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Sex Differences in Endurance Running

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Abstract

In recent years, there has been a significant expansion in female participation in endurance (road and trail) running. The often reported sex differences in maximal oxygen uptake (VO2max) are not the only differences between sexes during prolonged running. The aim of this narrative review was thus to discuss sex differences in running biomechanics, economy (both in fatigue and non-fatigue conditions), substrate utilization, muscle tissue characteristics (including ultrastructural muscle damage), neuromuscular fatigue, thermoregulation and pacing strategies. Although males and females do not differ in terms of running economy or endurance (i.e. percentage VO2max sustained), sex-specificities exist in running biomechanics (e.g. females have greater non-sagittal hip and knee joint motion compared to males) that can be partly explained by anatomical (e.g. wider pelvis, larger femur-tibia angle, shorter lower limb length relative to total height in females) differences. Compared to males, females also show greater proportional area of type I fibres, are more able to use fatty acids and preserve carbohydrates during prolonged exercise, demonstrate a more even pacing strategy and less fatigue following endurance running exercise. These differences confer an advantage to females in ultra-endurance performance, but other factors (e.g. lower O2 carrying capacity, greater body fat percentage) counterbalance these potential advantages, making females outperforming males a rare exception. The present literature review also highlights the lack of sex comparison in studies investigating running biomechanics in fatigue conditions and during the recovery process.

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Acknowledgements

The authors sincerely thank Callum Brownstein for English editing.

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Authors and Affiliations

  1. Univ Lyon, UJM-Saint-Etienne, Inter-University Laboratory of Human Movement Biology, EA 7424, 42023, Saint-Étienne, France

    Thibault Besson, Jeremy Rossi & Guillaume Y. Millet

  2. Institute of Movement Sciences (ISM), National Center of Scientific Research (CNRS) and Aix Marseille Univ, Marseille, France

    Robin Macchi, Yoko Kunimasa & Caroline Nicol

  3. Decathlon SportsLab, Movement Sciences Department, Lille, France

    Cédric Y. M. Morio

  4. Impact of Physical Activity on Health (IAPS), University of Toulon, Toulon, France

    Fabrice Vercruyssen

  5. Institut Universitaire de France (IUF), Paris, France

    Guillaume Y. Millet

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TB, RM, CN, FV and GYM drafted the manuscript; JR, CM and YK provided additional comments and contributions; all authors approved the final version.

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No sources of funding were used to assist in the preparation of this article.

Conflict of interest

Thibault Besson, Robin Macchi, Jérémy Rossi, Cédric Morio, Yoko Kunimasa, Caroline Nicol, Fabrice Vercruyssen and Guillaume Millet declare that they have no conflicts of interest relevant to the content of this review.

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Besson, T., Macchi, R., Rossi, J. et al. Sex Differences in Endurance Running. Sports Med 52, 1235–1257 (2022). https://doi.org/10.1007/s40279-022-01651-w

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