Associations Between Sport Specialization, Running-Related Injury, and Menstrual Dysfunction Among High School Distance Runners

Rauh, Mitchell J.; Tenforde, Adam S.; Barrack, Michelle T.; Rosenthal, Michael D.; Nichols, Jeanne F.

doi:10.3928/19425864-20180918-01

Cited by 15 publications

(24 citation statements)

References 39 publications

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“…Since then, sport specialisation at early age has increased globally [99] and participation in organised sport club has become more frequent in Finnish girls [100]. Early sport specialisation can lead to physical and mental harm as it has been linked to reduced motor skill development, increased injury rates, sport dropout, burnout, eating disorders, and menstrual dysfunction [99,[101][102][103]. Thus, generalisability of our results to those who are currently engaged in competitive sport should be done with caution.…”

Section: Limitationsmentioning

confidence: 89%

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

Ravi

Tammelin

Hirvensalo

et al. 2020

JCM

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This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47–55 years formed the sample of this retrospective study. Participants self-reported their PA level at age 13–16 years and AAM. The protocol also included dual-energy X-ray absorptiometry, physical performance tests, and accelerometer-measured PA. Participants were divided into three groups according to their PA level at the age of 13–16 (no exercise, regular PA, and competitive sport) and according to their AAM (≤12, 13, and ≥14 years). After adjusting for potential confounding factors, participation in competitive sport at age 13–16 was associated with higher midlife lean mass and BMD, and better physical performance compared to groups with no exercise or regular PA. Individuals with AAM ≥ 14 years had lower midlife BMI and fat mass than participants in the other AAM groups and pre- and perimenopausal women with AAM ≥ 14 years had lower BMD than those with AAM ≤ 12. The findings indicate that participation in competitive sport in adolescence is associated with healthier body composition, higher BMD, and better physical performance in midlife, but BMD might be impaired if menarche occurs late.

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Section: Limitationsmentioning

confidence: 89%

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

Ravi

Tammelin

Hirvensalo

et al. 2020

JCM

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“…All 64 runners underwent a dual-energy x-ray absoptiometry (DXA) scan ( Figure 1). 18,23 These runners were from a larger sample of 170 athletes who participated in 8 interscholastic sports 11,24,25 and completed questionnaires regarding competitive sport involvement and menstrual history. High school athletic directors and coaches in several local high school districts were contacted for approval to allow the research team to approach their runners regarding participation in the study's measures at the beginning of and throughout their interscholastic season.…”

Section: Methodsmentioning

confidence: 99%

“…If the athlete competed in track and field, she was asked to report the number of years and months she competed in distance, sprint, or field events. 23 An athlete was classified as a distance runner if she competed in crosscountry, outdoor track and field distance events (main running event[s]) 1600 m or longer), or both. 23 In this study, each distance runner was placed in 1 of 3 sport-specialization classifications 23 :…”

Section: Data Collectionmentioning

confidence: 99%

“…18 Therefore, female high school distance runners appear to be an important athletic population for examining the association between sport specialization and low BMD. Concern about sport specialization in this population is heightened by findings 23 that female high school distance runners (ie, athletes whose main running event was 1600 m or longer) who were classified as high sport specializers were at a nearly 2-fold increased risk for musculoskeletal injury and 4-fold increased risk for menstrual dysfunction in the past year than distance runners who were classified as low sport specializers. To date, no researchers have reported on the association between sport specialization in high school-aged distance runners and low BMD.…”

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confidence: 99%

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Sport Specialization and Low Bone Mineral Density in Female High School Distance Runners

Rauh

Tenforde

Barrack

et al. 2020

Journal of Athletic Training

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Context Sport specialization may contribute to sport injury and menstrual dysfunction in female high school distance runners. Despite the recent growth in sport specialization, including among high school–aged runners, the association of sport specialization with bone mineral density (BMD) remains poorly described. Objective To evaluate whether sport specialization was associated with BMD in female high school distance runners. Design Cross-sectional study. Setting Six high schools. Patients or Other Participants Sixty-four female runners (age = 15.6 ± 1.4 years) who competed in cross-country or track distance events and were not currently on birth control medication. Main Outcome Measure(s) Each runner completed a survey on menstrual history and sport participation. Height and weight were measured, and dual-energy x-ray absorptiometry was used to measure whole-body, spine, and hip BMD. Each runner was assigned a sport specialization status: low (participation in ≥1 nonrunning sport and distance-running sport(s) for ≤8 mo/y); moderate (participation in both distance-running sport(s) ≥9 mo/y and ≥1 nonrunning sports or limited to distance-running sport(s) for ≤8 mo/y); or high (participation only in distance-running sport(s) for ≥9 mo/y). Multivariable logistic regression was performed to determine the adjusted odds ratio and 95% confidence interval for sport specialization to BMD values, adjusting for body mass index and gynecological age. Results Overall, 21.9%, 37.5%, and 40.6% of participants were high, moderate, or low sport specializers, respectively. Low BMD (spine or whole-body BMD z score < −1.0 [standardized by age and sex normative values] was present in 23 runners [35.9%]). Compared with low sport specializers, high sport specializers were 5 times more likely (adjusted odds ratio = 5.42, 95% confidence interval = 1.3, 23.3; P = .02) to have low BMD. Conclusions A high level of sport specialization in high school female distance runners may be associated with a heightened risk for low BMD. Further investigation of this association is warranted due to the health concerns about low BMD in adolescent female runners.

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“…2,4,5 MD prevalence rates vary between studies depending on the diagnostic criteria and the population studied, with studies usually investigating only clinically detectable MD. [4][5][6][7][8][9][10][11][12][13][14] Nevertheless, the results of studies comparing the prevalence of MD in athletes and non-athletes have been inconsistent. Hoch et al 12 and Muia et al 6 found that MD was more common in runners and athletes competing in several different sports, respectively, than in sedentary controls.…”

Section: Introductionmentioning

confidence: 99%

Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non‐athletes

Ravi

Waller

Valtonen

et al. 2020

Scandinavian Med Sci Sports

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To determine the prevalence of menstrual dysfunction (MD; ie, oligomenorrhea or amenorrhea) and attitudes toward body weight among athletes and non‐athletes, we studied a cohort of athletes and non‐athletes, in adolescence (14‐16 years) and subsequently in young adulthood (18‐20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioral characteristics that might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre‐participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non‐athletes (4.7% vs 0%, P = .03). In young adulthood, athletes reported MD more frequently than non‐athletes (38.7% vs 5.6%, P < .001). Athletes had less desire than non‐athletes to lose weight at both time points, and in adolescence, athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non‐athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence. Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non‐athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliest feasible phase of an athlete's career.

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Associations Between Sport Specialization, Running-Related Injury, and Menstrual Dysfunction Among High School Distance Runners

Cited by 15 publications

References 39 publications

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

Sport Specialization and Low Bone Mineral Density in Female High School Distance Runners

Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non‐athletes

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