Cross-Sectional Investigation of Stress Fractures in German Elite Triathletes
Pauline Neidel,
Petra Wolfram,
Thilo Hotfiel,
Martin Engelhardt,
Rainer Koch,
Geoffrey Lee,
Stefan Zwingenberger
Affiliations
Pauline Neidel
Department of Sports Medicine at the University Center for Orthopaedics and Traumatology, University Medicine Carl Gustav Carus, Technical University Dresden, 01307 Dresden, Germany
Petra Wolfram
Department for Sports Science, German Triathlon Federation, 60528 Frankfurt/Main, Germany
Thilo Hotfiel
Department of Orthopaedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
Martin Engelhardt
Department of Trauma and Orthopedic Surgery, Klinikum Osnabrück, 49076 Osnabrück, Germany
Rainer Koch
Department of Medical Statistics and Biometry, Medical Faculty Carl Gustav Carus at Technical University Dresden, 01307 Dresden, Germany
Geoffrey Lee
Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7FY, UK
Stefan Zwingenberger
Department of Sports Medicine at the University Center for Orthopaedics and Traumatology, University Medicine Carl Gustav Carus, Technical University Dresden, 01307 Dresden, Germany
Triathlon is a popular sport for both recreational and competitive athletes. This study investigated the rates and patterns of stress fractures in the German national triathlon squad. We developed a web-based retrospective questionnaire containing questions about the frequency of stress fractures, anatomic localisation and associated risk factors. The survey was conducted as an explorative cross-sectional study. Eighty-six athletes completed the questionnaire. Twenty athletes (23%) sustained at least one stress fracture. All documented stress fractures were located in the lower extremities. Factors associated with a higher risk for stress fractures were female gender, competitive sport prior to triathlon career, Vitamin D or iron deficiency, menstrual disturbances and a high number of annual training hours. Disseminating knowledge among athletes and their professional community in order to raise awareness about early symptoms and relevant risk factors could help to improve prevention and reduce the incidence of stress fractures.
