Female Athlete Triad: Problems Caused by Extreme Exercise and Dieting

Female Athlete Triad: Problems Caused by Extreme Exercise and Dieting

Sports and exercise are healthy activities for girls and women of all ages. Occasionally, a female athlete who focuses on being thin or lightweight may eat too little or exercise too much. Doing this can cause long-term damage to health, or even death. It can also hurt athletic performance or make it necessary to limit or stop exercise.

Three interrelated illnesses may develop when a girl or young woman goes to extremes in dieting or exercise. Together, these conditions are known as the “female athlete triad.”

The three conditions are:

  • Disordered eating
  • Abnormal eating habits (i.e., crash diets, binge eating) or excessive exercise keeps the body from getting enough nutrition.
  • Menstrual dysfunction

Females at Risk

Females in any sport can develop one or more parts of the triad. At greatest risk are those in sports that reward being thin for appearance (such as figure skating or gymnastics) or improved performance (such as distance running or rowing).

Others feel pressure to lose weight from athletic coaches or parents.

Female athletes should consider these questions:

  • Are you dissatisfied with your body?
  • Do you strive to be thin?
  • Do you continuously focus on your weight?

Female Athlete Triad

Disordered Eating

Although they usually do not realize or admit that they are ill, people with disordered eating have serious and complex disturbances in eating behaviors. They are preoccupied with body shape and weight and have poor nutritional habits.

Females are five to 10 times more likely to have disordered eating compared with males, and the problem is especially common in females who are athletic. The illness takes many forms. Some people starve themselves (anorexia nervosa) or engage in cycles of overeating and purging (bulimia).

Others severely restrict the amount of food they eat, fast for prolonged periods of time or misuse diet pills, diuretics, or laxatives. People with disordered eating may also exercise excessively to keep their weight down.

Disordered eating can cause many problems, including dehydration, muscle fatigue and weakness, an erratic heartbeat, kidney damage, and other serious conditions. Not taking in enough calcium can lead to bone loss. It is especially bad to lose bone when you are a child or teenager because that is when your body should be building bone. Hormone imbalances can lead to more bone loss through menstrual dysfunction.

Menstrual Dysfunction

Missing three or more periods in a row is cause for concern. With normal menstruation, the body produces estrogen, a hormone that helps to keep bones strong. Without a menstrual cycle (amenorrhea), the level of estrogen may be lowered, causing a loss of bone density and strength (premature osteoporosis).

If this happens during youth, it may become a serious problem later in life when the natural process of bone mineral loss begins after menopause. Amenorrhea may also cause stress fractures. Normal menstruation is necessary for pregnancy.

Doctor Examination

Recognizing the female athlete triad is the first step toward treating it. See your doctor right away if you miss several menstrual periods, get a stress fracture in sports, or think you might have disordered eating.

Give the doctor your complete medical history, including:

  • What you do for physical activity and what you eat for nutrition.
  • How old you were when you began to menstruate and whether you usually have regular periods.
  • If you are sexually active, use birth control pills, or have ever been pregnant.
  • If you have ever had stress fractures or other injuries.
  • Any changes (up or down) in your weight.

Your doctor will give you complete physical examination and may use laboratory tests to check for pregnancy, thyroid disease, and other medical conditions. In some cases, a bone density test will be recommended.


Treatment for female athlete triad often requires help from a team of medical professionals including your doctor (pediatrician, gynecologist, family physician), your athletic trainer, a nutritionist, and a psychological counselor.


Last reviewed: October 2009

Co-developed with the American Orthopaedic Society for Sports Medicine

Shawn Matsunaga, ATC


Shawn Matsunaga received his degree in Physical Education/Athletic Training from California State University Dominguez Hills in 1993. He began his career working for a prominent surgeon Dr. Karlan Michelson. In addition to working for Dr. Michelson, he also worked as an assistant athletic trainer for California State University Los Angeles from 1994-1999. He relocated to Bartlett, Tennessee and began working for the University of Tennessee at Memphis as a senior research assistant. Upon completion of the study, he became an athletic trainer for the Memphis City Schools. In 2006 he became a Certified Specialist in Health Ergonomics. That same year he started his own company called The Ideal Connection which deals with ergonomics/wellness consulting. He was able to help many different types of employees from Delta, Fedex and Accredo Pharmaceutical achieve their goals. Shawn enjoys spending time with his family, snowboarding and fishing.

Prevent Pain Throughout Your Body By Taking Care Of Your Feet

Did you know your can prevent or reduce acute and chronic pain throughout the entire body merely by taking care of your feet? Your feet are the gateway to what is known as the kinetic chain. The kinetic chain is what the National Academy of Sports Medicine defines as the relationship or connection between your nerves, muscles and bones. In other words, how you walk/run (correctly or incorrectly) determines how your muscles, bones, and nerves respond to that stress.  Since your body is linked together, your feet can be the cause of pain in your knees, hips, back, and even your neck. Approximately 24% of adults have foot ailments, and the prevalence increases with age.

The first step and most obvious way to help is your footwear. Proper footwear should: smooth out gait inefficiencies, be flexible and durable, provide shock absorption, protect and adapt to uneven terrain, control motion, and prevent injury.  When selecting footwear you should consider all of these factors, especially with store bought shoes. Footwear can be customized to the specifications and needs of the individual, often times through a foot specialist or Podiatrist. In addition to footwear, an individual should also consider getting fitted for a custom orthotic. Orthotics are shoe inserts which support and align the foot and lower extremities, and are usually formed by making a plaster mold of the foot. Non-custom orthotics can also be found in foot/shoe stores but are generally not as effective as custom made orthotics. Ideally, orthotics should improve balance, re-align anatomical structures, control bio-mechanical function, accommodate foot deformities, and re-distribute external and internal forces.

Foot pain, particularly as it relates to shoes, footwear and arthritis-related disorders may be an important modifiable factor. Emerging research suggests that there may be a significant role for foot orthotics and footwear in the treatment of rheumatoid arthritis and osteoarthritis of the hip, knee and foot. Bio-mechanical evidence indicates that foot orthotics and specialized footwear may change muscle activation (muscles we use when we walk) and gait patterns (how we walk) to reduce the stress placed on our joints.


Mac JuVette

Mac Juvette, Athletic Trainer

Union University Graduate – B.S in Athletic Training

Mac has been with Memphis Orthopaedic since 2013 where he currently serves as an ATC to LeMoyne-Owen College and local high schools in Tipton County including Munford High School. He has a passion for serving the youth and local community with a dedication to providing care and assistance to the injured and the healthy.

Sports Hydration for Health and Performance

During sporting practices and events it is imperative for athletes to stay hydrated not only for health reasons but also for maximum performance. Dehydration can lead to life threatening conditions such as heat exhaustion or heat stroke if not treated and can lead to decreased  performance at the basic level.  Heat illnesses can range from heat cramps and heat exhaustion to heat stroke that can be fatal. All types of heat illnesses need to be recognized and properly treated quickly to decrease the severity of the situation.

Signs of Minor Heat Illness:

  • -Dizziness
  • -Cramps, muscular tightening and spasms
  • -Lightheadedness, when not associated with other symptoms

Early Warning Signs of Exertional Heat Exhaustion/Heat Stroke:

  • -Headache, dizziness, confusion and disorientation
  • -Excessive Sweating and/or flushing
  • -Fatigue
  • -Nausea and/or vomiting
  • -Chills and/or goose bumps

Signs of Exertional Heat Stroke:

  • -Core body temperature of more than 105 degrees
  • -Signs of nervous system dysfunction such as confusion, aggression and loss of consciousness
  • -Increased heart rate
  • -Rapid breathing
  • -Seizures
  • -Low blood pressure

Fluids should be consumed before, during and after practices and games to help prevent any heat illness from occurring and to replace fluids lost during activity. On average athletes should consume 200-300 milliliters of fluids every day.

A good way to measure how much fluid an athlete should consume after practices is a weigh in and weigh out chart. Athletes weigh in before activity starts and then weigh out after they have concluded the activities.  For every pound lost during activity an additional 16 ounces should be consumed on top of what the athlete already is consuming. The goal is for the athlete’s weight to be back to the starting weight by the next practice. This ensures that the athlete is properly re-hydrated.

The easiest way to determine if you are properly hydrated is the color of your urine. It should be light like lemonade.

Lori Conklin, MOG Staff Athletic Trainer, graduated from Lenoir-Rhyne University (Hickory, NC) in 2006 with a B.S in Athletic Training and a B.A in K-12 Physical Education. Shortly after graduation she became Head Athletic Trainer at a local high school as part of an outreach program with Carolina’s Medical Center for 3 years before relocating to Memphis in 2008. Lori worked with Baptist Rehabilitation Germantown covering St. George’s Independent School from 2008-2010. Lori has been Head Athletic Trainer at Arlington High School for the past 5 years and has been with Memphis Orthopaedic Group since September 2013. Lori is also a part of an elite group of Athletic Trainers that covers a World Championship Cheerleading Competition that is held in Atlanta, Ga. annually.


Hey Trainer!!! Do I Have To Wear A Mouthpiece?

Hey Trainer!!! Do I Have To Wear A Mouthpiece?

My name is Jay Phillips and I am a Certified Athletic Trainer. I want to talk briefly about mouthpieces and why they should be worn. There have been numerous studies that have been done by the American Dental Association and the Academy of Sports Dentistry that reveals a reduction is oral/facial injuries when athletes use a mouthpiece. Equally the National Federation of State High School Associations (NFHS) mandates the use of these devices in football, field hockey, ice hockey, lacrosse and wrestling (for wrestlers wearing braces).

The NFHS States before there was a mandate for athletic wear of the mouthpiece, that 50% of football player injuries were facial/oral and since the mandate the number of occurrences has dropped to 1%. The TSSAA adopted resolutions in 2006 that mandates mouthpieces in all TSSAA contact sports.   Mouthpieces should protect the entire biting surface of the teeth. It is widely acknowledged that mouthpieces should be properly fitted to the individual athlete and that the one size fits all is not always the best. An athlete should be able to speak if the mouthpiece is properly fitted.

So, the answer to the question of if a mouthpiece should be worn is a resounding yes! But, it is still up to the parent and student athlete to select the correct size and type of mouthpiece.



Hey Trainer! My Helmet is Too Big!

Hey Trainer!!! My Helmet is Too Big!


My name is Jay Phillips and I am a Certified Athletic Trainer. I want to talk briefly about helmets and why it is important to make sure they fit correctly. As fall sport’s season progresses, all athletes that wear helmets must be mindful of the movement of the helmets that they wear for their sport. Here are some tips to make sure that your helmet fits correctly:

  1. Measure Head Size: Using a tape measure, measure the head from above the brow to around the temples and at around the occiput (larger back portion of the head) back to above the brow.
  2. Confirm Helmet Size based on your Measurements:
Size Hat Size Circumference
S Up to 6 1/2 Up to 20 3/8″
M 6 1/2 – 7 20 3/8 – 22″
L 7 – 7 1/2 22 – 23 1/2″
XL 7 1/2 and Up 23 1/2 and Up

3. Putting on Helmet: Place thumbs over the base of the ear pads and gently lower helmet onto head at a considerable angle so that the ear pads 1st touch the temple.

4. Adjusting Fit: Inflation of the helmet is not always needed. Only use if the helmet does not fit properly.

  • Use an inflation bulb and a proper inflation needle
  • Add air to obtain a comfy fit
  • Ear pads should be comfortably fixed next to players face

5. Checking for Proper Fit:

  • Front of helmet should be 1” above players eye brow
  • Interlock hands over helmet and firmly press down unto head. The skin of the front head should move with the front pad
  • There should be no twisting of the helmet when pressure is applied
  • Remember that the pressure of the helmet should be felt at the crown of the head not the brow
  • Never wear a helmet that rests too high on the head or too low on the head

6. Attaching Chin Strap: Make sure that the chinstrap is at the middle of the

chin and comfortable over the chin

7. Taking Off Helmet: Unlatch the bottom button of the chin strap and then

gently press thumbs into ear pad and lift helmet off.





High School Sports Injuries

High School Sports Injuries

Every year, millions of teenagers participate in high school sports. An injury to a high school athlete can be a significant disappointment for the teen, the family, and the coaches. The pressure to play can lead to decisions that may lead to additional injury with long-term effects. High school sports injuries can cause problems that require surgery as an adult, and may lead to arthritis later in life.

When a sports injury occurs, it is important to quickly seek proper treatment. To ensure the best possible recovery, athletes, coaches, and parents must follow safe guidelines for returning to the game.

The Adolescent Athlete

Teenage athletes are injured at about the same rate as professional athletes, but injuries that affect high school athletes are often different from those that affect adult athletes. This is largely because high school athletes are often still growing.

Growth is generally uneven: Bones grow first, which pulls at tight muscles and tendons. This uneven growth pattern makes younger athletes more susceptible to muscle, tendon, and growth plate injuries.

Types of High School Sports Injuries

Injuries among young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones.

Acute Injuries

Acute injuries are caused by a sudden trauma. Examples of trauma include collisions with obstacles on the field or between players. Common acute injuries among young athletes include contusions (bruises), sprains (a partial or complete tear of a ligament), strains (a partial or complete tear of a muscle or tendon), and fractures.

A twisting force to the lower leg or foot is a common cause of ankle fractures, as well as ligament injuries (sprains).
Reproduced and modified with permission from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.

Overuse Injuries

Not all injuries are caused by a single, sudden twist, fall, or collision. Overuse injuries occur gradually over time, when an athletic activity is repeated so often, parts of the body do not have enough time to heal between playing.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. For example, overhand pitching in baseball can be associated with injuries to the elbow. Swimming is often associated with injuries to the shoulder. Gymnastics and cheerleading are two common activities associated with injuries to the wrist and elbow.

Stress fractures are another common overuse injury in young athletes. Bone is in a constant state of turnover—a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly, and the body cannot make new bone fast enough to replace it. As a result, the bone is weakened and stress fractures can occur—most often in the shinbone and bones of the feet.

Catastrophic Sports Injuries

Many sports, especially contact sports, have inherent dangers that put young athletes at special risk for severe injuries. Even with rigorous training and proper safety equipment, children are at risk for severe injuries to the head and neck with damage to the brain or spinal cord.

Catastrophic injuries have been reported in a wide range of sports, including ice hockey, wrestling, football, swimming, soccer, pole vaulting, cheerleading, and gymnastics. It is important for coaches, parents, and athletes to be aware of the guidelines and regulations developed for each sport to prevent head and neck injury.


Concussions are mild traumatic brain injuries. They are caused by a blow to the head or body that results in the brain moving rapidly back and forth inside the skull.

Although some sports have higher instances of concussion—such as football, ice hockey, and soccer—concussions can happen in any sport or recreational activity.

In 2010, the American Academy of Pediatrics recommended that young athletes with concussions be evaluated and cleared by a doctor before returning to sports. The American Academy of Neurology issued a similar statement, and stressed that doctors who clear athletes for return to sports should be trained in managing and assessing sports concussions.

Growth Plate Injuries

Growth plates are areas of developing cartilage tissue near the ends of long bones. When a child becomes full-grown, the growth plates harden into solid bone.

Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. Growth plates regulate and help determine the length and shape of adult bone, therefore, injuries to the growth plate can result in disturbances to bone growth and bone deformity.

Growth plate injuries occur most often in contact sports like football or basketball and in high impact sports like gymnastics.

Prompt Medical Attention

Whether an injury is acute or due to overuse, a high school athlete who develops a symptom that persists or that affects his or her athletic performance should be examined by a doctor. Untreated injuries could lead to permanent damage or disability.

Some athletes may downplay their symptoms in order to continue playing. Coaches and parents should be aware of the more common signs of injury, such as pain with activity, changes in form or technique, pain at night, and decreased interest in practice.

Doctor Examination

During the examination, the doctor will ask about how the injury occurred, the symptoms, and will discuss the athlete’s medical history. During the physician examination, the doctor will look for points of tenderness, as well as range of motion.

If necessary, the doctor may recommend imaging tests, such as x-rays or other tests, to evaluate the bones and soft tissues.


Treatment will depend upon the severity of the injury, and may include a combination of physical therapy, strengthening exercises, and bracing. More serious injuries may require surgery.

Return to Play

A player’s injury must be completely healed before he or she returns to sports activity.

  • In case of a joint problem, the player must have no pain, no swelling, full range of motion, and normal strength.
  • In case of concussion, the player must have no symptoms at rest or with exercise, and should be cleared by the appropriate medical provider.

Media stories about the early return to competition by professional athletes following injury create the impression that any athlete with proper treatment can return to play at the same ability level, or even better.

It is important for players, parents, and coaches to understand that depending on the type of injury and treatment required, the young athlete may not be able to return to the game at the same level of play—no matter how much effort is put into injury rehabilitation.


Many high school sports injuries can be prevented through proper conditioning, training, and equipment.

High school athletes require sport specific training to prevent injury. Many injuries can be prevented with regular conditioning that begins prior to the formal sports season. Injuries often occur when athletes suddenly increase the duration, intensity, or frequency of their activity. Young athletes who are out of shape at the start of the season should gradually increase activity levels and slowly build back up to a higher fitness level.

Using proper technique for the position being played is also key to preventing injury. Proper equipment—from the right shoes to safety gear—is essential. In addition, injuries can be prevented when athletes understand and follow the rules of the game, and display good sportsmanship.

Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

  • Limit the number of teams in which your child is playing in one season. Athletes who play on more than one team are especially at risk for overuse injuries.
  • Do not allow your child to play one sport year-round—taking regular breaks and playing other sports is essential to skill development and injury prevention.
Last reviewed: August 2012
Reviewed by members of POSNA (Pediatric Orthopaedic Society of North America)

The Pediatric Orthopaedic Society of North America (POSNA) is a group of board eligible/board certified orthopaedic surgeons who have specialized training in the care of children’s musculoskeletal health. One of our goals is to continue to be the authoritative source for patients and families on children’s orthopaedic conditions. Our Public Education and Media Relations Committee works with the AAOS to develop, review, and update the pediatric topics within OrthoInfo, so we ensure that patients, families and other healthcare professionals have the latest information and practice guidelines at the click of a link.
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS “Find an Orthopaedist” program on this website.

Job Opening — Cast Tech

Date of Posting:                        October 31, 2014

Position:                                 Cast Tech

Location:                                MOG 

Work Days/Hours:                 Full-Time    M-F   (Full Benefits)

Date Position Available:       Immediately

Immediate Spvr/Mgr:           Shirley Smith

Qualifications:                       Prefer cast tech experience.



Be able to interact with doctors, patients, employees and other ancillary personnel

with enthusiasm and grace.  Peform application of casts, splints, braces, etc.  Clean and

stock rooms.  Order supplies.  Be able to navigate through the charts, call for reports, and 

other duties that enhance the work flow of the physician.


Qualified applicants please contact Shirley Smith via email at:  ssmith@mskgroup.org


Memphis Orthopaedic Group Launches GWIG (Go Where I Go) – Digital Word of Mouth Referral App

Memphis Orthopaedic Group launched GWIG (Go Where I Go) at all 5 of their memphis area locations this week.

In the world of online reputation management, for years all we have had is Arbitrary Ratings and Anonymous Reviews.  With GWIG’s innovative technology, we now have what small business owners really want, Referrals.

MOG is the first ortho group to join the GWIG network and implement digital word of mouth referral technology in the United States

Some Stats: 

Out of 10 Satisfied Customers, 8 are willing to refer, however, only 3 actually do! #1 reason they don’t refer: LACK OF INCENTIVE! GWIG allows MOG to track and recognize folks for reccomending MOG to friends and family!

92% of consumers report that word-of-mouth recommendation is the top reason they buy a product or service.

How it Works:

You have a friend who needs a referral for a business. And, you have the perfect one to share. In a world where searching for a new business is confusing and backwards, we all know that the best recommendation comes from a trusted personal contact. How can we quickly send helpful business information to our friends?

Send your referral via GWIG. Send business information the fastest and most simple way possible. With your GWIG app, you are able to access your favorite businesses’ contact information and your contacts to quickly help your friend “Go Where I Go” .GWIG saves your favorite businesses in your personal smart rolodex – finding and sending this information to your contacts can be done through one easy step with your GWIG mobile app.

Your friend receives the GWIG. Imagine referring your favorite business to a friend, and having confidence that your friend is one click away from being in touch with a great business they need.

You’ll have confidence that your personal contact will be sent an email with the business’ Google Places profile information, without spam, ads or reviews from strangers .Your friend will be able to designate whether they would like the business to reach out to them and how – saving time and effort.

Download the app and refer MOG or your favorite MOG Physician today…


 visit www.gwig.com