Skeletal Health and Associated Injury Risk in Collegiate Female Rowers

Baker, BS, Buchanan, SR, and Bemben, DA. Skeletal health and associated injury risk in collegiate female rowers. J Strength Cond Res 36(4): 1125-1133, 2022-Rowing has been associated with low bone mass and stress fractures. The aim of this study was to compare bone density, geometry, and skeletal asymmetries between competitive female rowers and matched controls and within rowers based on reported injury status, allowing for the calculation of practical injury risk prediction equations. Rowers (n = 24) and controls (n = 24) completed total body, lumbar spine, and and dual femur and radii dual energy x-ray absorptiometry and peripheral quantitative computed tomography scans. One-way analyses of covariance were performed between rowers and controls, and one-way analyses of variance were performed between rowers based on reported rib injury status (injured [n = 11]; injury-free [n = 13]). Logistic regression was used to create prediction models of rowers' injury status. Significance was set at p ≤ 0.05. Rowers were taller, had greater lean mass, less fat mass, and mostly equivalent skeletal measures compared to controls, which were within normal ranges (p < 0.048). Injury-free rowers consumed over 500 mg·d-1 more calcium and were less symmetrical at the 4% tibiae and hips (p < 0.015). The strongest predictive regression model of reported rib injury in rowers comprised calcium intake and the symmetry index of hip strength index (R2 = 0.833; p < 0.001). A more practical model including daily calcium intake and total bone specific physical activity (PA) scores can be used to correctly predict injury status 75% of the time (R2 = 0.750; p = 0.022). This is the first study to provide practitioners an injury prediction model for competitive rowers, reiterating the importance of proper nutrition and auxiliary PA focusing on balanced movement patterns.