But seriously remember that dial approach to training I wrote so eloquently about (https://torunningchiro.com/2020/05/22/training-intensity-dial/)? Yeah, I did not listen to my own advice. I built up too quick after taking some time off in May and ended up with the same issue from the spring flaring up. There is no denying that I have a slight obsessive tendency when it comes to running, especially when there is external stress, such as a global pandemic. I latch on to my happy place (running) a little too hard. Every big injury I have had has always been around stressful life events: https://torunningchiro.com/2018/10/14/its-called-a-stress-fracture/
Fortunately I had a MRI previously scheduled so decided to get it done in order to know for certain whether the issue was in the bone, because if it was not I was not in pain and was more than happy to train through it. But annoyingly the MRI was quite inconclusive in that it was not an obvious stress fracture but rather they could not rule it out. So, we have to assume it is at least a stress reaction in my right lower femur (thigh bone). Which is a pretty big bone to have an issue with. As a not so fun side note we also found out I have a tear in my left hamstring tendon, which is where I previously had a tear a couple years a go.
What were my symptoms?
Yeah that is a tough one. I basically had no symptoms aside from a weird sensation in my lower quad. With a very mild ache sometimes at rest and made worse with sitting on a barstool with my feet dangling, but again nothing concerning or bad. I wanted to get it investigated due to my risk factors (see below) and history of stress fractures. And here we are 22 days no running so far.
So, lets talk about the real issue as I am always more than happy to use myself as an example. Hopefully, you can learn from my mistakes. My large bones should NOT be my limiting factor to training. But in the last 4 years I have had 3 bone stress injuries all in relatively large bones (tibia, sacrum, femur) meaning that there is likely something else at play.
We did some investigative blood work and found my vitamin D to be low not crazy low but not ideal. NOW remember, I spend 1-2hrs outside in minimal clothing and often without sunscreen and my vitamin D was low so next time you are near some supplements probably worthwhile to pick up some Vit D.
Next; I have been struggling to get a consistent period. Now again there are a few contributing factors to this. I went off the pill a year a go for the very reason I wanted to be able to rely on my period or lack there of as an indication that I was getting into an unhealthy zone. And also because I do want to have children one day and so having a consistent period is important.
Lastly, we realized that I have been taking a thyroid medication on and off since high school. It was never found that I had an auto immune issue that would cause the thyroid problem so my MD just put me on a medication. Thyroid health can be one of the indicators of RED-S.
SO all of this to say that likely I have been somewhere on the spectrum of RED-S for quite some time. And a risk of RED-S is bone stress injuries.
Not exactly sure what RED-S is?
Previously it was the female athlete triad but through further research experts found it was much more than; amenorrhea (loss of period), poor bone health and disordered eating. So, they came up with ‘Relative Energy Deficiency in Sport’. See resources below to read more from the experts.
Now before you go making assumptions. No, I was not purposefully being restrictive with my eating. I love food and sweets. BUT where I think I run in to problems is increasing the amount I consume when I increase the training load. And so I end up in a deficit. So for now I have increased my carbohydrate intake despite not running, lucky for me I have Chef Mike to make the extra calories delicious.
SO what am I doing about it?
I am working with a sports dietitian (Jennifer Sygo) and a sports MD (Dr Julia Hamilton) to try to really get to the bottom of this. GOAL–> solve the problem and become a more resilient runner so I can chase after my goals! Of course I am also getting treatment at The Runner’s Academy (Dr Kris Sheppard) as well. And taking a vitamin D supplement along with a few other bone health supplements.
How am I coping without running?
Just fine. This is not my first injury rodeo and I know I will run again, but for now my body needs a change. I think it is important to embrace the cross training and find new ways to challenge myself. I did my first open water swim and WOW it was no joke so challenging!! And I have really been enjoying biking as well. SUPER GRATEFUL that the pools opened the week I had to start with my time off.
This is a part of the game. So I am making the most of the change in activity! The time really does go by fast if you allow yourself to not be hung up on it… I promise!!!
I hope to find some time to write more about this soon but had been feeling like I wanted to share what was going on. So that’s it!
You can read more about RED-S here from the experts:
IOC consensus statement 2014: https://bjsm.bmj.com/content/48/7/491
IOC consensus statement updated 2018: https://bjsm.bmj.com/content/52/11/687
Screening tool: https://bjsm.bmj.com/content/49/7/421