Female AthleteThe Female Athlete Triad is a group of interrelated conditions that affect female athletes, particularly teenage athletes. It is widely believed that an energy imbalance is the cause, combined with competitive forces. This disrupts eating patterns and body image for female athletes. Despite the fact that this is common in athletes, several aspects of the triad are seen in non-athletes as well.

The three medical conditions associated with the triad are:

  1. Low energy availability/Poor Nutrition
  2. Amenorrhea: adverse impact on menstrual cycles
  3. Osteoporosis: low bone mass/density

Low Energy Availability/ Poor Nutrition– Energy availability is calculated by how much energy you gain from dietary sources, minus the amount of energy you expend during activity. Typically, with triad poor energy availability is the driving force behind abnormal bone density and menstrual dysfunction. Poor energy availability is caused by poor nutrition; it can occur with or without the presence of an eating disorder. Nutrients act to provide the necessary source of fuel for bones and muscles. Poor nutrition also can have a negative effect on the part of the brain that controls hormones that regulate the menstrual cycle. Optimal energy availability supports bone health specifically by maintaining estrogen levels. Estrogen is an important hormone that has a protective effect on bone by supporting the balance between bone building and bone loss. Therefore, lack of estrogen can impact bone density and may increase the risk of bone stress injuries.

Amenorrhea: adverse impact on menstrual cycles– Amenorrhea in athletes, sometimes called exercise-associated amenorrhea, occurs when a woman doesn’t have a regular period either because she exercises too much, eats too few calories, or both. In order to have regular periods, women need to consume a certain number of calories and maintain around 16 percent body fat or more. If a woman has too little body fat the ovaries stop producing estrogen and the woman stops menstruating.

Osteoporosis: low bone mass/density– The future health complications of loss of bone mass early in life can be devastating as a woman ages. The risk of stress fractures increases dramatically, but the long-term risk of severe osteoporosis that leads to bone fractures that may not heal properly as a woman ages is a real concern.

Female Athlete Triad Causes

There are times when the athlete exercises excessively while the body is experiencing an energy deficit. A reduced caloric intake combined with malnutrition leads to a pattern of disordered eating.

The pressure to ‘be thin’ is compounded by a society that idolizes celebrities and pop stars. This can result in compulsive dieting and exercise. For a growing teenage athlete, bone density can compromised if there are deficiencies in protein, vitamins and calcium. For female athletes participating in figure skating, ballet and gymnastics in particular, awareness is critical.

Female athletes are at an increased risk of developing triad due to the high demand that athletics place on the female body physically, as well as the increasing societal pressures for performance and image. For example, a female runner may feel that altering or restricting caloric intake will make her a faster runner, therefore gaining an edge on the competition and earning greater success in her sport. Triad can be present in any female athlete, from the elite athlete striving to reach high-performance goals, to the adolescent female whose body is going through normal changes related to puberty. In any case, there are physical and psychological aspects of this syndrome that affect its extent, impact, and treatment.

Female Athlete Triad Symptoms

Female athlete triad is not caused by a sudden traumatic injury; therefore, no immediate symptoms typically appear. Instead, symptoms related to the 3 components of triad may develop over time, ranging from months to years.

A female athlete may begin experiencing the following symptoms, conditions, or changes (separately or together) that may indicate she is developing female athlete triad:

  • Low energy during school, work, or exercise
  • Irregular or absent menstrual cycles
  • Stress-related bone injuries (stress reactions or fractures)
  • Difficulty concentrating
  • An unexplained drop in performance
  • Changes in eating habits
  • Altered sleeping patterns
  • An unusually high focus on performance or image
  • Experiencing high levels of stress

 

EXERCISE AND NUTRITION – A HEALTHY FOUNDATION FOR EVERY INDIVIDUAL

Female Athlete Triad Treatment involves:

Prevention of compulsive dieting by working with a sports nutritionist.

Increasing the strength of muscles, ligaments, bones and joints must be increased with a progressive exercise program designed by a physical therapist.

Physical therapy for athletes begins with a detailed evaluation of the flexibility, strength, range of motion and athletic goals.

The physical therapist is a critical member of the healthcare team and works closely with a coach and athletic trainer. The physical therapist may use a combination of the following treatments:

  • Ultrasound to heal connective tissue (tendons and ligaments).
  • Manipulative therapy that includes stretching and massage.
  • Resistance training to increase muscle strength.
  • Cold compress for acute injuries and heat to relax muscular spasms.
  • Low-level laser use for muscle and connective tissue injuries.
  • Functional Electrical Stimulation to restore strength in the muscles.
  • The use of tape to support muscles and assistive devices as needed to support joints.

SUCCESS STARTS WITH THE RIGHT ATTITUDE!

Physical therapy can keep young athletes healthy, strong and safe, but success begins with the right attitude towards the inner and outer self. Every physical active female should take three simple precautions to protect against the triad:

Eat healthy meals at regular intervals. Use nutritional supplementation if necessary.

Discuss menstrual irregularities (or sudden fluctuations in body weight) with your physician.

Track exercise and calorie expenditure.

An environment that makes the female athlete feel safe and comfortable encourages honest conversations that help identify underlying problems. If you suspect that someone in your family has some of the symptoms associated with the triad, seek medical attention immediately.

Physical therapy is an important part of long-term treatment of this condition. In fact, physical therapy can help most individuals to live a healthy, improved quality of life. Call us today to schedule an appointment. Your success is our success.