Abstract
Background: Musculoskeletal disorders (MSDs) are a prevalent health concern among athletes, particularly female university students, who may face sport-specific, physiological, and biomechanical risk factors. In Saudi Arabia, the increasing participation of women in organized sports underscores the need to examine the burden of MSDs in this under-researched population. Objectives: This study aimed to (1) determine the prevalence of MSDs among female university student athletes, (2) identify the most commonly affected body regions, and (3) investigate associations between MSD occurrence and risk factors including sport type, warm-up practices, weekly training frequency, and history of previous injuries. Methods: A cross-sectional study was conducted among 407 physically active female university students aged 16-25 years from multiple Saudi universities. Data were collected using the validated Arabic version of the Nordic Musculoskeletal Questionnaire (NMQ) and a structured risk factor survey. Descriptive statistics, chi-square tests, and logistic regression analyses were used to examine prevalence and associated factors. Results: Among 407 participants, 65.8% reported at least one MSD in the past 12 months. The most commonly affected regions were the shoulders (43.2%), neck (41.8%), and lower back (32.2%). However, multivariate logistic regression revealed that previous injury history (OR = 2.44, 95% CI: 1.47-4.06, p = 0.001) and higher weekly training frequency (OR = 1.23, 95% CI: 1.02-1.49, p = 0.034) were significant independent predictors of MSD occurrence, while participation in team sports showed a borderline association (OR = 1.59, 95% CI: 0.95-2.67, p = 0.079). Conclusions: MSDs are highly prevalent among female university student athletes in Saudi Arabia, particularly affecting the shoulders, neck, and lower back. A history of previous injury and higher weekly training frequency are identified as significant independent predictors of MSD occurrence, while team sport participation showed a borderline association that warrants further exploration. These findings highlight the need for targeted prevention strategies that emphasize rehabilitation continuity-particularly for athletes with prior injuries-and training load management for those with higher weekly training frequency to reduce the risk of MSDs and promote long-term musculoskeletal health.