Innovative Hospital: Stanford Medicine Children's Health

Clinical research can take a long time to directly affect the lives of those who benefit from it. For female athletes, there’s so much to learn about the way their bodies change as they age. It’s a subject that fascinates Emily Kraus, MD, a clinical assistant professor at Stanford Children’s Orthopedic and Sports Medicine Center. Dr. Kraus directs Stanford’s Female Athlete Science and Translational Research program, aka FASTR—a name she came up with, fittingly, while running. 

FASTR is a key part of a larger group of sports medicine research initiatives that are now engaging an international network of clinicians and researchers. Working in concert with the Female Athlete Program at Boston Children’s Hospital, FASTR focuses on women in sport and examines the way that they transition through different physical stages, starting in adolescence and continuing all the way through menopause. 

For Dr. Kraus, the topic hits close to home. An avid runner, she has completed at least nine marathons and one ultramarathon. She knows that there are times during which the body becomes more vulnerable to injury. In her sports medicine practice, she often sees female athletes who’ve been hurt, and many are unaware that the menstrual cycle plays a role in hormone balance, or that missing a period can affect bone health.

As she drew connections, she felt compelled to do more. “I felt this passion and drive to better understand and really help my patients by doing the research,” said Dr. Kraus.

Today, the FASTR program conducts its own studies into female athletes’ health and performance, and translates and publicizes those findings so that a wider audience can make use of them. To communicate the science effectively, the research team breaks down their findings on the FASTR website and throughout its social media postings.

Minding the Gap

When it comes to the science of sports, people assigned female at birth are typically underrepresented in research studies. There aren’t many that investigate the menstrual cycle or exercise physiology in female athletes, in part because—as Dr. Kraus has pointed out—it can be challenging to standardize studies when women have differing hormonal profiles or are undergoing hormonal shifts. But things have changed over the last five years, as interest in studying female athletes has grown. That has led to the funding of programs like FASTR.

“It’s been an exciting process,” said Dr. Kraus. 

Spreading the Word

To speak directly to female athletes, the FASTR team created five short videos that cover relevant subjects such as body image, self-compassion, and how to be a lifelong athlete. The videos also delve into the Female Athlete Triad—the relationship between menstrual function, bone mineral density, and energy availability from food intake, all of which impacts bone mass and the risk for stress fractures and osteoporosis. Each video contains a scientific overview and stories from female professional athletes.

To ensure that the videos have the desired effect, FASTR conducted a pilot study with female high school runners, asking them whether watching the pieces made them feel more knowledgeable about their bodies and their abilities. The young participants agreed that they did; as one student athlete said, “I liked that it was science-y but explained in a way I could understand without having a science background.”

That was what the FASTR team had hoped. “We really wanted to have these athletes be able to relate to the content and feel like it wasn't just another lecture… that there was almost this personal level and a story beyond just the science,” said Dr. Kraus.

Researchers ran a second study after the pilot, recruiting more participants from high school. This time, half of the group watched the videos while the other half read written handouts on the same subjects. When the two groups were compared, both of them demonstrated increased knowledge about the topics, but “there was this additional impact of the videos that wasn’t present with just the other content,” said Dr. Kraus.

The videos have been a hit with other audiences, too. Dr. Kraus likes to use them to educate her sports medicine patients. She values FASTR’s unique ability to meld research with clinical practice and make progress in both areas at the same time. “We’re actually having a direct impact right away as opposed to in 5-10 years,” she enthused.

Fact checked by Melinda Dodd.