Intrinsic Anthropometric Factors Associated with Bone Stress Injuries in Collegiate Runners: New Risk Metrics & Novel Field Screening Tools

Authors

Pranav Gadangi, Texas A&M UniversityFollow
Aaron Carbuhn, University of KansasFollow
Daniel Yu, University of KansasFollow
Lawrence Magee, University of KansasFollow
Patrick McCulloch, Houston MethodistFollow
Bradley Lambert, Houston Methodist HospitalFollow

Abstract

Lower extremity bone stress injuries (BSI) (i.e. pelvis, femur, tibia) are common in distance running athletes relative to other sports. PURPOSE: To (1) characterize bone mineral density (BMD), body composition (BComp, DXA), and anthropometric parameters in D1A collegiate runners presenting with and without BSIs during a collegiate season and (2) develop BMD prediction models with an accompanying mobile application for novel noninvasive field prediction of BMD and BSI risk. METHODS: Distance runners (n = 79; 42♂, 37♀) from a single university track and field team were retrospectively enrolled into study. The runners completed a DXA scan during fall screening (August-November). Three months after scanning, medical records were reviewed for the occurrence of BSI confirmed by a licensed physician. A t-test was used to compare BMD (total and regional [spine, pelvis, and legs]), BComp (% body fat, fat mass, and lean mass), and anthropometric measurements (shoulder width and leg, arm, and trunk length) between runners with versus without BSI (included subgroup analysis by sex). Multiple linear regression with stepwise removal was used to determine variables most predictive of BMD. Xcode (Apple Inc.) was used to develop the mobile application based on the derived BMD prediction models utilizing lower-bound 95% confidence intervals for runner-specific BMD norms as risk cutoffs. RESULTS: Eighteen runners (22.8%; 11♀, 7♂) sustained a lower limb BSI. Compared to the noninjured group (NoBSI), injured runners (BSI) had lower total BMD (NoBSI: 1.24 0.02, BSI: 1.15 0.04, p<0.001) and regional BMD (spine -11%, legs -9%, pelvis -10%, p<0.001). Injured athletes were observed to have shorter leg length (NoBSI: 95.6 1.4cm, BSI: 91.9 2.6cm, p=0.015) and arm length (NoBSI: 56.1 0.8, BSI: 53.8 1.5, p=0.006). Injured males had lower fat mass (NoBSI: 7.7 0.5kg, BSI: 6.4 0.7cm, p=0.041) and injured females had lower leg lean mass (NoBSI: 14.7 0.6kg, BSI: 13.5 0.7kg, p=0.035). BComp and anthropometric measures were predictive of bone mass (p<0.05, R² =0.61; SE= ±0.27^kg) and BMD (Total: p<0.05, R² =0.77; SE= ±0.05^g/cm2). BONE MASS, kg = (0.046 x Age^years) +(0.024 x Weight^kg) +(0.014 x %BodyFat) +(-0.017 x Arm Length^cm) +(0.017 x Shoulder Width^cm) +(-0.009 x Trunk Length^cm) +(0.037 x Leg Length^cm) -2.867] | BMD, g cm² =(-0.011 x %BodyFat) + (0.016 x Fat Mass ^kg) + (0.203 x Bone Mass^kg) +(-0.003 x Leg Length^cm) +1.023. The mobile application was able to successfully run the developed prediction models for BMD assessment. CONCLUSION: Collegiate distance runners with shorter limb lengths, reduced fat mass(♂), reduced leg lean mass(♀), and lower BMD are at an increased risk for a lower extremity BSI. BComp and anthropometric measures are predictive of BMD in this population and may be utilized with the mobile application developed here as a screening tool to identify potentially “at-risk” runners.

Recommended Citation

Gadangi, Pranav; Carbuhn, Aaron; Yu, Daniel; Magee, Lawrence; McCulloch, Patrick; and Lambert, Bradley (2022) "Intrinsic Anthropometric Factors Associated with Bone Stress Injuries in Collegiate Runners: New Risk Metrics & Novel Field Screening Tools," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 14, Article 20.
Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss14/20