Drive for Thinness Predicts Musculoskeletal Injuries in Division II NCAA Female Athletes

The female athlete triad is the interrelation of low energy availability, menstrual dysfunction, and low bone mineral density. Previously, the components of the female athlete triad have been linked to bone stress injuries. The objective of this study was to explore the relationship between drive for thinness, a proxy indicator of low energy availability, and musculoskeletal injuries. Fifty-seven female athletes, from an NCAA Division II college, were followed throughout their respective sport season for musculoskeletal injuries. Women were grouped based on a median split of the drive for thinness score (high drive for thinness (DT) vs. low DT). At the end of each sport season, injury data were compiled using an electronic medical record database. Forty-seven of the 57 women (82%) incurred 90 musculoskeletal injuries. The most prevalent injuries included: Low back pain/spasm/strain (n = 12), followed by shin splints/medial tibial stress syndrome (n = 9), general knee pain (n = 7), quadriceps strain (n = 6), and knee sprain (anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and lateral collateral ligament sprains; n = 5). The number of in-season injuries in the High DT group (2.0 ± 0.3) was significantly higher than the Low DT group (1.2 ± 0.2, p = 0.026). A high drive for thinness is associated with an increased number of injuries during the competitive season.