1. Exercise-based interventions reduce sport-related injuries 

Some of the most compelling evidence for injury prevention lies in exercise-based interventions. 

This is supported by the recent International Olympic Committee consensus statement Female, woman and/or girl Athlete Injury pRevention (FAIR) (Crossley et al 2025a). 

Exercise-based interventions such as neuromuscular training (eg, strength, stability and movement control and sportspecific exercises) should be completed for at least 10 minutes twice a week and be sport-specific. 

Evidence suggests that exercise-based programs can reduce the risk of first-time and recurrent knee and ankle injuries by up to 40–60 per cent (Bullock et al 2025). 

Exercise-based programs can also prevent shoulder injuries in overhead sports (Heming et al 2025). 

While there is limited evidence for exercise-based programs to reduce the risk of concussion in female athletes, Shill et al (2025) noted that neuromuscular training can reduce concussion risk in male youth rugby. 

Contact training skill development (eg, tackling and body checking) is an emerging intervention that could prevent concussion in contact and/or collision sports (Crossley et al 2025a, Patterson et al 2025). 

2. Implementation is critical for injury prevention 

Knowing what injury prevention interventions to offer female, woman and girl athletes is only part of the solution. 

Evidence-based interventions are poorly implemented outside of research trial settings—estimated at <15 per cent. 

The FAIR consensus provided 14 practical recommendations to guide health and exercise professionals on how to implement injury prevention interventions (Crossley et al 2025a). 

Physiotherapists have the knowledge and skills to implement education and/or workshops, which can drive behaviour change through building coach and athlete motivation and confidence (Patterson et al 2025). 

Education can be delivered online or in person, typically during preseason, with in-season support as feasible and appropriate. 

Tailoring may be important to optimise implementation. 

Physiotherapists should consider the unique needs and preferences of the group they are working with, taking into account sex and gender, age group, competition level and type of sport. 

Injury prevention is holistic and encompasses more than just exercise. 

There are 20 recommendations for prevention interventions. 

The FAIR consensus strongly supported mandating all types of evidence-based injury prevention interventions, from training and coaching to personal protective equipment (eg, mouthguards) and injury management (eg, concussion recognition and return-toplay policies). 

Physiotherapists have a role to play in reinforcing these holistic injury prevention interventions and influencing day-to-day practice. 

3. Injury prevention requires a supportive environment 

Female, woman and girl athletes thrive when they are surrounded by people who understand their specific needs, experiences and contexts in sporting environments. 

The FAIR consensus provided 10 practical recommendations for creating supportive injury prevention environments (Crossley et al 2025a). 

Safe spaces must be created that are free from body-shaming, the promotion of ‘ideal’ body shapes and gendered expectations that can negatively influence athlete wellbeing and participation. 

Sporting organisations need to foster environments where athletes feel supported to discuss any aspect of their health without judgement, including pregnancy, bone health, breastfeeding, postpartum health and the menstrual cycle. 

Athletes must also feel comfortable reporting injuries without fear or pressure to return prematurely or to play through pain. 

Sporting organisations must establish and enforce policies and procedures that provide safe, accessible avenues for athletes to report concerns. 

Sporting organisations should actively raise awareness of social and cultural biases that influence athlete experiences and develop clear policies to address them. 

Building environments that prioritise respect and open communication is essential—not only for preventing injuries but for enabling athletes to participate, perform and thrive. 

All individuals involved with the sporting system who influence day-to-day practice can help to foster such environments, from athletes to coaches, umpires, support staff, parents and sports administrators. 

4. Starting early encourages lifelong injury-prevention behaviours 

Injury prevention should be introduced to athletes at a young age to promote lifelong injury-prevention behaviours (Crossley et al 2025a). 

For example, junior athletes adopting neuromuscular training programs early in life may make them more likely to maintain and build on these habits as they progress through sport. 

However, current exercise-based interventions may need tailoring to suit the needs of younger athletes and their support teams. 

Junior athletes may have different time constraints, injury profiles and preferences (eg, for more fun or engaging activities). 

Consideration of early sport specialisation and load management in combination with exercise programs may also be critical to prevent overuse injuries (Crossley et al 2025a) in the lower limb (Whittaker et al 2025a), upper limb (Heming et al 2025) and spine/trunk/ pelvis (Whittaker et al 2025b). 

Knowledge, beliefs and skills of parents, teachers and coaches, along with sporting club culture, will also shape injury prevention uptake. 

Other factors may need to be considered when implementing an injury prevention program, including sex and gender, ability, ethnicity, culture, religion, healthcare access and the training and competition environment. 

This is why co-creating injury prevention interventions and implementation strategies with the end users (athletes and coaches) is critical to maximising uptake. 

For example, junior athletes training once a week for one hour are unlikely to implement a structured intraining 20-minute neuromuscular training program. 

Physiotherapists could provide coaches and athletes with appropriate modifications or time-saving tips (eg, replacing current cool-down stretching with strength training) while maintaining the core components of the evidence-based intervention. 

5. Sex and gender should be considered in injury prevention interventions 

Health professionals working with female, woman and girl athletes should apply injury prevention interventions that reflect the realities of their sport and consider their unique needs. 

This includes understanding the sex- and genderrelated factors (Crossley et al 2025b) and tailoring interventions as appropriate. 

Sex-related physiological factors such as menstrual cycle changes, pregnancy, postpartum recovery, breast and pelvic health, and life-stage transitions may influence an athlete’s injury risk profile or how they respond to or participate in an intervention. 

For example, for those who are breastfeeding, high-impact contact activities risk causing damage to ducts and may not be appropriate or comfortable for these athletes. 

Gender-related factors relate more to athletic environments and how they may influence the ability to implement best practice injury prevention interventions. 

For example, women’s sporting environments typically have fewer and less experienced support staff and less resources. 

Coaches are predominantly men, and athletes may be participating in traditionally maledominated sporting clubs. 

Sporting organisations should recruit and develop female support staff to strengthen gender equity, share available resources equally and provide training and education for male support staff so they can understand sex- and gender-related factors. 

Preferred uniforms, surveillance systems with female/ woman/girl-specific health codes and creating environments that are free of bodyshaming, the promotion of ideal body types or gendered norms are some examples that should be front of mind. 

>> Dr Brooke Patterson APAM is a physiotherapist and a senior research fellow at the La Trobe Sport and Exercise Medicine Research Centre, La Trobe University. Brooke is a member of the APA Sports and Exercise national group. 

>> Professor Kay Crossley FACP is an APA Honoured Member and the director of the La Trobe Sport and Exercise Medicine Research Centre. Kay is a Specialist Research Physiotherapist (as awarded by the Australian College of Physiotherapists in 2025). She is a member of the Sports and Exercise group. Melissa Haberfield APAM is a physiotherapist and a PhD candidate at La Trobe University. 

>> Melissa is a research officer at the La Trobe Sport and Exercise Medicine Research Centre. She is a member of the Sports and Exercise group. 

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