RT Journal Article SR Electronic T1 Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP 237 OP 242 DO 10.1136/bjsports-2018-099861 VO 53 IS 4 A1 Emily Kraus A1 Adam S Tenforde A1 Aurelia Nattiv A1 Kristin L Sainani A1 Andrea Kussman A1 Megan Deakins-Roche A1 Sonal Singh A1 Brian Young Kim A1 Michelle T Barrack A1 Michael Fredericson YR 2019 UL http://bjsm.bmj.com/content/53/4/237.abstract 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 7 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.