L9P Community and Ambassador Post: Sara Scinto
It’s time to talk about it. That’s what I thought after reading many honest and close-to-home stories about the female athlete triad recently popping up within the running community. I’m writing this in the midst of finishing my first year of graduate school when I should be working on the countless papers, projects, and presentations that are lined up in the next couple of weeks. But once I started thinking about what I had been through, I couldn’t stop. The feelings and words started pouring out like they had been waiting years to be spoken. Because they had.
I didn’t think my story was anything special.
For a long time, I didn’t think my story was worth putting out to the world. But the Lane 9 Project has shown me that there is no “right” way to experience the female athlete triad and that talking about it is important. I want to join the conversation and do my part in preventing this from happening to other women and girls. I want to strongly challenge the notion that it’s “just something that happens” in sport. It’s not normal, and we shouldn’t accept it as such.
I want to strongly challenge the notion that it’s “just something that happens” in sport.
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The trouble started in high school.
I chose to join cross country because I wasn’t a natural runner; I enjoyed working at something that didn’t come easily to me. I saw big improvements my first season and thereafter became utterly hooked on running. Over the next couple of years, I worked tirelessly to move my way up the team. I ran and cross-trained during the off-seasons to slowly catch up to girls I never thought I would be fast enough to run alongside. My intense dedication allowed me to move from the bottom of my team to Varsity by my senior year. But this move was accompanied by skewed thoughts about body image and food. I was always comparing my body to my faster teammates’ bodies and felt like I came up short. I thought that I needed to restrict food (even though I loved it) and train harder so that I could look and run like them.
I lost my period, which was sadly “normal” among my team.
Consequently, I didn’t think it was an issue (PSA: it is). I never became injured during my time in high school, but the combination of high mileage, mild disordered eating, and amenorrhea did eventually catch up with me.
Being able to continue running competitively was an important factor in deciding where I wanted to go to college; I felt it was important to keep running in my life for many reasons, including my love for being part of a team. But I started experiencing pain in my left lower leg within a month of starting my first college semester. I had no idea what it was because I had never been injured before. Despite visiting the trainers many times and having an X-ray, I was not promptly diagnosed. I tried so hard to run through it because I was terrified of losing all the progress I had made, but I eventually woke up one morning and couldn’t walk.
1: It felt like there was a knife jabbing into my shin with each step
Even getting into the shower was painful. An MRI showed that I had an anterior tibial stress fracture. I was immediately sidelined for the rest of the season. Although I cross-trained almost every day during my recovery (pool running still haunts me), I was not able to exercise at the intensity I was accustomed to. This, along with the usual holiday indulgence, brought me into spring semester with just a little extra baggage. I distinctly remember the night I realized this. I was studying in my dorm room, sitting cross-legged on my chair. I looked down and suddenly thought, “Oh my god. When did my hips get so big?” That was the moment that concurrently set off the worst stage in my struggle and the best running season of my life.
I was determined to make up for the season I had lost to injury.
I readopted my troubling high school habits, to a much greater degree. I never weighed myself or counted calories, because to me that would mean I had a “problem.” Instead, my compensatory behaviors were subtle. In the dining hall I was known for the multiple enormous salads I would devour at lunch and dinner. This created the illusion that I was eating enough, but I needed to eat more calories and fat instead of micronutrients and fiber.
I pushed my body to do 15 mile long runs and tagged on extra minutes to my cool-downs and warmups. On our off days, I snuck in extra cross-training sessions. If I knew I was going out to eat or having a treat later, I would purposely skimp on meals and resist my feelings of hunger so I would feel less guilty about “splurging.” My behaviors were not sustainable for long term running success. But they sure did work for a little while.
My behaviors were not sustainable for long term running success.
I don’t remember anyone asking me that season whether I was eating enough or running too much. Or maybe they did and I just blocked it out, ignored it, denied that there was anything to be worried about. Because how could there be something wrong when my running was going so well?
2: And another
By the end of that track season I was fastest I had ever been. I still look at this picture and see a runner in her prime. And I was. But then the bright pink shin sleeve catches my eye and suddenly I remember: another stress fracture had appeared, this time in my right shin. And the battling thoughts start. How can I be proud of my running achievements that season when deep down I know I wasn’t healthy? I had been forcing myself into a mold that I thought I needed to look like. I had been fighting against my body’s set point. How could I celebrate the most monumental day in my running career without also revering the behaviors that caused my body to break down?
3–5: The streak continues
Soon after this high began my string of bone injuries, a total of 4 stress fractures and 2 stress reactions over the course of 4 years. It was like a depressing game of hot potato as my injuries were passed from one side of my body to the other.
First was the stress fracture was in my left shin, then one in my right that continued into the next cross country season along with a new one in my left, then my right again, and finally my left (this one was a posterior tibial stress fracture so it wasn’t caught right away). I got really good at self-diagnosing and began to dread the familiar stabs of pain alongside my lower leg that seemed to keep popping up with ever lower mileage. My shin sleeves became a common sight to teammates and coaches as I was constantly trying to prevent, stave off, or recover from an injury. I began to lose motivation as each break I took from running brought me back slower and slower.
I considered giving up running more than a few times.
Negative thoughts plagued my mind. I loved (and still love) my team, but watching and cheering from the sidelines took a toll. Every athlete who has been injured knows it’s extremely tough to watch others do what you love while you pretend to be okay; I had to do it almost every season. I began to feel disconnected from the only established support system I had and it felt like I wasn’t truly a part of the team anymore.
To begin recovering
I made plenty of visits to sports doctors and specialists, which led to hormone therapy. This allowed me to get back to a healthy weight for me and establish a regular menstrual cycle. Cycles of physical therapy helped me strengthen my calves and ankles after significant muscle loss from being in a boot so many times. These measures certainly helped, but the damage couldn’t be undone so quickly.
6: Healthy shins, fractured femur
In my senior year, I finally succeeded with my goal of making it through the season without a tibial stress fracture, but not in the way I had hoped. I started to get some hip pain about 3/4 of the way through the cross country season, which I ignored because I was laser focused on how my shins were feeling. I wrote it off as a tight hip flexor, but it would not go away no matter how much I stretched. I was able to run in the final meet of the season, but had developed a noticeable limp by the cool-down and felt that my hip was faltering with every step I took—a warning sign I couldn’t overlook. This time it was a stress fracture in the neck of my femur, a significantly more concerning injury than a tibial stress fracture.
I was tired of having to explain why I was always injured, wearing a boot, or hobbling my way through a run.
I was prescribed crutches, but decided to stop using them after about a day and just deal with the pain of walking. Because frankly, I was tired of having to explain why I was always injured, wearing a boot, or hobbling my way through a run. It was exhausting and upsetting—another reminder that I couldn’t run.
But what is really sad is that I never told the truth. I didn’t want to admit that the reason I could never finish the season uninjured was because I had been at an unhealthy weight and lost my period for long enough that it caused lasting damage to my bone health. Disordered eating and amenorrhea are such taboo subjects for most people, not something you bring up in casual conversation. It was easier to lie and say I was “injury prone.”
I wish I had been more vocal about it then, so I’m talking now.
I should have acknowledged that the female athlete triad is not rare, and it can set off recurring injuries that are career-ending, as it did for me. So I’m talking about it now, hoping that some part of my message will get through to others because I will unfortunately not be the last to experience something like this.
Some lessons I’ve learned over the years and through writing this essay:
- You can be informed about the female athlete triad, but still be susceptible to the pressures of society and perpetuated norms of what an “ideal” female runner looks like. I could not even recognize the condition in myself, despite having researched the female athlete triad as part of one of my college courses.
- Proper nutrition is key for the body to withstand the extreme stress of endurance running. Even though I was knowledgeable about nutrition and generally “ate healthy,” I wasn’t eating enough and I wasn’t eating the right things.
- Eating disorders look different on everyone. Just because I didn’t appear too thin doesn’t mean that I was at a healthy weight for my body.
- A bone injury almost every season should never be considered “normal” in any sport.
Luckily, I didn’t go through this alone.
I am extremely thankful for my family, loved ones, teammates, coaching staff, and mentors that helped me get through my many bouts of injury and listened when I was mentally and emotionally at my lowest. I may never have normal bone density again, but I know I have a support system that will love me no matter how fast I run or what size I wear. I just wish female athletes—well, let’s be honest, females in general—didn’t constantly get bombarded with the message that they are only as good as they look. We can change that.
Despite the past 4 years and advice to the contrary, I am nowhere near done with running. Last summer I completed a half Ironman (shout-out to my mom for going through the journey with me!) and I have just signed up for my first marathon. This might seem foolish, but I am still in love with running regardless of the trouble it has caused me. It is challenging. And stress-relieving. And empowering. And no other activity makes me feel as as good as when I am flying over the pavement, exhilarated with just being alive.
I can work every single day to view my body in a positive light, accept where it is currently, and rejoice in what it is still capable of (it’s a work in progress).
Although my bones may be weak, I am strong.
And I will become stronger. I cannot run 50 miles a week anymore, but I can cross-train, rest, and recover like nobody’s business. I can strengthen the supportive muscles of my body that prevent injury. I can take my calcium+vitamin D chews every day and keep my body fueled with foods that support hormone balance and bone health (hello, unsaturated fats!). I can work every single day to view my body in a positive light, accept where it is currently, and rejoice in what it is still capable of (it’s a work in progress). And as long as I can painlessly put one foot in front of another, I will be running.
Comment or reach out to me with your story or experience if you’d like, especially if you are/were a collegiate female runner. Let’s continue the conversation!
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