The Female Athletic Triad
As can be seen above there are three main components to this condition and they are:
Energy Deficiency with or without disordered eating
Menstrual Disturbances / Amenorrhea
Bone loss / Osteoporosis
Energy deficiency
Is clinically denoted by an imbalance between the amount of energy consumed and the amount of energy expended during exercise. This can be a conscious effort by the athlete to restrict their intake driven by body image issue in sport, coaching comments and performance goals and a desire to ‘be thin’. More often than not, this element of the triad can develop into a clinical eating disorder such as anorexia or bulimia.
Menstrual Disturbances
Often female athletes with a high training load will have issues with their menstrual cycle including infrequent / altered menstrual cycles and at the severe end of female athletic triad the can stop having periods.
Bone loss / Osteoporosis
Bone density is reduced with female athletic triad and can develop into osteoporosis – as seen in elderly individuals where their bones become brittle and susceptible to fracture. In young female athletes, stress fractures are a significant issue and should be considered means for investigation of the other two issue as mentioned above.
In Surf Sports?
Unfortunately, very common. There are so many elements within surf sports that produce an ideal environment for female athletic triad. The first is that compared to many other sports, the sports science behind training such as periodisation, acute and chronic load management and even simple injury management is well back in the dark ages. Many surf coaches still think that ‘doing the way they did it’ back in the 80’s is correct, and that grinding out more and more kilometres on the board, ski or in the pool is the way to make you faster and stronger. There are a few exceptions to this rule and more people should look to the beachie coaches for direction in this – they do it better.
The second is that we have a sport that female athletes compete, train and market themselves in swimwear. Now without delving into the massive issue that is sexualisation in women’s sport – this creates a precedent that matches up with modern society – to appear attractive, slim and fit. Combine this with teenage pressures from school and the media and it’s a melting pot of social pressure to ‘look good’ which obviously can result in forced energy reduction and result in female athletic triad.
How Do I Get My Daughter Help?
The approach to helping athletes with female athletic triad needs to be multidisciplinary. A physiotherapist, sports dietitian and trusted GP are essential in working on the key elements of the triad. More often than not athletes will come in our door with nothing but a stress fracture to complain about – but it is still an indication that we may need to broach the “awkward” topics about periods and diet.
Written By Josh Carter