My 16 year old daughter is a gymnast and was just diagnosed with a stress fracture in her foot. She has now stopped training altogether and is starting to dramatically decrease her food intake as she is concerned about her body image. I am worried, and wonder if physical therapy can help her recover quickly and safely?

This sounds like a potentially dangerous situation. Female athletes are at risk for what is called the "Female Athlete Triad." This refers to 3 different conditions-disordered eating, amenorrhea (loss of menstrual cycle), and osteopenia/osteoporosis. Alone, or together, these factors can cause serious injury to the female athlete. This is commonly seen in sports where aesthetics or a lean body type are encouraged; such as gymnastics, dance, figure skating, and distance running. Loss of body weight combined with overtraining can lead to amenorrhea. With the absence of a menstrual cycle, estrogen levels decline, causing a decrease in bone mass and bone density. As a result, injury to the bone, such as a stress fracture, is more likely to occur. The teen years are critical to building bone mass since maximum bone density is achieved by our early 20's. Since your daughter has already sustained a stress fracture, it is that much more important that she is eating a balanced diet in order to sufficiently fuel her body for the demands of her sport. In addition, her menstrual cycles should be tracked to watch for irregularity. Physical therapy can certainly be helpful in dealing with your daughter's training needs.

While rest is most important when healing from a stress fracture, this does not mean that your daughter is to remain completely inactive. A physical therapist will provide intervention and education for injury prevention. Your therapist will also be able to thoroughly evaluate her training program and make appropriate modifications so that she can continue to safely be active without worsening her condition. Involvement from otmay also be necessary to provide optimal care for your daughter.

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