In 1993, the American College of Sports Medicine first held a symposium on the "female athlete triad." While moderate exercise is beneficial for women of all ages, "excessive" exercise training in some women could lead to abnormally low body fat, amenorrhea (irregular periods) from low estrogen, and osteoporosis (thinning bones). These female athletes were prone to musculoskeletal injuries and other unhealthy sequelae such as athlete "burnout." It was not until 2016 that published reports first appeared about a subset of male athletes who excessively train and could similarly experience adverse health issues that parallel those outcomes from the female athlete triad of low body fat, increased stress hormones (i.e. the "fight or flight" hormones) with hy- pogonadism (low testosterone), low bone mineral density, and burnout. The investigators hope to determine whether a similar syndrome, the "male warrior triad," exists in some men who train at the highest intensity level over prolonged periods of time. The principal investigator hypothesizes that, in some pre-disposed male athletes, as in special operations personnel, exhaustive training increases the stress hormones adrenaline and cortisol and reduces an athlete's testosterone levels. These hormonal changes lead to increased risk of musculoskeletal injury, hindered recovery from training, heightened sensitivity to pain, and diminished feelings of well-being, and greater propensity for analgesic misuse. This work is mission essential because understanding training-induced trends in stress hormones and testosterone may help to identify those athletes at greater risk of musculoskeletal injury, increased pain sensitivity and analgesic use, and athlete burnout, i.e. depression and anxiety. We shall follow male, collegiate level athletes over the course of their competitive season in both an observational study and a longitudinal study to test the hypothesis that training-induced increases in stress hormones, and reductions in testosterone concentrations, will correlate with an increased propensity for musculoskeletal injury, increased pain sensitivity, increased analgesic use, and burnout (i.e. a decrement in mood--depression and anxiety).
Conduct basic science and human subjects research. Write abstract, paper, and present at a national scientific meeting.