The Relationship Between Amenorrhea and Injury Among Girls High School Cross Country Runners

Abstract

0260 Recent studies indicate amenorrhea may be a risk factor for musculoskeletal injury and osteopenia/osteoporosis. The relationship between amenorrhea and injury among female runners has been primarily reported in collegiate, military and adult populations, but few studies have reported this relationship among female high school runners. PURPOSE: To determine the prevalence and relationship of amenorrhea and injury among female athletes participating in high school cross country running. METHODS: This prospective study of 186 high school female cross country runners involved pre- and post-season measures of self-reported menstrual cycle history. Coaches/athletic used the Athletic Health Care System Daily Injury Report to report running-related injuries. Relative risk estimates and 95% CIs were used to determine the relationship of amenorrhea and risk of running injury. RESULTS: Runners reported a prevalence of amenorrhea of 30.1% pre-season. At post-season, 64 runners (34.4%) reported a history of amenorrhea during the past year. Of these, 1.6% (n = 3) reported primary amenorrhea (no onset of menarche by age 16), and 32.8% (n = 61) secondary amenorrhea (<9 menstrual cycles during the past year). Relative risk estimates between amenorrhea and all running injuries (RR = 1.3, 95% CI: 0.9–1.9; p>.05), shin injuries only (RR = 1.3, 95% CI: 0.7–2.3; p>.05), and stress fractures (RR = 2.9, 95% CI: 0.5–16.7; p>.05) were found. CONCLUSIONS: In this study, no significant relationship was found between amenorrhea and injury among high school cross country runners. However, the prevalence estimates and observed trend between amenorrhea and incidence of stress fractures reported here confirm the need for additional studies in this population. Supported by a grant from the American Physical Therapy Association