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95; 95% CI 0.91 to 0.98) with each one step/min increase in step rate. BMD z-score was not a statistically significant risk predictor in the final multivariable model (RR 0.93, 95% CI 0.85 to 1.03). No other biomechanical variables were found to be associated with BSI risk. Low step rate is an important risk factor for BSI among collegiate cross country runners and should be considered when developing comprehensive programmes to mitigate BSI risk in distance runners. Low step rate is an important risk factor for BSI among collegiate cros