American Medical Society for Sports Medicine
For Immediate Release Apr 15, 2019

Female High School Distance Runners Found to be at Increased Risk for Female Athlete Triad

Paige Skorseth, a third year medical student at the University of Wisconsin-Madison, presented a research abstract about the prevalence of female athlete triad risk factors in high school runners at the 28th Annual Meeting of the American Medical Society for Sports Medicine in Houston, TX. The study was conducted under the mentorship of Dr. Emily Kraus, MD, Clinical Assistant Professor in the Department of Orthopedic Surgery at Stanford University last summer.

The "female athlete triad" is a term used to describe three distinct but connected conditions, including, low energy availability, menstrual dysfunction and low bone mineral density. This condition has been linked with increased risk of stress fractures in some athletes.

The study evaluated the prevalence of triad risk factors and identified hormonal factors that might influence the risk to high school distance runners.

“We found alarmingly high rates of disordered eating in high school distance runners, highlighting the importance of nutrition education and the deleterious effects chronic energy deficit can have on optimal hormonal status and bone health,” Skorseth said.

A total of 38 female high school distance runners completed a survey that included dietary habits, menstrual and stress fracture history. Then they underwent DXA scans to measure body fat and bone mineral density, and Triad risk scores were calculated with the results using a modified Female Athlete Triad Cumulative Risk Assessment Tool. Finally, runners underwent lab draws including 25-hydroxyvitamin D, estradiol, and free T3.

They found a high rate of individual Triad risk factors for these athletes, with alarmingly high rates of disordered eating, eating disorders, and other related factors. They also found low free T3 was significantly associated with higher Triad risk scores.

Findings underscore an important reminder about proper screening for the Triad in high school runners, and may warrant a call to action in increasing awareness of Female Athlete Triad to physicians, athletes, and parents for better treatment and preventive care regimens among our athletes.

“Given the high prevalence of Triad risk factors in high school runners and the potential for long-term consequences, it’s essential we find a screening tool that can be implemented in settings like the pre-participation physical and allow for early recognition and intervention,” Dr. Kraus said.

About the AMSSM Annual Meeting: The 2019 AMSSM Annual Meeting brings more than 2,000 sports medicine physicians together from throughout the United States and around the world. The meeting theme is, “Small Steps and Giant Leaps in Sports Medicine,” and explores the great accomplishments, evolving technology and the accumulation of new knowledge in the field of sports medicine.

About the AMSSM: AMSSM is a multi-disciplinary organization of more than 3,800 sports medicine physicians dedicated to education, research, advocacy and the care of athletes of all ages. The majority of AMSSM members are primary care physicians with fellowship training and added qualification in sports medicine who then combine their practice of sports medicine with their primary specialty. AMSSM includes members who specialize solely in non-surgical sports medicine and serve as team physicians at the youth level, NCAA, NFL, MLB, NBA, WNBA, MLS and NHL, as well as with Olympic and Paralympic teams. By nature of their training and experience, sports medicine physicians are ideally suited to provide comprehensive medical care for athletes, sports teams or active individuals who are simply looking to maintain a healthy lifestyle. www.amssm.org