The Surprising Reason this Woman Kept Getting Stress Fractures
Jill Kanney was preparing for another successful track season when a stress fracture sidelined her from training. The root cause may surprise you.
Courtesy Jill KanneyAs a freshman, Jill Kanney walked on to Ohio State University cross-country team—one of the top programs in the United States. Although she hadn’t been recruited, Kanney’s high school athletic success predicted a strong college debut. The fall season went well, with Kanney at the top of the OSU team rankings. Then trouble started: While transitioning to the winter indoor track season, her groin began to hurt. She pushed on through a meet; the following day the pain became so intense she sought medical attention. Kanney had a stress fracture in her pelvis.
Kanney wasn’t alone in battling painful stress fractures that kept her from training and competing. The Ohio State University Wexner Medical Center’s Timothy Miller, MD, was tracking women athletes and their risk of injury. The orthopedic surgeon found in his study that one of the dangers of being underweight for female runners is a higher risk of stress fracture, and a longer recovery time. The findings don’t surprise Kanney—she was one of the study’s subjects.
The study specifically addressed stress fractures, which are tiny cracks in the bone that are caused by repetitive force. When runners, specifically the female athletes in the study, were underweight, their lack of body mass created additional stress on their bones. “There’s nowhere for that shock to be absorbed other than directly back into the bone,” says Dr. Miller. “Until they build some muscle mass, put a little bit of weight back on, they’re actually still at risk of developing a stress fracture later on in their career.” Dr. Miller’s study revealed that female athletes with a body mass index (BMI) of 19—for a 5’6″ woman, that’s less than 118 pounds—or lower had an increased risk of injury compared to their heavier counterparts. (Vitamin D also plays a role in keeping bones strong.)
Kanney had been dealing with a low BMI due to digestive issues that weakened her bones and kept her weight low. Kanney was in high school when a nutritionist suggested that gluten might be causing Kanney severe gastric distress. She eliminated gluten for a while, but at OSU, Kanney—like most freshmen—became much less careful about her diet. It was around the same time that her pelvis flared up. Unfortunately, this turned out to be only the first of many running injuries. (Don’t miss these symptoms of celiac disease.)
More trouble cropped up the summer leading into Kanney’s sophomore year when she was preparing for training camp. She had just fully recovered from her first fracture and was getting back into running when her right shin began to throb. This time it was a stress fracture in her tibia. By the time she recovered, it was indoor track season. But she barely got started when on Christmas eve of her sophomore year, she was wracked with severe pain in her left side. It was Kanney’s third stress fracture—this time in her rib.
“That’s when we really started wondering what was going on,” says Kanney. “They re-took my calcium levels which had decreased, even though I was supplementing with calcium. My bone density had decreased significantly in only a year and a half. It was really scary since I didn’t know what to do.” (Here are some simple things to do to increase bone density.)
Kanney met Dr. Miller at OSU, who—in addition to overseeing the study on stress fractures—was part of Kanney’s recovery team. “We looked into both the physical and mental part of it. Dr. Miller, as a former college athlete, understood both of those aspects and it helped me recover better and stronger,” she says. “The team told me to totally cut out gluten for the entire summer,” says Kanney. “They told me if my bone density dropped anymore I couldn’t compete for the rest of the season.” After only two months after being on the gluten-free diet, her bone density started increasing. That’s because one complication of untreated celiac disease is osteoporosis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. People with celiac have trouble absorbing nutrients, like calcium, which is essential for healthy bones—and even if they are consuming enough of the nutrient, people with celiac are often deficient. (Don’t miss these silent signs you are running low on essential nutrients.)
Courtesy Jill KanneyGluten-free, and stress fracture-free, Kanney returned for her junior year at OSU, running “high 18 minutes” for her 5K races—a competitive time. “I had a few minor aches and pains that year, but nothing major,” she says. “Nothing like the stress fractures.”
Kanney graduated from OSU undergraduate a year early and headed to medical school where she is now studying to become an orthopedic surgeon. She’s still running—and eating gluten-free. “My injuries at school were a combination of my gluten allergy keeping me from absorbing nutrients correctly, the stress of college and the workouts, and trying to always be on the top of the team,” she says.”Now, I’m feeling much better. I don’t wake up with the aches and pains I had in college, and I’m running quite a lot.” Her advice? “Listen to your body. If you don’t feel right, find out why.”
- Timothy Miller, MD, orthopedic surgeon, The Ohio State University Wexner Medical Center
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: "What People With Celiac Disease Need To Know About Osteoporosis"