Author(s): KRZYWANSKI, J., STEPIEN, K., MALISZEWSKI, P., MLYNCZAK, M., POKRYWKA, A., KRYSZTOFIAK, H., Institution: POLISH ATHLETIC ASSOCIATION, Country: POLAND, Abstract-ID: 1025

INTRODUCTION:
Bone Stress Injuries (BSIs) are one of the main health problems among elite athletes causing loss of a large number of training days and even the end of the competition season. BSI occur as a result of an imbalance between the mechanical load placed on the bone that leads to abnormal remodelling. Numerous risk factors have been postulated for their development, including training load, type of sport, individual anatomical and biomechanical characteristics, nutritional status, and general health factors. Identifying such determinants could enable the creation of effective screening tools and targeted preventive programs to reduce injury risk among athletes. The aim of the study was to provide information about the prevalence, and selected characteristics associated with BSIs among professional Polish athletes.
METHODS:
The study included elite Polish athletes representing Olympic sport disciplines who completed a questionnaire during routine medical examinations regarding lifetime history of BSIs and training-related factors.
RESULTS:
64 of 956 active athletes (6,7%) reported BSI in their medical history. The prevalence of BSI was higher in women than in men and differed significantly across sport categories, with the highest proportion among endurance athletes. Within the BSI group, 76.6% of athletes reported a subjective relationship between the occurrence of the injury and a significant change in their training regimen. The most frequently mentioned training-related changes included increased intensity (43.8%) and training volume (21.9%), as well as early sport specialization (51.6%).
CONCLUSION:
The number of BSI reported in our group is comparable with the results of other studies which range from 4-5% annually among runners to 8.3%-52% in endurance runners and track and field athletes. The main findings of our study indicate significant associations between incidence of BSI and sex (female athletes), as well as the type of training, with a higher prevalence observed in endurance sports. Factors that have been proposed to explain higher incidence of BSIs among female athletes can be divided into two categories - those related to the constitutional structure of the female body and those related to behaviours that influence the hormonal balance. It appears that the specific nature of endurance sports appears to have a substantial influence on disrupting bone remodelling. Early specialization was significantly more prevalent in athletes with a history of BSI in mixed sports compared with endurance sports. A plausible explanation is that mixed training - combining high load in terms of volume and intensity - can cause excessive loading that disrupts bone remodelling in the developing skeletal system.
Conclusion: BSIs represent a relevant health issue among professional athletes, particularly among women and endurance athletes. Early specialization and increases in training volume were commonly reported characteristics among athletes with a history of BSI.