Objectives: Relative energy deficiency in sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA, measured by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative CT (HR-pQCT) is an advanced imaging device that provides measures of volumetric BMD (vBMD), bone microarchitecture, geometry and strength. This study aimed to assess the prevalence of REDs in elite winter sport athletes and to observe the associations in bone parameters using HR-pQCT in athletes identified as at-risk or not at-risk of REDs. Methods: Participants included 101 elite athletes (24.1±4.4 SD years; 52% female). The REDs Clinical Assessment Tool (CAT2) was used to determine REDs risk. HR-pQCT scans of the non-dominant radius and left tibia were analysed on REDs risk grouping. Results: 17 athletes (17%; 71% female) were at-risk based on the REDs CAT2. After covarying for lean mass, OR suggested a higher likelihood of REDs risk classification for athletes with low cortical thickness, cortical area, total vBMD and bone strength. Conclusions: Impaired total vBMD, bone strength and cortical bone parameters were approximately twice as likely (OR: 1.9–3.0) in athletes at-risk of REDs. Results agree with the consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. Future directions should use HR-pQCT to explore REDs risk longitudinally, using bone change over time, as this may provide greater insight. Using advanced imaging to explore REDs risk in a population of winter high-performance athletes is novel.

Objectives: Relative Energy Deficiency in Sport (REDs) is a syndrome resulting from problematic low energy availability (LEA). Low areal bone mineral density (aBMD) is a primary indicator of LEA, measured by dual X-ray absorptiometry (DXA). High-resolution peripheral quantitative computed tomography (HR-pQCT) is an advanced imaging device that provides measures of volumetric BMD (vBMD), bone microarchitecture, geometry, and strength. The objective of this study was to assess prevalence of REDs in elite winter sport athletes and to observe the associations in bone parameters using HR-pQCT in athletes identified as at-risk or not at-risk of REDs. Methods: Participants included 101 elite athletes (24.1±4.4 SD years; 52% female). The REDs Clinical Assessment Tool (CAT2) was used to determine REDs risk. HR- pQCT scans of the non-dominant radius and left tibia were analyzed upon REDs risk grouping. Results: Seventeen athletes (17%; 71% female) were at-risk based on the REDs CAT2. After covarying for lean mass, odds ratios (OR) suggested higher likelihood of REDs risk classification for athletes with low cortical thickness, cortical area, total vBMD, and bone strength. Conclusions: Impaired total vBMD, bone strength and cortical bone parameters were approximately twice as likely (OR: 1.9-3.0) in athletes at-risk of REDs. Results agree with the consensus statement that HR-pQCT may identify impaired bone health in athletes at-risk of REDs. Future directions should use HR-pQCT to explore REDs risk longitudinally, utilizing bone change over time as this may provide greater insight. Using advanced imaging to explore REDs risk in a population of winter high-performance athletes is novel.

The purpose of this study was to investigate the athlete biomechanical differences across three artificial turfs associated with changes in athletic performance. Eighteen university grid-iron football players performed three modified football specific movements (agility drill, vcut, three-cone drill) on three artificial turf surfaces (Control, Shockpad and Low Faceweight) that have been shown to alter athletic performance. The utilized traction and player kinematics were recorded and compared between the surfaces using a repeated-measures ANOVA within participant factors of surface and between participants’ factors of player position. The significant effect of the surface on utilized traction at takeoff, and the frontal plane ankle angle was present with the players utilizing a lower traction and peak frontal plane ankle angle on the low-traction surface (Low Faceweight). During the agility drill and vcut, the significant effect of the surface was seen for peak frontal plane rearfoot–floor angle, with players having a flatter foot on high-traction surfaces (Control and Shockpad). Across tasks, high-traction surfaces were associated with flatter foot orientations and increased frontal plane ankle and foot kinematics during the cutting movements.