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García-Alonso M, Corral-Gudino L. High prevalence of stress fractures and long-term amenorrhoea in high endurance female athletes: The misleading lack of correlation with bone mineral density. J Orthop 2024; 55:109-113. [PMID: 38681828 PMCID: PMC11047200 DOI: 10.1016/j.jor.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open
Abstract
Aim & objectives Females who engage in high levels of sports have a high prevalence of menstrual cycle disorders and bone stress injuries (BSI). In this study, we determined the prevalence of menstrual disorders and fractures in female athletes and their association with bone mineral density (BMD) parameters. Material & methods Cross-Sectional Study. Forty-one female athletes from a public High-Performance Regional Centre; 24 high-endurance athletes (HEA) and 17 other athletes, were included. To form the control group, we invited medical students from a public University. Twenty-nine non-athletes (NA) were included. A health surveys and a dual-energy X-ray absorptiometry (DXA) were conducted for all participants. Results Among the participants (median age, 24 years; body mass index, 21 kg/m2), the percentage of long-term amenorrhoea was 42 % in HEA vs. 0 % in NHEA (OR 25.35; 95 % CI 1.37-470.50, p = 0.008) or 10 % in NA (OR 6.20; 95 % CI 1.46-26.24, p = 0.022), and the percentage of BSI was 29 % in HEA vs. 0 % in NHEA or NA. Both groups of female athletes (HEA and NHEA) showed higher Z-scores than those of NA in the femur; however, only NHEA had a significant increase in the BMD on lumbar spine than that of NA. Conclusion The prevalence of long-term amenorrhoea and/or BSI was significantly higher in the HEA than in the NHEA or NA females. In contrast, HEA, like NHEA, had higher BMD values in the femur than those of controls. It is unlikely that DXA parameters can be used to estimate cortical BSI risk in this population.
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Affiliation(s)
- M. García-Alonso
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005, Valladolid, Spain
| | - L. Corral-Gudino
- Department of Medicine, Dermatology and Toxicology. School of Medicine, University of Valladolid, Av. Ramón y Cajal, 7, 47005, Valladolid, Spain
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Walton CC, Purcell R, Henderson JL, Kim J, Kerr G, Frost J, Gwyther K, Pilkington V, Rice S, Tamminen KA. Mental Health Among Elite Youth Athletes: A Narrative Overview to Advance Research and Practice. Sports Health 2024; 16:166-176. [PMID: 38173251 PMCID: PMC10916785 DOI: 10.1177/19417381231219230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
CONTEXT Participation in sports during youth is typically beneficial for mental health. However, it is unclear whether elite sport contexts contribute to greater risk of psychological distress or disorder. The aims of this paper are to highlight conceptual issues that require resolution in future research and practice, and to examine the key factors that may contribute to the mental health of elite youth athletes (EYAs). EVIDENCE ACQUISITION A narrative overview of the literature combined with the clinical and research expertise of the authors. STUDY DESIGN Narrative overview. LEVEL OF EVIDENCE Level 5. RESULTS EYAs experience a range of biopsychosocial developmental changes that interact with mental health in a multitude of ways. In addition, there are various sport-specific factors that contribute to the mental health of EYAs that may become more prominent in elite contexts. These include - but are not limited to - patterns relating to athlete coping and self-relating styles, the nature of peer, parental, and coach relationships, organizational culture and performance pressures, and mental health service provision and accessibility. CONCLUSION A range of critical factors across individual, interpersonal, organizational, and societal domains have been shown to contribute to mental health among EYAs. However, this evidence is limited by heterogeneous samples and varied or imprecise terminology regarding what constitutes "youth" and "elite" in sport. Nevertheless, it is clear that EYAs face a range of risks that warrant careful consideration to progress to best practice principles and recommendations for mental health promotion and intervention in elite youth sport. SORT Level C.
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Affiliation(s)
- Courtney C Walton
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Rosemary Purcell
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Jo L Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Jeemin Kim
- Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Gretchen Kerr
- Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada
| | - Joshua Frost
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Kate Gwyther
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Vita Pilkington
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Simon Rice
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Elite Sports and Mental Health, Orygen, Melbourne, Australia
| | - Katherine A Tamminen
- Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada
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