In this episode, Owner of Sisu Performance and Physical Therapy, Dr. Ellie Somers, talks about bone stress injuries, specifically in female runners. Today, Ellie tells us about differentiating between the male and female runner, and she elaborates on a subjective and objective exam of a bone stress injury. We learn about the most vulnerable sites for a bone stress injury, the misconception about the severity of the diagnosis, and the strategies Ellie uses to get women on to strength and flexibility training programs. Ellie talks about the concerns that many people have after a BSI, and she gives her younger self some valuable advice, all on today’s episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways “Female runners have a lot of particular and special needs and considerations when talking about evaluation from a physical therapist perspective, as well as from a communication standpoint, that need to be considered.” “When you’re getting someone into your clinic, you don’t want to make assumptions about their circumstance.” Things to consider in a subjective exam for a bone stress injury: Is the patient grasping why they got into this situation? A bone stress injury isn’t necessary about the shape of their body or foot, it’s a result of limitations of their dietary intake. Their menstrual cycle. This can be an uncomfortable conversation for many clinicians, but it is a required question for a subjective exam. “If a runner is coming to you explaining that they think they sustained a BSI because of their pronated foot or because they were wearing the wrong shoes, we’ve missed a huge piece of why bone stress injuries actually happen.” The most vulnerable sites for a BSI: The femoral neck, the first and second metatarsal, and the anterior tibia, among others. The objective exam: Palpation, single-leg balance, and walking. More explosive movements. These include the single-leg hops and taking steps up or down. “You can still be stressing bone and it’s going to heal. When we don’t stress bone enough, it could theoretically take longer and put that bone in a more vulnerable position.” “Women athletes are more prone to lower bone density than male athletes are.” “Runners kind of have this misconception that running itself actually strengthens bone. In reality, it doesn’t really strengthen bone as much as we’d like to think.” “History of bone stress injury is the number one risk factor for new bone stress injury.” “There’s no rush. You have your entire life ahead of you to work and refine. As long as you’re working on something, you’re working towards it.”   Suggested Keywords Running Injuries, Rehabilitation, Therapy, Physiotherapy, PT, Training, Injuries, Sport, Wellness, Health, Recovery, Female Runners, BSI, Bone Stress Injury, RTS   More about Dr. Ellie Somers Dr. Ellie Somers is a physical therapist, run coach, weightlifting coach and the owner of Sisu (pronounced see-su) Performance and Physical Therapy in Seattle, WA. She also serves as the team physical therapist for the women’s United States Australian Rules Football Team. As a private practice owner and coach, Ellie specializes in work with women athletes, specifically runners and field athletes.     To learn more, follow Ellie at: Email:              ellie@sisuwolf.com Facebook:       Sisu Performance PT Instagram:       @thesisuwolf Twitter:            @drelliesomers YouTube:        Sisu Sports Performance and Physical Therapy Website:          https://sisuwolf.com/resources/e-books/return-to-run (FREE gift!)   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-sma