Risk Factors for Bone Stress Injuries Dr Leon Creaney Consultant in Sport & Exercise Medicine UK Athletics Coach BMedSci MB ChB MRCP FFSEM

What is Bone Stress Injury? An impending fracture and at least 8 weeks missed from training!

Stress Fractures: The Consequences Stress Fractures may lead to poor race preparation, performance and dropping out

Gold medals can be denied to even the best athletes if nutrition and Bone Health are not optimal.

Toughest part of your sporting life: “A stress fracture of the pelvis, which was awful...” Mo Farah - Telegraph

Nutritional Risk Factors Low energy intake –Dieting or Low carbohydrate diet (complex sugars) –Failure to take on fuel before, during and after sessions –Low Calcium and Vitamin D intake –Need at least 1000mg Calcium per day Good sources of Calcium – cheese, milk Green leafy vegetables and salmon. Supplements if necessary

Medical & Training risk factors Overtraining, constantly tired or can’t finish sessions properly Ignoring pain in the bones (especially aching at night in bed) Rapid increase in the volume of training Always running on hard surfaces (track/road) instead of grass Poor cushioning in training shoes or wearing spikes all the time instead of cushioned trainers Poor foot/running posture (can be checked by a Physio) Low Bone Density (can be checked with a “DEXA” scan) A sign that something is wrong:- –Irregular, reduced or absent menstrual period (girls & women) Girls and Women - this is your body telling you that your energy intake doesn’t match your training requirements. The body has started conserving fuel by stopping your monthly period and doesn’t have enough energy to put Calcium in the bones

Healthy Diet & Quick energy A balanced diet and extra fuel around sessions

A well-chosen diet offers many benefits to all athletes, irrespective of event, gender, age or level of competition: Optimal gains from the training programme Enhanced recovery within and between workouts and events Achievement and maintenance of an ideal body weight and physique A reduced risk of injury and illness Confidence in being well-prepared for competition Consistency in achieving high-level performances Enjoyment of food and social eating occasions Get this!

Good advice from Athletics Weekly Good nutrition and energy intake (carbohydrates) are essential for bone health and peak performance