High-impact sports associated with increased risk of stress fracture among adolescent girls

Apr 04, 2011

Adolescent girls participating in high-impact physical activity, specifically basketball, running and gymnastics/cheerleading, appear to be at increased risk for developing stress fractures, according to a report posted online today that will appear in the August print issue of Archives of Pediatrics & Adolescent Medicine.

"Weight-bearing activity stimulates bone remodeling and thus increases bone mass density, but very high levels of activity may be detrimental to bone health and increase the risk of stress fracture," the authors write as background information in the article. "Although stress fractures are relatively uncommon, they affect as many as 20 percent of young female athletes and military recruits."

Alison E. Field, Sc.D., of Children's Hospital and Harvard Medical School, Boston, and colleagues examined data on 6,831 girls between the ages of 9 and 15. Participants were daughters of women enrolled in the Nurses' Heath Study II, and data were collected using self-report questionnaires between 1996 and 2004.

During seven years of follow-up, 267 girls (3.9 percent) developed a stress fracture. Family history of osteoporosis or low bone mass density was strongly associated with the risk of stress fracture. Girls reporting a family history of osteoporosis or low bone mass density were almost twice as likely to develop stress fracture. Additionally, girls who engaged in eight or more hours of a week were twice as likely to develop a stress fracture as those who engaged in less than four hours of activity per week.

When examining high-impact sports individually, only basketball, running, and gymnastics/cheerleading were independently associated with increased risk of stress fracture. Neither nonimpact activity nor medium-impact activity was predictive of increased risk, but each hour of high-impact activity increased the risk of stress fracture by approximately 8 percent.

Older age at the start of a girl's menstrual period also increased the risk of developing stress fracture. Each one-year delay in onset of menstruation was associated with an approximate 30 percent increase in risk. Being underweight, overweight and engaging in disordered eating were not associated with the risk of developing stress fracture.

"Our study observed that high impact activities, specifically , running and gymnastics/cheerleading, significantly increase risk for stress fracture among . Thus, there is a need to establish training programs that are rigorous and competitive but include varied training in lower-impact activities to decrease the cumulative amount of impact in order to reduce the risk of stress fracture," the authors conclude. "Therefore, clinicians, parents and coaches should continue to promote activity to young girls but should make sure that training hours are not excessive, thereby not compromising bone health."

Explore further: Sugary drinks linked to earlier onset of menstrual periods

More information: Arch Pediatr Adolesc Med. Published online April 4, 2011. doi:10.1001/archpediatrics.2011.34

add to favorites email to friend print save as pdf

Related Stories

HIV patients at greater risk for bone fractures

Aug 28, 2008

HIV-infected patients have a higher prevalence of fractures than non HIV-infected patients, across both genders and critical fracture sites according to a new study accepted for publication in The Endocrine Society's Journal of ...

Gymnastic training improves bone health in girls

May 05, 2010

According to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM), long-term elite rhythmic gymnastics exerts positive effects on volumetric bone density and bo ...

Recommended for you

Health insurers using drug coverage to discriminate

2 hours ago

Some insurers offering health plans through the new federal marketplace may be using drug coverage decisions to discourage people with HIV from selecting their plans, according to a new study from Harvard ...

Why medical debt – and bankruptcy – are growing problems

3 hours ago

Burdensomely high medical costs are often blamed for pushing many Americans into bankruptcy. According to the Consumer Financial Protection Bureau some 43 million Americans have unpaid medical debt on their credit reports. ...

California declares electronic cigarettes a health threat

4 hours ago

California health officials on Wednesday declared electronic cigarettes a health threat that should be strictly regulated like tobacco products, joining other states and health advocates across the U.S. in seeking tighter ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.