Epidemiology of Bone-Stress Injuries and Health Care Use in Pac-12 Cross-Country Athletes.
Bone-stress injuries (BSIs) are prevalent among collegiate cross-country runners, accounting for 20% of all reported injuries, with higher rates observed in female athletes and during the 2019-2020 season. The study highlights the significant health care resources utilized for BSIs, emphasizing the need for adequate staffing of athletic trainers and the importance of medical diagnosis for suspected injuries.
College of Health researcher(s)
Abstract
Context
Bone-stress injury (BSI) is common in collegiate athletes. Injury rates and health care use in running athletes are not well documented.
Objective
To describe the rate and classification of injury and associated health care use in collegiate cross-country runners with BSI.
Design
Descriptive epidemiology study.
Setting
Sports medicine facilities participating in the Pac-12 Health Analytics Program.
Patients or Other Participants
Pac-12 Conference collegiate cross-country athletes.
Main Outcome Measure(s)
Counts of injury and health care resources used for each injury. Injury rates were calculated based on athlete-seasons.
Results
A total of 168 BSIs were reported over 4 seasons from 80 team-seasons (34 men’s and 46 women’s team-seasons) and 1220 athlete-seasons, resulting in 1764 athletic training services and 117 physician encounters. Bone-stress injuries represented 20% of all injuries reported by cross-country athletes. The average BSI rate was 0.14 per athlete-season. Injury rates were higher in female (0.16) than male (0.10) athletes and higher in the 2019–2020 season (0.20) than the 2020–2021 (0.14), 2018–2019 (0.12), and 2021–2022 (0.10) seasons. Most BSIs occurred in the lower leg (23.8%) and the foot (23.8%). The majority of injuries were classified as overuse and time loss (72.6%) and accounted for most of the athletic training services (75.3%) and physician encounters (72.6%). We found a mean of 10.89 athletic training services per overuse and time-loss injury and 12.20 athletic training services per overuse and non–time-loss injury. Mean occurrence was lower for physician encounters (0.70), prescription medications (0.04), tests (0.75), procedures (0.01), and surgery (0.02) than for athletic training services (10.50).
Conclusions
Bone-stress injuries are common in collegiate cross-country runners and require considerable athletic training resources. Athletic trainers should be appropriately staffed for this population, and suspected BSIs should be confirmed with a medical diagnosis. Future investigators should track treatment codes associated with BSI to determine best-practice patterns.