Bone Stress Injury in Division I Collegiate Long-Distance Runners: A Five Year Retrospective Analysis

Abstract

Stress fractures continue to be a common source of injury in competitive athletes, especially those that participate in high impact exercise. These overuse injuries cause considerable loss of training time, inability to compete and in extreme cases can be career ending for the competitive athlete. Over the last decade much emphasis has been rightly placed on the female athlete triad and their risk of bone stress injury. Incidence rates of injury however, appear to be more closely distributed between males and females in the athletic population as demonstrated in studies by Nattiv et al and Bennell et al. PURPOSE: To study the incidence of bone stress injury over the course of five years in male and female Division I collegiate distance runners. METHODS: A retrospective chart review was undertaken to identify male and female long distance runners of the University of Colorado Cross Country and or Track and Field teams who were diagnosed with bony stress injuries during the time from August 1st 2004 to July 31st 2009. Our definition of distance runners were athletes that raced distances of at least 5000m, were not cut from the team during the academic year and competed and trained as active members of the team for at least six months of the academic year. RESULTS: 102 athletes met the criteria standard for inclusion into our analysis and were evenly split with 51 female and 51 male distance runners. There were a total of 56 stress fractures/stress reactions diagnosed by MRI and or bone scan during the 5 year interval with 31 occurring in female athletes and 25 in males. Annual incidence of bone stress injury ranged from 16.7% to 41.2% in females with an annual incidence rate of 28.1% averaged over 5 years, and ranged from 14.3% to 31.8% in the men with an annual incidence rate of 21.8% when averaged over 5 years. CONCLUSIONS: Bone stress injury rates in our study population of Division I collegiate distance runners remain persistently high, with elevated rates in both male and female runners alike.