Staying current matters as much as starting strong
Girls' athletic programs that build a prevention culture often do the hard work of launching a warm-up protocol or hiring an athletic trainer — and then treat that as "done." But sports medicine is an evolving field, and several recent developments deserve a place on every program's radar. This update complements our deeper dives into female athlete biomechanics and our research roundup by focusing specifically on emerging clinical and policy developments.
Update 1: Broader recognition of RED-S beyond endurance sports
Relative Energy Deficiency in Sport (RED-S) was historically discussed mainly in the context of endurance sports like distance running. More recent sports medicine literature emphasizes that RED-S risk extends to a much broader range of sports, including team sports like soccer, basketball, and volleyball — any setting where high training volume intersects with inadequate energy intake, whether intentional or not.
What the evidence says
The IOC's consensus statements on RED-S have progressively broadened their scope, urging clinicians and coaches across all sports — not just leanness-focused endurance disciplines — to screen for signs of low energy availability in adolescent athletes.
What programs should do: Include basic RED-S education in preseason parent and athlete meetings, not just for cross-country or gymnastics teams.
Update 2: Menstrual health as a vital sign
There is growing consensus among sports medicine practitioners that menstrual cycle history should be treated as a standard vital sign in adolescent female athlete health assessments — comparable to tracking growth or blood pressure. Irregular or absent periods can be an early indicator of RED-S, overtraining, or other health concerns, and normalized "athletes just don't get periods" attitudes are increasingly discouraged in clinical guidance.
Practice tip
Encourage athletes to track their menstrual cycles using a simple app or journal, and make clear that irregularities are worth discussing with a healthcare provider, not something to dismiss as a normal side effect of being an athlete.
Update 3: Concussion protocols continue to evolve for female athletes
Emerging research suggests that female athletes may experience concussions at different rates and with somewhat different symptom profiles than male athletes in comparable sports, though the underlying mechanisms are still being studied. Updated return-to-learn and return-to-play protocols increasingly emphasize individualized, symptom-guided progression rather than fixed timelines.
What programs should do: Ensure concussion protocols are current with the latest consensus guidance (e.g., the Concussion in Sport Group statements) and are applied consistently across boys' and girls' teams, avoiding assumptions based on outdated stereotypes about symptom reporting.
Update 4: ACL reconstruction graft and rehab guidance updates
Sports medicine surgeons and physical therapists continue to refine guidance on graft selection and rehabilitation timelines following ACL reconstruction in skeletally immature and adolescent athletes. Current guidance generally favors:
- Physeal-sparing surgical techniques for athletes with significant growth remaining
- Criteria-based (rather than purely time-based) return-to-sport progression
- Incorporation of psychological readiness measures, as discussed in our research roundup
| Consideration | Older approach | Current guidance direction |
|---|---|---|
| Return-to-sport timing | Fixed at 6 months | Criteria-based, often longer |
| Graft choice for young athletes | Standardized across ages | Physeal status considered |
| Readiness assessment | Strength/ROM only | Add psychological readiness tools |
| Post-op prevention training | Optional | Increasingly standard of care |
Update 5: Policy movement on access to athletic trainers
A number of states and school associations have advanced policy proposals requiring or incentivizing access to certified athletic trainers at the high school level, recognizing their role in both injury prevention and early identification of conditions like RED-S and concussion. Access remains uneven, particularly in under-resourced and rural schools.
Caution
Programs without on-site athletic training coverage should not assume "no injuries reported" means "no injuries occurring." Under-resourced settings often have under-reporting, not under-incidence, of injury.
What programs should do: Advocate at the district or state level for athletic training access, using data from organizations tracking these policy gaps. G-MIP's get involved page includes advocacy resources for parents and coaches.
Bringing it into your program
None of these updates require overhauling an existing prevention program from scratch. Most can be integrated incrementally:
- Add a RED-S and menstrual health segment to your next parent meeting
- Review your concussion protocol against the most recent consensus statement
- Confirm your athletic training or sports medicine partner is following current ACL rehab guidance
- Identify one advocacy action your program can take this year regarding athletic trainer access
Note
If your school doesn't yet have a structured prevention program, our programs page is the best starting point, and our coach education playbook will help you build lasting adoption once you do.
The bigger picture: why staying current is a form of prevention
Injury prevention is often framed narrowly as exercises performed before practice. But staying current on evolving clinical guidance — concussion protocols, RED-S screening, ACL rehab standards, and policy advocacy — is itself a form of prevention, addressing risks that a warm-up routine alone cannot. Programs that build a habit of periodically reviewing updates like these, alongside their physical training protocols, tend to catch emerging issues earlier and adapt more quickly as evidence improves.
Our editorial team monitors these developments continuously and shares updates through the blog and at our community events. We also welcome input from coaches, parents, and clinicians encountering new guidance in their own practice — reach out to share what you're seeing in your community.
Building relationships with local sports medicine providers
Many of the updates described above are best implemented in partnership with local sports medicine clinics, physical therapists, and physicians who specialize in adolescent athletes. Programs that establish a standing relationship with a local provider — even informally, through a single point of contact — tend to identify and respond to emerging concerns, from RED-S symptoms to concussion recovery questions, more quickly than programs relying solely on general practitioners unfamiliar with sport-specific guidance.
A brief word on health equity
Access to the specialized care described in these updates is not evenly distributed. Families in under-resourced communities may have limited access to sports medicine specialists, athletic trainers, or even basic preventive education. Addressing this gap is part of G-MIP's broader mission, described on our about and problem pages, and is one of the reasons we prioritize free, publicly available educational resources rather than paywalled content.
Conclusion
Sports medicine guidance for adolescent female athletes continues to evolve across energy availability, menstrual health, concussion care, ACL rehabilitation, and policy access to athletic trainers. Programs that build small, regular habits of reviewing and integrating these updates — rather than treating prevention as a "set it and forget it" initiative — are best positioned to protect their athletes as the evidence continues to develop.
References
- Mountjoy, M., et al. "IOC consensus statement on relative energy deficiency in sport (RED-S)." British Journal of Sports Medicine.
- Concussion in Sport Group. "Amsterdam Consensus Statement on Concussion in Sport."
- AAP Council on Sports Medicine and Fitness. "Anterior Cruciate Ligament Injuries in Youth Athletes."
- National Athletic Trainers' Association (NATA) position and policy statements on athletic trainer access.