Knowledge, Attitude, and Skill of High School Coaches with Regard to the Female Athlete Triad.

STUDY OBJECTIVE: The purpose of this study was to investigate knowledge high school coaches have about the female athlete triad and to determine if gender differences in knowledge, attitudes, and behaviors exist. DESIGN: Cross-sectional survey. SETTING: Twenty-six high schools in and around the vicinity of Cleveland, Ohio. PARTICIPANTS: Two-hundred currently employed high school coaches. INTERVENTIONS: Participants completed a 30-question survey used to assess knowledge, attitudes, and behaviors coaches had about the female athlete triad. MAIN OUTCOME MEASURES: Descriptive statistics (means, SD, frequency) and gender differences in response to triad knowledge, attitude, and behavior questions. RESULTS: One hundred twenty-three high school coaches completed the survey. Survey respondents were between 25 and 35 years of age, coached for 6-10 years, and coached female athletes 75%-100% of the time. Twenty-four percent reported "having heard of the triad" and 14% (17 of 123) were able to correctly name all of its components. There were no significant differences between gender and the coach's ability to correctly name the 3 triad components (t = 1.47, P = .14). There was no correlation between coach gender (r = 0.13, P = .07), age (r = 0.07, P = .42), number of years of coaching (r = 0.014, P = .88), and coach's knowledge of the triad components, respectively. CONCLUSION: Female athletes might be at risk for developing the female athlete triad and high school coaches can be instrumental in identifying athletes who are at risk. This study showed that gaps in knowledge about the triad exist and that educating coaches about the condition could serve as an important means of prevention for the condition.

Obstacles in the optimization of bone health outcomes in the female athlete triad.

Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the 'female athlete triad'. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture. This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging. Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.

Current knowledge, perceptions, and interventions used by collegiate coaches in the u.s. Regarding the prevention and treatment of the female athlete triad.

BACKGROUND: Coaches play an important role in the prevention of female athlete triad, but their current knowledge level, perceptions, and practice behaviors are not known. OBJECTIVES: The purpose of this study was to describe the knowledge, perceptions, and behaviors college coaches have about the female athlete triad. This study's purpose was to describe the relationships between these variables, and to compare coaches having high levels of general knowledge about the triad with coaches having low levels of general knowledge with their perceptions, behaviors, and more specific knowledge about the triad. METHODS: A questionnaire was sent to 300 Division I collegiate coaches in the United States. Descriptive statistics, the Pearson product-moment correlation, and independent t-tests were used to describe the participants, relationships between variables, and compare groups of coaches with high and low levels of knowledge about the triad. RESULTS: Forty-three percent of the 91 college coaches responding to the survey (30% return rate) were able to correctly list the specific components of the disorder. Coaches with high levels of general knowledge about the triad had statistically significant differences in their perceptions, behaviors, and more specific knowledge of the triad than coaches with low levels of general knowledge about the triad. CONCLUSION: The best intervention for the female athlete triad is prevention. Future education about the triad should focus on treatment and prevention as well as specific factors related to the syndrome, such as nutritional requirements, methods of assessing menstrual irregularities, and screening techniques.

Differences in peak knee valgus angles between individuals with high and low Q-angles during a single limb squat.

BACKGROUND: Differences in anatomical alignment between genders have been suggested as causes of the disparity in anterior cruciate ligament injury rates. A larger Q-angle may be associated with increased knee valgus during movement resulting in anterior cruciate ligament strain. This study investigated whether healthy college-aged subjects with a large Q-angle display greater peak knee valgus during a single limb squat compared to those with a small Q-angle. The study also determined whether the high and low Q-angle groups displayed differences in other select anatomical variables, and whether these anatomical variables were related to knee valgus. METHODS: Twenty subjects, categorized as having a "high Q-angle" (> or = 17 degrees) or a "low Q-angle" (< or = 8 degrees) were videotaped during the performance of a single leg squat. The peak valgus angles for the right knee were calculated. One-tailed independent measures t-tests were used to determine whether individuals with a large Q-angle exhibit (1) significantly greater peak knee valgus during a single leg squat compared to those with a small Q-angle and, (2) greater pelvic width to femoral length ratios and greater static knee valgus than subjects with a small Q-angle. The Pearson product-moment correlation was used to establish the relationships between pelvic width to femoral length ratios and static knee valgus, pelvic width to femoral length ratios and dynamic knee valgus, and static knee valgus and dynamic knee valgus. FINDINGS: Peak knee valgus during the single leg squat, and static knee valgus were not significant greater in the high Q-angle group compared to the low Q-angle group (P=0.09; P=0.31). Subjects with a larger Q-angle, however, had a significantly greater pelvic width to femoral length ratios (P=0.015) compared to subjects with a small Q-angle. Pelvic width to femoral length ratios was related to both static and dynamic knee valgus (r=0.47, P=0.02; r=0.48, P=0.02), but static knee valgus was not related to dynamic knee valgus. INTERPRETATION: The findings suggest that pelvic width to femoral length ratios, rather than Q-angle, may be a better structural predictor of knee valgus during dynamic movement.