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Here are a couple of thought provoking abstracts from ACSM.

Prevalence of Menstrual dysfunction and Low bone Mineral Density among High school Cross-Country Runners Without disordered eating

Mitchell J. Rauh, FACSM, Michelle T. Barrack, Marta D.Van Loan, Jeanne F. Nichols,

While much attention has been devoted to female athletes with disordered eating and its relationship to menstrual status and bone mineral density (BMD), less is known about the occurrence of these conditions in female athletes with normal eating behaviors.

Purpose: To determine the prevalence of menstrual dysfunction (MD), low BMD and low levels of selected hormones among adolescent female runners with normal eating behaviors.

Conclusions: Our findings indicate that female high school runners who report normal eating behaviors may still be at risk for MD and low BMD as they may inadvertently consume insufficient energy to balance their high exercise expenditure. Interventions targeted to decrease health risks associated with low energy status require different approaches for athletes with and without disordered eating.

Bone Loss Over 1 year of Training and Competition in Female Cyclists

Vanessa D. Sherk, Daniel W. Barry, Karen L. Villalon, Kent C.

Hansen, Pamela Wolfe, Wendy M. Kohrt.

Previous studies of male cyclists demonstrated areal bone mineral density (aBMD) losses at similar rates that occur in early postmenopausal women. It is unclear whether women cyclists experience similar bone loss.

Purpose: To observe changes in central (hip and spine) and peripheral (tibia) bone characteristics in female cyclists over the course of 1 year of training.

Conclusions: Bone loss in female cyclists was site specific and similar in magnitude to losses previously reported in male cyclists. Research is needed to understand the mechanisms by which cycling, and perhaps other types of prolonged endurance exercise, cause bone loss.

Hip Muscle Weakness as a Risk Factor For The development Of exertional Medial Tibial Pain: a Prospective study.

Ruth Verrelst, Tine Willems, Dirk De Clercq, Philip Roosen, Lennert Goossens, Erik Witvrouw.

Exertional medial tibial pain (EMTP) is a common and complex overuse problem among civilian, military and athletic populations and is usually induced by repetitive lower leg strain imposed by loading during weight-bearing activities. EMTP is characterised by exertional pain along the posteromedial border of the middle and distal thirds of the tibia and can include diagnostic entities of medial tibial stress syndrome (MTSS), tibial stress fracture, chronic exertional compartment syndrome, and muscular an tendon injuries. The treatment of such an injury is often difficult, expensive and time-consuming. Hence, being injured can have a significant effect on a physically active lifestyle, and they can sometimes end activity-related careers entirely. The understanding of injury causation should therefore be of primary concern.

Purpose: To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP).

Conclusion: Hip abductor weakness is a significant predictor for EMTP. Preventive screening methods for EMTP should therefore include this proximal contributing factor.

All three of these papers present red flags to clinicians treating athletes.

Cheers
simon