Stress fractures (SF) may affect all people who participate in sporting activities, but most commonly, they occur in athletes. Female athletes seem to experience more stress fractures than their male counterparts. There is limited research assessing the stress fractures among Bulgarian athletes. The aim of this study was to describe the incidence of SF among female athletic population and to analyze the selected risk factors. Ninety-three female athletes from different sports aged 19.2±3.8 years were recruited for this cross-sectional retrospective study. They completed a questionnaire to provide information on demographic data, sport experience, history of SF, menstrual function, and lifestyle risk factors. They also completed Eating attitude test (EAT-26) and questions aimed at identifying the presence of extreme weight control behaviors. The athletes were divided into two groups depending on whether or not they had SF in the past. Crude odds ratios (OR) were calculated to assess the association of SF with the studied factors. A total of 21 (22.6%) of the athletes reported at least one previous SF, with most injuries located in the lower extremity. The training factors and disordered eating traditionally believed to increase the risk for SF did not contributed to the development of SF in our study. Among all studied factors only the primary amenorrhea was significantly associated with an increased risk of SF (OR 6.56, 95% CI:1.4-30.6). These results suggest that in female athletes with similar sport experience, anthropometric characteristics, prevalence of disordered eating psychopathology and behavioral and lifestyle factors, those with primary amenorrhea are more likely to have stress fractures.
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