Sports Medicine Primer Series – Bone Stress Injury (Part 2)

On this episode of the Sports Medicine Primer Series, host Dr. Zainab Shirazi, MD, continues the conversation with Dr. Adam Tenforde, MD, discussing how to manage a case of hip pain in a 25-year-old recreational weightlifter.

The goal of this ongoing series is to provide an audio study aid for anyone pursuing a career as a sports medicine physician and to prepare them for a sports medicine fellowship.

Dr. Tenforde is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. He is a sports medicine physician at the Spaulding National Running Center – one of the only centers in the United States exclusively dedicated to the diagnosis and treatment of running-related injuries. He has the unique perspective of being both a doctor and a former professional runner who was an All-American at Stanford University, where he contributed to three NCAA National Team Championships and later qualified for the Olympic trials.

Dr. Shirazi is an Attending Physician at Women's Health, Sports & Performance (WHSP) Medical in Brighton, MA, and a dual board-certified physician in Sports Medicine and Physical Medicine & Rehabilitation. She has a passion for advancing the health and performance of female athletes and specializes in the non-operative management of musculoskeletal and sports-related injuries, providing comprehensive care for athletes of all ages and abilities.

Resources

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4. Nattiv A, Kennedy G, Barrack MT, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41(8):1930-1941. doi:1177/0363546513490645
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6. Barrack MT, Fredericson M, Tenforde AS, Nattiv A. Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes. Br J Sports Med. 2017;51(3):200-205. doi:1136/bjsports-2016-096698
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8. Fredericson M, Roche M, Barrack MT, et al. Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners. BMJ Open Sport Exerc Med. 2023;9(2):e001545. doi:1136/bmjsem-2023-001545
9. Roche M, Nattiv A, Sainani K, et al. Higher Triad Risk Scores Are Associated With Increased Risk for Trabecular-Rich Bone Stress Injuries in Female Runners. Clin J Sport Med. 2023;33(6):631-637. doi:1097/JSM.0000000000001180
10. Burke LM, Ackerman KE, Heikura IA, Hackney AC, Stellingwerff T. Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs. Br J Sports Med. 2023;57(17):1098-1108. doi:1136/bjsports-2023-107335
11. Tenforde AS, Barrack MT, Nattiv A, Fredericson M. Parallels with the Female Athlete Triad in Male Athletes. Sports Med. 2016;46(2):171-182. doi:1007/s40279-015-0411-y
12. Hoenig T, Eissele J, Strahl A, et al. Return to sport following low-risk and high-risk bone stress injuries: a systematic review and meta-analysis. Br J Sports Med. 2023;57(7):427-432. doi:1136/bjsports-2022-106328
13. Nattiv A. Stress fractures and bone health in track and field athletes. J Sci Med Sport. 2000;3(3):268-279. doi:1016/s1440-2440(00)80036-5
14. Nattiv A, Armsey TDJ. Stress injury to bone in the female athlete. Clin Sports Med. 1997;16(2):197-224. doi:1016/s0278-5919(05)70017-x
15. Nattiv A, De Souza MJ, Koltun KJ, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part 1: Definition and Scientific Basis. Clin J Sport Med. 2021;31(4):335-348. doi:1097/JSM.0000000000000946
16. Fredericson M, Kussman A, Misra M, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clin J Sport Med. 2021;31(4):349-366. doi:1097/JSM.0000000000000948