Relationships Among Injury and Disordered Eating, Menstrual Dysfunction, And Low Bone Mineral Density in High School Athletes: A Prospective Study (Original Research) (Report‪)‬

The participation by girls in interscholastic sports in the United States has increased from 1.84 million during the 1988-1989 school year to 3 million high school athletes during the 2007-2008 school year. (1) This participation represents an increase of 65.9% for girls, compared with 27.6% for boys during the 2-decade span. Although many benefits can be gained from involvement in interscholastic sports, the increased activity among girls may also present greater opportunities for musculoskeletal injury. In fact, authors (2-4) of recent prospective studies of high school populations have reported higher injury rates among female athletes than male athletes in similar sports. Negative consequences of sport-related musculoskeletal injuries among female athletes include reduced playing time and possible loss of an entire season of sport participation. Over the long term, injuries may lead to chronic musculoskeletal problems, restricting pain-free mobility and participation in fitness-enhancing activities later in life. (5) Information regarding risk factors specific to musculoskeletal injuries among female high school athletes is limited. Growing evidence suggests that the 3 interrelated conditions of the female athlete triad (low energy availability, with or without disordered eating; menstrual dysfunction; and low bone mass) may place a female athlete at greater risk for musculoskeletal injury, primarily stress fracture. (6) However, few researchers (7-9) have reported the association among musculoskeletal injury and all triad components simultaneously in female athletes. Instead, most investigators have evaluated the association among musculoskeletal injury and 1 or 2 individual components.