Menstrual Irregularity and Musculoskeletal Injury in Female High School Athletes

Abstract

Context:The female athlete triad describes the interrelatedness of energy availability, menstrual function, and bone density. Although associations between triad components and musculoskeletal injury (INJ) have been reported in collegiate athletes, limited information exists about menstrual irregularity (MI) and INJ in the high school population.Objective: To determine the prevalence of and relationship between MI and INJ in high school athletes.Design: Cross-sectional study. Setting: High schools. Patients or Other Participants:The sample consisted of 249 female athletes from 3 high schools who competed in 33 interscholastic, school-sponsored sport teams, dance teams, and cheerleading or pom-pon squad during the 2006-2007 school year. Each athlete remained on the roster throughout the season.Main Outcome Measure(s): Participants completed a survey regarding injury type, number of days of sport participation missed, and menstrual history in the past year.Results: The prevalences of M I and INJ were 19.7% and 63.1 %, respectively. Athletes who reported MI sustained a higher percentage of severe injuries (missing ;:>:22 days of practice or competition) than did athletes who reported normal menses. Although the trend was not significant, athletes with MI were almost 3 times more likely to sustain an injury resulting in 7 or more days of time lost from sport (odds ratio=2.7, 95% confidence interval = 0.8, 8.8) than those who sustained an injury resulting in 7 or fewer days of time lost.Conclusions: The incidences of MI and INJ in this high school population during the study period were high. Athletes who reported MI sustained a higher percentage of severe injuries than did athletes who reported normal menses. Education programs to increase knowledge and improve management of MI and its potential effects on injury in female high school athletes are warranted.

The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad

“…Thein-Nissenbaum et al 30 showed an increased risk for muscular skeletal injuries in female athletes with restricted eating behaviour and MD. These results confirm earlier findings of increased risk for muscular skeletal injuries in female athletes with restricted eating behaviour, MD as well as low BMD 11.…”

2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013

“…While such screening is most typically completed at the collegiate level, the panel recommended screening for younger athletes (high school age) as well 43 44. A major point that the panel emphasised is that existence of any one Triad component should prompt more thorough investigation for the others.…”

Athletic Activity and Hormone Concentrations in High School Female Athletes

“…44 Menstrual irregularities have also been associated with increased risk of musculoskeletal injuries and stress fractures in athletes. 45,46 The percentages of those participants with no complete cycle appeared to be similar in athletes (14 of 74, 19%) and nonathletes (3 of 24, 12%), (P ¼ .47). Those percentages are much higher than the 4.75% of anovulatory athletic women recently reported by Dragoo et al 43 Of similar concern are the 29 participants (30%) with cycles shorter than 24 days or longer than 35 days.…”