Young women: pledge to protect your pelvis
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Since 15, I’ve been a pretty good runner, but a pretty bad athlete. I could outpace my very fit dad on a gym treadmill, run circles around classmates at track-and-field and get out every day – no rest, no recovery – to do it all over again. Somehow, I managed to cheat injury day in and day out.
That lucky streak lasted around seven years, and included very little stretching, insufficient food and an increasingly obsessive relationship with morning mileage. Just ask my husband, who, when we started dating, didn’t really understand why I preferred a 6 a.m. run to toast and coffee with my new boyfriend. Since then, we’ve both figured it out and can talk about it openly: I had one of those eating disorders that seem – tragically – more common than not among female athletes (and non, for that matter) these days. Nothing diagnosable – few eating disorders can ever fall under the very precise criteria laid out by the DSM-IV – but for a 20-year-old woman, losing clumps of hair in the shower is as good a criterion as any.
But back to that lucky streak, and how it ended. In January, weight finally regained, potential running sponsorship in my back pocket, and attitude towards food healthier than ever, I felt a – snap – agonizing twinge in my left pelvis. And, you know, I kept running. And then hobbling. And then wondering who to call first: my husband or an ambulance.
Since then, I’ve been misdiagnosed with a torn muscle, rediagnosed with a fractured pelvis, then double rediagnosed with a doubly-fractured pelvis. I can assure you that there are few things scarier than breaking a bone as big as your pubic ramus when you are 22-years-old, but, sadly, it’s far from a rarity. In a study comparing rates of stress fracture among military recruits, researchers found that women had a significantly higher risk of suffering from stress fractures than men, in particular those of the pelvis (accounting for 40 percent among women who suffered some kind of break).
In part, that’s because of our bone structure: a woman’s pelvis is more susceptible to added weight-bearing, impact and pressure. But among the general population, pelvic stress fractures are exceedingly rare (they account for around 2 percent of all athletic stress fractures). So why are young, fit women at-risk for such a freak injury? There’s a pretty troubling reason: the sole factor that these researchers attributed to the women’s pelvic bone breaks was a loss of menses – often tied to insufficient caloric intake, excessive exercise or some disordered combination of the two. Without menstruation, women’s bones can’t uptake dietary calcium, so they start to leech it to support bodily functions.
In the final logistic model, we found that only women who reported no menses during the past year had a greater likelihood of stress fracture (or pelvic or femoral stress fracture) than did women who reported 10 to 12 menses…Others have also shown that athletes or recruits reporting lesser menstrual irregularity (9 or fewer menses during the prior 12 months) were at increased risk for stress fracture.”
For comparison’s sake, consider that those who usually suffer from pelvic stress fractures are elderly women, as the result of post-menopausal bone loss. Among the average population, it takes a fall “from significant height” or “a traumatic accident” to put a dent in this very big, very serious piece of bone. In other words, 20-something athletes who don’t take care of themselves are essentially replicating the bones of an 80-year-old or the trauma of a catastrophic car accident.
Maybe you want to keep running, or you don’t want to talk to your doctor about your menstrual cycle, or you don’t want to gain 10 pounds even if it means being healthy. As someone who’s been through all three, and made all three wrong choices before – cutting off an otherwise promising, and potentially lucrative, running career, I’m asking other women, very sincerely, to get over it. If you’ve got the bones of an elderly woman now, imagine what they’ll resemble when you actually turn eighty.
I’m not suggesting that women curb their athletic careers to avoid potential menstrual crises or geriatric bone density. For me, athletics was one of the primary motivations in choosing recovery – and health – over illness and obsession. I strongly believe that you can’t be an Extreme Self without recognizing that extreme rest and extreme eating are part of the package. And while it took a (twice) broken pelvis for that to really sink in, I’ve thankfully still got plenty of years left for bone-jarring (not breaking) experiments in athletic masochism. So ladies, vow to love your pelvis, and hopefully you will too.
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Great post! Thanks for sharing your story so honestly. If more women — including serious athletes — were honest with each other about the costs (not just the rewards) of pushing our bodies really hard, injuries would not be so prevalent. Who do we see — and listen to — most often, our doctors or our friends, family, fellow athletes and coaches?
As you may know, many young women are suffering athletic injury and surgery at much higher rates than ever before from over-use or over-focus on one set of activities and muscle groups.
Every time I end up back at physical therapy, the treatment room contains a significant number of teen girls. I was fortunate enough to only need surgery/re-hab only much later in life.
Thanks, Caitlin. It was a tough lesson to learn, and it still makes me cringe to think that I’m paying the price *now* for the illness I suffered earlier. I ignored so many doctors who told me to slow down, and you’re right that it took a smart husband and a very worried family to get me to chill and get better.
This teen girl/young adult woman injury rate stuff is scary, too. It’s not just pelvises, you’re right. I think it’s awesome to work your body really hard – as long as you recover with equal intensity, and heed your body when it tells you to slow down. Because the signs are very obvious.
Slowing down is so counter-cultural, though. There is tremendous pressure to dododododododododododododo. Not be. Not rest. Not sleep. Not nap. Not stare up at the sky for a long time with zero electronic interruption.
I think if you’re a driven sort of person it’s especially difficult to give yourself permission to stop, heal, recover. When I was 17 a doctor — then — told me to slow down and try meditation. “I don’t have time,” I told her. Yeah, right.
I’m a 61-year-old guy reading the posts of a True/Slant contributor young enough to be my daughter. In fact, I read your posts, Katie, partly to help understand my daughter and my nieces and their contemporaries. You seem so clear-headed and you write so lucidly. Thank you for sharing from your life.
Thanks, Steve. I figure, at the very least, writing something like this might help other women my age rethink a decision or two. And, from a few emails I’ve gotten yesterday, I think it has.
I agree with Caitlin: your personal story is interesting, mainly because it’s not one that just affects women. I recently spent a weekend with my friend from home who claimed he was “getting fat” because he hadn’t been to the gym in 36 hours. It was a bit of a shock, to be honest. I didn’t expect that of him…
Colin: good point. Although it often seems like this kind of thing only affects women, men are also troubled. And they have other unique challenges, too – “bulking up” as a physical ideal, for example.
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