The relationship between the female athlete triad and injury rates in collegiate female athletes

Abstract

Background This study aimed to clarify the relationship between the triad risk assessment score and the sports injury rate in 116 female college athletes (average age, 19.8 ± 1.3 years) in seven sports at the national level of competition; 67 were teenagers, and 49 were in their 20s. Methods Those with menstrual deficiency for >3 months or <6 menses in 12 months were classified as amenorrheic athletes. Low energy availability was defined as adolescent athletes having a body weight <85% of ideal body weight, and for adult athletes in their 20s, a body mass index ≤17.5 kg/m2. Bone mineral density (BMD) was measured on the heel of the right leg using an ultrasonic bone densitometer. Low BMD was defined as a BMD Z-score <−1.0. The total score for each athlete was calculated. The cumulative risk assessment was defined as follows: low risk (a total score of 0–1), moderate risk (2–5), and high risk (6). The injury survey recorded injuries referring to the injury survey items used by the International Olympic Committee. Results In swimming, significantly more athletes were in the low-risk category than in the moderate and high-risk categories (p = 0.004). In long-distance athletics, significantly more athletes were in the moderate-risk category than in the low and high-risk categories (p = 0.004). In the moderate and high-risk categories, significantly more athletes were in the injury group, whereas significantly more athletes in the low-risk category were in the non-injury group (p = 0.01). Significantly more athletes at moderate and high-risk categories had bone stress fractures and bursitis than athletes at low risk (p = 0.023). Discussion These results suggest that athletes with relative energy deficiency may have an increased injury risk.

Direct and indirect impact of low energy availability on sports performance

“…The results revealed that runners with FHA had more injury days and less annual running distance compared with the eumenorrheic runners, and only the eumenorrheic runners improved their performance over the year. 85 This study confirms the results from other research 86,87 that FHA is a potential predisposing factor for musculoskeletal overload injuries. Other reported predisposing factors are restricted EI, 88,89 DE behavior/EDs, 88 and low BMD.…”

The female athlete triad: review of current literature

“…Thus, there is a critical need to educate dancers and other athletes regarding the Triad. Young female collegiate athletes engaged in long-distance sports compared to swimmers are at a higher risk of bone stress injuries and bursitis (risk categorization based on presence or absence of amenorrhea, low BMI and BMD) [36]. Among high school female runners, up to 25.8% report irregular menses [37], while in adult runners this number is as high as 62%.…”

Taxa de lesões de ligamento cruzado anterior em jovens atletas de futebol: uma revisão sistemática

“…Além disso, a tríade da mulher atleta, caracterizada por distúrbios alimentares, ciclo menstrual irregular e baixa densidade mineral óssea, está associada com um maior número de lesões (EDAMA et al, 2021), além da associação das diferentes fases do ciclo menstrual com a frouxidão ligamentar e lesões de LCA (HERZBERG et al, 2017), que em suma apresentam um fator de risco elevado para atletas do sexo feminino.…”