PT - JOURNAL ARTICLE
AU - Kraus, Emily
AU - Tenforde, Adam S
AU - Nattiv, Aurelia
AU - Sainani, Kristin L
AU - Kussman, Andrea
AU - Deakins-Roche, Megan
AU - Singh, Sonal
AU - Kim, Brian Young
AU - Barrack, Michelle T
AU - Fredericson, Michael
TI - Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury
AID - 10.1136/bjsports-2018-099861
DP - 2019 Feb 01
TA - British Journal of Sports Medicine
PG - 237--242
VI - 53
IP - 4
4099 - http://bjsm.bmj.com/content/53/4/237.short
4100 - http://bjsm.bmj.com/content/53/4/237.full
SO - Br J Sports Med2019 Feb 01; 53
AB - Objectives Bone stress injuries (BSI) are common in runners of both sexes. The purpose of this study was to determine if a modified Female Athlete Triad Cumulative Risk Assessment tool would predict BSI in male distance runners.Methods 156 male runners at two collegiate programmes were studied using mixed retrospective and prospective design for a total of 7â€‰years. Point values were assigned using risk assessment categories including low energy availability, low body mass index (BMI), low bone mineral density (BMD) and prior BSI. The outcome was subsequent development of BSI. Statistical models used a mixed effects Poisson regression model with p<0.05 as threshold for significance. Two regression analyses were performed: (1) baseline risk factors as the independent variable; and (2) annual change in risk factors (longitudinal data) as the independent variable.Results 42/156 runners (27%) sustained 61 BSIs over an average 1.9 years of follow-up. In the baseline risk factor model, each 1 point increase in prior BSI score was associated with a 57% increased risk for prospective BSI (p=0.0042) and each 1 point increase in cumulative risk score was associated with a 37% increase in prospective BSI risk (p=0.0079). In the longitudinal model, each 1 point increase in cumulative risk score was associated with a 27% increase in prospective BSI risk (p=0.05). BMI (rate ratio (RR)=1.91, p=0.11) and BMD (RR=1.58, p=0.19) risk scores were not associated with BSI.Conclusion A modified cumulative risk assessment tool may help identify male runners at elevated risk for BSI. Identifying risk factors may guide treatment and prevention strategies.