Poster 155 Higher Cumulative Risk Assessment Scores Are Associated with Delayed Return to Play in Division I Collegiate Distance Runners

Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes

“…Sports medicine professionals should incorporate the risk assessment score into standard PPE practice and should consider expanding screening during PPE to include a full menstrual history, reasons for hormonal therapy use, and questions about EA and disordered eating to ensure that accurate triad risk assessment scores are obtained. The elevated risk for BSIs with higher triad risk assessment scores from our investigation adds to the literature demonstrating detrimental effects of the triad, including longer time for return to sports after sustaining a BSI with higher risk assessment scores 11 and performance decrements with negative energy balance. 24 By identifying athletes at elevated risk categories, sports medicine providers can better guide management and ensure that the health of each athlete is addressed in a comprehensive manner.…”

“…1,7,22 In addition, collegiate athletes with triad risk factors including oligomenorrhea/amenorrhea or elevated risk assessment scores had higher grade BSIs on magnetic resonance imaging (MRI) and longer return to play. 11,18 Triad risk factors can be identified in the required preparticipation physical examinations (PPEs). In the largest study to date in National Collegiate Athletic Association (NCAA) Division I athletes, investigators reported the following in a population of 797 female athletes using an electronic preparticipation physical examination (ePPE): 3% had a prior or current eating disorder, 20% experienced irregular menstrual cycles, 3% had a history of low bone density, and 15% had a history of a stress fracture.…”

Female Athlete Triad

“…These guidelines are based on scientific evidence and must be used in the context of clinical judgment while considering “decision modifiers” such as the type of sport, the timing during the season, the position played, etc. These approaches represent the translation of Triad science into practice at an organizational and policy level, with recent reports confirming that these recommendations are being implemented and adapted [118 119]. Future research should include refinements and modifications to these algorithms that improve their sensitivity and specificity.…”