Participation in athletics and exercise are a great way for all girls and women to stay healthy and active throughout the lifespan. However, a real danger is presented when this participation is taken to extremes or when unhealthy dieting is involved. Pressure from sports that promote a thinner physique (for either physical appearance or sport performance) and from society in general make women more likely to engage in over-exercising or unsafe dieting. This behavior can have significant and potentially long-term implications on physical and mental health, along with sport and exercise performance. When a young girl or woman goes to extremes with her exercise or her dieting, it can result in illnesses/conditions that are linked to one another, and are collectively known as the female athlete triad. The triad consists of 1) insufficient nutrition/disordered eating, 2) irregular menstruation/amenorrhea, and 3) low bone mineral density.
Insufficient Nutrition/Disordered Eating
Nutrition is an important aspect of personal health for everyone, athletes included. The nutrients that we take in from the food that we eat are responsible for fueling the bones and muscles that allow us to move. Therefore, food intake must be sufficient to provide the energy necessary to participate in daily and sports/exercise-related activities. Eating disorders such as anorexia nervosa or bulimia can obviously result in poor nutrition, but disordered eating may also look like severe caloric restriction, prolonged fasting, or misuse of laxatives, among other behaviors. The physical consequences can be very serious, and include dehydration, weakness, irregular heartbeat, and organ dysfunction or damage. This aspect of the triad is often what leads to the other two conditions, especially because poor nutrition can lead to hormonal imbalances of estrogen, which promotes bone health.
Irregular Menstruation/Amenorrhea
A normal menstrual cycle is important for maintaining the level of estrogen within the body. Nutritional deficiencies can lead to dysfunction in the hypothalamus that causes an alteration in a female’s menstruation. This may be as simple as inconsistent menstrual cycles, or as severe as the complete absence of a menstrual cycle (amenorrhea). Without a regular menstruation, estrogen levels may be decreased and result in decreased bone mineral density and strength.
Low Bone Mineral Density
Without sufficient nutrients and hormonal activity to support bone health, the bones begin to weaken. Additionally, excessive stress from overexercise can also cause bone weakness. This can lead to lower than normal bone mineral density, or a loss of bone strength that is significant enough to put an individual at increased risk for fracture (osteoporosis).
Treatment
Treatment of such a complex condition with both physical and psychological aspects requires the work of a large group of individuals. The medical team may consist of doctors, dieticians, athletic trainers, physical therapists, and psychologists who work to address the physical impairments and psychological difficulties associated with the triad. In addition, non-medical personnel such as the athlete’s parents, friends, co-workers, teammates, and coaches can help to identify the signs of female athlete triad and serve as a valuable resource to medical professionals.
But Is Physical Therapy Really Appropriate?
You may be thinking “If physical therapists make people exercise, wouldn’t that be bad for someone with the female athlete triad?” Actually, physical therapists can play a helpful role in treatment. A physical therapist can perform screenings and identify the signs of female athlete triad. They can educate athletes, their families, and others to aid in prevention efforts and promote proper fitness and health behaviors. Physical therapists are also trained to rehabilitate injuries sustained as a result of the triad, prescribe exercises that are appropriate based on training and knowledge regarding the female athlete triad, and develop programs that will allow an athlete to safely return to activity.
If you are an individual, female or male, looking to receive education and exercises that optimize exercise/sport performance and recovery from injury or conditions like the female athlete triad, our physical therapists are here to help! Call Respire Physical Therapy at (703) 671-1871 or click here to schedule your personalized evaluation today!
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