Gary Moller: [DipPhEd PGDipRehab PGDipSportMed(Otago)FCE Certified, Kordel's and Nutra-Life Certified Natural Health Consultant]. ICL Laboratories registered Hair Tissue Mineral Analysis and Medical Nutrition Consultant.

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Tuesday, November 03, 2009

A marathon runner with a pelvis stress fracture

Hi Gary

I have been diagnosed with a stress fracture in my inferior pubic ramus. I am not having any treatment. I was simply told to rest.
I got the fracture approximately 5 weeks ago whilst training for the Auckland marathon and am now taking flax seed oil (omega 3) and Glucosomine Chondroitin.

And here is what I have had to eat in the last 24 hours:
Handful of almonds x2
Lamb curry with rice
Apple
Chi
Water x 6
Rice bubbles with banana and skim milk
Coffee
Tuna sushi
Coke zero

Regards T
__________________________________
Gary responds:
This kind of injury happens when the normal biological responses to stress fail to keep up. In the
case of bone, special cells are stimulated to first remove the bone damaged during exercise. These are called "osteoclasts". Other cells get to work producing new and stronger bone to replace that which was damaged earlier on. These cells are called "osteoblasts". A healthy response to exercise stress is complete in just a couple of days - hence the wisdom of training hard only every 2nd or 3rd day - not every day. Running is particularly hard on the skeleton.

For these cells to do their work, they rely on a rich and continuous supply of minerals, fats and proteins. If just one of dozens and dozens of nutrients are in short supply, the end result is an incomplete and weak job. If there is also inadequate rest of a day or two between workouts, the strengthening response to a workout may further be compromised. In this case, the consequence is a stress fracture.

Two terms worthy of understanding are:

Catabolism
The process by which tissue is broken down in the body.

Anabolism
The process by which tissue is built within the body.

Please go here for marathon training advice including more about these terms.

Here is an article I wrote earlier about stress fractures.

In T's case, rest alone is not nearly enough to ensure she makes a full and final recovery and able to resume training pain free and with vigour. Toni's diet is one that is actually conducive to catabolism, including bone breakdown. It will not aid the process of healing that is necessary to be completed well before any attempt is made to resume running. Let me explain why:
  • Even bearing in mind she is resting at the moment, the total calories in her diet are far too low for anybody attempting training for a marathon. This daily total is about what my 50kg partner, Alofa, will eat in a single meal. A calorie and nutrient poor diet will lead to a state of ongoing lean tissue catabolism.
  • The total protein is inadequate for bone health and clumped into two lots over 24 hours. She needs more protein spread in small lots over the day.
  • While there may be a little fat in the lamb curry, there is woefully little in the way of fats and oils. The body must have a wide variety of fatty acids to be healthy. In her case, fats should make up about 40% of her total calories.
  • There appear to be no unprocessed carbohydrates. Rice bubbles and white rice are barely different from eating plain sugar and have no appreciable nutritional merits. They are best left out. The diet requires a generous intake of carbohydrates from sources like taro, kumara, pumpkin, lentils, hummus, chick peas, whole grains, lightly cooked carrots and so on.
  • While there may be a little minerals in the lamb, the almonds and the sushi, this is just not enough for even the most sedentary person to survive on. She needs to ensure every food that enters her mouth is rich in minerals and other nutrients - such as the foods mentioned in the above bullet point.
  • Skim milk has no nutritonal merits worthy of mention and best replaced with highly nutritious full cream, non-homogenised silver top milk.
  • Unless she is working in an industrial boiler room, there is too much water from all sources in this diet and may lead to flushing precious minerals out of an already depleted body. It is a commercially driven myth that one must drink beyond the signals of thirst in order to be healthy (This is called "brain-washing"). More people die nowadays in sports events from too much water than from too little. In fact I can not recall a single case of a person dying of dehydration during a sports event. Please read this to understand why drinking water can be harmful to your health.
  • Coke and coffee are acidic and by this fact alone are mineral robbers. Minerals like magnesium, calcium and zinc are drawn out of the tissues to neutralise the acid found in these drinks. They have no place in an athlete's, diet, let alone one recovering from a stress fracture. Please read this article here. While coffee is not all that bad, coke sure is alongwith horrible drinks like Powerade. These also rot your teeth out. These drinks are best replaced by a good mineral water (tap water for example) and only drinking as required as per the guidelines in the articles linked above.
Action to take to assist bone healing

Your inquiry is timely, T. I have just returned from another Practitioner's course that
covered this health issue and I have only just received delivery of two products from Inter

Clinical Laboratories (ICL) that will greatly assist your recovery and full return to running.
  • ICL Alogotene
  • ICL Reparen
Please refer to the product information pages, including the PDF files for details of their actions.

You may also need to take additional vitamin D if you are not a regular sunbather.

Additional protein can be conveniently added to the diet with whey protein if need be.

Please be guided by the advice of your doctor or therapist and the many articles and E-Books on this site about running, nutrition and injury prevention as to how and when you resume running. The Reparen and Algotene, along with the dietary changes should expedite your recovery.

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