Female trail running: a systematic scoping review

Trail running's popularity among women is increasing, yet research addressing the unique physiological demands, performance factors, and injury patterns in this population remains limited. This scoping systematic review aimed to map the existing research landscape on female trail runners; synthesize current evidence across physiological, nutritional, injury, and performance domains; and identify critical knowledge gaps to guide future investigations. A systematic search was conducted across four major databases (EBSCO, PubMed, Scopus, Web of Science) up to December 2024. Eligible studies were original peer-reviewed articles reporting sex-specific data on female trail runners within the above domains. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results from the 22 included studies (pooled sample ≈ 2,476 participants), predominantly published in the last decade, primarily focused on physiology and biomarkers (10 studies) and nutrition and body composition (6 studies), with fewer investigations into injuries (4 studies) or performance (3 studies). These studies indicated significant exercise-induced physiological stress and highlighted links between nutrition, body composition, and performance outcomes. However, a recurring limitation was the pervasive inconsistency in reporting participant characteristics, especially evident for key female-specific factors such as menstrual cycle status and hormonal contraceptive use, which were sparsely detailed. Furthermore, considerable heterogeneity in methodologies and the poor reporting of race characteristics and environmental conditions limited the synthesis of actionable insights. Most included studies (21 out of 22) demonstrated good methodological quality. In conclusion, while the research on female trail runners is growing, its practical application and the ability to draw robust conclusions are constrained by widespread reporting inconsistencies and a notable lack of depth in female-specific physiological data. Further progress in this field relies on the adoption of standardized reporting guidelines and a concerted effort to conduct robust, longitudinal investigations. Future studies should address hormonal influences, energy availability, effective training methodologies, and targeted injury prevention strategies tailored to female trail runners, ultimately to optimize their health, well-being, and athletic potential.