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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Autores principales:	Therese E Johnston, Allison E Jakavick, Caroline A Mancuso, Kathleen C McGee, Lily Wei, Morgan L Wright, Jeremy Close, Ayako Shimada, Benjamin E Leiby
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/bb84b5549d294f9a8afbbbf6d84efdab
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spelling	oai:doaj.org-article:bb84b5549d294f9a8afbbbf6d84efdab2021-12-02T17:43:26ZRisk Factors for Stress Fractures in Female Runners: Results of a Survey10.26603/001c.188062159-2896https://doaj.org/article/bb84b5549d294f9a8afbbbf6d84efdab2021-02-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/18806-risk-factors-for-stress-fractures-in-female-runners-results-of-a-survey.pdfhttps://doaj.org/toc/2159-2896# 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 IVTherese E JohnstonAllison E JakavickCaroline A MancusoKathleen C McGeeLily WeiMorgan L WrightJeremy CloseAyako ShimadaBenjamin E LeibyNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 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
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
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
title	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_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_sort	risk factors for stress fractures in female runners: results of a survey
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/bb84b5549d294f9a8afbbbf6d84efdab
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Risk Factors for Stress Fractures in Female Runners: Results of a Survey

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