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Female Athletes: Three Metrics To Start Tracking in 2023

I’ll confess: I’m partly writing this blog to give myself a kick in the pants. 2022 was the year where I was going to be on top of all of my doctor appointments, markers of health, and to really take the little things seriously.

Don’t get me wrong, I was successful in many areas - however there are definitely some appointments and metrics that fell through the cracks. So, just like everyone else, I’m vowing to make 2023 a better year from a health perspective. Given my personal health history there are some actions I will take that pertain to my specific situation (as you should, too!), but let’s discuss three ways to take agency of your own health next year.

1. Blood Work

As athletes, we really stress our bodies, much more than the typical adult working a full-time job. Heck, sometimes training is a full time job in and of itself! For the highly competitive athlete, checking key biomarkers every three months can go a long way in detecting health issues before they occur. Insight to an athlete’s iron lab values, thyroid function, hormones, and blood cell counts can help us detect low energy availability (LEA), illness, and overall stress levels that will impact bodily function (and as a result, training!). Quarterly testing will also help to pick up trends that occur over the course of the year: during a training cycle, rest periods, life changes, diet changes, etc. Having a trusted physician and/or sports dietician can help you interpret the data and course correct if needed. It’s important to remember that “optimal” for certain lab values are different in athletes than less intensely active individuals, so working with someone who is familiar with athletes is key.

2. Menstrual Cycle

My favorite update that the Garmin app added in the past few years has been a calendar to help track the menstrual cycle. I like it because it’s right there along with all of my training information, and it’s easy to cross reference if things seem awry. A normal menstrual cycle length is 21-40 days, with the average for women (from the data that we are able to collect) is 28 days. Increasingly shorter or longer cycles can indicate hormonal imbalances or changes occurring in the body, some of which may need to be monitored by your gynecologist. Therefore, if you consistently track your cycle you can pick up on these changes, which may indicate overtraining, insufficient recovery, underfueling, or some combination thereof. There are other apps out there as well - Clue, Flo, Cycles, Fitrwoman, etc., many of which are more detailed and sophisticated than Garmin, with improved systems to track symptoms. Making note of the symptoms that occur along with different phases of the cycle and their effect on your training can help make sense of why sometimes you feel amazing in workouts and other times you feel like you’re moving in slow-mo. More than anything, I think doing this helps you to be more gentle on yourself if a workout doesn’t go as well as you want it to.

3. Heart Rate Variability/Heart Rate

Heart Rate Variability (HRV) is the time between each heartbeat, and is a metric that is being increasingly used by wearables such as Whoop, the Oura ring, Apple Watch, or Garmin watches. To simplify it, this value gives us an indication of the state of the nervous system, and therefore our recovery from training. Devices that measure this will give you the data in the form of a “recovery score”, “body battery”, or the raw number with an indication of HRV status. Changes in HRV can indicate fatigue, stress, or illness, and can point to increased injury risk, not to mention poor adaptation to training. The accuracy of this data is still hotly debated and studied, however it is still a useful tool to correlate with how you feel subjectively as you make your training decisions. As aforementioned not every device has the capability to measure HRV, but there are apps such as HRV 4 Training that can measure it using the camera lens on your phone. My only issue with using the app instead of a device was that I would forget to measure it first thing in the morning. Another option to check the “pulse” (pun intended” of your nervous system is to look at heart rate trends, both at rest and during activity. A higher resting heart rate or higher heart rate at lower exercise intensities can suggest that more recovery is needed or that an illness is developing.

Wishing you a happy, healthy, and fulfilling 2023! Take care of your body, and it will take care of you.

Keep going, you got this!

Dr. Kacy Seynders, PT, DPT


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