High-Impact Activities Increase Fracture Risk in Girls

Basketball, running, gymnastics, or cheerleading predict stress fractures in adolescent girls

TUESDAY, April 5 (HealthDay News) -- Specific high-impact activities, including basketball, running, gymnastics, and cheerleading, significantly increase the risk of stress fractures among adolescent girls, according to a study published online April 4 in the Archives of Pediatrics & Adolescent Medicine.

Alison E. Field, Sc.D., from Harvard Medical School in Boston, and colleagues assessed the relationship between the type and quantity of physical activity and the risk of developing a stress fracture in 6,831 adolescent female participants (aged 9 to 15 years) from the Growing Up Today Study. The researchers assessed the girls' exposure to physical activity each year, from 1996 to 2003, through self-report questionnaires completed by the participants. In 2004, the girls' mothers reported any history of a stress fracture, including the site and age at which it occurred. Incident stress fracture occurring between 1997 and 2004 was the main outcome of the study.

The researchers found that 3.9 percent of girls developed stress fractures. Hours per week of running, basketball, and cheerleading or gymnastics (hazard ratios, 1.13, 1.12, and 1.12, respectively) were significant predictors of developing a stress fracture, independent of age, family history of fracture, age at menarche, and hours per week of low- and moderate-impact activity. Other high-impact activities were not correlated with increased risk of stress fractures.

"Girls who engage in running, basketball, cheerleading, or gymnastics should be encouraged to include varied training in lower-impact activities to decrease the cumulative amount of impact in order to minimize their risk of stress fractures," the authors write.

Two study authors disclosed financial relationships with the pharmaceutical industry.

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