Multidimensional evidence map of sport science and medicine research in highly trained, elite and world-class female athletes: a scoping review

OBJECTIVE: Conduct a comprehensive scoping review of sport science and medicine (SSM) research in highly trained, elite and world-class female athletes. DESIGN: Scoping review. DATA SOURCES: PubMed (MEDLINE, EBSCOhost), Scopus, SPORTDiscus (EBSCOhost), Web of Science and base-search (grey literature). ELIGIBILITY: Peer-reviewed and grey literature informing the health and performance of highly trained, elite and/or world-class female athletes (>16 years of age), with mixed-group studies retained when data were reported separately. Sports that require physical exertion or highly skilled movements were included. The search was restricted to English with no date limits. RESULTS: 3,867 (1970-2025) records including 3,250 (84%) original studies reporting 4,374,571 participants [31% female (n=1,368,170)] were reviewed. 3,221 (99%) studies included athletes [world class, n=433 (13%); elite, n=1,873 (58%); highly trained, n=1,302 (40%)] across 102 different sport disciplines from 74 different countries. 135 (4%) studies included athletes with disabilities, 58 (2%) retired and 37 (1%) masters athletes. Physiology (n=1,059 studies, 33%), performance analysis (n=947, 29%) and injury (n=820, 25%) were the most common SSM general themes; equipment (n=84, 3%), law (n=17, 1%) and business (n=8, 0%) were least common. Health-related SSM themes included musculoskeletal (n=364, 22%), mental (n=243, 15%) and cardiovascular (n=183, 11%) health; pelvic floor (n=26, 2%), breast health (n=11, 1%) and (peri-)menopause (n=2, 0%) were least common. CONCLUSION: Research in high-performing female athletes is increasing, however persistent gaps remain in participant representation, geographical coverage and health-related themes. Targeted, co-created and multidisciplinary research approaches are needed to improve equity, relevance and impact in female athlete health and performance.