The Association Between Pain Sensitivity and Low Energy Availability, Sleep, Mental Health, and Stress in Female Endurance Athletes

Author

Taylor R. Moler, University of Central FloridaFollow

Keywords

Low energy availability; Relative Energy Deficiency in Sports; Female endurance athletes; Pressure pain threshold; Pain sensitivity

Abstract

The disruption of certain physiological functions due to low energy availability (LEA) in female endurance athletes is a prominent concern. This condition resulting from LEA has been described as Relative Energy Deficiency in Sport (RED-S), which can include alterations in metabolism, menstrual function, bone deposition and resorption, mental well-being, and more. The goal of this study was to determine whether pain sensitivity was associated with LEA, sleep, mental health, and stress in female endurance athletes. Participants completed a demographic survey, the Low Energy Availability in Females Questionnaire (LEAF-Q), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-4), and the Perceived Stress Scale (PSS) to collect data on their overall physical and mental health. Patients then underwent Pressure Pain Threshold (PPT) using a pressure algometer to determine their pain sensitivity. A Pearson correlation analyzed the association between the demographic data, questionnaires, and PPT testing. There was a small to medium negative correlation between pain ratings following PPT testing and LEAF-Q. This was postulated to be due to individuals with LEA developing increased pain-coping mechanisms, as endurance athletes present with less pain sensitivity compared to non-athlete controls in multiple studies. There were no other significant correlations found between PPT and the LEAF-Q, PSQI, PSS, or PHQ-4. This study increased the understanding of the effect of LEA, sleep, mental health, and stress on female endurance athletes’ pain experience.

Thesis Completion Year

2025

Thesis Completion Semester

Fall

Thesis Chair

Rothschild, Carey

College

College of Health Professions and Sciences

Department

Doctor of Physical Therapy

Thesis Discipline

Physical Therapy

Language

English

Access Status

Open Access

Length of Campus Access

None

Campus Location

Orlando (Main) Campus

STARS Citation

Moler, Taylor R., "The Association Between Pain Sensitivity and Low Energy Availability, Sleep, Mental Health, and Stress in Female Endurance Athletes" (2025). Honors Undergraduate Theses. 449.
https://stars.library.ucf.edu/hut2024/449