Achilles Pain

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ACL Knee Injury

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Bone Health

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IT Band Syndrome

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Muscle & Tendon Strains

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Plantar Fasciitis

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Shin Splints

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Achilles Pain 〰️ ACL Knee Injury 〰️ Bone Health 〰️ IT Band Syndrome 〰️ Muscle & Tendon Strains 〰️ Plantar Fasciitis 〰️ Shin Splints 〰️

Common Running Injuries

 

Stress Fracture

  • A stress fracture is a tiny crack in a bone that is a common injury in runners. Unlike a regular fracture caused by a sudden and severe impact, a stress fracture develops gradually from repeated stress on the bone without enough time for recovery.

    Pain: The most common symptom is persistent pain, often localised to a specific area.

    Tenderness: You may experience tenderness when pressure is applied to the affected area.

    Swelling: You might experience swelling around the painful area.

    Bruising: There might be some bruising in the area of the stress fracture.

    Worsening Pain: Pain that worsens with activity and improves with rest is a typical characteristic of a stress fracture.

  • Overtraining: Running without allowing your body enough time to rest and recover can put excessive stress on your bones, leading to a higher risk of stress fractures.

    Hormones: When oestrogen levels fluctuate throughout a menstrual cycle or during menopause transition the balance between bone formation and resorption can be disrupted. This imbalance can lead to a decreased bone mineral density and increased risk of a stress fractures.

    Footwear: Wearing old or trainers that haven’t been properly fitted for your running style, that may not provide enough cushioning or support can contribute to the development of a stress fractures over time.

    Poor Nutrition: Following a calorie deficit diet could lead to an inadequate intake of essential nutrients like calcium and vitamin D which an weaken bones and make them more susceptible to stress fractures.

    Previous Fractures: Having a history of stress fractures or other bone injuries can indicate a higher risk of experiencing them again in the future.

  • The treatment for stress fractures typically involves rest to allow the bone to heal. In some cases, crutches or a walking boot may be necessary to reduce weight-bearing on the affected bone.

    Icing the area and taking anti-inflammatory medications can help manage pain and reduce any swelling.

    Strength & Conditioning may be recommended to improve strength and flexibility once healing progresses.

    Hormone Replacement Therapy:(HRT) is a treatment commonly used to alleviate symptoms associated with menopause transition. However, recent research suggests that by replenishing oestrogen levels through HRT, the loss of bone density that typically occurs during menopause can be slowed down thus maintaining bone density and reducing the risk of fractures.

    It is essential to approach HRT decisions in a personalised manner, considering individual health factors and working closely with healthcare providers to ensure the best outcomes for bone health.

    It's crucial to follow a gradual return-to-running plan to prevent reinjury.

ACL Knee Injury

  • An ACL injury is a common knee injury & occurs when the anterior cruciate ligament is torn or strained.

    • Pain: Immediate, varying in intensity.

    • Swelling: Significant swelling around the knee.

    • Instability: Knee may give way or buckle during movement.

    • Reduced Range of Motion: Difficulty straightening or bending the knee.

    • Popping Sound: A pop may be heard at the time of injury.

    • Weight-Bearing Issues: Difficulty standing or walking due to pain and instability.

  • Female runners face a higher risk of ACL injuries due to several factors:

    • Anatomy: A wider pelvis increases the "Q angle," placing more stress on the ACL.

    • Hormones: Fluctuating oestrogen levels can affect ligament laxity, increasing injury risk.

    • Muscle Imbalance: Weak quadriceps, hamstrings, or poor core stability can alter running form, straining the ACL.

    • Previous Injuries: Past ACL tears or leg injuries weaken knee stability.

    • Overtraining: Rapid mileage or intensity increases without proper recovery elevate injury risk.

    • Footwear: Worn or poorly fitted shoes may lack proper support, leading to injury.

  • Conservative Treatment: This involves physical therapy to strengthen the muscles around the knee and improve flexibility. It may also include bracing and reduced running to allow the ligament to heal.

    Surgical Intervention: In cases where the ACL is severely torn and conservative treatment is not effective, surgery may be recommended. Surgical options include ACL reconstruction, where the torn ligament is replaced with a graft.

    Rehabilitation: Regardless of the chosen treatment, rehabilitation is crucial involving a structured program of exercises to regain strength, stability, and range of motion in the knee.

    It's crucial to follow a gradual return-to-running plan to prevent reinjury.

Muscle & Tendon Strains

  • A muscle strain occurs when the muscle fibres stretch or tear.

    A tendon strain involves damage to the tendon, which is the fibrous tissue that connects muscle to bone.

    Pain: One of the earliest signs of a strain/tear is localised pain in the affected muscle or tendon. This pain may range from mild discomfort to sharp and severe.

    Swelling: Swelling around the injured area can be accompanied by tenderness to the touch.

    Stiffness: Limited range of motion and stiffness in the muscle or tendon can indicate a strain. This may make it challenging to move the affected body part.

    Weakness: Weakness in the muscle or difficulty bearing weight on the affected limb is a red flag for a strain. This weakness can impact your running performance.

    Bruising: In more severe cases, bruising may develop around the injured area due to blood vessel damage.

    Muscle Cramps: or spasms can occur as a result of a strain, adding to the discomfort.

  • Overuse: Engaging in high-volume or high intensity running without adequate rest can overload muscles and tendons, leading to strains.

    Hormones: Oestrogen plays a crucial role in maintaining tissue strength and elasticity, and its decline during the menopause transition can lead to changes that may increase susceptibility to strains in muscles and tendons.

    Muscle Strains:

    Oestrogen helps regulate collagen production, which is essential for maintaining muscle integrity and function. Declining oestrogen levels can reduce collagen synthesis, potentially making muscles more prone to strain injuries.

    Oestrogen also influences muscle recovery and repair processes. A decrease in oestrogen levels may slow down the healing of damaged muscle tissue, increasing the risk of recurring strains.

    Tendon Strains:

    Tendons rely on collagen for their structural integrity and flexibility. Oestrogen deficiency can impair collagen production in tendons, leading to decreased tensile strength and increased vulnerability to strains.

    Oestrogen helps maintain tendon thickness and blood flow, crucial for proper tendon function. Lower oestrogen levels may result in reduced tendon quality and resilience, making them more susceptible to overuse injuries.

    Poor biomechanics: Running with improper form or alignment can put excess stress on certain muscles and tendons, making them more susceptible to strains.

    Muscle imbalances: Weakness or tightness in certain muscle groups can disrupt the body's natural movement patterns, increasing the risk of strains.

    Inadequate warm-up: Skipping a proper warm-up before running can leave muscles and tendons cold and stiff, making them more prone to injury.

    Sudden increases in training intensity: Rapidly ramping up mileage or speed without allowing the body to adapt can overwhelm muscles and tendons, leading to strains.

    Footwear: Wearing worn-out or improper running shoes can alter biomechanics and increase the risk of strains.

    Running on uneven surfaces: Uneven terrain can challenge stability and increase the likelihood of awkward footfalls that strain muscles and tendons.

  • Rest: It's crucial to give your body the rest it needs to recover.

    Ice and Heat Therapy: Alternating between ice packs and heat packs can help reduce inflammation and relieve pain. Apply ice for the first 48 hours after the injury to reduce swelling, then switch to heat to promote blood flow and relaxation.

    Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help reduce pain and inflammation. However, consult your healthcare provider before taking any medication, especially if you have other health conditions or are taking other medications.

    Hormone Replacement Therapy:(HRT) is a treatment commonly used to alleviate symptoms associated with menopause transition. However, recent research suggests that HRT may also play a role in managing and preventing common running injuries.

    Running often leads to inflammation in the joints and muscles, which can result in conditions like tendonitis. Oestrogen has anti-inflammatory properties that may help in speeding up the recovery process from these types of injuries.

    HRT can also improve muscle strength and recovery. During menopause, the decrease in hormone levels can contribute to muscle weakness and slower recovery times.

    Restoring hormonal balance through HRT, can help improve muscle strength, endurance, and recovery. It is essential to approach HRT decisions in a personalised manner, considering individual health factors and working closely with healthcare providers to ensure the best outcomes for your muscles and tendons.

    Physical Therapy: Working with a physical therapist can help you develop a customised exercise plan to strengthen and stretch the affected muscles and tendons. Physical therapy can also improve range of motion and mobility.

    Massage Therapy: Massage can help relax tight muscles, improve circulation, and promote healing. Consider seeing a licensed massage therapist experienced in treating muscle and tendon injuries.

    Nutrition: Maintaining a healthy diet rich in nutrients such as calcium, magnesium, and vitamin D can support muscle and tendon health.

Disrupted Sleep

  • Getting quality sleep is key to optimizing your running performance and aiding recovery.

    • Fatigue: Poor sleep can leave you feeling tired and sluggish during runs.

    • Decreased Performance: Lack of sleep can impair coordination, reaction time, and decision-making, lowering your performance in training and races.

    • Mood Swings: Sleep helps regulate emotions. Disrupted sleep can lead to irritability, anxiety, or depression.

    • Poor Recovery: Quality sleep is crucial for muscle repair. Without it, muscle soreness and recovery times may increase.

    • Injury Risk: Poor sleep weakens your immune system, increasing your risk of injuries and illness.

    • Impaired Focus: Lack of sleep affects focus and concentration during runs.

    • Appetite Changes: Sleep disruption can trigger cravings for unhealthy foods and lead to weight gain.

    • Increased Stress: Sleep deprivation raises stress levels, making it harder to manage training and daily tasks.

  • Several factors can contribute to disrupted sleep:

    • Training Intensity: Intense workouts near bedtime can raise cortisol levels, making it harder to fall asleep.

    • Late-Night Runs: Running too late can increase adrenaline, making it difficult to unwind.

    • Nutritional Choices: Stimulants like caffeine or heavy meals before bed can interfere with sleep.

    • Stress and Anxiety: Pre-race nerves, training goals, or life stress can increase anxiety, making relaxation difficult.

    • Poor Sleep Environment: Noise, light, uncomfortable bedding, or using electronic devices before bed can disrupt your sleep cycle.

  • Getting consistent quality sleep every night is one of the best ways to maximise your recovery.

    Consistent Sleep: Maintaining a regular sleep routine can help regulate the body's internal clock, making it easier to fall asleep and wake up at the same time each day.

    Relaxation Techniques: Incorporating relaxation techniques such as deep breathing, meditation, or gentle stretching before bedtime can help calm the mind and body.

    Avoid Stimulants: Limiting caffeine and alcohol intake, especially in the evening, can prevent disruptions in sleep patterns.

    Comfortable Sleep Environment: Creating a comfortable sleep environment with a cool room temperature, comfortable bedding, and minimal noise and light.

    Evaluate Training Schedule: Adjusting your training schedule to avoid intense workouts close to bedtime can help prevent overstimulation and promote better sleep.

    Tart Cherry Juice: Research suggests tart cherry juice consumed in the evening may improve sleep quality and quantity through increasing dietary melatonin.

Shin Splints

  • Shin splints are characterised by a dull, aching pain along the inner part of the shin bone (tibia) that may become sharper when running.

    Tenderness: The area may feel tender to the touch, especially along the lower two-thirds of the shin bone.

    Swelling: You may experience mild swelling in the lower leg area where the pain is located.

    Redness: In some cases, the skin over the shin bone may appear slightly red or inflamed.

    Stiffness: Tightness or stiffness in the muscles surrounding the shin bone, especially after running.

  • Overtraining: Increasing the intensity or duration of running too quickly can put excessive stress on the shin muscles and bones, leading to shin splints.

    Hormones: Fluctuations in oestrogen levels during the menstrual cycle and menopause transitional can affect the bone formation and remodelling process as well as impacting the strength of the surrounding connective tissues.

    Footwear: Wearing old or trainers that haven’t been properly fitted for your running style, that may not provide enough cushioning or support can increase the risk of developing shin splints.

    Biomechanical Issues: Flat feet, high arches, or abnormal foot mechanics can alter the distribution of forces along the lower leg, potentially causing shin splints.

    Muscle Weakness: Weakness in the muscles of the lower leg, such as the shin and calf muscles, can result in poor shock absorption and stability, making the area more susceptible to shin splints.

    Training Surface: Running on hard or uneven surfaces can increase the strain on the lower leg muscles, heightening the likelihood of developing shin splints.

    Previous Injury: Individuals with a history of shin splints or other lower leg injuries are more prone to experiencing recurring shin splints.

    Inadequate Warm-up or Cool-down: Skipping proper warm-up and cool-down routines can leave the muscles tight and vulnerable to injury when running.

    Inadequate Recovery: Insufficient rest between runs does not allow the muscles in the lower leg to recover fully, increasing the risk of overuse injuries like shin splints.

  • Treatment for shin splints involves a combination of rest, ice, compression, and elevation (RICE) to reduce pain and inflammation.

    It's essential to take a break from running to allow the shin muscles to recover.

    Gentle stretching and strengthening exercises for the calves, shins, and ankles can also help in the rehabilitation process.

    Following a gradual return-to-running plan is recommended to ensure full rehabilitation and prevent further injury.

Plantar Fasciitis

  • Plantar fasciitis is a common foot condition characterised by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes.

    Pain: Usually felt on the bottom of the foot near the heel. It can be sharp or dull and may worsen when running.

    Stiffness: Especially in the morning or after long periods of rest, making those first few steps quite painful.

    Swelling: In some cases, you might notice swelling in the heel area.

    Tenderness: The affected area may be tender to the touch, making activities like massaging the foot uncomfortable.

    Difficulty walking: Severe cases of plantar fasciitis can make walking particularly challenging due to the pain and discomfort.

  • Overuse: Running long distances or increasing mileage too quickly can strain the plantar fascia, leading to micro-tears and inflammation.

    Hormones: Oestrogen can impact plantar fasciitis due to its role in regulating collagen metabolism and promoting inflammation. Fluctuations in oestrogen levels, during menstrual cycles or menopause transitions, can also influence the elasticity of the plantar fascia.

    Higher levels of oestrogen may lead to increased flexibility of the plantar fascia, making it more prone to overstretching and micro-tears when running. But conversely lower oestrogen levels can contribute to decreased collagen production and impaired tissue repair, potentially exacerbating plantar fasciitis symptoms.

    Footwear: Wearing shoes that lack proper support or cushioning can put excess stress on the plantar fascia and contribute to its irritation.

    Biomechanical Issues: Factors such as flat feet, high arches, or abnormal gait patterns can alter the way weight is distributed on the feet.

    Tight Muscles: Tight calf muscles and Achilles tendons can pull on the heel and increase tension on the plantar fascia.

    Inadequate Recovery: Not allowing enough time for rest and recovery between runs can prevent the plantar fascia from healing properly.

  • Treatment for plantar fasciitis typically involves a combination of rest, stretching exercises, and supportive footwear.

    Exercises that focus on strengthening and stretching the calf muscles and plantar fascia can help alleviate pain and improve flexibility.

    Orthotic inserts or supportive shoes with proper arch support can help distribute pressure more evenly on the foot and reduce strain on the plantar fascia.

    Other treatment options may include applying ice to the affected area, using night splints to keep the foot in a dorsiflexed position while sleeping, and taking anti-inflammatory medications to reduce pain and swelling.

    In severe cases, corticosteroid injections may be recommended to help alleviate symptoms.

Achilles Pain

  • Achilles pain is a common issue affecting the tendon at the back of the ankle. Symptoms include:

    • Pain and Stiffness: A dull ache or sharp pain in the heel or lower calf, especially during or after running.

    • Swelling: Inflammation around the tendon, making it tender to touch.

    • Tightness: Reduced flexibility or tight calf muscles can worsen the pain.

    • Weakness: Difficulty pushing off the ground or reduced calf strength.

    • Warmth/Redness: The area may feel warm or appear red due to inflammation.

    • Clicking/Pop Sounds: Audible clicks or pops during movement may signal tendon problems.

  • Key risk factors for Achilles pain in runners include:

    • Overuse: Excessive running or sudden increases in training can strain the Achilles tendon.

    • Hormones: Declining oestrogen levels during menstrual cycles or menopause can make the tendon more prone to injury.

    • Improper Footwear: Running in unsupportive shoes increases stress on the Achilles tendon.

    • Poor Running Form: Overstriding or heavy heel strikes can put extra strain on the tendon.

    • Muscle Imbalance: Tight or weak calf muscles can disrupt leg biomechanics, leading to pain.

    • Overtraining: Lack of rest and recovery can lead to overuse injuries, including Achilles pain.

    • Rest: Allow the Achilles tendon time to recover by reducing activity.

    • Ice Therapy: Apply ice for 15-20 minutes several times a day to reduce pain and swelling.

    • Hormone Replacement Therapy (HRT): HRT may help improve muscle strength, recovery, and reduce inflammation, particularly for menopausal women. Consult with your GP for advice.

    • Stretching & Strengthening: Gentle calf stretches and strengthening exercises for calves and ankles can improve flexibility and reduce tension.

    • Proper Footwear: Ensure you wear supportive, cushioned running shoes; avoid worn-out pairs.

    • Orthotics: Inserts may help correct biomechanical issues that contribute to Achilles pain.

    • Anti-Inflammatory Medication: Consult a healthcare professional before using medications to reduce pain and inflammation.

    • Eccentric Exercises: Eccentric heel drops can strengthen the Achilles tendon and promote healing.

    • Massage Therapy: Gentle massage can increase blood flow and support healing.

    • Gradual Return to Running: Slowly reintroduce running, starting with short, easy runs to avoid re-injury.

IT Band Syndrome

  • IT band syndrome, or iliotibial band syndrome, is a common injury among runners that causes pain and discomfort along the outside of the thigh and knee.

    Pain on the outside of the knee: Pain is usually a sharp or burning pain on the outside of the knee, especially when running or going downhill.

    Tenderness: The area where the IT band rubs against the knee joint may feel tender to the touch which suggests there is some inflammation and irritation.

    Swelling: In some cases, there might be some swelling around the knee joint due to the constant friction and pressure on the IT band.

    Snapping sensation: You may feel a snapping or popping sensation near the knee when the IT band moves over the joint, which can cause further discomfort.

    Stiffness: Stiffness in the hip or knee joint, particularly after periods of inactivity or prolonged sitting.

    Increased pain when running: Symptoms of IT band syndrome tend to worsen with continued running.

  • Increasing mileage or intensity too quickly can strain the IT band, leading to the development of IT band syndrome.

    Hormones: Some studies suggest that changes in oestrogen levels during the menstrual cycle and menopause transition ay influence the flexibility and elasticity of connective tissues, including the iliotibial (IT) band. Fluctuations in oestrogen levels could affect the IT band's ability to withstand stress during running, potentially leading to increased tightness or irritation.

    Additionally, oestrogen has been associated with changes in muscle strength and recovery, which could indirectly impact IT band syndrome. For example, lower oestrogen levels may lead to decreased muscle strength and slower recovery from intense workouts, potentially placing more strain on the IT band.

    Poor Biomechanics: Issues such as overpronation, leg length discrepancies, or muscle imbalances can place excess stress on the IT band during running.

    Inadequate Warm-Up or Cool Down: Skipping proper warm-up exercises or neglecting post-run stretching can contribute to tightness and inflammation in the IT band.

    Footwear: Wearing worn-out or unsupportive running shoes can alter your gait and increase the risk of IT band issues.

    Running Surface: Constantly running on uneven or sloped surfaces can aggravate the IT band due to the altered mechanics and repetitive strain.

    Muscle Weakness: Weak hip abductor and gluteal muscles can result in poor stabilization, affecting the alignment and function of the IT band.

    Previous Injuries: Past knee or hip injuries may disrupt the natural biomechanics of the lower body, predisposing runners to IT band syndrome.

    Tightness: Tight muscles, especially in the hip flexors, quadriceps, hamstrings, and calves, can pull on the IT band, leading to irritation and pain

  • Treatment typically involves a combination of rest, stretching, and strengthening exercises.

    Rest: Reduce or stop running to allow the irritated IT band to heal. Cross-training activities that do not aggravate the condition, such as swimming or cycling, can be beneficial.

    Icing: Applying ice to the affected area can help reduce inflammation and pain. Ice should be applied for about 15-20 minutes at a time, several times a day.

    Massage Therapy: Getting regular massages can help loosen tight muscles and improve circulation. A sports therapist can recommend stretches that can help alleviate tightness and improve flexibility.

    Strengthening Exercises: Strengthening the hip abductor and glute muscles can help correct imbalances and reduce strain on the IT band.

    Foam Rolling: Using a foam roller on the IT band and surrounding muscles can help break up adhesions and improve blood flow, reducing pain and discomfort.

Bone Health

  • Bones are constantly renewed by two types of cells—osteoblasts (which build new bone) and osteoclasts (which break down bone). A balance between these cells is essential for healthy bones.

    • Stress Fractures: These can signal weakened bones that struggle to handle the impact of running.

    • Persistent Bone Pain: Long-lasting pain in areas like the shins, feet, or hips may indicate bone health issues.

    • Decreased Performance: Struggling to maintain pace or endurance might be linked to weakened bones affecting your strength.

    • Delayed Healing: If bone injuries take longer to heal, it could be due to reduced bone density.

    • Recurring Injuries: Frequent bone injuries, like repeated stress fractures, may point to poor bone health.

    • Muscle Weakness: Weak muscles can lead to instability, making bones more vulnerable to injury.

    • Low Energy Availability: Not getting enough nutrients like calcium, Vitamin D, and protein can weaken bones and increase fracture risk.

    • Overtraining: Too much running without enough rest can cause overuse injuries.

    • Low Body Weight: Runners with low body weight or disordered eating may have lower bone density, making them more prone to stress fractures.

    • Inadequate Recovery: Not giving your body enough time to rest between runs prevents bones from repairing, raising the risk of injury.

    • Hormonal Imbalance: Changes in oestrogen, especially during menstrual cycles or menopause, can weaken bones and increase injury risk.

    • Calcium Intake: Eat foods rich in calcium like dairy, leafy greens, nuts, and seeds to keep bones strong.

    • Vitamin D: Consider Vitamin D supplements, especially if you get limited sunlight, as it helps your body absorb calcium.

    • Weight-Bearing Exercise: Running helps maintain bone density, and adding strength training can further boost bone strength.

    • Rest and Recovery: Give your body enough time to rest between runs to prevent injuries and support bone healing.

    • Hydration: Stay well-hydrated for overall health, including bone health, especially after exercising.

    • Hormone Replacement Therapy (HRT): HRT can help slow bone density loss during menopause by replenishing oestrogen, reducing fracture risk. It’s important to work with healthcare providers to decide if HRT is right for you.

REDS - Relative Energy Deficiency in Sport

  • Relative Energy Deficiency in Sport (RED-S) is a condition that occurs when the energy intake is insufficient to support the energy expenditure required for optimal health and performance.

    Decreased performance: You may experience a decline in your performance despite continued training.

    Fatigue: Persistent fatigue and low energy levels, even after adequate rest.

    Menstrual irregularities: You may experience disruptions in your menstrual cycle, including amenorrhea (absence of menstruation).

    Decreased bone mineral density: RED-S can lead to weakened bones and an increased risk of stress fractures and other bone-related injuries.

    Decreased immune function: You may be more susceptible to illness and infections due to compromised immune function.

    Mood disturbances: Symptoms such as irritability, anxiety, or depression can be associated with RED-S.

  • Inadequate Caloric Intake: Failing to consume enough calories to sustain the energy demands of intense training and exercise.

    Excessive Training Volume: Engaging in high-intensity training without adequate rest and recovery can exacerbate caloric deficits and increase the risk of RED-S.

    Psychological Stress: If you are under significant psychological stress, such as pressure to perform or body image issues, this might creep up on you as you might be unaware that you have develop disordered eating habits that could contribute to RED-S.

    Previous History of Eating Disorders: If you have a history of eating disorders you could be more susceptible to developing RED-S due to a predisposition to disordered eating patterns.

    Poor Body Composition Awareness: You may focus excessively on achieving a specific body weight or composition and resort to extreme dietary measures that compromise your energy balance.

  • Relative Energy Deficiency in Sport (RED-S) is a multi-faceted issue that can have serious implications on your health and performance. Identifying risk factors and addressing them are essential. If you are concerned at all, seek help via your coach or health care professional.