On What Scares Me & Calcium

Posted on May 19, 2011 by Kelly

Want to know something that really scares me?

Ok, besides large, hairy spiders, flying in tiny airplanes and relationships (TMI?), the running related answer is stress fractures.

(source)

Despite the plethora of injuries I’ve experienced as a gymnast and now as a runner, I’ve never had a stress fracture.

Knock on wood. Knock on wood. And one more time for good measure…

I’ve known other runners and athletes that have had them, and some that have them right now, and they just seem to suck. Unlike some soft tissue injuries, stress fractures are an immediate sentence of NO RUNNING for at least 6-8 weeks. On top of that, a full recovery can take much longer, and the risk for another fracture a little greater.

To that, I say no thank you.

I know part of what causes a stress fracture is overuse, which we runners are often guilty of. But another factor (especially for us lady runners) is the actual health of our bones. Most of us have already reached about 90 percent of our peak bone mass by the time we’re 18, but the good news is that bone tissue can keep growing until we’re 30.

If you’re in this category (I’ve only got one more year, OMG), this means you still have time to make your bones stronger. If you’re not, then you can still take steps to make sure your bones stay healthy and strong.

Enter: calcium. An essential nutrient for bone health, whether you’re still growing or trying to prevent bone loss.

We need it. Most of us don’t get enough of it. Here’s how you can change that.

How much we need: 1,000 mg/day*

Where we can get it:

  • Skim milk (1 cup): 300 mg
  • Plain yogurt (1 cup, regular or Greek): 440 mg
(note: most yogurt containers are 6 ounces, or a little less than a cup)
  • Cheese (1.5 oz., or about one big slice): 250-300 mg
  • Cooked spinach (1/2 cup): 120 mg
  • Canned salmon (3 oz., with bones!): 180 mg
  • Canned sardines (3 oz., with bones!): 320 mg
*women and men ages 19-50

Lots of other foods are fortified with calcium, like orange juice, tofu, soy milk, cereal and almond milk. Take a look at food labels the next time you’re at the grocery store. On most foods, calcium is listed as a percentage of daily value. So if a food is shown as having 20% calcium, that means it has roughly 200 mg.

I’m definitely one to taut real foods over vitamins and supplements, but calcium is one exception I make.

I take a supplement that has 500 mg of calcium, half of what I need in a day, and also contains vitamin D (we need D to help absorb calcium!) to make sure I get enough calcium and keep my bones strong.

I’m also lucky that I have a mild obsession with Greek yogurt and probably go through two 17 ounce containers of Fage each week.

(with Dark Chocolate Dreams peanut butter)

It makes a perfect nighttime snack and excellent fuel for early morning runs – all of which have been in the rain this week.

  • Tuesday: 7.7 miles easy
  • Wednesday: 8 miles easy
  • Thursday: 7.1 miles “steady state” – about 8:30/mile

I think I’m actually starting to like running in the rain a bit! Ok, I say this now, but please no rain for this year’s NYC Marathon, running/weather Gods!

Question: Do you think you get enough calcium? Ever had a stress fracture?

Important note: I’m not a registered dietitian yet (but I will be soon!), but all of the information above is based on reputable research and government standards. Always talk to your doctor before starting a supplementation regimen!

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  • http://www.insightfulappetite.com sofia

    Ah, what an important post! As someone with unnaturally low bone density, I can say that stress fractures DO happen (I’ve had for 4 – two in the metatarsals of my feet, one rib fracture, and last year the femur) and the no running thing isn’t hard to follow because usually just walking (and breathing, with the rib fracture) hurts like a mother. I do my best to eat yogurt daily, don’t shy away from cheese, and take calcium. And of course see my special old lady osteoporosis doc at NYU. How’s that for being a special case? Haha.

    • http://mealsformiles.wordpress.com mealsformiles

      I thought of you while writing this post! I think the scariest thing about stress fractures is what a wake up call they are about our bone health, which is serious. I’m glad you’re currently fracture-free and would eat cheese with you anytime :)

  • Larry Kellogg

    There is some evidence that taking calcium supplements may raise the risk of heart attack. The jury is still out. See: http://www.webmd.com/heart-disease/news/20110419/calcium-supplements-may-increase-heart-risk So, yes, speak to your doctor before taking any supplements. Get a blood test so that you know your levels.

    I had a stress fracture and, like Sofia says, the no running part isn’t hard to follow when you’re in a lot of pain. One of our coaches says that stress fractures are her favorite injury because she knows how long it is going to last and that she will be stronger when she has healed.

    I love running but I love being injury free even more. A forced 8 week recovery period, due to a stress fracture, is not the end of the world. You can always do the stationary bike and pool running. That’s what I did. Pool running is quite a workout, when done properly.

  • Larry Kellogg

    Oh yeah, I knew I had a stress fracture when the pain in my leg would not go away when standing, and even when sleeping. I got to the point where I could not run a warm up lap on the track without being in excruciating pain.

    It is not a good idea to try to run through a stress fracture as it is possible to have a complete fracture, although you would have to have an incredibly high level of pain tolerance to do it. There is a video on YouTube of a girl breaking down in a cross country race and it is a terrible thing to watch. The word is that she ran all season on a stress fracture.

    My stress fracture came after 15 weeks and 550 miles of a marathon training plan. When the muscles are fatigued they transfer the load to the bone. At some point in the cycle of bone growth, the bone sheds material, making the bone weaker, before it rebuilds itself to be stronger. If you run at that point, you can cause stress fractures. So it goes.

  • http://secondcityrandomness.wordpress.com Amy @ Second City Randomness

    I had a stress reaction- according to my doctor, it’s what basically happens right before the fracture (inflammation and serious stress on the area). It hurt. So I can imagine how awful the actual fracture is.

    Since then, I’ve been very well aware of my calcium intake- something I was never good at, even as a kid, bc I hated milk.

  • http://keepingitrealfood.com Jess

    I had a stress reaction in my forearm last summer and it sucked. Luckily, I had a great physical therapist, and even though it’s taken almost a year to totally heal, I think I’m actually stronger than I was before it happened. I got a bone scan this fall and am going to get another one in a couple years to see if calcium supplements help build bone mass. I’ve always been good about getting calcium, but osteoporosis seems to run in the family.

  • http://www.earlymorningrun.blogspot.com lisa @ early morning run

    Great post. As you know, I’m dealing with one now and have had several in the past. This last one though, was disguised as muscle pain for the longest time. It wasn’t till I had an MRI and started using crutches that the pain was really centralized.

    I was diagnosed with osteopenia when I was 27, which is really young. I take calcium and vitamin D every day and thankfully I am also in love with greek yogurt! I get a bone density scan every year now to see how I’m progressing and last year there was some improvement. I’m having one next week and hope to see that again. It’s a struggle and so frustrating. Thanks for writing about this important topic.

  • http://angryrunner.wordpress.com angryrunner

    Nice post. I’ve also never had a stress fracture and I’m getting nervous since 1. I don’t eat dairy 2. I’m over 30 3. I’m trying to figure out a mystery injury right now and I don’t like it.

    since you’re a future RD: is it even SAFE to take calcium once you’re over 30? I’ve heard mixed thoughts on this.

    • http://mealsformiles.wordpress.com mealsformiles

      My short answer is in most cases, yes. There has been some recent research linking calcium supplementation to increased risk for heart attack in women (most women in this particular study were over 40), but there were a lot of holes in the study and it was highly criticized. Based on most research, the benefits outweigh these potential risks (unless you have any other medical condition that should be taken into consideration, of course). There is always a concern with oversupplementation – you never want to take too much. I think as long as you’re smart about the amount of calcium you take, it can benefit you. Especially if you’re not getting what you need from your diet. But of course, if you’re worried or have more concerns you should talk to a doctor (though I know you’re not a huge fan of those :) ) Does that help?

      • http://angryrunner.wordpress.com angryrunner

        That does – there is so much conflicting information out there, so I’m glad to hear that.

  • bethp262

    I had a femur stress fracture a couple of years ago (at age 40) and feel it was truly lack of calcium and not increased training. I was about 6 weeks out from a marathon but had not done anything differently with that marathon training cycle. I was on crutches nonweight bearing for 2 weeks then started stationary bike daily. Began running again after 8 weeks. Went on to BQ at a marathon 6 months later. I now take about 2000mg calcium daily when marathon training and 1000mg otherwise. A bit much, but your cells utilize calcium for muscle contractions and if your muscles use it all then there’s none left for your bones.

  • http://outtomunchnyc.com Ada

    omg stress fractures totally freak me out also. In fact, I’ve spent this entire morning seeking out a good sports doctor bc I think I stress fractured my leg. ugh. Hopefully that will never happen to you! Thanks for all the great calcium tips:)

  • http://naturallycassie.wordpress.com naturallycassie

    Thank you thank you thank you for this post!!
    I feel like i’m definitely not alone out there.

    After a stress fracture in my toe 4 weeks ago, I got my boot off on Monday, and can start slowly running again when I am experiencing no pain. Hopefully, only another 2 weeks.

    Besides focusing on calcium (a great excuse for more yogurt!), I have been taking D3, and magnesium.

    As usual, great information! You will be a FANTASTIC dietitian!

    • http://mealsformiles.wordpress.com mealsformiles

      thank YOU for the kind words! Hope your toe heals quickly :)

  • http://runnerscookie.com Corey @ The Runner’s Cookie

    I love your RD-related posts! Thanks for the reminders on where to get Calcium…I always remember milk and yogurt, but forget about the others.
    I definitely hear you on fearing stress fractures, especially since they are so common with us runners. Even though I’ve been running since high school, I’m happy to say I’ve never had one. I mostly attribute that to being really in tune with the little pains I feel during or after running, and not over-training. If I start to feel some unfamiliar and “bad” pain, even if it’s really slight, I will back off for a day. I really think that paying attention to the little things goes a long way to preventing them from becoming big things.

    • http://mealsformiles.wordpress.com mealsformiles

      thanks! totally agree – even though stressing about every little pain here and there can be annoying, it definitely pays off in terms of preventing any serious injuries from happening!

  • http://www.runnerskitchen.com Megan (The Runner’s Kitchen)

    i love, love, love adora calcium supplements (they taste like chocolate – no chalky/vitamin taste at all!)

    i’m pretty sure i get enough calcium and have strong bones (thanks mom and dad!) – the only fracture/break i had was in my nose…after an unfortunate accident at a pool party (a 190 lb man’s leg came crashing down on my nose, ouch).

  • http://www.beinghealthier.com Laural (bhealthier)

    I had stress fractures in high school track, and in college, I ended my track career with my knee- went back to cheerleading only to be dropped and fracture my ankle in 3 places. Ugh.
    I am 29 this year too AND I love your answers to some of the comment/questions- perfect for what a future-RD should say!

  • http://runlindsrun.wordpress.com runlindsrun

    As someone who has had two stress fractures, thanks for this post! I was in high school and was really not knowledgeable at all. I wasn’t getting my period (TMI? Whatever) because of running, and NOW know that a regular period helps build bone density. On top of eating nutritionally-bland food and a summer of increasing my mileage too much, too soon, I found myself with a stress fracture in my left tibia! I took about 6 weeks off and guess I started up too soon, because I then got a stress fracture in my right tibia only a few weeks into training. Luckily, I knew the signs so caught it pretty early, and also got orthotics to help a leg length issue that was throwing off my mechanics and placing too much stress on my tibias.

    Now, I take calcium supplements regularly and also have a greek yogurt addiction :) But, it is so important to know how a stress fracture can result, and how you can avoid it through proper training and nutrition.

    • http://mealsformiles.wordpress.com mealsformiles

      so many lady runners are in that boat – irregular or no periods – and don’t know they are at an increased risk for fractures because the hormonal fluctuations can contribute to bone loss. So not TMI, thanks for sharing! <3 Greek yogurt <3

  • http://www.gotracygo.com Tracy

    I’ve had two tibial fractures, but a dexa scan said my bone density was healthy. Who knows? And I took 6 weeks off with each of them – lame. I was scared after my first because a salesgirl at a running store (Marathon Sports in Boston!) said, “Oh, I had a stress fracture in my ankle. I tried to run through it and it just snapped one day!” Yeah, no thanks!

  • Mary

    Thanks for this post :)

    I LOVE milk! If I don’t have a big glass with dinner, I feel weird. I eat lots of yogurt and cheese. I hope (and think) I’m covered, especially because I turn 30 in just a few months!

    I have never had a stress fracture, but my sister has. She has found that lower mileage and more cross training/yoga are key to maintaining balance.

  • http://fitgirlfoodie.wordpress.com Jenny

    I’ve never had a stress fracture but I definitely try to keep into mind how much calcium I’m getting and what my body needs for maximum bone health :)

  • http://sweettoothrunner.com Emma (Sweet Tooth Runner)

    I’m so scared I’m getting a stress fracture :( I’ve seen a doctor (who said it was servere shin splints but he couldn’t be sure) so I’m gonna make a PT appointment soon!

    I take a calcium supplement just to make sure I’m getting enough as a vegan. This post is AWESOME! :D

  • http://movesnmunchies.wordpress.com movesnmunchies

    ahh this post hits home for me.. I have really bad osteopenia.. and im 17 which means I have 13 years to get my bones strong.. im SO SCARED though- i dont wnt my bones to get osteoporosis.. they are already close! it was all a result ofmy ED past.. !

  • http://runningonwords.wordpress.com Sarah S @RunningOnWords

    Stress fractures are the stuff of my nightmares! I had to get both legs x-rayed for them last summer and it was a serious wake-up call to slow down a little. I take a pre-natal vitamin for my extra calcium and eat a lot of dairy.

  • http://yummyrunning.blogspot.com J

    stress fractures scare me too! I have been slacking on taking my vitamins. I need to get back on that!

  • http://yourdailygrace.wordpress.com yourdailygrace

    I’m exactly sure if I get enough calcium? I’m guessing that isn’t a great thing…and I’ve never had a stress fracture and hope to never get one.

  • greensandjeans

    As someone who has had to deal with more than one stress fracture, this is a subject that is near and dear to my heart! My boyfriend’s stepdad is a doctor and recently he called me out of the blue to ask how much vitamin D I get because he thinks that might be my problem. I was tested and it turns out I need THOUSANDS more mg of vitamin D than I had been taking! Who would have thought?!

  • http://www.seejessrun.com Jess

    Stress fractures freak me out so much, but luckily I’ve never had one. And yes, I do think I get enough calcium, which is probably why.

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