Risk Factors for Stress Fractures in Female Runners: Results of a Survey
# Background Few studies compare women with and without stress fractures and most focus on younger, elite runners. # Hypothesis/Purpose Compare risk factors between female runners with and without a stress fracture history. # Study Design Case control # Methods An online survey targeting women a...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2021-02-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.18806 |
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| _version_ | 1825139407029534720 |
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| author | Therese E Johnston Allison E Jakavick Caroline A Mancuso Kathleen C McGee Lily Wei Morgan L Wright Jeremy Close Ayako Shimada Benjamin E Leiby |
| author_facet | Therese E Johnston Allison E Jakavick Caroline A Mancuso Kathleen C McGee Lily Wei Morgan L Wright Jeremy Close Ayako Shimada Benjamin E Leiby |
| author_sort | Therese E Johnston |
| collection | DOAJ |
| description | # Background
Few studies compare women with and without stress fractures and most focus on younger, elite runners.
# Hypothesis/Purpose
Compare risk factors between female runners with and without a stress fracture history.
# Study Design
Case control
# Methods
An online survey targeting women age ≥18 years was distributed primarily via social media. Questions included demographics, running details, cross training, nutrition, injury history, medical/menstrual history, and medications. Women with stress fracture histories answered questions about location, number, and changes made. Data were compared between groups using t-tests, chi-square tests, or Fisher’s exact tests. Multivariable logistic regression models simultaneously investigated associations of multiple factors using backward variable selection.
# Results
Data from 1648 respondents were analyzed. Mean age was 40 years, and 25.4% reported stress fractures. Significant differences were found between groups for days/week running, mileage/week, running pace, years running, having a coach, cycling or swimming, calorie consumption for activity, other running injuries, medical history, medication/supplement intake, age at menarche, and going ≥6 months without a menstrual period. Odds of having a stress fracture were increased with osteopenia (OR 4.14), shin splints (OR 3.24), tendon injuries (OR 1.49), running >20 miles/week (OR 1.74-1.77) compared to 11-20 miles/week, having a coach (OR 1.86), and cycling (OR 1.15). Women running 11:00-11:59 minutes/mile or slower were less likely to have a stress fracture compared to those running 9:00-9:59 minutes/mile (OR 0.43-0.54). The odds of having a stress fracture were 1.43 times higher for going ≥ 6 months without a menstrual period. Use of calcium, probiotics, and vitamin D increased odds. Post fracture, common changes made were with cross training (49%), mileage (49%), and strength training (35%).
# Conclusions
Multiple intrinsic and extrinsic factors were identified for female runners who sustained one or more stress fracture during running. Prospective studies are warranted to infer a cause and effect relationship amongst these variables and stress fracture risk.
# Level of Evidence
Level IV |
| format | Article |
| id | doaj-art-bb84b5549d294f9a8afbbbf6d84efdab |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-bb84b5549d294f9a8afbbbf6d84efdab2025-02-11T20:28:21ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962021-02-01161Risk Factors for Stress Fractures in Female Runners: Results of a SurveyTherese E JohnstonAllison E JakavickCaroline A MancusoKathleen C McGeeLily WeiMorgan L WrightJeremy CloseAyako ShimadaBenjamin E Leiby# Background Few studies compare women with and without stress fractures and most focus on younger, elite runners. # Hypothesis/Purpose Compare risk factors between female runners with and without a stress fracture history. # Study Design Case control # Methods An online survey targeting women age ≥18 years was distributed primarily via social media. Questions included demographics, running details, cross training, nutrition, injury history, medical/menstrual history, and medications. Women with stress fracture histories answered questions about location, number, and changes made. Data were compared between groups using t-tests, chi-square tests, or Fisher’s exact tests. Multivariable logistic regression models simultaneously investigated associations of multiple factors using backward variable selection. # Results Data from 1648 respondents were analyzed. Mean age was 40 years, and 25.4% reported stress fractures. Significant differences were found between groups for days/week running, mileage/week, running pace, years running, having a coach, cycling or swimming, calorie consumption for activity, other running injuries, medical history, medication/supplement intake, age at menarche, and going ≥6 months without a menstrual period. Odds of having a stress fracture were increased with osteopenia (OR 4.14), shin splints (OR 3.24), tendon injuries (OR 1.49), running >20 miles/week (OR 1.74-1.77) compared to 11-20 miles/week, having a coach (OR 1.86), and cycling (OR 1.15). Women running 11:00-11:59 minutes/mile or slower were less likely to have a stress fracture compared to those running 9:00-9:59 minutes/mile (OR 0.43-0.54). The odds of having a stress fracture were 1.43 times higher for going ≥ 6 months without a menstrual period. Use of calcium, probiotics, and vitamin D increased odds. Post fracture, common changes made were with cross training (49%), mileage (49%), and strength training (35%). # Conclusions Multiple intrinsic and extrinsic factors were identified for female runners who sustained one or more stress fracture during running. Prospective studies are warranted to infer a cause and effect relationship amongst these variables and stress fracture risk. # Level of Evidence Level IVhttps://doi.org/10.26603/001c.18806 |
| spellingShingle | Therese E Johnston Allison E Jakavick Caroline A Mancuso Kathleen C McGee Lily Wei Morgan L Wright Jeremy Close Ayako Shimada Benjamin E Leiby Risk Factors for Stress Fractures in Female Runners: Results of a Survey International Journal of Sports Physical Therapy |
| title | Risk Factors for Stress Fractures in Female Runners: Results of a Survey |
| title_full | Risk Factors for Stress Fractures in Female Runners: Results of a Survey |
| title_fullStr | Risk Factors for Stress Fractures in Female Runners: Results of a Survey |
| title_full_unstemmed | Risk Factors for Stress Fractures in Female Runners: Results of a Survey |
| title_short | Risk Factors for Stress Fractures in Female Runners: Results of a Survey |
| title_sort | risk factors for stress fractures in female runners results of a survey |
| url | https://doi.org/10.26603/001c.18806 |
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