Dr. Emily Kraus is a Clinical Assistant Professor at Stanford Children’s Orthopedic and Sports Medicine Center. She specializes in Physical Medicine and Rehabilitation (PM&R) sports medicine and takes a unique approach to the diagnosis, treatment, and prevention of sports injuries in athletes of all ages. She is involved in multiple Stanford IRB-approved research projects, including The Healthy Runner Project, a multicenter prospective interventional study focused on bone stress injury prevention in collegiate middle and long distance runners.
Dr. Kraus also spends time performing gait analysis at the Stanford Run Safe Injury Prevention Program and serves as a medical advisors for the Adaptive Sports Injury Prevention Program at the Palo Alto VA. She has research and clinical interests in endurance sports medicine, injury prevention, running biomechanics, the prevention of bone stress injuries in collegiate athletes and the promotion of health and wellness at any age of life.
She has completed seven marathons including Boston Marathon twice and one 50k ultramarathon. With running and staying physically active as one of her personal passions, she recognizes the importance of fitness for overall wellbeing and the prevention of chronic medical conditions.
- Female Athlete Triad
- Running Injuries
- Stress Fractures
- Overuse Injuries
- Physical Medicine and Rehab
Clinical Assistant Professor, Orthopaedic Surgery
Board Certification: American Board of Physical Medicine and Rehab, Physical Medicine and Rehab (2017)
Board Certification: American Board of Physical Medicine and Rehab, Sports Medicine (2017)
Fellowship: Stanford University Sports Physical Med and Rehab Fellowship (2017) CA
Residency: Stanford University Physical Medicine and Rehabiliation (2016) CA
Internship: University of Nebraska Medical Center Internal Medicine Residency (2013) NE
Medical Education: University of Nebraska College of Medicine (2012) NE
Narrative Review - Knee Pain in the Pediatric Athlete.
Current reviews in musculoskeletal medicine
PURPOSE OF REVIEW: This review article seeks to highlight common youth athlete knee conditions due to overuse or trauma and elucidate differences from the adult populations.RECENT FINDINGS: Overuse conditions presented include apophysitis, osteochondritis dissecans plica syndrome, and discoid meniscus. Traumatic conditions presented include patellar instability, patellar sleeve fracture, and patellofemoral osteochondral fractures. Knee injuries affect a significant proportion of youth athletes. These injuries place athletes at higher risk of chronic pain and potentially osteoarthritis. We have reviewed common overuse and traumatic knee injuries and differentiating factors between the adult population to improve and expedite the diagnosis, treatment, and prognosis for youth athletes with knee injuries.
View details for DOI 10.1007/s12178-021-09708-5
View details for PubMedID 33818701
Dietary Supplement Use According to Sex and Triad Risk Factors in Collegiate Endurance Runners.
Journal of strength and conditioning research
Barrack, MT, Fredericson, M, Dizon, F, Tenforde, AS, Kim, BY, Kraus, E, Kussman, A, Singh, S, and Nattiv, A. Dietary supplement use according to sex and Triad risk factors in collegiate endurance runners. J Strength Cond Res XX(X): 000-000, 2020-This cross-sectional study evaluated the prevalence in the use of dietary supplements among elite collegiate runners among 2 NCAA Division I cross-country teams. At the start of each season from 2015 to 2017, male and female endurance runners were recruited to complete baseline study measures; the final sample included 135 (male n = 65, female n = 70) runners. Runners completed a health survey, web-based nutrition survey, and Triad risk assessment. The prevalence of dietary supplement use and Triad risk factors, including disordered eating, low bone mass, amenorrhea (in women), low body mass index, and stress fracture history, was assessed. A total of 78.5% (n = 106) runners reported taking 1 or more supplements on ≥4 days per week over the past month, 48% (n = 65) reported use of ≥3 supplements. Products used with highest frequency included multivitamin/minerals 46.7% (n = 63), iron 46.7% (n = 63), vitamin D 34.1% (n = 46), and calcium 33.3% (n = 45). More women, compared with men, used iron (61.4 vs. 30.8%, p < 0.001) and calcium (41.4 vs. 24.6%, p = 0.04); men exhibited higher use of amino acids and beta-alanine (6.2 vs. 0%, p = 0.04). Runners with bone stress injury (BSI) history, vs. no previous BSI, reported more frequent use of ≥3 supplements (61.5 vs. 32.8%, p = 0.001), vitamin D (49.2 vs. 19.4%, p < 0.001), and calcium (47.7 vs. 19.4%, p = 0.001). Low bone mineral density was also associated with higher use of vitamin D and calcium. Most runners reported regular use of 1 or more supplements, with patterns of use varying based on sex, history of BSI, and bone mass.
View details for DOI 10.1519/JSC.0000000000003848
View details for PubMedID 33278271
Identifying Triad Risk Factors In Ultramarathon Runners
LIPPINCOTT WILLIAMS & WILKINS. 2020: 68
View details for Web of Science ID 000590026300193
Relationship Between Dynamic Limb Symmetry And Subjective Limb Confidence Post ACL Reconstruction In Youth Athletes
LIPPINCOTT WILLIAMS & WILKINS. 2020: 2–3
View details for Web of Science ID 000590026300006
Dietary Intake Patterns And Risk Of Energy Deficiency In Ncaa Endurance Athletes
LIPPINCOTT WILLIAMS & WILKINS. 2020: 753
View details for Web of Science ID 000590026303111
Genetic Predictions Of Bone Mineral Density In Ultramarathon Runners: For Men, But Not For Women
LIPPINCOTT WILLIAMS & WILKINS. 2020: 783–84
View details for Web of Science ID 000590026303200
Food Accessibility And Eating Patterns In Elite Collegiate Endurance Runners
LIPPINCOTT WILLIAMS & WILKINS. 2020: 757
View details for Web of Science ID 000590026302610
Predictors And Prevalence Of Low Bone Mineral Density And Bone Stress Injuries In Ultramarathon Runners
LIPPINCOTT WILLIAMS & WILKINS. 2020: 492
View details for Web of Science ID 000590026301707
Youth running consensus statement: minimising risk of injury and illness in youth runners.
British journal of sports medicine
Despite the worldwide popularity of running as a sport for children, relatively little is known about its impact on injury and illness. Available studies have focused on adolescent athletes, but these findings may not be applicable to preadolescent and pubescent athletes. To date, there are no evidence or consensus-based guidelines identifying risk factors for injury and illness in youth runners, and current recommendations regarding suitable running distances for youth runners at different ages are opinion based. The International Committee Consensus Work Group convened to evaluate the current science, identify knowledge gaps, categorise risk factors for injury/illness and provide recommendations regarding training, nutrition and participation for youth runners.
View details for DOI 10.1136/bjsports-2020-102518
View details for PubMedID 33122252
Prevalence of Female Athlete Triad Risk Factors and Iron Supplementation Among High School Distance Runners: Results From a Triad Risk Screening Tool.
Orthopaedic journal of sports medicine
2020; 8 (10): 2325967120959725
Investigations of the female athlete triad (Triad) in high school athletes have found that 36% had low energy availability, 54% had menstrual abnormalities, and 16% had low bone mineral density (BMD). Limited data are available showing the prevalence of these risk factors in high school distance runners or regarding best practice on screening for the Triad in the adolescent population.To (1) evaluate the prevalence of Triad risk factors and iron supplementation in high school distance runners and (2) pilot a screening tool for Triad risk score.Descriptive epidemiology study.The study population included female high school athletes who participated in cross-country/track. Participants completed a survey including questions regarding dietary habits, menstrual history, and bone stress injury (BSI) history. They then underwent evaluation of 25-hydroxyvitamin D, free triiodothyronine (T3), and dual-energy x-ray absorptiometry scan to measure body fat and BMD through use of age-, sex-, and ethnicity-matched Z scores. Triad scores were calculated. Relationships were analyzed using Spearman correlation coefficient.There were 38 study participants (mean age, 16.9 years). Average body mass index was 19.8 kg/m2. Disordered eating or eating disorders were reported in 76.3% of runners; in addition, 23.7% reported delayed menarche, 45.9% had a history of amenorrhea or oligomenorrhea, 42.1% had low BMD (Z score < -1.0), and 15.8% reported prior BSI. Low free T3 was significantly associated with higher Triad risk scores (rS = -0.36; P = .028). More than 42% of athletes were supplementing iron.The prevalence of Triad risk factors in high school distance runners was high. Free T3 was inversely associated with Triad score, which may serve as an indicator of low energy availability. Nearly half of the athletes were using iron supplementation.
View details for DOI 10.1177/2325967120959725
View details for PubMedID 33195716
View details for PubMedCentralID PMC7605010
Impact of Adaptive Sports Participation on Quality of Life.
Sports medicine and arthroscopy review
2019; 27 (2): 73–82
The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and employment in those with disabilities. Facilitators of participating in adaptive sports include a desire to improve social support, physical fitness, health, and fun. Unfortunately, those with disabilities face numerous barriers to participate in adaptive sports including accessibility, transportation, awareness, finances, and physical and cognitive impairments. Further studies are needed to investigate facilitators and barriers to participating in adaptive sports to capitalize on the physical and psychosocial benefits of regular recreational activity. The aim of this article is to review the available literature on the effects of adaptive sports participation on quality of life.
View details for DOI 10.1097/JSA.0000000000000242
View details for PubMedID 31046012
Iron Supplementation and the Female Athlete Triad in High School Distance Runners
LIPPINCOTT WILLIAMS & WILKINS. 2019: 736
View details for Web of Science ID 000481662802675
Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury.
British journal of sports medicine
OBJECTIVES: Bone stress injuries (BSI) are common in runners of both sexes. The purpose of this study was to determine if a modified Female Athlete Triad Cumulative Risk Assessment tool would predict BSI in male distance runners.METHODS: 156 male runners at two collegiate programmes were studied using mixed retrospective and prospective design for a total of 7years. Point values were assigned using risk assessment categories including low energy availability, low body mass index (BMI), low bone mineral density (BMD) and prior BSI. The outcome was subsequent development of BSI. Statistical models used a mixed effects Poisson regression model with p<0.05 as threshold for significance. Two regression analyses were performed: (1) baseline risk factors as the independent variable; and (2) annual change in risk factors (longitudinal data) as the independent variable.RESULTS: 42/156 runners (27%) sustained 61 BSIs over an average 1.9 years of follow-up. In the baseline risk factor model, each 1 point increase in prior BSI score was associated with a 57% increased risk for prospective BSI (p=0.0042) and each 1 point increase in cumulative risk score was associated with a 37% increase in prospective BSI risk (p=0.0079). In the longitudinal model, each 1 point increase in cumulative risk score was associated with a 27% increase in prospective BSI risk (p=0.05). BMI (rate ratio (RR)=1.91, p=0.11) and BMD (RR=1.58, p=0.19) risk scores were not associated with BSI.CONCLUSION: A modified cumulative risk assessment tool may help identify male runners at elevated risk for BSI. Identifying risk factors may guide treatment and prevention strategies.
View details for PubMedID 30580252
Corrigendum to "A little bit faster: Lower extremity joint kinematics and kinetics as recreational runners achieve faster speeds" [J. Biomech. 71 (2018) 167-175].
Journal of biomechanics
View details for PubMedID 30442429
Team Approach: Bone Health in Children and Adolescents.
View details for PubMedID 30325758
Utilization And Efficacy Of The "Run Fueled" Smart-phone Application Among Collegiate Endurance Runners
LIPPINCOTT WILLIAMS & WILKINS. 2018: 82
View details for Web of Science ID 000456870500261
A Review and Proposed Rationale for the use of Ultrasonography as a Diagnostic Modality in the Identification of Bone Stress Injuries.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
Bone stress injuries are common in military personnel and athletes. The delayed diagnosis of a bone stress injury can lead to a more severe injury that requires a longer period of treatment. The early detection of bone stress injuries is a central part of management. Currently, the reference standard for detecting bone stress injuries is magnetic resonance imaging. However, the expanding use of point-of-care ultrasonography (US) may enable the early detection of bone stress injuries in the clinical setting. In this article, we review the US detection of bone stress injuries, as well as discuss the rationale for the use of US in the diagnosis of these injuries.
View details for PubMedID 29655254
- Nutrition Goals Prioritized By Elite Endurance Runners Undergoing A Nutrition Education Intervention LIPPINCOTT WILLIAMS & WILKINS. 2017: 852
- Preliminary Results from a Prospective Study Using the Female Athlete Triad Cumulative Risk Assessment LIPPINCOTT WILLIAMS & WILKINS. 2017: 1098
Integrating Musculoskeletal Education and Patient Care at Medical Student-Run Free Clinics.
PM & R : the journal of injury, function, and rehabilitation
Student-run free clinics (SRFCs) have emerged as an important educational component of United States (US) medical schools. Despite the prevalence of musculoskeletal (MSK) problems presenting to SRFCs, students and clinics are often unprepared to diagnose and to treat common MSK complaints.We sought to determine the scope of diagnosis and treatment at a medical student-run free clinic specializing in musculoskeletal care using physical medicine and rehabilitation (PM&R) residents. Secondary goals included reviewing student satisfaction and determining the appropriateness of the clinic in medical education.Retrospective chart review, anonymous online survey.Primary care, free student clinic affiliated with tertiary academic medical center.A total of 20 medical student volunteers, 6 PM&R residents, and 91 community patients.We established a musculoskeletal clinic as a specialty referral clinic for the 2 primary care SRFCs with institutional support from a partner medical school. We then reviewed clinical operations retrospectively using electronic medical records and student satisfaction based on an online survey.We analyzed patient demographics and chief complaints, referrals provided, and medical services rendered. We also used a 5-point Likert scale to assess student satisfaction.A monthly musculoskeletal referral clinic was established with the oversight of PM&R attendings and residents. The clinic received 91 referrals and managed 61 unique patients over a 2.5-year study period. The most common presentations to the clinic involved knee pain (n = 17, 27.9%) and back pain (n = 16, 26.2%). Pro bono relationships with community and institutional partners enabled all patients to receive medical examinations, physical therapy visits, plain film radiographs, and insurance consultations free of charge. Student satisfaction with teaching and patient care was high, with 19 of 20 students reporting their experience as "good" or "excellent."SRFCs represent an underused opportunity to enhance MSK education among medical students by treating a variety of common MSK complaints in an underserved population.To be determined.
View details for DOI 10.1016/j.pmrj.2017.03.008
View details for PubMedID 28389399
- Poster 155 Higher Cumulative Risk Assessment Scores Are Associated with Delayed Return to Play in Division I Collegiate Distance Runners. PM & R : the journal of injury, function, and rehabilitation 2016; 8 (9S): S212-S213
Piriformis Syndrome With Variant Sciatic Nerve Anatomy: A Case Report.
PM & R : the journal of injury, function, and rehabilitation
2016; 8 (2): 176-179
A 68-year-old male long distance runner presented with low back and left buttock pain, which eventually progressed to severe and debilitating pain, intermittently radiating to the posterior thigh and foot. A comprehensive workup ruled out possible spine or hip causes of his symptoms. A pelvic magnetic resonance imaging neurogram with complex oblique planes through the piriformis demonstrated variant anatomy of the left sciatic nerve consistent with the clinical diagnosis of piriformis syndrome. The patient ultimately underwent neurolysis with release of the sciatic nerve and partial resection of the piriformis muscle. After surgery the patient reported significant pain reduction and resumed running 3 months later. Piriformis syndrome is uncommon but should be considered in the differential diagnosis for buttock pain. Advanced imaging was essential to guide management.
View details for DOI 10.1016/j.pmrj.2015.09.005
View details for PubMedID 26377629
Bone Stress Injuries in Runners.
Physical medicine and rehabilitation clinics of North America
2016; 27 (1): 139-149
Bone stress injuries (BSIs) are common running injuries and may occur at a rate of 20% annually. Both biological and biomechanical risk factors contribute to BSI. Evaluation of a runner with suspected BSI includes completing an appropriate history and physical examination. MRI grading classification for BSI has been proposed and may guide return to play. Management includes activity modification, optimizing nutrition, and addressing risk factors, including the female athlete triad. BSI prevention strategies include screening for risk factors during preparticipation evaluations, optimizing nutrition (including adequate caloric intake, calcium, and vitamin D), and promoting ball sports during childhood and adolescence.
View details for DOI 10.1016/j.pmr.2015.08.008
View details for PubMedID 26616181