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First published on April 24, 2006, doi:10.1177/0363546506287298
This version was published on September 1, 2006
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The American Journal of Sports Medicine 34:1500-1507 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Exercise-Related Leg Pain in Female Collegiate Athletes

The Influence of Intrinsic and Extrinsic Factors

Mark F. Reinking, PT, PhD, SCS, ATC*

From the Department of Physical Therapy, Saint Louis University, St. Louis, Missouri

* Address correspondence to Mark F. Reinking, PT, PhD, SCS, ATC, Saint Louis University, Doisy College of Health Sciences, Department of Physical Therapy, St. Louis, MO 63104 (e-mail: reinking{at}slu.edu).

Background: Exercise-related leg pain is a common complaint among athletes, but there is little evidence regarding risk factors for this condition in female collegiate athletes.

Purpose: To examine prospectively the effect of selected extrinsic and intrinsic factors on the development of exercise-related leg pain in female collegiate athletes.

Study Design: Cohort study; Level of evidence, 2.

Methods: Subjects were 76 female collegiate athletes participating in fall season sports, including cross-country running, field hockey, soccer, and volleyball. Athletes were seen for a preseason examination that included measures of height, weight, foot pronation, and calf muscle length as well as a questionnaire for disordered eating behaviors. Body mass index was calculated from height and weight (kg/m2). Those athletes who developed exercise-related leg pain during the season were seen for follow-up. All athletes who developed the condition and a matched group without such leg pain underwent bone mineral density and body composition testing. Statistical analyses of differences and relationships were conducted.

Results: Of the 76 athletes, 58 (76%) reported a history of exercise-related leg pain, and 20 (26%) reported occurrence of exercise-related leg pain during the season. A history of this condition was strongly associated with its occurrence during the season (odds ratio, 13.2). Exercise-related leg pain was most common among field hockey and cross-country athletes and least common among soccer players. There were no differences between athletes with and without such leg pain regarding age, muscle length, self-reported eating behaviors, body mass index, menstrual function, or bone mineral density. Athletes with exercise-related leg pain had significantly (P < .05) greater navicular drop compared with those without.

Conclusion: Exercise-related leg pain was common among this group of female athletes. The results suggest that there are certain factors, including foot pronation, sport, and a history of this condition, that are associated with an increased risk of exercise-related leg pain.

Key Words: leg pain • female athlete • overuse injury • foot pronation






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