Injury risk assessments in collegiate female athletes

Only six percent of sport and exercise science research focuses exclusively on women. Further, factors such as the menstrual cycle, hormonal contraceptive (HC) use, and disordered eating behavior may influence sex-specific musculoskeletal injury, as seen in conditions of the Female Athlete Triad. PURPOSE: The aims of this dissertation were to 1) assess the relationships between menstrual status, hormonal contraceptive use, and skeletal and body composition measures in elite cross-country and track and field (XC&T+F) athletes, 2) examine the prevalence of symptoms relating to the Female Athlete Triad across elite athletes of various sports: XC&T+F, cheerleading, pom, and softball, and assess the most appropriate predictors of injury within each sport, and 3) investigate the relationship between menstrual status and skeletal measures in elite softball athletes, emphasizing practical monitoring protocols and injury predictors to enhance athlete health. METHODS: Elite level athletes completed training, injury and menstrual history questionnaires, the EDE-Q 6.0, validated sleep surveys, a dietary recall, and Dual-energy X-ray Absorptiometry scans (DXA). Statistical analyses were conducted specific to each research project’s aim. RESULTS: This dissertation showcased XC&T+F athletes with infrequent/absent menstrual cycles had lower lumbar spine bone density than athletes using HCs, all teams were at a similar high risk for symptoms relating to the Female Athlete Triad, and the prevalence and impact of the symptoms of the Female Athlete Triad appear to expand beyond only endurance or aesthetic-based sports as softball athletes had a high-risk of symptoms. However, these power-based athletes are not typically considered in this body of research. CONCLUSION: Taken altogether, these findings suggest a more comprehensive athlete health monitoring protocol may be warranted for early diagnosis of Female Athlete Triad symptoms.