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.
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