{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T05:43:19Z","timestamp":1775713399125,"version":"3.50.1"},"reference-count":38,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"\n Context<\/jats:title>\n Bone-stress injury (BSI) is common in collegiate athletes. Injury rates and health care use in running athletes are not well documented.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To describe the rate and classification of injury and associated health care use in collegiate cross-country runners with BSI.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Descriptive epidemiology study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Sports medicine facilities participating in the Pac-12 Health Analytics Program.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n Pac-12 Conference collegiate cross-country athletes.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Counts of injury and health care resources used for each injury. Injury rates were calculated based on athlete-seasons.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 168 BSIs were reported over 4 seasons from 80 team-seasons (34 men\u2019s and 46 women\u2019s team-seasons) and 1220 athlete-seasons, resulting in 1764 athletic training services and 117 physician encounters. Bone-stress injuries represented 20% of all injuries reported by cross-country athletes. The average BSI rate was 0.14 per athlete-season. Injury rates were higher in female (0.16) than male (0.10) athletes and higher in the 2019\u20132020 season (0.20) than the 2020\u20132021 (0.14), 2018\u20132019 (0.12), and 2021\u20132022 (0.10) seasons. Most BSIs occurred in the lower leg (23.8%) and the foot (23.8%). The majority of injuries were classified as overuse and time loss (72.6%) and accounted for most of the athletic training services (75.3%) and physician encounters (72.6%). We found a mean of 10.89 athletic training services per overuse and time-loss injury and 12.20 athletic training services per overuse and non\u2013time-loss injury. Mean occurrence was lower for physician encounters (0.70), prescription medications (0.04), tests (0.75), procedures (0.01), and surgery (0.02) than for athletic training services (10.50).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Bone-stress injuries are common in collegiate cross-country runners and require considerable athletic training resources. Athletic trainers should be appropriately staffed for this population, and suspected BSIs should be confirmed with a medical diagnosis. Future investigators should track treatment codes associated with BSI to determine best-practice patterns.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0089.23","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T17:41:48Z","timestamp":1689615708000},"page":"641-648","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiology of Bone-Stress Injuries and Health Care Use in Pac-12 Cross-Country Athletes"],"prefix":"10.4085","volume":"59","author":[{"given":"Robert Aaron","family":"Wayner","sequence":"first","affiliation":[{"name":"Division of Physical Therapy, School of Rehabilitation and Communication Sciences and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathleen N.","family":"Brown Crowell","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences, Oregon State University, Corvallis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"Bovbjerg","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences, Oregon State University, Corvallis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Federicson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University, Redwood City, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Soucy","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences, Oregon State University, Corvallis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SeokJae","family":"Choe","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences, Oregon State University, Corvallis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet E.","family":"Simon","sequence":"additional","affiliation":[{"name":"Division of Athletic Training, School of Applied Health Sciences & Wellness, Ohio University, Athens"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"key":"i1938-162X-59-6-641-b01","article-title":"Physical Activity Council","author":"2021 Participation report","unstructured":"2021 Participation report\n . Physical Activity Council. Accessed June 21, 2021. http:\/\/www.physicalactivitycouncil.com\/"},{"issue":"7","key":"i1938-162X-59-6-641-b02","series-title":"J Athl Train","first-page":"622","article-title":"Epidemiology of injuries in National Collegiate Athletic Association women\u2019s cross-country: 2014\u20132015 through 2018\u20132019","volume":"56","author":"Chandran","year":"2021","unstructured":"Chandran\n A,\n \n \n Morris\n SN,\n \n \n Boltz\n AJ,\n \n \n Robison\n HJ,\n \n \n Collins\n CL.\n \n \n Epidemiology of injuries in National Collegiate Athletic Association women\u2019s cross-country: 2014\u20132015 through 2018\u20132019. J Athl Train. 2021;56(7):622\u2013628. doi:10.4085\/1062-6050-395-20"},{"key":"i1938-162X-59-6-641-b03","article-title":"NCAA sports sponsorship and participation rates report. 1956\u201357 through 2020\u201321","unstructured":"NCAA sports sponsorship and participation rates report. 1956\u201357 through 2020\u201321. National Collegiate Athletic Association. Published December 1, 2021. Revised January 1, 2022. Accessed July 29, 2022. https:\/\/ncaaorg.s3.amazonaws.com\/research\/sportpart\/2021RES_SportsSponsorshipParticipationRatesReport.pdf"},{"key":"i1938-162X-59-6-641-b04","article-title":"National Federation of State High School Associations","author":"2018\u201319 High school athletics participation survey.","unstructured":"2018\u201319 High school athletics participation survey.\n \n National Federation of State High School Associations. Accessed September 13, 2021. https:\/\/www.nfhs.org\/media\/1020412\/2018-19_participation_survey.pdf"},{"issue":"7","key":"i1938-162X-59-6-641-b05","series-title":"Sports Med","first-page":"1017","article-title":"Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis","volume":"45","author":"Videb\u00e6k","year":"2015","unstructured":"Videb\u00e6k\n S,\n \n \n Bueno\n AM,\n \n \n Nielsen\n RO,\n \n \n Rasmussen\n S.\n \n \n Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med. 2015;45(7):1017\u20131026. doi:10.1007\/s40279-015-0333-8"},{"issue":"7","key":"i1938-162X-59-6-641-b06","series-title":"J Athl Train","first-page":"629","article-title":"Epidemiology of injuries in National Collegiate Athletic Association men\u2019s cross-country: 2014\u20132015 through 2018\u20132019","volume":"56","author":"Chandran","year":"2021","unstructured":"Chandran\n A,\n \n \n Morris\n SN,\n \n \n Boltz\n AJ,\n \n \n Robison\n HJ,\n \n \n Collins\n CL.\n \n \n Epidemiology of injuries in National Collegiate Athletic Association men\u2019s cross-country: 2014\u20132015 through 2018\u20132019. J Athl Train. 2021;56(7):629\u2013635. doi:10.4085\/1062-6050-394-20"},{"issue":"10","key":"i1938-162X-59-6-641-b07","series-title":"J Athl Train","first-page":"966","article-title":"The epidemiology of stress fractures in collegiate student-athletes, 2004\u20132005 through 2013\u20132014 academic years","volume":"52","author":"Rizzone","year":"2017","unstructured":"Rizzone\n KH,\n \n \n Ackerman\n KE,\n \n \n Roos\n KG,\n \n \n Dompier\n TP,\n \n \n Kerr\n ZY.\n \n \n The epidemiology of stress fractures in collegiate student-athletes, 2004\u20132005 through 2013\u20132014 academic years. J Athl Train. 2017;52(10):966\u2013975. doi:10.4085\/1062-6050-52.8.01"},{"issue":"1","key":"i1938-162X-59-6-641-b08","series-title":"Phys Med Rehabil Clin N Am","first-page":"139","article-title":"Bone stress injuries in runners","volume":"27","author":"Tenforde","year":"2016","unstructured":"Tenforde\n AS,\n \n \n Kraus\n E,\n \n \n Fredericson\n M.\n \n \n Bone stress injuries in runners. Phys Med Rehabil Clin N Am. 2016;27(1):139\u2013149. doi:10.1016\/j.pmr.2015.08.008"},{"issue":"10","key":"i1938-162X-59-6-641-b09","series-title":"J Orthop Sports Phys Ther","first-page":"749","article-title":"Management and prevention of bone stress injuries in long-distance runners","volume":"44","author":"Warden","year":"2014","unstructured":"Warden\n SJ,\n \n \n Davis\n IS,\n \n \n Fredericson\n M.\n \n \n Management and prevention of bone stress injuries in long-distance runners. J Orthop Sports Phys Ther. 2014;44(10):749\u2013765. doi:10.2519\/jospt.2014.5334"},{"issue":"8","key":"i1938-162X-59-6-641-b10","series-title":"Am J Sports Med","first-page":"2227","article-title":"Peak and per-step tibial bone stress during walking and running in female and male recreational runners","volume":"49","author":"Meardon","year":"2021","unstructured":"Meardon\n SA,\n \n \n Derrick\n TR,\n \n \n Willson\n JD,\n \n et al.\n Peak and per-step tibial bone stress during walking and running in female and male recreational runners. Am J Sports Med. 2021;49(8):2227\u20132237. doi:10.1177\/03635465211014854"},{"issue":"9","key":"i1938-162X-59-6-641-b11","series-title":"Med Sci Sports Exerc","first-page":"1457","article-title":"Risk factors for stress fracture among young female cross-country runners","volume":"39","author":"Kelsey","year":"2007","unstructured":"Kelsey\n JL,\n \n \n Bachrach\n LK,\n \n \n Procter-Gray\n E,\n \n et al.\n Risk factors for stress fracture among young female cross-country runners. Med Sci Sports Exerc. 2007;39(9):1457\u20131463. doi:10.1249\/mss.0b013e318074e54b"},{"issue":"2","key":"i1938-162X-59-6-641-b12","series-title":"Am J Sports Med","first-page":"211","article-title":"The incidence and distribution of stress fractures in competitive track and field athletes: a twelve-month prospective study","volume":"24","author":"Bennell","year":"1996","unstructured":"Bennell\n KL,\n \n \n Malcolm\n SA,\n \n \n Thomas\n SA,\n \n \n Wark\n JD,\n \n \n Brukner\n PD.\n \n \n The incidence and distribution of stress fractures in competitive track and field athletes: a twelve-month prospective study. Am J Sports Med. 1996;24(2):211\u2013217. doi:10.1177\/036354659602400217"},{"issue":"4","key":"i1938-162X-59-6-641-b13","series-title":"Sports Health","first-page":"340","article-title":"Expected time to return to athletic participation after stress fracture in Division I collegiate athletes","volume":"10","author":"Miller","year":"2018","unstructured":"Miller\n TL,\n \n \n Jamieson\n M,\n \n \n Everson\n S,\n \n \n Siegel\n C.\n \n \n Expected time to return to athletic participation after stress fracture in Division I collegiate athletes. Sports Health. 2018;10(4):340\u2013344. doi:10.1177\/1941738117747868"},{"issue":"5","key":"i1938-162X-59-6-641-b14","series-title":"Med Sci Sports Exerc","first-page":"1163","article-title":"Injured runners do not replace lost running time with other physical activity","volume":"52","author":"Davis","year":"2020","unstructured":"Davis\n JJ IV,\n \n \n Gruber\n AH.\n \n \n Injured runners do not replace lost running time with other physical activity. Med Sci Sports Exerc. 2020;52(5):1163\u20131168. doi:10.1249\/MSS.0000000000002227"},{"issue":"1","key":"i1938-162X-59-6-641-b15","series-title":"J Sci Med Sport","first-page":"106","article-title":"Reasons and predictors of discontinuation of running after a running program for novice runners","volume":"22","author":"Fokkema","year":"2019","unstructured":"Fokkema\n T,\n \n \n Hartgens\n F,\n \n \n Kluitenberg\n B,\n \n et al.\n Reasons and predictors of discontinuation of running after a running program for novice runners. J Sci Med Sport. 2019;22(1):106\u2013111. doi:10.1016\/j.jsams.2018.06.003"},{"issue":"7","key":"i1938-162X-59-6-641-b16","series-title":"Circulation","first-page":"798","article-title":"Running forward: new frontiers in endurance exercise biology","volume":"129","author":"Rowe","year":"2014","unstructured":"Rowe\n GC,\n \n \n Safdar\n A,\n \n \n Arany\n Z.\n \n \n Running forward: new frontiers in endurance exercise biology. Circulation. 2014;129(7):798\u2013810. doi:10.1161\/CIRCULATIONAHA.113.001590"},{"issue":"21","key":"i1938-162X-59-6-641-b17","series-title":"Int J Environ Res Public Health","first-page":"8059","article-title":"A scoping review of the relationship between running and mental health","volume":"17","author":"Oswald","year":"2020","unstructured":"Oswald\n F,\n \n \n Campbell\n J,\n \n \n Williamson\n C,\n \n \n Richards\n J,\n \n \n Kelly\n P.\n \n \n A scoping review of the relationship between running and mental health. Int J Environ Res Public Health. 2020;17(21):8059. doi:10.3390\/ijerph17218059"},{"issue":"2","key":"i1938-162X-59-6-641-b18","series-title":"Am J Sports Med","first-page":"302","article-title":"Association of the female athlete triad risk assessment stratification to the development of bone stress injuries in collegiate athletes","volume":"45","author":"Tenforde","year":"2017","unstructured":"Tenforde\n AS,\n \n \n Carlson\n JL,\n \n \n Chang\n A,\n \n et al.\n Association of the female athlete triad risk assessment stratification to the development of bone stress injuries in collegiate athletes. Am J Sports Med. 2017;45(2):302\u2013310. doi:10.1177\/0363546516676262"},{"issue":"7","key":"i1938-162X-59-6-641-b19","series-title":"Orthop J Sports Med","first-page":"23259671211014496","article-title":"Epidemiology of NCAA bone stress injuries: a comparison of athletes in Divisions I, II, and III","volume":"9","author":"Bratsman","year":"2021","unstructured":"Bratsman\n A,\n \n \n Wassef\n A,\n \n \n Wassef\n CR,\n \n \n Jayaram\n P,\n \n \n Mosely\n JB,\n \n \n Shybut\n TB.\n \n \n Epidemiology of NCAA bone stress injuries: a comparison of athletes in Divisions I, II, and III. Orthop J Sports Med. 2021;9(7):23259671211014496. doi:10.1177\/23259671211014496"},{"issue":"4","key":"i1938-162X-59-6-641-b20","series-title":"J Athl Train","first-page":"552","article-title":"National Collegiate Athletic Association Injury Surveillance System: review of methods for 2004\u20132005 through 2013\u20132014 data collection","volume":"49","author":"Kerr","year":"2014","unstructured":"Kerr\n ZY,\n \n \n Dompier\n TP,\n \n \n Snook\n EM,\n \n et al.\n National Collegiate Athletic Association Injury Surveillance System: review of methods for 2004\u20132005 through 2013\u20132014 data collection. J Athl Train. 2014;49(4):552\u2013560. doi:10.4085\/1062-6050-49.3.58"},{"issue":"2","key":"i1938-162X-59-6-641-b21","series-title":"Br J Sports Med","first-page":"76","article-title":"Not all bone overuse injuries are stress fractures: it is time for updated terminology","volume":"57","author":"Warden","year":"2023","unstructured":"Warden\n SJ,\n \n \n Hoenig\n T,\n \n \n Sventeckis\n AM,\n \n \n Ackerman\n KE,\n \n \n Tenforde\n AS.\n \n \n Not all bone overuse injuries are stress fractures: it is time for updated terminology. 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J Sport Rehabil. 2023;32(2):133\u2013144. doi:10.1123\/jsr.2022-0121"},{"issue":"6","key":"i1938-162X-59-6-641-b23","series-title":"J Athl Train","first-page":"435","article-title":"Athletic training services during daily patient encounters: a report from the Athletic Training Practice-Based Research Network","volume":"51","author":"Lam","year":"2016","unstructured":"Lam\n KC,\n \n \n Valier\n AR,\n \n \n Anderson\n BE,\n \n \n McLeod\n TC.\n \n \n Athletic training services during daily patient encounters: a report from the Athletic Training Practice-Based Research Network. J Athl Train. 2016;51(6):435\u2013441. doi:10.4085\/1062-6050-51.8.03"},{"issue":"2","key":"i1938-162X-59-6-641-b24","series-title":"BMJ Open Sport Exerc Med","first-page":"e001055","article-title":"Pac-12 CARE-Affiliated Program: structure, methods and initial results","volume":"7","author":"Bohr","year":"2021","unstructured":"Bohr\n AD,\n \n \n Aukerman\n DF,\n \n \n Harmon\n KG,\n \n et al.\n Pac-12 CARE-Affiliated Program: structure, methods and initial results. BMJ Open Sport Exerc Med. 2021;7(2):e001055. doi:10.1136\/bmjsem-2021-001055"},{"issue":"7\u20138","key":"i1938-162X-59-6-641-b25","series-title":"J Athl Train","first-page":"655","article-title":"Pac-12 Health Analytics Program (HAP): an innovative approach to health care operations, data analytics and clinical research in intercollegiate athletics","volume":"58","author":"Robell","year":"2023","unstructured":"Robell\n KC,\n \n \n Norcross\n MF,\n \n \n Bohr\n AD,\n \n \n Harmon\n KG.\n \n \n Pac-12 Health Analytics Program (HAP): an innovative approach to health care operations, data analytics and clinical research in intercollegiate athletics. J Athl Train. 2023;58(7\u20138):655\u2013663. doi:10.4085\/1062-6050-0063.22"},{"issue":"3","key":"i1938-162X-59-6-641-b26","series-title":"Clin J Sport Med","first-page":"201","article-title":"The Orchard Sports Injury Classification System (OSICS) version 10","volume":"17","author":"Rae","year":"2007","unstructured":"Rae\n K,\n \n \n Orchard\n J.\n \n \n The Orchard Sports Injury Classification System (OSICS) version 10. Clin J Sport Med. 2007;17(3):201\u2013204. doi:10.1097\/JSM.0b013e318059b536"},{"issue":"6","key":"i1938-162X-59-6-641-b27","series-title":"J Sci Med Sport","first-page":"526","article-title":"Medial tibial stress fracture diagnosis and treatment guidelines","volume":"24","author":"Milgrom","year":"2021","unstructured":"Milgrom\n C,\n \n \n Zloczower\n E,\n \n \n Fleischmann\n C,\n \n et al.\n Medial tibial stress fracture diagnosis and treatment guidelines. J Sci Med Sport. 2021;24(6):526\u2013530. doi:10.1016\/j.jsams.2020.11.015"},{"issue":"3","key":"i1938-162X-59-6-641-b28","series-title":"Sports Med","first-page":"405","article-title":"Definition and usage of the term \u201coveruse injury\u201d in the US high school and collegiate sport epidemiology literature: a systematic review","volume":"44","author":"Roos","year":"2014","unstructured":"Roos\n KG,\n \n \n Marshall\n SW.\n \n \n Definition and usage of the term \u201coveruse injury\u201d in the US high school and collegiate sport epidemiology literature: a systematic review. Sports Med. 2014;44(3):405\u2013421. doi:10.1007\/s40279-013-0124-z"},{"issue":"12","key":"i1938-162X-59-6-641-b29","series-title":"J Athl Train","first-page":"1278","article-title":"Timing of stress fractures in soldiers during the first 6 career months: a retrospective cohort study","volume":"56","author":"Kardouni","year":"2021","unstructured":"Kardouni\n JR,\n \n \n McKinnon\n CJ,\n \n \n Taylor\n KM,\n \n \n Hughes\n JM.\n \n \n Timing of stress fractures in soldiers during the first 6 career months: a retrospective cohort study. J Athl Train. 2021;56(12):1278\u20131284. doi:10.4085\/1062-6050-0380.19"},{"issue":"12","key":"i1938-162X-59-6-641-b30","series-title":"J Athl Train","first-page":"1230","article-title":"Characteristics of injuries occurring during cross-country: a report from the Athletic Training Practice-Based Research Network","volume":"55","author":"Marshall","year":"2020","unstructured":"Marshall\n AN,\n \n \n Valovich McLeod\n TC,\n \n \n Lam\n KC.\n \n \n Characteristics of injuries occurring during cross-country: a report from the Athletic Training Practice-Based Research Network. J Athl Train. 2020;55(12):1230\u20131238. doi:10.4085\/1062-6050-541-19"},{"issue":"1","key":"i1938-162X-59-6-641-b31","series-title":"Sports Health","first-page":"67","article-title":"Injury and treatment characteristics of sport-specific injuries sustained in interscholastic athletics: a report from the Athletic Training Practice-Based Research Network","volume":"7","author":"Lam","year":"2015","unstructured":"Lam\n KC,\n \n \n Snyder Valier\n AR,\n \n \n Valovich McLeod\n TC.\n \n \n Injury and treatment characteristics of sport-specific injuries sustained in interscholastic athletics: a report from the Athletic Training Practice-Based Research Network. Sports Health. 2015;7(1):67\u201374. doi:10.1177\/1941738114555842"},{"issue":"2","key":"i1938-162X-59-6-641-b32","series-title":"J Athl Train","first-page":"156","article-title":"Athletic training services in public secondary schools: a benchmark study","volume":"50","author":"Pryor","year":"2015","unstructured":"Pryor\n RR,\n \n \n Casa\n DJ,\n \n \n Vandermark\n LW,\n \n et al.\n Athletic training services in public secondary schools: a benchmark study. J Athl Train. 2015;50(2):156\u2013162. doi:10.4085\/1062-6050-50.2.03"},{"issue":"10","key":"i1938-162X-59-6-641-b33","series-title":"J Athl Train","first-page":"1059","article-title":"Athletic directors\u2019 barriers to hiring athletic trainers in high schools","volume":"50","author":"Mazerolle","year":"2015","unstructured":"Mazerolle\n SM,\n \n \n Raso\n SR,\n \n \n Pagnotta\n KD,\n \n \n Stearns\n RL,\n \n \n Casa\n DJ.\n \n \n Athletic directors\u2019 barriers to hiring athletic trainers in high schools. J Athl Train. 2015;50(10):1059\u20131068. doi:10.4085\/1062-6050-50.10.01"},{"issue":"1","key":"i1938-162X-59-6-641-b34","series-title":"Am J Sports Med","first-page":"255","article-title":"Diagnostic accuracy of various imaging modalities for suspected lower extremity stress fractures: a systematic review with evidence-based recommendations for clinical practice","volume":"44","author":"Wright","year":"2016","unstructured":"Wright\n AA,\n \n \n Hegedus\n EJ,\n \n \n Lenchik\n L,\n \n \n Kuhn\n KJ,\n \n \n Santiago\n L,\n \n \n Smoliga\n JM.\n \n \n Diagnostic accuracy of various imaging modalities for suspected lower extremity stress fractures: a systematic review with evidence-based recommendations for clinical practice. Am J Sports Med. 2016;44(1):255\u2013263. doi:10.1177\/0363546515574066"},{"issue":"5","key":"i1938-162X-59-6-641-b35","series-title":"J Am Coll Radiol","first-page":"S293","article-title":"ACR Appropriateness criteria stress (fatigue\/insufficiency) fracture, including sacrum, excluding other vertebrae","volume":"14","author":"Expert Panel on Musculoskeletal Imaging","year":"2017","unstructured":"Expert Panel on Musculoskeletal Imaging; BencardinoJT,StoneTJ,RobertsCC,et al.\n ACR Appropriateness criteria stress (fatigue\/insufficiency) fracture, including sacrum, excluding other vertebrae. J Am Coll Radiol. 2017;14(5):S293\u2013S306. doi:10.1016\/j.jacr.2017.02.035"},{"issue":"4","key":"i1938-162X-59-6-641-b36","series-title":"Int J Sport Nutr Exerc Metab","first-page":"316","article-title":"International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update","volume":"28","author":"Mountjoy","year":"2018","unstructured":"Mountjoy\n M,\n \n \n Sundgot-Borgen\n J,\n \n \n Burke\n L,\n \n et al.\n International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Int J Sport Nutr Exerc Metab. 2018;28(4):316\u2013331. doi:10.1123\/ijsnem.2018-0136"},{"issue":"4","key":"i1938-162X-59-6-641-b37","series-title":"Clin J Sport Med","first-page":"335","article-title":"The male athlete triad\u2014a consensus statement from the Female and Male Athlete Triad Coalition part 1: definition and scientific basis","volume":"31","author":"Nattiv","year":"2021","unstructured":"Nattiv\n A,\n \n \n De Souza\n MJ,\n \n \n Koltun\n KJ,\n \n et al.\n The male athlete triad\u2014a consensus statement from the Female and Male Athlete Triad Coalition part 1: definition and scientific basis. Clin J Sport Med. 2021;31(4):335\u2013348. doi:10.1097\/JSM.0000000000000946"},{"issue":"3","key":"i1938-162X-59-6-641-b38","series-title":"Athl Train Sports Health Care","first-page":"143","article-title":"Variability in the identification and reporting of overuse injuries among sports injury surveillance data collectors","volume":"11","author":"Roos","year":"2019","unstructured":"Roos\n KG,\n \n \n Kucera\n KL,\n \n \n Golightly\n YM,\n \n \n Myers\n JB,\n \n \n Rosamond\n WD,\n \n \n Marshall\n SW.\n \n \n Variability in the identification and reporting of overuse injuries among sports injury surveillance data collectors. 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