Research

Mixed

The incidence of bone stress injuries in female athletes increases significantly with the cumulative number of Female Athlete Triad-related risk factors, rising from approximately 15-20% for single factors to 30-50% for combined factors.

For female athletes, injury risk is not just about how much you train, but your metabolic health. If you have low bone density, low body weight, irregular periods, or high dietary restraint, your risk of stress fractures multiplies. To prevent injury, you must address these underlying Triad factors—specifically ensuring adequate energy availability and bone health—rather than just modifying training volume.

GoodSupportsHIGH confidence
the risk of BSIs increased from approximately 15% to 20% for significant single risk factors to 30% to 50% for significant combined female athlete triad–related risk factor variables.
Michelle T. Barrack et al. · The American Journal of Sports Medicine · 2014

Why this rating

Prospective multisite cohort study with a reasonable sample size (N=259) and physician-confirmed outcomes, though not a randomized controlled trial.

Source

Higher Incidence of Bone Stress Injuries With Increasing Female Athlete Triad–Related Risk Factors

Michelle T. Barrack et al. · The American Journal of Sports Medicine · 2014

DOI 10.1177/0363546513520295

cohort · n=259Cited 336×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →