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Stress Fractures in Female Runners

Female Athlete Stress Fracture Treatment

Patient diagnosis is a medial tibial stress fracture with underlying etiology of the female athlete's terrible triad. This patient, as standard protocol for stress fractures, should be non weight bearing for 6 to 8 wks. During this time, she should consult a nutritionist and establish an appropriate diet. This consists of adequate calories, as well as incorporating a variety of foods including increased protein and carbohydrate intake as well as fruits and vegetables into her diet. Blood and urine tests should determine appropriate vitamin and mineral supplements in addition to dietary modifications. Of specific concern for this runner are her calcium and iron levels. In a female athlete, calcium intake should be between 1000 1500 mg/day and calcium levels can be determined through bone density screening. The iron levels are determined through blood tests of hemoglobin and hematocrit. The red blood cells transmit oxygen and iron, in the form of hemoglobin and hematocrit. Low levels of iron can cause a decrease in oxygen-carrying capacity which results in fatigue of the individual. Appropriate iron levels for a female athlete should fall between 12 to 16 g/dL for hemoglobin and 38 to 50% for hematocrit.

After the physician has given the stress fracture diagnosis, the physical therapist should instruct the patient to discontinue all exercise.

A. True
B. False

The patient's health care team, consisting of the physician, coach, nutritionist, physical therapist, and psychologist, should work together to figure out an appropriate exercise routine. Her coach must be educated on the health concerns and rehabilitation process involved to allow the patient to return to running. The physical therapist and nutritionist must monitor daily activity and caloric intake. It would be most beneficial to allow the patient to exercise on the elliptical, or to swim, and / or to weight lift. This would result in bone remodeling based on the stresses applied to it. However, the patient's weight must be maintained and monitored closely to allow continued exercising.

What would be the best option for this patient concerning walking around on campus?

A. A cast and crutches
B. Properly fitted tennis shoes
C. Walk around in whatever they would like to
D. A wheelchair
E. A walking boot

Support for the patient

The patient's family, friends, and psychologist must work together to help with the patient's feelings. She presents as a Type A personality with slight tendency towards depression. The patient needs to define a safety net of people to talk with and to help her deal with the problems, changes, and increased stress in her life.