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Musculoskeletal Risk Factors as Predictors of Injury in Community-Dwelling Women


Medicine & Science in Sports & Exercise: September 2014 - Volume 46 - Issue 9 - p 1752–1757
doi: 10.1249/MSS.0000000000000295

Background Participating in health-related physical activity (PA) may increase risk for musculoskeletal injury (MSI).

Purpose This study aimed to estimate the prevalence of structural/biomechanical risk factors in community-dwelling women and associated risk for incidence of MSI in women who are physically active.

Methods The Women’s Injury study is a surveillance of PA behaviors and MSI in women age 20–83 yr. An orthopedic examination was performed before entry into the study to assess presence of structural/biomechanical risk factors. A total of 886 women completed data collection by reporting weekly PA behavior and MSI for up to 3 yr (2007–2009), with the average participant enrolled for 98 wk. To estimate MSI risk associated with each risk factor separately, time to first MSI was modeled using proportional hazard regression with time-dependent PA covariates, controlling for age, body mass index, and previous injury.

Results Over the course of the study, 236 of the women (26.6%) reported at least one MSI that was PA related. We found a significant association between the number of high flexibility risk factors and PA-related injury at all levels of PA exposure (HR = 1.15 and confidence interval (CI) = 1.04–1.27 for moderate-to-vigorous PA; HR = 1.16 and CI = 1.05–1.28 for moderate PA; HR = 1.15 and CI = 1.04–1.27 for vigorous PA).

Conclusions When participating at any level of PA for health benefits, women with hypermobility in multiple muscle groups or joints should be watchful for musculoskeletal symptoms and should be counseled not to ignore symptoms when they first occur.

1School of Physical Therapy, Texas Woman’s University, Dallas, TX; 2The Cooper Institute, Dallas, TX; and 3Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX

Address for correspondence: Elaine Trudelle-Jackson, P.T., Ph.D., 5500 Southwestern Medical Avenue, Dallas, TX 75235; E-mail:

Submitted for publication July 2013.

Accepted for publication January 2014.

© 2014 American College of Sports Medicine