Abstract
Coach-athlete relationships are central to athlete development, health, and performance in elite sport. This study explored how retired elite female athletes retrospectively narrate their coaching experiences, with attention to how these relationships intersected with female-specific health concerns, training autonomy, and psychological support. A biopsychosocial perspective informed the interview design, focusing on how physical, psychological, and social factors coalesce to shape athletes’ experiences. Using a qualitative interview design and thematic narrative analysis, interviews were conducted with eight retired Norwegian elite female athletes. Participants reflected on relational dynamics across their careers, including trust, silence, vulnerability, and how topics such as menstrual health and low-energy availability were addressed or ignored, in their coaching environments. Two narrative trajectories were constructed. The first described relationships characterised by long-term trust, emotional availability, and openness to female-specific concerns, which supported athletes’ willingness to share bodily cues and collaborate on adjustments. The second trajectory depicted more distant and rigid environments, where health-related concerns were overlooked, and athletes gradually learned to withhold concerns, often normalising silence as part of the high-performance culture. Across both trajectories, the narratives highlighted how coaching relationships shape athletes’ sense of safety, autonomy, and capacity to voice physical and psychological needs. The findings suggest that a female-informed relational approach (brief state checks, explicit validation, and proportionate adjustments) may help foster more open dialogue about body-related cues. These insights may support the continued development of coach education programmes that integrate biopsychosocial awareness to create more responsive and sustainable coaching environments for elite female athletes.
Keywords
Introduction
Coaches play an important role in shaping athletes’ development, well-being, and capacity to navigate the complex demands of elite sport. 1 Their influence extends beyond training outcomes to include psychological safety, relational responsiveness, and identity formation. In elite environments, where athletes’ bodies and performances are continually evaluated, coaching relationships may function as stabilising forces or sources of strain. 2 For female athletes, these dynamics can be further complicated by limited discussion of topics such as menstruation, energy availability, and emotional vulnerability.3,4 Despite progress toward gender equity in participation, female athletes continue to navigate coaching environments that are often male-dominated, under-informed about female health considerations, and shaped by normative ideals rooted in high-performance sport culture. 5
Although approximately half of the athletes at the Paris 2024 Olympic Games were female, 6 only a small minority of accredited coaches were women. 7 The most common coaching relationship in elite sport, therefore, remains a male coach working with a female athlete. Such relationships are not inherently problematic, yet they may involve gendered dynamics that have implications for communication, trust, and the ability to recognise and address female health considerations.5,8 These dynamics can be further influenced by asymmetries in emotional labour, knowledge gaps around female physiology, and culturally embedded silences surrounding menstruation and energy availability. 9
Coaching quality, manifested in trust, empathy, and responsiveness, has been associated with athletes’ physical and emotional well-being, motivation, and sustainable performance.10,11 Supportive relationships have been linked to psychological resilience and positive identity development. By contrast, environments marked by emotional detachment, poor communication, or controlling practices have been associated with higher risks of maladaptation, including injury, burnout, and dropout. 2 These issues may be especially salient for female athletes, who do not consistently receive tailored guidance around menstrual health, hormonal fluctuations, and energy balance.4,12 Such relational patterns may diminish psychological safety, whereby bodily experiences are marginalised rather than discussed and supported. 13
There remains a significant gap in understanding how retired elite female athletes retrospectively interpret their coaching experiences, particularly regarding embodied realities and health narratives. Limited qualitative work that centres on retired elite female athletes’ retrospective coaching accounts exists, particularly regarding bodily experiences and health narratives.7,14,15 While prospective studies capture current behaviours and perceptions, retrospective narratives may enable reflection across career stages and transitions, clarifying how athletes evaluate the long-term significance of coach-athlete relationships.14,16 Despite this potential, coach education programmes commonly prioritise technical and tactical content over relational and interrelated biopsychosocial competencies.17,18 In the Norwegian context, perspectives from retired elite female athletes do not appear to be systematically integrated into coach education programmes. By examining how these athletes construct and narrate supportive versus unsupportive coaching experiences, the present study seeks to advance a more in-depth understanding of the psychosocial dimensions of coaching and their potential implications for health and sustained engagement in elite sport.
Aim of the study
This study explores how retired elite female athletes retrospectively construct and make sense of their coaching experiences. The analysis focuses on how supportive and unsupportive relational dynamics were narrated as influencing bodily awareness, long-term well-being, and performance.
Methods
Philosophical stance
This study is positioned within an interpretivist–constructivist paradigm that assumes multiple, context-bound realities and emphasises the co-construction of meaning within researcher–participant interactions.19,20 Ontological relativism and epistemological social constructionism underpin this stance, whereby stories are treated not as neutral reports of events but as culturally situated resources through which people organise experience, negotiate identity, and make sense of power relations in sport. 21 Attention to temporality, sociality, and place (the three-dimensional inquiry space) provided a scaffold for examining how athletes’ accounts were shaped across career phases, relational contexts, and settings specific to elite sport.21,22 A biopsychosocial perspective functioned as a sensitising lens for question design and interpretive orientation rather than as an analytic framework.23,24
Study design
This study employed a qualitative interview design. Thematic narrative analysis (TNA) was utilized as the methodological and how analytic framework to examine both how participants told their stories of coaching and how analytic narratives were constructed across cases to account for patterned meanings.25,26 In this study, story denotes the participants’ accounts as told in the interviews, whereas narrative denotes the researcher-constructed analytic storyline developed within and across cases. 25 TNA was selected because it preserves the storied character of lived experience while enabling cross-case patterning of meaning, identity work, and relational positioning in context.21,26 Theme construction proceeded reflexivity and iteratively, with attention to plot, tone, temporal ordering, and coach-athlete positioning, consistent with guidance on reflexive thematic research.
Participants and recruitment
Eight retired elite female athletes were purposively sampled from major Norwegian sports. Inclusion criteria required that participants had competed at an international level (e.g., World Cup, World Championship, or Olympic Games), had been retired for at least one year, and had worked with at least two coaches during their careers. Participants were 29 to 41 years old at the time of the interview, with elite careers spanning 8 to 15 years. Post-retirement, five participants held roles in sport-related professions such as coaching, education, or health care. Purposive sampling was used to obtain information-rich cases that could illuminate variation in coaching relationships. 27 To protect confidentiality, we present pseudonyms and non-identifying descriptors (Table 1). Recruitment was facilitated through professional networks and contacts within national sport federations.
Participants characteristics.
Explanation of abbreviations: yrs = years, CL = Champions League, OG = Olympic Games, EC = European Championship, WC = World Cup, jrWC = junior World Cup, TS = Norwegian Premier League. All athletes represented Tier 4-5 based on the McKay et al. 28 performance tier system.
Data collection
A biopsychosocial perspective was used to structure the semi-structured interview guide, ensuring systematic attention to biological (e.g., menstrual function, energy status), psychological (e.g., emotion regulation, perceived support), and social (e.g., communication patterns, role expectations) domains. This perspective informed only the question prompts; interviews were participant-led, and no a priori analytic categories were imposed.24,29
The study employed a retrospective, qualitative interview design and collected data in a single wave from eight retired elite female athletes via semi-structured interviews. The interview architecture operationalised the three-dimensional narrative space by inviting temporal trajectories from early career through retirement, probing social relationships and power dynamics with coaches and support staff, and situating accounts within the places where coaching occurred and decisions were made (training venues, competition sites, medical and team environments).21,26
Interviews were conducted in person or via a secure video platform, according to participants’ preferences and location. They lasted 45–85 min (total ≈ 12 h), were audio-recorded, transcribed verbatim by the first author, anonymised, and accuracy-checked, producing ≈ 90,000 words (≈ 320–360 double-spaced pages). Interviews began with an opening prompt: “Please tell me about your experiences with coaching during your elite career; start wherever feels most important.” Follow-up questions covered five domains informed by the biopsychosocial perspective24,29,30:
The interview guide was iteratively refined through three pilot interviews. After the first pilot, the guide was shortened to reduce burden; the two subsequent pilots refined phrasing and the timing of follow-up questions to support uninterrupted storytelling while ensuring coverage of core domains. During data collection, participants were reminded they could pause or decline any question, and the interviewer safeguarded a respectful, non-judgmental setting given the sensitivity of health- and body-related disclosures. 31
Data analysis
A thematic narrative analysis (TNA) was conducted to examine both how athletes told their coaching stories and how researcher-constructed narratives accounted for patterned meanings across cases.25,26 In this study, story refers to the participant's account as told in the interview, whereas narrative denotes the analytic storyline developed within and across cases. For each transcript, a structured case summary was written that mapped temporal ordering (setup, turning points, consequences), key characters, with an emphasis on coaches, narrative tone, and identity positioning (e.g., agentic, constrained). This preserved the coherence of each story as the initial unit of meaning. 25
Latent, inductive coding was then applied to extended narrative segments (episodes) rather than isolated lines, to retain plot and context. 26 Coding focused on patterned meanings aligned with the study aim: the presence or absence of athlete voice in coach–athlete communication; autonomy support versus control; the handling of training and recovery in relation to bodily cues (e.g., pain, fatigue, cycle-related changes); and whether topics such as menstrual symptoms or mental health were raised and how coaches responded. Using comparative matrices, cases were then read against each other to examine convergences and tensions in plot lines, tone, coach positioning, and recurring metaphors. Rival narrative configurations (one, two, or three trajectories) were drafted and compared. Two trajectories were ultimately constructed because they best balanced internal coherence and distinctiveness: one emphasising trust, dialogue, and adaptive support, and one emphasising rigidity, silence, and emotional distance. Decision rules prioritised recurrence of language and tone, coherence within each trajectory, and stability of coach–athlete positioning across career phases. 26
Finally, the developing interpretation was situated within established features of elite-sport culture (e.g., performance surveillance), and attention was directed to what was present or absent in coach–athlete communication. A biopsychosocial perspective informed interpretation by drawing attention to intersections among biological factors (e.g., menstrual symptoms, possible low energy), psychological processes (e.g., anxiety, perceived safety), and social conditions (e.g., selection norms, time pressures), while not serving as a coding template or determining theme boundaries.24,29,30 Analytic quality was supported by an audit trail documenting case summaries, code development, trajectory drafts, and decision points; by negative-case testing and peer debriefs that challenged early readings; and by wording that avoided implying that themes “emerged,” instead acknowledging that they were constructed through analysis. 25
Reflexivity and ethical considerations
The interviewer was an experienced male practitioner in elite sport. This positionality may have shaped rapport and participants’ comfort discussing female-specific topics (e.g., menstruation), thereby requiring sustained reflexive attention to assumptions and power relations in the interview setting.21,32 To enhance reflexive rigour rather than to eliminate researcher influence, we maintained a reflexive journal documenting positioning and analytic decisions, 32 held regular peer debriefs with a qualitative researcher not involved in data collection, 33 and kept an auditable trail of coding iterations, trajectory decisions, and interpretive shifts.25,33 Credibility was supported by member reflections from three participants, who confirmed the resonance of their analytic summaries (16), alongside thick description and embedded quotations to preserve the storied texture.21,25 Transferability was enhanced by rich contextualisation of narrative segments, 25 while confirmability and dependability were strengthened via peer review of analytic choices and transparent documentation of the analytic pathway.26,33
Ethical approval was granted by the University of Agder, Faculty of Health and Sport Science research ethics committee (Ref: 23/02830), and the Norwegian Agency for Shared Services in Education and Research, all participants provided written informed consent. Because the sample comprises high-profile elite athletes and the narratives include potentially identifying details, full transcripts are not publicly available to protect confidentiality and prevent deductive disclosure, consistent with the approved protocol.
Results
The TNA constructed two distinct trajectories in how retired elite female athletes described their experiences with coaches across their elite careers. Four athletes told stories shaped by safety, dialogue, and relational trust, while four described emotionally constrained, physically demanding coaching environments where silence was normative and bodily cues were marginalised. These groupings do not represent fixed identities, but narrative tendencies shaped by relational contexts across time. These two overarching trajectories, “Guided by Trust” and “Pushed Past the Limit”, illustrated how coaching relationships shaped psychological resilience, performance adaptation, and attention to female-specific considerations. Each trajectory includes three interconnected subthemes, which are presented below with illustrative quotes and brief thematic overviews (Table 2).
Overview of narrative trajectories and subthemes.
Trajectories were researcher-constructed analytic narratives, not fixed categories; some stories blended both. Abbreviations: Cycle = menstrual cycle; REDs = Relative Energy Deficiency in Sport. Terms: permission to voice = routine invitation to share bodily cues (e.g., pain, fatigue, menstrual symptoms); proportionate adjustment = small, time-limited session changes; monitoring over mentoring = surveillance and compliance with little dialogue; learned silence = withholding disclosure to avoid selection or reputational costs. Columns summarise the dominant plotline, coach positioning, key subthemes, and brief mechanisms linking relationship quality to health and engagement.
Guided by trust: Coaching that built connection and confidence
In the present construction, the stories told by Johanne (Swimming), Lisa (Football), Oda (Cross Country Skiing), and Annika (Athletics) predominantly followed this trajectory, while still containing moments that overlapped with the second trajectory. Stories in this trajectory depict coaches as consistent, emotionally available partners who recognised the athlete beyond performance and created space for body-related communication. The narrative tone is measured and agentic: athletes describe being able to speak, adapt, and sustain engagement through difficult phases. The three subthemes below render the prevailing plotline.
Across these stories, coaching was experienced as responsive rather than rigid. Athletes emphasised small, timely adjustments grounded in careful noticing of mood, language, or movement quality.
“He wasn’t the type to overcomplicate things. But he watched and listened. When I wasn’t myself, he noticed.” (Johanne)
These early, situation-specific checks signalled attention without drama and invited athletes to share usable information. The recognition was not limited to crisis moments; it showed up in everyday planning where flexibility signalled trust rather than indulgence.
“Once, I had to skip a week of training due to personal stuff, and instead of pushing me, he just said ‘take your time.’ That stuck with me.” (Lisa)
Athletes linked such responses to a greater willingness to disclose state and to collaborate on small changes. “I could say, ‘Something's off today,’ and he’d ask one or two questions and tweak the session. It wasn’t a drama.” (Oda)
Athletes remembered proportionate changes as relationship-defining small shifts that communicated attention and respect.
“He’d change the plan by ten percent, not fifty. It told me he was paying attention, not panicking.” (Annika)
When athletes felt seen early in a session, they were more willing to provide information that improved subsequent decisions.
“He’d pick up on my stride being flat and just say, ‘Let's move the quality to tomorrow.’ It made me want to be honest because it helped.” (Ingrid)
Responsive noticing and proportionate adjustment legitimised voice, reduced second-guessing, and supported steady self-regulation.
The long game of trust
Continuity and steadiness during dips were repeatedly foregrounded. Athletes contrasted “staying” with the experience of attention moving elsewhere when results waned.
“He didn’t just disappear when I was struggling. He stayed, even when the results weren’t there.” (Oda)
Trust reshaped self-talk; honesty became a routine rather than a risk.
“That trust made me more honest with him — and with myself. I didn’t feel the need to fake being okay.” (Lisa)
Consistent presence reduced pressure to perform and accelerated return to sport.
“Even in tough periods, I never felt like I had to earn his attention again. That helped me recover faster, mentally and physically.” (Johanne)
Athletes connected this steadiness to identity beyond results, which, in turn, buffered motivation.
“It felt like I mattered as a person. That made the hard parts doable.” (Annika)
This stability also extended to transitions, including changes in event focus, injuries, or life events, where the coach's reliability anchored planning.
“When my goals shifted, he didn’t make it a drama. We sat down, mapped it, and got on with it.” (Oda)
A distinctive feature of these stories was the normalisation of talk about cycles, energy, and symptoms. Coaches were not positioned as medical experts, but as safe interlocutors who could fold bodily cues into everyday decisions.
“There were days when I just said, ‘I’m drained today - it's that time’ - and he understood.” (Johanne)
Practical adaptations followed from conversation, not confession.
“Two days before bleeding, I get heavy and flat. We’d move the hardest session by a day, no drama.” (Lisa)
Openness reduced overreaching during sensitive phases and prevented minor issues from escalating.
“If I felt a bit lightheaded, we’d swap intervals for tempo. It kept me consistent instead of crashing.” (Oda)
Athletes emphasised that being heard mattered as much as the specific change to the plan.
“Sometimes it wasn’t the tweak, it was that he didn’t make it a big deal.” (Annika)
This routine dialogue created a shared language for planning around variability rather than resisting it.
“He’d ask, ‘Where are you at today?’ and I could answer honestly. That's what made the plan work.” (Ingrid)
Several athletes, reflecting with hindsight, linked longevity to learning to speak earlier and more directly.
“I’d tell my younger self: speak up sooner, be clear about what you need. It helps them help you.” (Lisa)
Narrative vignette
The following short composite vignette integrates common elements from the “Guided by Trust” trajectory to convey the typical rhythm of coach–athlete dialogue as told across athletes: I text him in the morning: “Heavy legs, think it's starting.” He replies, “Let's switch the session order, easy today, quality tomorrow.” At the track, he watches a few strides and says, “Keep it smooth, we’ll bank the tempo later in the week.” No lecture, no fuss. When I wobble on the third rep, he calls it, and I don’t feel like I failed. We sit on the curb for five minutes and talk about the weekend plan. I leave feeling like an athlete again, not a problem to solve.
Pushed past the limit: Coaching that silenced and strained
In the present construction, the stories told by Sara (Handball), Linne (Alpine Skiing), Kari (Gymnastics), and Eva (Cycling) predominantly followed this trajectory, while still showing occasional elements of the trust-based storyline.
Stories in this trajectory portray coaching as rigid, transactional, and emotionally distant. Voice felt risky; athletes described learning to conceal discomfort, pain, and doubt to meet expectations and protect selection. The narrative tone is constrained and vigilant. Across accounts, the absence of dialogue about body-related cues, especially around the menstrual cycle, low energy, and fatigue, was experienced as a defining feature of the relationship.
Athletes described a delivery style in which routines were non-negotiable, and monitoring took precedence over mentoring. Requests for adjustment were read as a sign of weakness, and plans were applied regardless of context.
“If you didn’t meet the expectations, someone else was waiting. It was always like that.” (Sara)
The working rule, as told, was to comply first and explain never.
“There was no room for off-days or explanations. You showed up, or you were weak.” (Linne)
“Once I asked for a lighter week and was told, ‘That's what makes champions pushing through.’ I didn’t ask again.” (Sara)
Uniformity of plan was emphasised as a virtue, even when athletes signalled that something was off.
“It was copy-paste: same workouts, same target splits, even if I said my legs were dead. The answer was, ‘Everyone's tired.’” (Kari)
In that logic, uniformity equalled fairness, and idiosyncratic cues were treated as noise rather than actionable data.
The consequence was a narrowing of acceptable talk: information that did not fit the plan felt unusable.
“I learned to say, ‘Okay,’ and do it. Anything else just made it worse.” (Eva)
Silence did not appear all at once; it was learned through repetition. Athletes described swallowing questions, shelving doubts, and masking symptoms to avoid being seen as unreliable.
“I remember wanting to talk, needing to say something, but just swallowing it. It became automatic.” (Eva)
Pain and injury were managed privately to protect standing within the group.
“I never told anyone about my hip injury. I just trained through it until I broke.” (Kari)
The relational cost of disclosure was framed as too high.
“You learned quickly that vulnerability wasn’t welcomed. You’re either tough or out.” (Linne)
Silence also extended to cycle-related discomfort. Several athletes described training through cramping and heavy bleeding without signalling it.
“First day of bleeding I’d get cramps so bad I had to bend over between reps. I kept my head down so no one would ask.” (Sara)
Cycle-related pain thus remained visible in behaviour but invisible in conversation.
In hindsight, athletes noted how the strategy spread beyond sessions and seasons.
“Once you get used to not saying anything, it follows your home. You stop checking in with yourself.” (Eva)
“
The silence also had clear content; it concerned specific topics that rarely entered coaching exchanges. The absence of conversation about menstruation, energy, and nutrition was described as conspicuous. Even obvious monthly fluctuations were left unaddressed.
“I lost my period for almost two years. Nobody asked, and I didn’t know it mattered.” (Linne)
In these accounts, menstrual dysfunction was normalised as part of “being serious,” and the lack of inquiry by staff was interpreted as tacit acceptance, which delayed recognition of risk. Food and weight were discussed as levers for performance, but there was no space to explore energy status or warning signs.
“Talk about food was mostly about being lighter. If I said I felt wiped, the answer was, ‘Clean up the diet.’” (Kari)
Athletes recounted not having a shared language to bring body-state information into planning.
“We never talked about food or energy or cycles. It was like that part of me didn’t exist in sport.” (Athlete 7)
Several described days when symptoms were visible but still ignored within the coaching exchange.
“He could see I was curled up with cramps between sets and still said, ‘Same set as yesterday.’ I didn’t argue.” (Sara)
An understanding of potential risks often came after careers had ended.
“Only years later did I learn what low energy even was. At the time, I just thought being tired and light was part of being serious.” (Eva)
A few participants wondered whether shared lived experience might have opened earlier conversation, while emphasising that the core issue was not identity but relationship.
“Maybe with someone who’d been through the same, I’d have said it sooner. But really it was that we didn’t have that kind of relationship.” (Linne)
Narrative vignette
The following short composite vignette integrates common elements from the “Pushed Past the Limit” trajectory to convey the typical rhythm of coach-athlete dialogue as told across accounts:
I arrive ten minutes early and start the warm-up. My stomach is tight and low; the first day is always like this. The plan on the board doesn’t change. When the third rep bites, I say nothing. I focus on the watch and keep the splits. Between sets, I lean on the fence and breathe shallow, so it doesn’t show. He calls out, “Good, same again,” and I nod. After the last rep, I jog the cool-down alone. No one asks. Tomorrow is the same session again.
Trajectory summary
Across both trajectories, pressure and high standards were present. The decisive difference was whether pressure was accompanied by dialogue that legitimised bodily cues (for example, pain, fatigue, menstrual symptoms). Where talk was routine and safe, athletes adjusted and sustained engagement; where silence was learned and rewarded, athletes concealed symptoms and disconnected from bodily cues.
Discussion
This study explored how retired elite female athletes retrospectively construct and make sense of their coaching experiences, with specific attention to how coach-athlete relationships were described as shaping physical health, autonomy, and social belonging, particularly in relation to menstrual health, energy availability, and emotional support. Using TNA, the analysis constructed two contrasting narrative trajectories: “Guided by Trust” and “Pushed Past the Limit.” These trajectories organise prevailing plotlines rather than fixed categories of athletes and highlight how coaching relationships were narrated as supporting or constraining athletes’ willingness to share bodily cues (e.g., pain, fatigue, menstrual symptoms) and sustain their development in elite sport. The analysis specifies relational features that participants linked to day-to-day adaptation: regular check-ins about bodily signals, proportionate adjustments to plans, and consistent attention during downturns; in contrast, rigid monitoring with limited dialogue was associated in these accounts with learned silence. Athletes within” Guided by Trust” described emotionally responsive relationships that were experienced as fostering psychological safety and validated individual experiences, aligning with research on the benefits of relational competence in coaching.10,11 In contrast, recalled emotionally distant environments where bodily cues and female-specific considerations were described as overlooked, and participants connected these conditions to concerns about REDs, psychological distress, and burnout.12,34 These findings underscore that trust is a reciprocal and ongoing process; for the relationship to remain effective, the coach must also demonstrate trust in the athlete's subjective knowledge of their own body and performance needs.14,35
Coaching as relational practice
The findings suggest that coaching in elite sport is not only the technical execution of training plans but also is inherently relational, deeply embedded in responsiveness, mutual recognition, and the maintenance of trust over time. Athletes who described feeling psychologically safe, respected, and understood also described coaching relationships that enhanced not only performance but also self-awareness, training autonomy, and emotional resilience. These accounts align with need-supportive coaching perspectives and confirm longstanding work emphasising the interpersonal dimension of coaching.1,11,36,37 Crucially, the stories demonstrate that support was enacted through small, timely behaviours, such as asking about the state, legitimising disclosure, and making proportionate adjustments, rather than through wholesale programme changes.
Trust was narrated not as a given, but as a social process cultivated through sustained emotional presence, responsiveness, and situational flexibility. Athletes who reported this described their coaches as allies who adapted, listened, and validated their subjective experiences, even without deep expertise in female-health issues. Where such maintenance of trust was inconsistent, voice was withdrawn, and signals from the body were kept private. Interpersonal trust can function as a psychological buffer, supporting voice, vulnerability, and self-regulation in elite sport environments.38,39 The present analysis illustrates this buffering in practice: when routine communication about the body is normalised and acted on proportionately, the information available for day-to-day decisions improves, and training choices become safer and more effective.
Viewed through the biopsychosocial lens, the relational patterns observed here show how physical factors (e.g., menstrual symptoms, low energy availability), psychological responses (e.g., worry, internalised withholding), and social conditions (e.g., coaching norms, communication climate) can converge to shape outcomes.24,29,40,41 Contexts that did not acknowledge bodily cues appeared to amplify risk; contexts that promoted routine dialogue appeared to support self-regulation, reflection, and sustained engagement. To capture this stance, female-centred coaching denotes practice that treats bodily cues as routine performance data and positions the athlete as a trusted partner in planning. In day-to-day work this relies on a small set of relational micro-skills: brief state checks at session start that invite concrete examples (energy, pain, cycle phase); explicit validation that reduces status threat when discomfort is disclosed; proportionate adjustments to session order, intensity, or recovery when warranted; transparent rationales linking information to decisions; and simple follow-ups to review the consequence of changes.
The cost of silence: Ethical and psychological considerations
A salient theme of the “Pushed Past the Limit” trajectory was the learned, strategic silencing of embodied experiences. Silence was normalised not only for physical pain but also for psychological strain and menstrual dysfunctions. Athletes in this study were often socialised to view openness as risky, thereby learning to suppress expression in favour of perceived toughness. This pattern was said to be reinforced when disclosure carried selection risk or reputational cost within the training group. Such relational dynamics may carry ethical implications. When coaches abstain from initiating or encouraging dialogue around critical female health topics, particularly menstrual health and energy availability, this may contribute to cultures of inattention or invisibility that participants linked to conditions such as REDs.4,34,42 The internalisation of silence often begins early in athletic development, as athletes learn from daily cues that disclosure may jeopardise selection, status, or belonging.21,26 Female athletes may lack adequate language or permission to articulate discomfort, especially in high-performance environments.43,44 This may leave them vulnerable to physical problems and injuries, mental health issues, and progressive disconnection from bodily cues. In this study, silence was described as a short-term strategy to remain selectable, but participants also linked it to the accumulation of strain over time.
These findings invite a pragmatic consideration of the suitability of elite sport environments for female athletes experiencing menstrual symptoms. In systems where schedules, expectations, and feedback loops are calibrated primarily to male physiology, athletes may be penalised for cyclical variations in well-being or performance. This observation reinforces the argument that sport systems and organisations could adapt to female physiology rather than require conformity to standards calibrated to male physiology.45,46 In practice, this might mean making space for pre-bleed pain, heaviness, or fatigue to be named without status loss and enabling routine micro-adjustments without stigma.
Menstrual literacy and relational skills as core coaching competencies
In this study, participants described menstrual health as salient for understanding how coaching relationships supported or constrained athletes’ autonomy. This emphasis reflects the study's focus and should be read as an analytic interpretation of participant accounts rather than a universal claim. Athletes in the trust-centred trajectory recounted speaking candidly about cycles, fatigue, and symptoms. In contrast, those in the silence-centred trajectory recounted long-term menstrual dysfunctions without a single inquiry from their coaches. Recent literature corroborates these concerns, highlighting a persistent gap in coach menstrual literacy.47,48 Coaches do not need medical expertise, but they may need relational skills to invite, receive, and act on bodily cues. The findings of the present study suggest two practice-proximal elements: (a) normalising conversations about cycle-related variations as routine, and (b) implementing proportionate, time-limited adjustments without moralising the athlete's state. These points are offered as interpretations grounded in participants’ narratives rather than as tested interventions. Including cycle considerations in training load planning may enhance performance and reduce injury risk.34,45,46,49 Importantly, participants highlighted the days immediately preceding and the first days of bleeding as periods when psychological safety to disclose pain or heaviness mattered most for timely adjustment. Relatedly, several athletes connected absent dialogue to experiences consistent with REDs, underscoring the value of broader “health literacies” in coaching, including energy-availability literacy, mental-health literacy, and menstrual literacy. 5
Moreover, several athletes reported that they struggled to form deep relationships when they perceived a lack of knowledge or willingness to engage with menstrual-health topics. This relational gap was experienced as a sense of distancing, which participants linked to reduced trust and diminished athlete voice. Accordingly, menstrual literacy is not just knowledge; it can be conceptualised as relational competence that supports coach-athlete-centred coaching.1,4,50 In this interpretation, menstrual, energy-availability, and mental-health literacies are complementary components of a broader female-informed relational skillset rather than standalone solutions.
Gendered dynamics and emotional labour
The narrative trajectories also draw attention to gendered dynamics in the understanding and enactment of emotionally supportive work in elite sport coaching. Women remain underrepresented among accredited coaches at major international events, even though roughly half of the athlete population is female, which means that the coach–athlete pairing is commonly cross-gender.6,10 Within this structural backdrop, Pushed Past the Limit shows how limited attention to athletes’ psychological states, well-being, and bodily cues was described as making disclosure more difficult. In contrast, Guided by Trust illustrates how regular check-ins, responsiveness, and acknowledgement of concerns supported a sense of safety and collaborative decision-making.
In this study, emotionally supportive work refers to the coach's ability to notice, interpret, and respond to athletes’ physical and psychological cues. This aspect of coaching received varying emphasis in the athletes’ stories and is not always central in traditional coaching frameworks. 10 Across the trajectories, athletes described how the degree to which this support was present shaped their sense of autonomy and willingness to speak openly. When such support felt inconsistent, several participants recalled holding back information about pain, fatigue, or menstrual symptoms. These accounts are in line with research showing that relationships characterised by attentiveness and care can contribute to well-being and a stronger sense of partnership between coaches and athletes.1,50,51
Additionally, the narratives suggest that simple, regular conversations about bodily cues were meaningful to athletes as they navigated menstrual symptoms, changes in energy, or psychological strain. Some participants felt that having a coach with a similar lived experience might have made early disclosure easier. At the same time, the trajectories highlight that the overall relationship, including responsiveness and emotional presence, appeared more important in shaping athletes’ comfort in raising sensitive issues than coach identity alone. This observation adds nuance to existing calls for both broader female representation in coaching and improved training for all coaches in relational skills and female-health literacy.7,48,52,53
Terminology considerations
The present study uses the term “female athletes” to refer to biological characteristics relevant to health and performance, such as hormonal profiles and menstrual function.54,55 This choice reflects the study's focus on embodied health within a biopsychosocial perspective. In parallel, women are recognised as a gendered term encompassing social and cultural identities. 56 While sex and gender are interwoven in real-world experiences, the use of female reflects the emphasis on biological realities within coach-athlete-centred coaching. Future research should continue to explore how these dimensions intersect and shape athlete development, inclusion, and equity in elite sport.3,57
Methodological considerations
This study employed TNA to explore how retired elite female athletes made sense of their coaching relationships over time. The approach supports detailed insight into subjective meaning-making but also carries epistemological limitations. The sample comprised eight retired elite female athletes from eight of Norway's largest sports, selected through purposeful sampling to access information-rich accounts. 27 As with all retrospective work, participants’ present professional roles and identities may have shaped how earlier experiences were remembered and narrated. At the same time, this perspective offered layered reflections on both past and current relational dynamics. Narrative inquiry understands stories as co-constructed and therefore requires attention to researcher positioning.21,26 The lead researcher's background as a coach and his role as a male interviewer were examined throughout the research process.16,25 This process is referred to here as triangulation across analytic materials, meaning that interpretations were checked against multiple sources within the dataset rather than relying on single excerpts. The interviewer's sex may still have influenced what participants felt able to share, particularly on menstrual health. To reduce potential barriers, the interview introduction normalised the discussion of cycle-related experiences, and participants were invited to offer clarifications or additions during transcript review. The purpose was not to eliminate positional influence but to make analytic decisions transparent and reflexive.26,58 The study's focus on female athletes also shaped how established frameworks, including autonomy-supportive coaching 37 and coach–athlete relationship frameworks, 1 were interpreted. These frameworks are largely derived from mixed- or male-dominant samples, and the present analysis offers one way to read participants’ stories in relation to menstrual health, disclosure, and relational safety. This should not be taken as evidence of how these frameworks universally apply, but as an interpretation grounded in a small sample of retrospective accounts.
Future research could examine whether similar relational dynamics, including silence, emotional labour, and trust maintenance, are described across gender identities and competitive levels. Longitudinal or participatory designs may allow athletes and coaches to reflect jointly on how communication patterns develop and change over time. Participants’ retrospective advice to their younger selves (speak up sooner and be direct so coaches can help) suggests a parallel research question about coaches’ readiness to receive and act upon such disclosures.
Practical implications
The findings point towards a female-centred coaching stance that treats bodily cues as routine performance data and relies on a small set of relational micro-skills: (a) brief state scans at session start, (b) explicit validation of disclosures, (c) proportionate micro-adjustments to session order or intensity, (d) transparent rationales linking information to decisions, and (e) simple follow-ups to check consequence. Implementing these skills can preserve training continuity, reduce unnecessary strain, and strengthen trust within the coach-athlete relationship. Accordingly, the following practice guidelines are proposed:
Make check-in routines: Begin sessions with a brief “state scan” (e.g., energy, pain, cycle phase) and invite specific examples, and act on disclosures with small, proportionate adjustments. Protect disclosure status: State explicitly that naming pain, heaviness, or pre-menstruation symptoms will not jeopardise selection or status, and follow through consistently. Teach female health literacy as a relational skill: Train coaches to ask, listen, and translate cycle-related information into pragmatic micro-changes (session order, intensity, recovery), without moralising the athlete's state. Stabilise attention during performance dips: Maintain consistent contact and collaborative planning when results wane; avoid contingent attention that incentivises surface compliance. Use language that normalises variability: Replace “tough it up” talk with neutral planning language (“shift quality to tomorrow,” “bank volume later in the week”). Mentor relational micro-skills: Pair less experienced coaches with mentors to practise state scanning, reflective listening, and proportionate adjustment using real case vignettes from elite female sport.
Conclusion
This study explored how retired elite female athletes retrospectively constructed their coaching experiences, focusing on how relational dynamics shaped physical health, autonomy, and social belonging in connection with menstrual health, energy availability, and emotional support. Two narrative trajectories were constructed: one in which athletes experienced responsive, trust-maintaining coaching that legitimised communication and enabled proportionate adjustments; and another in which rigid, evaluative practices taught silence and normalised the suppression of bodily cues. Together, the findings clarify how the quality of the coach–athlete relationship is linked to sustained engagement and health outcomes. When bodily-felt signals are invited and used, continuity tends to be preserved; when discouraged or ignored, strain tends to accumulate.
In addressing the study's aim, our analysis shows that coach–athlete relationships shape athletes’ health, autonomy, and belonging through concrete relational mechanisms, including routine embodied dialogue, proportionate adjustments, and sustained attention during downturns, and that female health literacy functions as a core relational competence within athlete-centred coaching. Accordingly, coaching that consistently invites, listens to, and judiciously uses bodily cues is not only a preferred practice; it also constitutes a future standard of ethical responsibility in elite female sport.
Footnotes
Ethical considerations
Ethical approval for this study was granted by the University of Agder, Faculty of Health and Sport Science research ethics committee (Ref: 23/02830), and the Norwegian Agency for Shared Services in Education and Research.
Consent to participate
All participants provided written informed consent to participate in the study prior to data collection.
Consent for publication
Informed consent for the publication of anonymised narrative data and illustrative quotations was obtained from all participants as part of the written informed consent process.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of conflicting interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data availability
Because the sample comprises high-profile elite athletes and the narratives include potentially identifying details, full transcripts are not publicly available to protect confidentiality and prevent deductive disclosure, consistent with the approved protocol.