Female Health: Equipping Coaches to be a Solution

Female Health:
Equipping Coaches to be a Solution
Female distance runners and eating disorders in the NCAA
“It makes me sad and disappointed when I see coaches not helping a young woman
with ED because at the end of the day I believe coaches have the ability and power
to set the stage for that young person’s life. It’s a big responsibility, but it’s all about
teaching life lessons and becoming the best versions of ourselves.”
Shalane Flanagan, Pro Athlete
What can coaches do ?
1.
RECOGNIZE
2.
REFER
3.
DON’T RACE …
Eating Disorders (ED)
Mental disorders that manifest themselves in a variety of eating and weight related signs and symptoms (Thompson & Sherman, 2010)
Most Common Types of ED you will likely encounter:
Anorexia - Self Starvation
Bulimia - Binge and Purge
* or a combination of these
Female Athlete Triad
Triad Components:
1. Low energy availability/disordered eating
2. Amenorrhea
3. Osteoporosis
Female Health: Equipping Coaches to be a Solution
15 Red flag symptoms coaches can recognize …
1. Noticeable lanugo hair / “fur” on arms, face or anywhere on body
2. Brittle fingernails, blue fingertips
3. Itchy dry skin, pale skin tones
4. High risk stress fractures: pelvis, spine, femur, femoral neck
5. Overuse injuries that take unusual amount of time to heal
6. Menstrual Irregularity, losing three cycles in a row
7. Loss of bone density
8. Decreased Immunity: frequent colds, infections
9. Excuses to skip meals
10. Preoccupation with one’s food and others food
11. Exercise is the athlete’s primary way of coping; may react poorly forced days
off or rest
12. Personality shifts: Withdrawal, negative moods, decreased ability to
concentrate, impatience, crankiness
13. Light-headedness and dizziness, abdominal pain
14. Decrease in sport performance over time
15. Trainer or teammates reporting concern
Female Health: Equipping Coaches to be a Solution
Red Flags in Recruiting
Can elite high school championships be misleading?
Things I look for when recruiting a high school runner:
Indicators of over training?
Late onset or loss of menstrual cycle
Eating behavior during on-campus recruiting visits
Overall appearance
Signs of obsession or compulsion about exercise
Injury history
Female Health: Equipping Coaches to be a Solution
Peak Bone Mass Formation in Females
What you need to know …
“Bone mass is now thought to peak between the ages of 18-25. Thus, behaviors
which result in low bone density in youth could be detrimental to an athlete’s bone
health throughout her lifetime.”
(Hobart & Smucker, 2000)
PLEASE share this with your runners:
90% of your peak bone mass by age 17
(NATIONAL INSTITUTES OF HEALTH, 2006)
Calcium Needs for Teenagers
Between 9 and 18 should get 1300 milligrams of calcium every day
(AAP, American Academy of Pediatrics)
“That translates into somewhere between four to five glasses of milk or equivalent
per day. And most teens are not doing that.” Dr. Neville Golden AAP
Educate Your Runners … Calcium Sources in Food
Choosing the right calcium supplement … Key Ingredients
Calcium Citrate
Magnesium
Vitamin D3
Vitamin K
Other factors effecting calcium absorption
Cola
Coffee
Lactose Intolerance
Iron
Female Health: Equipping Coaches to be a Solution
Referring and Getting Support
Find out from your administration what the referral protocol is at your school
If there is no protocol, consider working with your school to develop one ahead of a
problem developing
Most states require a pre-participation physical evaluation
Questions on this required form can help flag possible ED
HS Coach can refer to :
School counselor
School nurse
Athletic Director
At this point, your school may require the runner to go back her physician
The physician would then redo her physical
In order for her to return to the team she would need a letter from her physician
stating that she healthy, not underweight and/or at risk for ED
DON’T Race Runners with Eating Disorders
“When you allow an athlete with an ED the opportunity to compete in uniform you
are sending a strong message to the team that poor choices are supported and you
are sending a strong message to every single athlete that their health is not
important as their immediate performance.”
Lauren Fleshman, Pro Athlete, Partner at Oiselle
Lauren Fleshman, in her own words –
Why you Don’t RACE a girl with ED:
You lose your credibility as caring for your athlete’s health
You send a statement to your athletes that performance trumps health
You essentially tell them that EDs aren’t a big deal
You make it an “unspeakable” thing … rather than something out in the open
You provide opportunities for photos to be taken of your athlete in competition,
which can become standards for what “fast” looks like
”This is a cycle that needs to be broken!”
Female Health: Equipping Coaches to be a Solution
Conclusion: Dangers of NOT Recognizing & Referring
Ticking time bomb?
Death
Serious Stress Fractures
Life Long Battle with ED
Making Other Athletes at Risk for ED
Female Health: Equipping Coaches to be a Solution
“Most coaches encourage it, by doing nothing about it.”
Letsrun.com Anonymous Poster
You are equipped to do the right thing now …
You can be a solution!
Coach Karen Harvey
[email protected]
Florida State University
Female Health: Equipping Coaches to be a Solution
References:
Hobart, JA, and DR Smucker. "The Female Athlete Triad." American Family Physician
61.11 (2000): 3357-364.
Laker, SR, D. Saint-Phard, M.Tyburski, and B. Van Dorsten. “Stress Fractures in Elite
Cross Country Athletes.” Orthopedics. 30.4 (2007): 313-5.
Loud, KJ, GM Gorden, LJ Micheli, and AE Field. “Correlates of Stress Fractures
among Preadolescent & Adolescent Girls.” Pediatrics. 115.4 (2005): 399-406.
Neighmond, Patti. “Recipe for Strong Teenage Bones: Exercise, Calcium and
Vitamin D” Health News from NPR. 28 October 2013. Web.
Pantano, Kathleen J. “Coaching Concerns in Physically Active Girls and Young
Women – Part 1: Female Athletes Triad.” Strength and Conditioning Journal. 32.2
(2009): 68-72.
Roberts, Michelle Renae. "Disordered Eating Guidelines for Intercollegiate Athletics
at California State University." Diss. California State University, 2010. Print.
Siegle, Jaimie. “Athletes and Nutrition – The Victory Program.” NATA magazine Oct.
2013: 12-15.
Thompson, Ron A. and Roberta Trattner Sherman. Eating Disorders in Sport. NYC:
Routledge, 2010.
Wentz, L, PY Liu, JZ Ilich, and EM Haymes. “Dietary and Training Predictors of Stress
Fractures in Female Runners.” International Journal of Sport Nutrition and Exercise
Metabolism. 22.5 (2012): 374-82.
USA. National Institute of Child Health and Human Development. National Institute
of Heath. Building Strong Bones: Calcium Information for Health Care Providers.
Publication No. 05-5305A. January 2006.
Suggested Reading:
Thompson, Ron A. and Roberta Trattner Sherman. Eating Disorders in Sport. NYC:
Routledge, 2010.
Brittin, Lize. Training on Empty.” CreateSpace Independent Publishing Platform,
2013.