Update on the female athlete triad

Barrack, Michelle T.; Ackerman, Kathryn E.; Gibbs, Jenna C.

doi:10.1007/s12178-013-9168-9

Cited by 69 publications

(47 citation statements)

References 102 publications

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“…22 Among distance runners, concern about energy deficits is heightened because of the prevalence of eating disorders and the female athlete triad, both of which may contribute to bone loss and bone injury. 11,[23][24][25][26] We did not formally evaluate the female athlete triad, although the number of reported fractures and stress fractures is small. Nevertheless, primary prevention of disordered eating is an important strategy for risk reduction related to compromised bone density and other physiologic health consequences of inadequate energy intake.…”

Section: Overuse and Ntl Injuriesmentioning

confidence: 99%

Epidemiology of National Collegiate Athletic Association Men's and Women's Cross-Country Injuries, 2009–2010 Through 2013–2014

Kerr

Kroshus

Grant

et al. 2016

Journal of Athletic Training

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Context: Recent injury-surveillance data for collegiate-level cross-country athletes are limited.Objective: To describe the epidemiology of National Collegiate Athletic Association (NCAA) men's and women's crosscountry injuries during the 2009-2010 through 2013-2014 academic years.Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data collected from 25 men's and 22 women's cross-country programs, providing 47 and 43 seasons of data, respectively.Patients or Other Participants: Collegiate student-athletes participating in men's and women's cross-country during the 2009-2010 through 2013-2014 academic years.Main Outcome Measure(s): Injury rates; injury rate ratios (RRs); injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs).Results: The Injury Surveillance Program captured 216 injuries from men's cross-country and 260 injuries from women's cross-country, leading to injury rates of 4.66/1000 athleteexposures (AEs) for men (95% CI ¼ 4.04, 5.28) and 5.85/1000 AEs for women (95% CI ¼ 5.14, 6.56). The injury rate in women's cross-country was 1.25 times that of men's cross-country (95% CI ¼ 1.05, 1.50). Most injuries affected the lower extremity (men ¼ 90.3%, women ¼ 81.9%). The hip/groin-injury rate in women (0.65/1000 AEs) was higher than that in men (0.15/1000 AEs; RR ¼ 4.32; 95% CI ¼ 1.89, 9.85). The ankle-injury rate in men (0.60/ 1000 AEs) was higher than that in women (0.29/1000 AEs; RR ¼ 2.07; 95% CI ¼ 1.07, 3.99). Common diagnoses were strains (men ¼ 19.9%, women ¼ 20.4%) and inflammation (men ¼ 18.1%, women ¼ 23.8%). The majority of injuries were classified as overuse (men ¼ 57.6%, women ¼ 53.3%).Conclusions: Consistent with prior research, injury distributions varied between male and female athletes, and the injury rate among females was higher. Understanding the epidemiology of these cross-country injuries may be important for developing appropriate preventive interventions.Key Words: injury prevention, collegiate sports, distance running Key PointsOur findings indicate a lower injury burden in men's and women's cross-country than previously reported. The injury rate in women's cross-country was 1.25 times that of men's cross-country. Most injuries affected the lower extremity and were diagnosed as strains and inflammation.

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Section: Overuse and Ntl Injuriesmentioning

confidence: 99%

Epidemiology of National Collegiate Athletic Association Men's and Women's Cross-Country Injuries, 2009–2010 Through 2013–2014

Kerr

Kroshus

Grant

et al. 2016

Journal of Athletic Training

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“…10,15,21,22,24,31 The prevalence of anovulation and luteal phase deficiency has not been evaluated in adolescent athletes but ranges from 5.9% to 30% in adult athletes. 11 Amenorrheic adolescent athletes have a significantly lower BMD than eumenorrheic adolescent athletes or sedentary controls. 13,31,33 Some studies have found that athletes with menstrual irregularities are as much as 3 times more likely to sustain bone stress injury and other musculoskeletal injury than are eumenorrheic athletes, 26, 34-36 but this finding has not been consistent.…”

Section: Menstrual Functionmentioning

confidence: 96%

“…In high schoolaged female athletes, the prevalence of 2 concurrent components of the triad is 4% to 18% and of any 1 component is as high as 16% to 54%. [9][10][11][12][13][14][15] Education of pediatricians, who are most likely to encounter adolescents with triad-related disorders, is especially important. Unfortunately, a 2009 study found that only 20% of pediatricians were able to correctly identify all 3 components of the triad, compared with 50% of family medicine physicians and 41% of orthopedic surgeons.…”

Section: Introductionmentioning

confidence: 99%

The Female Athlete Triad

Kelly¹,

Hecht²,

Brenner³

et al. 2016

Pediatrics

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The number of girls participating in sports has increased significantly since the introduction of Title XI in 1972. As a result, more girls have been able to experience the social, educational, and health-related benefits of sports participation. However, there are risks associated with sports participation, including the female athlete triad. The triad was originally recognized as the interrelationship of amenorrhea, osteoporosis, and disordered eating, but our understanding has evolved to recognize that each of the components of the triad exists on a spectrum from optimal health to disease. The triad occurs when energy intake does not adequately compensate for exercise-related energy expenditure, leading to adverse effects on reproductive, bone, and cardiovascular health. Athletes can present with a single component or any combination of the components. The triad can have a more significant effect on the health of adolescent athletes than on adults because adolescence is a critical time for bone mass accumulation. This report outlines the current state of knowledge on the epidemiology, diagnosis, and treatment of the triad conditions.

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“…RED-S is an interrelation between sufficient energy intake, menstrual function, and bone mineral density. Female athletes are at risk for this condition, where energy restriction can lead to amenorrhea and osteoporosis, cardiovascular effects, stress fractures, and musculoskeletal injuries [6]. Screening for RED-S and disordered eating is commonly provided for female athletes entering college, especially in schools that employ a sports Registered Dietitian who can provide appropriate education [7].…”

Section: Introductionmentioning

confidence: 99%