Date of Graduation
5-2026
Document Type
Thesis
Degree Name
Bachelor of Science in Nursing
Degree Level
Undergraduate
Department
Nursing
Advisor/Mentor
Dr. Marilou Shreve
Committee Member
Dr. Emily Richardson
Abstract
Background: RED-S is a risk factor for bone stress injuries in female athletes. Athletes that compete in sports that involve repetitive movements of impact are prone to stress injuries. The treatment of stress fractures requires addressing all potential causes of the injury to accelerate healing and prevent reinjury. Since RED-S is a well-established risk factor for stress injuries, early detection of RED-S is crucial to prevent long term negative health consequences in athletes including the development of stress fractures. It is also confirmed that certain sports have a higher prevalence of reported stress fractures in female athletes such as cross country, gymnastics, track, basketball, soccer.
Purpose: The purpose of this research is to explore if there is a correlation between RED-S score and bone injuries in female athletes.
Methods: An online survey was distributed to approximately 220 female athletes at the University of Arkansas using Qualtrics. The 69-question survey was adapted and expanded from a dance specific energy availability questionnaire and asked 22 questions linked to clinical outcomes of RED-S. Scoring of RED-S may range from -20 to +40. A negative score suggests a higher risk for RED-S Syndrome.
Results: Fifteen female athletes completed the survey. The mean RED-S score among collegiate female athletes was 2.47. There was no statistical significance found between a lower RED-S score and bone injuries (p=.077, r = -0.47). The only significant finding (p = 0.01) was a positive correlation (r = 0.76) between the number of hours athletes reported strength training and number of reported days missed in the last year due to injury.
Conclusions: This study contradicts current literature suggesting female athletes who participate in sports prone to stress fractures are at a greater risk for RED-S. The findings of this study cannot be generalized to population of female collegiate athletes due to a small sample size. Future research, using a larger sample size, may support current idea that lower RED-S scores are associated with a higher incidence of stress fractures.
Keywords
RED-S, Stress Fracture, Stress Injury, Women's Health, Amenorrhea, Collegiate Sport, Sport
Citation
Couch, L. G., & Shreve, M. D. (2026). The Prevalence of Stress Fractures in Relation to RED-S Syndrome Among Various Sports in Collegiate Female Athletes. The Eleanor Mann School of Nursing Undergraduate Honors Theses Retrieved from https://scholarworks.uark.edu/nursuht/229
