Practical and Applied Knowledge of Athletic Trainers on the Female Athlete Triad


Health Promotion

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Medicine & Science in Sports & Exercise

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BACKGROUND: The female athlete triad is the interrelation of low energy availability, menstrual dysfunction, and low bone mineral density. Athletic trainers are in a position to be able to identify the female athlete triad in athletes. However, limited research exists regarding practical and applied knowledge of the female athlete triad.

PURPOSE: The purpose of this study was to determine the level of practical knowledge of athletic trainers on the female athlete triad and also determine if athletic trainers are applying this knowledge by properly screening athletes for the female athlete triad.

METHODS: Certified athletic trainers (n=116) completed an online survey via Qualtrics that assed both knowledge of the female athlete triad and current practical application of the female athlete. Linear-by-linear tests were used to find associations between practical knowledge and applied knowledge for related components of the triad.

RESULTS: The athletic trainers mostly work with high school athletes (39%) and college athletes (32%). Fifty percent of the athletic trainers had at least 7 years of experience. Sixty-nine percent of the athletic trainers were female. While most of the general knowledge of the athletic trainers was high (for example 70% believe that increasing energy availability is key when returning an athlete back to sport and 73% believe that repeated stress fractures is a red flag for the female athlete triad) most of the applied knowledge was low (for example only 14% screen their athletes for eating disorders and only 36% ask about history of stress fractures). Linear-by-linear association (p=0.050) demonstrated an association between agreeing about importance of energy availability and always screening for eating disorders. However, we did not demonstrate linear-by-linear association (p=0.354) between agreeing that stress fractures are a red flag for the female athlete triad and asking about history of stress fractures.

CONCLUSION: While general knowledge of the female athlete triad is high, a low percentage of athletic trainers appear to be applying their knowledge in prevention and detection of the female athlete triad. More education is need to help athletic trainers to implement screening, prevention, and return to play techniques to keep our athletes safe.