The Weight of Health Monitoring: Elite Female Footballers Perspectives on Relative Energy Deficiency in Sport Detection

Health monitoring research specific to elite female footballers remains limited, contributing to gaps in physical and psychological health. This study investigates the health monitoring practices and the experiences of elite female footballers in the Australian Women’s A-League, with a focus on the detection of Relative Energy Deficiency in Sport. Using a cross-sectional qualitative design, semistructured focus groups were conducted with athletes (n = 23) from five A-League clubs during the 2023–2024 season. The study is underpinned by a critical realist perspective, exploring the complex interplay between health monitoring practices, athlete autonomy, and multidisciplinary support available to players. Through thematic analysis, three overarching themes emerge: (a) the silent sideline: the absence of informed support, (b) poor multidisciplinary support practices, and (c) more than muscle: a hollistic approach. Findings reveal that while athletes value autonomy and open communication in health monitoring, significant barriers exist, including menstrual stigma, inadequate privacy protections, safeguarding issues, and a lack of knowledge among support staff. These barriers reinforce dissatisfaction with current health practices, often perceived as superficial or insufficient. This study highlights the urgent need for improvements in the approaches to health monitoring in elite women’s football, stressing the importance of collaborative, athlete-centered care.