Addressing a Critical Gap in Sports Medicine
Women athletes often face challenges that differ markedly from their male counterparts, yet most sports medicine protocols are built around male physiology. Menstrual health, hormonal fluctuations, injury risks related to bone density, and birth control management are among areas historically overlooked or poorly understood in athletic programs. The limited funding allocated to female-specific research exacerbates these issues, leaving coaches and trainers inadequately equipped to address them.
Research indicates that female athletes are nearly twice as likely as male athletes to experience delayed diagnosis and treatment of injuries, often due to gendered gaps in healthcare knowledge and research. A 2022 survey published in Sports Medicine found that only 18% of sports medicine research specifically addressed women’s health issues, underscoring the systemic neglect and the need for more targeted studies to improve care outcomes for female athletes.
In response, UW’s Global Center for the Integrated Health of Women, Adolescents, and Children (WACh) has integrated research and practice to bridge these gaps. One of the center’s Managing Directors emphasizes the importance of translating research into tangible care improvements. “Our mission is to develop personalized healthcare solutions that recognize and respect the unique physiological and emotional needs of women in sports,” she explains. “This is a step toward gender equity in athletic health management.”
Pioneering Programs and Personal Narratives
UW’s approach combines scientific research with personalized, athlete-centered care. A key component has been fostering open communication about menstrual health and reproductive cycles among female athletes, coaches, and medical staff. Instead of relying solely on wearable technology, athletes regularly inform their trainers and coaches about their cycle stages, which are discussed as openly as muscle soreness or injury updates. This ongoing dialogue enables training and recovery plans to be adjusted accordingly, thereby reducing injury risks such as stress fractures and overtraining.
Riley Newman, a sprinter on UW’s track team, exemplifies the profound impact of these initiatives. A few years ago, Riley endured two stress fractures that sidelined her from competition for months. The recovery process was grueling, marked by physical pain and emotional frustration. But thanks to the university’s holistic support—focused on her physical health, nutrition, mental well-being, and open discussions about her menstrual cycle—she was able to return to the track stronger than before.
“Initially, I felt overlooked,” Riley recalls. “They didn’t realize how hormonal imbalances or stress contributed to my injuries. But once I started openly sharing my cycle and the coaches and medical staff began paying attention to my entire health picture, I saw a real difference.”
Her recovery wasn’t just physical; she noted improved mental resilience after working with sports psychologists and healthcare providers trained explicitly in women’s health issues. “It was empowering to have an advocate who understood what I was going through. That support made all the difference in my return,” Riley adds.
Her experience highlights the importance of a comprehensive approach—combining physical therapy, psychological support, and reproductive health education—to promote athlete well-being and enhance performance.
Improving Knowledge and Awareness: Addressing Systemic Gaps
One of the central lessons from UW’s initiatives is that systemic change requires more than just new programs; it requires widespread education. Many coaches, trainers, and medical staff lack sufficient training on women's health, leading to misdiagnosis or overlooked symptoms.
WACh staff members emphasize that fostering awareness at all levels is critical. “We’re developing training modules for coaches and medical staff that focus on gender-specific health concerns,” states the center’s managing director. “Understanding menstrual cycles, hormonal impacts, and emotional health are crucial components of effective care.”
This focus on education aligns with broader shifts in sports culture, as teams increasingly recognize that supporting female athletes involves addressing not only physical care but also mental health, emotional well-being, and social needs. Creating an environment where conversations about women’s health are normalized and mental health issues are openly addressed is part of this movement toward holistic support.
Limitations
While UW’s efforts in women’s sports healthcare are impressive and innovative, challenges persist regarding scalability and consistency. Unlike UW’s well-established research centers and comprehensive programs, Washington State University (WSU) has only recently initiated pilot initiatives, such as menstrual health tracking, and lacks the extensive infrastructure to implement widespread change. Both universities face difficulties in ensuring all coaches and staff are adequately trained, particularly across different teams and sports. Additionally, addressing socioeconomic and cultural disparities remains an ongoing challenge. Recognizing these limitations highlights the need for sustained funding, broader collaboration, and ongoing education to ensure that advances in women’s athlete healthcare are equitable and widespread.
Policy and Community Support as Catalysts
Legislative support has also played a crucial role in advancing these efforts. In January 2025, Washington state approved new legislation aimed at improving access to reproductive health services for student-athletes. The bill allocates grants for university health centers to develop and expand gender-specific programs and research.
Senator Senait Brown, a key supporter of the bill, affirms its significance: “This legislation ensures that every woman athlete, regardless of background or socioeconomic status, has access to the support she needs. It’s about creating a fairer, more equitable system that recognizes and addresses the unique health needs of women in sports, paving the way for lasting systemic change.”
Looking Ahead
The 2025 legislative bill in Washington state, coupled with the university’s emphasis on open communication and comprehensive education for coaches and trainers, signals a meaningful shift toward bridging the gender gap in athletic healthcare support. By prioritizing transparent dialogue among athletes, medical professionals, and coaching staff, UW is fostering an environment where the unique health needs of female athletes are acknowledged and addressed proactively. Investing in the education of coaches and trainers through expert-led training and research ensures that care is grounded in scientific understanding and best practices. Together, these efforts are empowering female athletes to not only compete at their highest levels but also
to thrive in a supportive, equitable environment. As this model continues to evolve, it offers a promising blueprint for other institutions seeking to create lasting change in women’s athletic health support.
Moa Segerholt is a student at the University of Washington. She was one of the students in the "Media Responsibility in a Diverse Society" class, taught by Hugo Balta.
Balta is the executive editor of the Fulcrum and the director of NextGen initiatives. He is also the publisher of the Latino News Network and an accredited Solutions Journalism and Complicating the Narratives trainer with the Solutions Journalism Network.
The Fulcrum is committed to nurturing the next generation of journalists. Learn more by clicking HERE.
From top left to right and then clockwise: Lluvia Chavez, Roselyn Gonzalez, Layla Halilbasic, Nathaly Suquinagua, Jared Tuckerthefulcrum.us
In the next and final part of the special report, she investigates the many approaches that the city's local government can take to mitigate urban flooding for its residents, including green alleys.
Basements filled with murky storm and sewer water, or back alleys riddled with standing water. These are some of the images that Berwyn’s urban flooding problem evokes for residents who needto deal with it. What is local government doing to help residents protect their homes from rising waters? And how can residents take control to mitigate damage from excess runoff and sewer backups?
As made clear by the 2018 Stormwater Plan, there are many approaches Berwyn’s local government can take to mitigate urban flooding for its residents. One of the effective ones has been green alleys. As opposed to regular alleys, green alleys are built with sustainable materials, such as pervious pavements. Green alleys allow for better stormwater drainage, as standing water is more likely to sink into the permeable ground rather than drain into someone’s basement.
The left is a photo of a green alley located at the 3700 block of Cuyler after heavy rain. The right is a photo of a normal alley at the 3700 block of Lombard after the same rainfall. Credit: Joshua Bowman
While green alleys can improve standing water in Berwyn, and this is something local government is looking to continually implement, they’re expensive and time-consuming to construct.
“Berwyn has 655 alleys,” said Robert Schiller, Berwyn’s Director of Public Works. “Not all of them will qualify for a green alley.”
This is because a green alley can only be implemented somewhere with permeable soil that will allow for water absorption, and it’s up to Schiller and his team to test that. Soil testing isn’t the only hurdle to implementing more green alleys.
“The cost for a green alley is about $360,000, and that's one 600-foot alley. So, yeah, it's a very long and slow process going through and applying. You apply for a grant, you get maybe a million dollars or a million three or something to that effect. Then we have our match. So we might get four, maybe five alleys done,” said Schiller, “To have the funding to be able to go through and do all that you need to do would be great, but it's unrealistic to expect to get, you know, $70, $80, $90 million, $100 million for a community of 57,000 to install green alleys.”
This doesn’t mean green alleys are a dead end; members of local government, such as Alderman-elect Joshua Bowman, are looking to find ways to overcome these challenges, and of course, the MWRD will still work in collaboration with Berwyn to provide funding for these types of projects.
“We consistently and are constantly applying for grant funding for various types of stormwater mitigation,” Schiller confirms.
In the meantime, local government has given agency to the individual homeowner to mitigate flooding in their homes with the Residential Flood Mitigation Shared Cost Program. This program provides a grant to homeowners who wish to install a flood control system - this can come in several forms, such as a backflow prevention device or check valve. The program is designed to reimburse the costs of installation with a city grant that covers up to $3,500.
However, these flood control systems are often much more expensive than a few thousand dollars to install.
“There's a lot of concern from people that the overall cost is going to be so high that even with the offsetting grant that they can't absorb the cost,” said South Berwyn resident Karin Nangreave.
Micah Caldwell, Berwyn resident and 1st Ward Alderman, said he spent around $15,000 to install an overhead sewer system, one of the options for homeowners who take advantage of the program.
However, now may be the best time to take advantage of the Shared Cost Program, as the American Rescue Plan has recently dedicated $500,000 to subsidize the program.
This means that, through the Shared Cost Program, a resident can receive an upfront grant of $4,000 to install a flood mitigation device.
“If it’s a backflow prevention device with a sump pump, electric discharge bypass pump, they would get $4,000 credit through the ARPA funds from the grant. And then after that, you take the balance of what’s owed and you get 50% of that up to $3,500 from the city,” said Schiller.
However, city officials understand that, despite these extra funds incentivizing the program, the Flood Mitigation Shared Cost Program may still be too expensive for residents to pursue.
So, where is the middle ground? Something cost-effective and sustainable in the long term.
“Trees are the simplest solution, and the cheapest,” said Alicia Ruiz, former 6th Ward Alderman and Aldermanic Co-Chair of the Department of Public Works.
Specifically, the focus is on planting more native species around Berwyn to help mitigate flooding. Even the Environmental Protection Agency (EPA) suggests trees and native species as a viable method to reduce runoff (while also removing harmful pollutants in water at the same time).
This figure shows how an urban tree absorbs water and can impact flooding and water quality. Source: https://host10.viethwebhosting.com/~cwsp/docs/Urban_Tree_Canopy_EP_Report_WQGIT_approved_final.pdf
As per the U.S. Forest Service’s guidance, there are four main ways in which increased canopy can reduce runoff:
“1) Through evapotranspiration, trees draw moisture from the soil ground surface, thereby increasing soil water storage potential. 2) Leaves, branch surfaces, and trunk bark intercept and store rainfall, thereby reducing runoff volumes and delaying the onset of peak flows. 3) Root growth and decomposition increase the capacity and rate of soil infiltration by rainfall and reduce overland flow. 4) Tree canopies reduce soil erosion by diminishing the impact of raindrops on barren surfaces.”
In short, native plants have very deep root systems that permeate the ground and can better absorb rainwater. There are several other benefits to planting native species, including improving air quality, mitigating erosion, and preserving local ecosystems, among others.
In fact, Berwyn resident and founder of Spoke Pockette Farm, Julia Klee, has witnessed the benefits of native species firsthand. Klee noticed a pattern of excess water built up in a cement alley that sits between her and her neighbor’s house.
“When we got a really bad rain,” Klee said, “It almost went into my neighbor’s window.”
In reaction, Klee built a pocket forest in her yard. A pocket forest is a densely planted collection of trees and shrubs; they have a host of benefits, including carbon sequestering and runoff reduction. As it exists now, Klee has around 25 native trees in her forest.
“That's keeping water out of the alley. Anytime it rains and floods, there's zero flooding right there.”
Klee now manages her business, Spoke Pockette Farm, and helps her neighbors and clients plant gardens with more native species.
“I want to make sure this is accessible for people,” said Klee. “The cost of labor and just the work of doing the install is prohibitive for a lot of people right now.”
Julia Klee: Working With Space
Julia Klee: Working With Spaceopen.spotify.com
Affordability is key to successful mitigation plans for urban flooding, especially in areas where green infrastructure is often sacrificed to reduce funding burdens. The Berwyn Tree Canopy Initiative recognizes this and has been encouraging residents to take advantage of Berwyn’s free tree-planting program.
“What we’re trying to do is get the city to plant more trees as part of a flood mitigation strategy,” said McKinley of the BTCI. “They [the city] already have a free tree planting program, but it relies on resident requests, and it’s not advertised terribly well.”
McKinley believes that the City of Berwyn should be more proactive in their native species planting mission, especially where it concerns city-owned land and new construction projects.
In fact, in August 2024, the City of Berwyn and the Township of Berwyn signed an intergovernmental agreement that allocated $75,000 toward the Tree Canopy Restoration Program.
“Should the Program not commence by or before March 31, 2025, the parties (and each of them) shall have the option to immediately terminate this Agreement and withdraw from the Program and this Agreement.”
Robert Schiller clarified that, although the City has yet to receive the $75,000 to begin planting, the agreement remains intact. We reached out to the mayor’s office for comment on numerous occasions, but the only response to date refers [publication] to its flood information page online. Inaction to increase canopy coverage in Berwyn is potentially due to a lack of desire for more trees.
“There is a high percentage of residents in the community that are anti-tree,” said former 6th Ward Alderman Alicia Ruiz.
Schiller attributes some of the anti-tree sentiment to the fear of the large and deep roots that native plants grow. The fear residents maintain, Schiller said, is that these root systems will grow down to the sewer systems looking for a water source, and cause damage to the pipes - an expensive repair.
“Whether they’re on their property, the city’s property, the neighbor’s property, the tree roots will eventually get to those lines. And for those reasons are why some of these people say no, they don’t want a tree in their front yard, in their parkway, any of that.”
These fears are not completely unrealistic. CMAP’s Climate Resilience Program Lead said damage from large root systems happens and is potentially expensive to fix.
“Yeah, there could be some negative tradeoffs. But I think on the whole, trees can reduce flooding to a degree,” said Evasic.
While trees may not prevent major flood disasters such as the one in July 2023, experts agree that their benefits likely outweigh the maintenance costs. Decades-old studies have consistently shown that increasing tree canopy reduces runoff after a storm. A 2014 study conducted in Wilmington, North Carolina, found an 80% reduction in runoff using trees in combination with Silva Cell (a stormwater management deep root system). A similar study in Manchester, UK, found a 58% reduction in runoff during the summer and a 62% reduction in the winter.
The EPA completed 17 studies showing how trees (on a large scale) greatly reduced financial and physical burdens on America’s stormwater systems.
In its report, the EPA cited Minneapolis, Minnesota, as one of its case studies. In 2010, Minneapolis committed to planting 173 trees using a structural cell model, resulting in a 10% reduction in peak flows to the city’s stormwater management system. To this day, Minnesota continues to utilize this model in its construction efforts to support stormwater control and management.
While long-term investments in green-based solutions are largely reliant on local government initiatives, requesting a tree in Berwyn is a small step individuals can take to begin mitigating the risk of floods, especially as the rainy season approaches. This, in tandem with other measures such as disconnecting downspouts and investing in a rain barrel, may hopefully keep Berwyn residents a little safer (and drier) from urban flood and stormwater.
Editor’s Note: This story is made possible through the Berwyn Collaborative: Understanding Community Needs, led by News Ambassadors in collaboration with local news outlets, including Illinois Latino News, click HERE.
Britton Struthers-Lugo is a reporter with the Medill News Service at Northwestern University, a freelance journalist, and a photographer.
The Fulcrum is committed to nurturing the next generation of journalists. To learn about the many NextGen initiatives we are leading, click HERE.
