Cross-Sectional Investigation of Stress Fractures in German Elite Triathletes

Neidel Neidel,Engelhardt Engelhardt,Wolfram Wolfram,Hotfiel Hotfiel,Koch Koch,Zwingenberger Zwingenberger,Lee Lee

doi:10.3390/sports7040088

Abstract

Triathlon is a popular sport for both recreational and competitive athletes. This study investigated the rates and patterns of stress fractures in the German national triathlon squad. We developed a web-based retrospective questionnaire containing questions about the frequency of stress fractures, anatomic localisation and associated risk factors. The survey was conducted as an explorative cross-sectional study. Eighty-six athletes completed the questionnaire. Twenty athletes (23%) sustained at least one stress fracture. All documented stress fractures were located in the lower extremities. Factors associated with a higher risk for stress fractures were female gender, competitive sport prior to triathlon career, Vitamin D or iron deficiency, menstrual disturbances and a high number of annual training hours. Disseminating knowledge among athletes and their professional community in order to raise awareness about early symptoms and relevant risk factors could help to improve prevention and reduce the incidence of stress fractures.

Highlights

Triathlon is an endurance sport that is growing in popularity
A central aim of this investigation was the identification of factors that may be associated with an increase of risk for stress fractures
Taking all aspects into consideration, among German elite triathletes, athletes with the following factors were associated with sustaining a stress fracture: female gender, background in competitive sports, Vitamin D or iron deficiency, nutritional supplementation, irregular menstrual cycles and high total training amounts

Summary

Introduction

Triathlon is an endurance sport that is growing in popularity. It comprises three disciplines in one event: swimming, cycling, and running. There are numerous competitive events ranging from sprint distance (0.75 km–20 km–5 km) to long distance triathlon (3.8 km–180 km–42 km). Related formats are duathlon or relay competitions. Games reflects the highest achievable sporting event for short distance athletes. Triathlon has been included in the Olympic Program since Sydney 2000.

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Conclusion