Female Athlete Triad

We all have our weaknesses. Whether it is shin splints, tight Achilles, stomach problems, cramping, knees or ankles. Mine are hormones and bones. And, unfortunately, for a lot of female runners it is theirs, too. I have seen far too many women with a massive amount of potential have a season of success and then disappear with injuries that are all too easy to prevent. Just like altitude sickness – you only need to go down. If only it was that easy!

November 2010
I prepared, with single mindedness, for the North Face 50-mile in San Francisco. I had never done this distance and decided I needed to get as fit, as lean and as strong as I could in 4 weeks. That was the first mistake. I was training 25-30 hours a week with a combination of running 4.5 hour runs, cross training, swimming, biking and weights. Along with this, I ate a low carbohydrate diet. And, naturally, I started to lose 1 kilogram a week, which I now know was too much, too quickly for my body to have a natural balance.

The Female Athlete Triad (FAT) is a state of imbalance between diet equilibrium, hormone regulation and bone density. And with only one of these slightly out of sync the others will try to adjust often creating a weakness such as going into a state of amenorrhea (menstruation ceases) or getting bone stresses.

April 2011
Six months later, after putting myself into FAT and scoring a stress fracture, I was told by the specialist to put on 1 kilogram a week until my hormones balanced out again. The production of estrogen – the regulation hormone – is directly related to body fat content. I had 6 weeks off running and got fit in the gym and loaded up on natural fat like avocado, sun-dried tomatoes, nuts and some homemade cakes (not quite natural, but helped with my grumpiness).

Finally, after an extra 5 kilograms and almost at break point mentally, my system finally balanced itself out. The heel pain disappeared and I could begin my slow progression into running. I ran heavy for the next 6 months. My hormones remained balanced, but my body did not want to let go of the weight. I was traveling a lot, changing diets, and this didn’t help.

November 2011
I was right back where I didn’t want to be. I had been struggling with a knee problem since the end of August that just would not go. I was getting race results, but didn’t feel good with my running. The North Face 50 in San Francisco had come around again. I needed to get fit and lean. Could I drop the weight safely? Five weeks and 4 kilograms. I decided to try and if my hormone balance changed I would stop. I made it to the race safe and sound.

March 2012
OUCH! Oh no, I have done it again. I was in a ‘moon boot’ and on crutches. My foot had a shooting pain. I was waiting for my bone scan to come back. I had decided I could not go on doing this to my body. If this was a stress fracture, I would take a step back from running. I would focus on being healthy and keeping it that way. There is too much life to live. Fortunately, after a long week hobbling around (my golf did get quite good though) I was cleared. I was balanced. My body was just giving me a reminder. I have slightly changed my diet, keeping the natural fats in place of carbohydrates and dairy, which seems to be working with keeping weight down and hormone balance up.

Sometimes we need that reminder. When we do something because we love it, and we have the time to do more, then we do. However, this isn’t always the best for our bodies. It is important to talk about this to people. To your coach, your doctor, your training buddies. There is no reason for this to be taboo. Let’s discuss it! Let’s help each other reach our potential.