Case Study Insights Into Female World-Class and Elite Athletes' Training and Physiology

This article offers a structured overview of published case studies involving elite and world-class female Olympic athletes, highlighting the unique insights these studies provide into training characteristics, physiology, performance, and female-specific factors.

Four databases were systematically searched for peer-reviewed case studies involving tiers 4 to 5 female Olympic athletes reporting individual-level data on training, physiological, and/or performance characteristics.

Thirty-eight studies describing 54 elite and world-class female athletes from 18 countries and 19 Olympic sports met the inclusion criteria. Most studies were published after 2017 (68%), originated from Europe (58%), and involved endurance sports (81%). Fifteen studies examined long-term athlete development, with observation periods ranging from 4 to 26 years. Fourteen studies reported annual training and physiological characteristics across 10 sports including training volume, intensity distribution, periodization, and physiological profiling. Four studies examined altitude training, 8 addressed competition demands, tapering, and precompetition strategies, and 8 focused on female-specific physiology, health, and performance, including energy availability, menstrual function, hormonal cycle monitoring and pregnancy, and postpartum return to sport.

Case studies provide unique athlete-centered insights into the complex interactions between training, physiology, health, and performance in elite female athletes. Collectively, they demonstrate that pathways to world-class performance are highly individualized, while generating hypotheses that complement group-based research. Future case studies should prioritize underrepresented sports, geographical regions, and female-specific topics to expand the diversity of performance environments and athlete populations represented in the literature.