FIGURE
So many of us come in contact with children every day, whether in our practice, neighborhood, school, or church. In the capacity of a nurse or just an athletic observer, we can identify the telltale signs of a child at risk. As I began to learn about the female athlete triad problem, it all of a sudden dawned on me that one of my daughter's friends might be at risk. A small wisp of a thing who ate everything in sight but never gained an ounce. And yes, you know how girls talk, no periods yet, and she was 15. We do know that this can be normal, but it can also be a sign. After all, maybe all of these things are just genetic, her mom was petite.
This young lady was blessed with superior athletic skills and played basketball with more aggressiveness than some college athletes. To some observers, she seemed obsessed with sports, but who would discourage a young girl who happened to like a sport. Not in this day and age. As a society, we had finally come to grips with the fact that boys' and girls' athletics should be equal. We are proud of our girls who excel in sports. We think it is healthy, and, in most cases, it is. This friend of my daughter's played volleyball, ran track, and participated in field events.
I decided to keep a watchful eye on her. It became obvious, over time, that she was bulimic. After spending time with her and having a degree of suspicion, my concerns were validated. Then came the stress fractures in her feet and her tibia, and not once did anyone ask her a question about menstrual history, weight loss, body image, or history of other stress fractures. What seemed obvious to me eluded her healthcare providers.
In Dr. Cameron Donaldson's article, "The Female Athlete Triad," she describes the signs and symptoms of this problem that are affecting our girls in great numbers. Although many children may not exhibit all of the signs of female athlete triad, how many girls do you know who believe that their body types just don't make it in our society? From thinking that their thighs are too fat to wishing they could make their stomachs concave, the concerns are all around us.
In his article entitled "Patients With Eating Disorders-A High-Risk Group for Fractures," Vestergaard further elucidates the problems that eating disorders impose on young women. When reading both articles together, how can we not become concerned?
Orthopaedic nurses are a great source to help educate and intervene. NAON and the Sports Medicine Special Interest Group continue to be involved in looking at the Female Athlete Triad. To me it looks like another place for us to make a difference!