often receive little attention in the research literature such as cheerleading. It does not, however, include other popular sports played by females around the world such as rugby, netball, and handball. The omission of a chapter on rugby is surprising, as the USA are former world champions in this sport!

    Of course not every book will please every reader all the time, and this book is no exception. However, it does, and very successfully, attempt to cover a huge area in dealing with many aspects of care of both the recreational and the professional athlete. Overall, this book makes practical and enjoyable reading and it should be on the shelf of all those managing athletes. Obviously it is impossible to include everything that each reader wants to see, but I want to commend the authors and contributors for their hard work in providing this wide reference base on the female athlete. Such a work is long overdue.

    Evidence basis15/20