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Female Athletes at Risk of Stress Fractures

Female college athletes who are on low-calorie diets could be at risk for stress fractures, according to new Saint Louis University research which was published in this month’s The American Journal of Sports Medicine. //

Researchers studied risk factors for exercise-related leg pain, including stress fractures in women participating in four popular fall sports – cross-country running, field hockey, soccer and volleyball.

Women with "disordered eating," which includes eating disorders such as bulimia and anorexia but more generally refers to insufficient caloric intake, were more likely to develop stress fractures as a result of decreased estrogen production, says researcher Mark Reinking, PT, Ph.D., chairman of the department of physical therapy at Saint Louis University's Doisy College of Health Sciences.

"When people expend more calories than they consume, they release fewer hormones, which slows down menstrual cycles. This decreases estrogen in the body, which is responsible for bone development," says Reinking, also chairman of the American Board of Physical Therapy Specialties.

Leg pain is one of the most common problems afflicting athletes, Reinking says.

"It causes people to miss practices and competitions, and I wanted to understand if two people were undergoing the same exercise regime, why only one of them would have leg pain," he says. "It’s not as simple as 'Run less' or 'Change your shoes every 300 miles.' It's a complex problem, and you can't prevent something if you don't know what causes it." Risk factors for exercise-related leg pain were a prior history of the condition, disordered eating and excessive pronation (a rolling inwards) of the foot.

"Exercise-related leg pain is often described as common in athletes, but this is only the second study of its kind to quantitatively describe the condition and identify the risk factors for it," Reinking says. "The history and incidence data from
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