FEMALE college runners -advice please!

I'm male and not in college. The two things that I can offer are the suggestion to avoid soda and lift weights.

Why avoid soda? Most sodas contain phosphoric acid. The body excretes calcium phosphate to rid itself of this. It's not known where the calcium binding with the phosphoric acid comes from. (Is it coming from excess in food? or from your body?) Since the answer is not known, the best course of action is to avoid the possibility of contributing by avoiding it (if not entirely, then mostly).

Weight lifting is supposed to also stimulate bone density development, so adding it to your program may help in this area...the problem, it may also tend to add some muscle mass, which is a mixed blessing if you're a distance runner.

I'm also a former female collegiate distance runner who suffered 7 stress fractures between high school and college. I took Fosamax for about a year, which is usually given to post-menopausal women to increase bone density and decrease the risk of stress fractures. However, I suffered 2 more stress fractures, 4 months after I began taking the Fosamax. Why did you start taking oral contraceptive in the first place? Did you have regular periods BEFORE you started taking them? My best suggestion is to continue taking the oral contraceptives. It is extremely important, as a woman, to get your periods, as the regular cycle of estrogen does act to protect your bones. Moreover, it is somewhat stress-relieving to know when your period is coming. Now whether it increases bone density is somewhat inconclusive. I participated in a 2-year bone density/oral contraceptive study at Stanford Univ.. The study is not yet complete, but it will prove valuable as to the conclusion of this theory.

Regarding trying to prevent stress fractures.... I don't believe nutrition (calcium, vitamin D) makes a difference, although as a serious runner it is important to make sure you're fueling your body adequately. Probably the biggest things that helped me break the cycle were taking a 6 month sabbatical from running, giving up the collegiate running, learning to take easy days EASY and hard days hard, getting more sleep, and changing to running in flats/barefoot running (used to train in trainers/orthotics). I do believe stress plays a large part in it. I also found that when I cross trained during a layoff, I had a greater likelihood of coming back too quickly; your heart is more fit than your muscles/bones. I haven't had a stress fracture in almost 4 years and have run much better on my own.

Unfortunately, most college coaches want to try and get as much out of you in 4-5 years. You're somewhat obligated to train with your teammates, even if you're at a different fitness level. Some days you may feel tired and need recovery, but unfortunately you have to train according to your coach's plan. I hope you have a coach who is willing to work with you individually. That's about everything I can think of-- you gotta have the right balance. You can email me at

runcamille@utulsa.edu

if you need further advice.

:) jag

i do think that birth control is very overrated in preventing stress fractures, i agree with the previos post on that subject.

myself, i would look at your technique and strength levels (as a coach myself) and back you off of your training. my top girl is prone to stress fractures b4 i started coaching her (broke her hip-yuck). and so i just emphasize strength with her and we only ran her 30-40 miles a week during cross country and she still was all-conference and almost all-region, so she did alright. but she did not get hurt and we are slowly, slowly progressing her mileage. everyone is different and has different needs. i would have a heart to heart with your coach and see if he/she is willing to work with you and reduce your training load for a period of time and get your form better and your strength levels up. but slow things down with your running progressions, that is some of the best advice. if not, i would consider finding a coach who will work with you so you can still have the college experience. there are a few out there who will work with the individual.

I definitely agree with Cal State about a slow progression towards higher mileage. After the sabbatical from running, I spent 8 months building my aerobic base back. Even if you cross train during a layoff, you can't ignore building an aerobic mileage base for a few months to let your bones/muscles adapt. What I learned most importantly during this time was the need to take your easy days easy-- recovery is so important. I used to kill myself trying to keep up with my teammates and pushed hard every day, even with a tired body. You'll feel better and perform better on your hard days with adequate recovery. Regarding the strength training, it's something worth trying. Your bones remodel according to the stress you place on them.

Thanks for all the advice and insight. I finally did give up college running because it was making my miserable with all the injuries and I realized I only stayed healthy when I was doing my own thing (summers, breaks, etc..) It was a hard decision and I still feel bad about it, especially since I disappointed my coach who I really respect, but I was too worn down physically/mentally from the injury cycle to stick with it. I've learned alot through my injuries about what I can and can't handle. I am focusing more on diet, stress, sleep,and recovery, all of which seem to be much better since I stopped college running. I was just so freaked about the low bone density but the few stress fractures I've had have been very mild, healed quickly and corresponded to periods of overtraining. I also have pretty screwed up flat feet, but I've started some barefoot strides and am wearing lighter shoes with my orhotics. Granted, not minimalist, but it's a start. With my feet, the transition has to be pretty slow and I may never get down to flats. I just wonder how much one can put into those bone density tests since the dr. said they rarely do them on young athletes so there's not really a baseline to compare to. I refuse to take Fosamax because I know girls who took it and still got fractures. Plus no one knows the effects on young girls. And reading studies on the pill doesn't convince me that works either. Plus, runners are usually put on the pill when they don't get periods at all, so I figure if I can get one without them, I'd rather interfere with drugs.

sorry for the typos -i meant "rather NOT interfere with the drugs"

and also you have progress slowly on workouts, the rest of my girls may do 2-3 workouts a week, but someone with injury issues may only do 1-2 of that and spend a day in the pool instead or on an easy run. and recovery is essential, i communicate as much as i can with the athletes and as they are getting to know their bodies, i err on the side of caution and tend to hold them back until they figure it out themselves. you runners tend to be a bit on the do more side of things and need the idea of "less is more" beat into your heads sometimes.

i think you are on the right track and are thinking correctly. you may be able to go back to college running if you play your cards right.

but i wouldnt take too much stock in those bone density tests, relax about it a bit. i had a teammate in college who had all the same stuff happen. but she just decided to not take the pill and just take things a bit differently and still ended up a D1 all-american, despite her low bone density and is healthy as can be 8 years later! without the pill! i think a lot of it is overrated and in the american system our biggest problem is overtraining/overracing!

Stress fractures are an OVERUSE injury.

Muscles get tired, quit working, pounding referred to bone, bone gets stressed and causes fracture.

Muscles get tired, go into spasms, pull on bone, bone gets stressed, causes fracture.

Either way, training is too much or too intense.

With the onset of any pain, a day off is needed to recover.

Crosstrain on those days to keep aerobic fitness.

I agree with rip that it's overuse. Sure femals have to watch the bone density with the estrogen and such but bottom line if you tire the body, the muscles that support the body weaken and become unable to support the bone and absorb the shock. Just my 2 cents but I am going through this stress fracture stuff now for a second time in my tibias. I have taken a bone density test and passed it just fine. The fractures did come after some experimentation with a couple of long tempo runs so I figure that's what caused them. I no way can increase my miles by 10 0/0 a week like all the experts say, I just know I can't keep up with that pace. My buildup is I run for 4 to 5 weeks then cut my miles in half for a week to recoup, and then increase by ten percent. I think I just got crazy trying to keep the fast pace on the longer tempos and wore myself down to a point of no return.

I beg to differ. Multiple stress fractures are not "normal" overuse injuries. Either there is a bone density/hormone issue, eating disorder, or biomechanical lower leg problem. For example: I have run and competed for 30 years - no stress fractures.

Actually they are overuse injuries. I know lots of runners both male and female who've gotten mulitple stress fractures in college due to overtraining, pushing the envelope with their mileage and intensity, and not getting enough recovery. Many went on to run afterwards and had no problems once they were out of that setting. Just because you've never had one doesn't mean everyone can avoid them. Some people's bodies are just more durable than others.

massrunner wrote:

Actually they are overuse injuries. I know lots of runners both male and female who've gotten mulitple stress fractures in college due to overtraining, pushing the envelope with their mileage and intensity, and not getting enough recovery. Many went on to run afterwards and had no problems once they were out of that setting. Just because you've never had one doesn't mean everyone can avoid them. Some people's bodies are just more durable than others.

and many who have not - and done the same thing. Define durable. I would define it as appropriate nutrition and calorie intake and excellent biomechanics.

All the advice so far has been great. Does anyone out there know anything about taking Hormone Replacement Therapy (such as the stuff they give post-menopausal women)? I have extremely low hormone levels (almost menopausal) but I'm only early 20's. I don't get my period, can't go on the pill, run high mileage, and have low bone density. I've had one stress fracture that I'm prety sure was just over use. So, any suggestions? Know anything about HRT? Thank you!

bump, please

Have you gone to your doctor and done bloodwork to see your deficientcies? I would think that there has to be a doctor who can put this all together for you and get your density levels corrected if needed along with some good nutritional information. Also calcium alone does very little if not supported with vitamin D and minerals. You may want to increase soy intake also for calcium and try to include it more in your meals. If your doctor just tells you the bla bla bla without taking you seriously or your running seriously then move on quickly to another. Running means a lot more to you than it does them so you have to get a doctor interested in helping you.

About the stress fractures it can be other things. Changing your form trying to increase speed. Maybe a leg length dicrepancy.

Bottom line see a good gyno to help figure out the hormone levels. As hard as you are training though I would just try and learn from what you have possible done to cause the fractures if it is in fact overuse as it looks like. I let fractures keep me down before and thought that it was the end of running and stopped for about 8 years, big mistake. Fractures for a lot of people are just a fact of running but do try and give yourself the best protection from them reaccurring, Sal.

I agree about seeing a doctor. There are great concerns (such as breast cancer) with being a young woman ingesting any oral hormone. Regarding the soy milk, that's a very good idea! I've been drinking vanilla soy milk (8th Continent) for the past year, and it is supposed to be good for women's health. Plus, it tastes very good! I agree about stress fractures being mostly overuse, although it doesn't help any if you have other problems (eating disorder, low bone density). Even if you do have bone density problems, you just have to be more careful with your training and balancing everything in life. Regarding having flat feet and training in flats.... I have the flattest feet in the world. Everyone's feet pronate to a certain extent-- you will have the "ideal" amount of pronation for your body while barefoot. The higher your center of gravity (thicker the midsole of a shoe) the more unstable you are on your feet and the greater the degree of pronation. I really do believe in training in minimalist shoes after trying it out the past year. Of course, I was nervous going from trainers/orthotics to hardly anything on my feet, but I've been able to run more miles (70+ miles/week) while running some amazing times this year. My feet and legs look and feel stronger. It just doesn't make sense if you're light and efficient to have something heavy on your feet. Ok, I hope my advice helps! Cheers, :) jag