When to use this
When bone pain, a stress injury, or a planned jump in training load puts durability on the agenda.
- An athlete has pain that localizes to one bone, or is returning from a stress reaction or fracture.
- A mileage build is coming and the staff wants fueling and calcium habits in place before the load rises.
- A parent asks what to feed a runner with a fracture history, beyond drinking more milk.
Advanced lab
The daily calcium plan and the escalation line
The sheet names the principles. The food plan for the calcium floor, the vitamin D conversation, and the point where soreness becomes a referral are here.
Testing, interpreting results, and any supplement decisions sit with the athlete's physician. Pair that visit with a sports dietitian so total energy and calcium intake get reviewed, not just the injury.
Evidence sources
These references support the handout’s general education. Individual medical, supplement, laboratory, or injury questions should be handled by the appropriate qualified clinician.
- Nattiv A, Loucks AB, Manore MM, et al. American College of Sports Medicine position stand: The Female Athlete Triad. Med Sci Sports Exerc. 2007.
- Mountjoy M, Ackerman KE, Bailey DM, et al. IOC consensus statement on Relative Energy Deficiency in Sport (RED-S): 2023 update. Br J Sports Med. 2023.
- Weaver CM, Gordon CM, Janz KF, et al.The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors.
Where to go next
PrintableStart with energy availabilityMost bone problems in female runners trace back to underfueling before calcium.
ToolCheck the signs and the referral pathWalk the observation list, then pick the referral path. Not a diagnosis.
PrintableWatch the cycle signalRegular cycles are one of the clearest windows into whether bones are getting support.
