Female Athlete Triad And Customized Fitness Program For Jenny

Jenny is 17 years old.  She is a junior professional tennis player who has been performing quite well winning three of her last four events.  However, she has noted that she has had continuous disruptions to her menstrual cycle that has caused it to cease over the last four months.  She has also indicated that she has been putting herself on a strict diet to cut calories so that she can lose weight.  She has also admitted to taking diet pills to help this process.

Jenny has been feeling very fatigued since the last tournament she played in.  She informed her doctor of what has been happening with her.  The doctors and coaches are very concerned with her health and have indicated that she may have female athlete triad.

Jenny recently completed the 20-metre Multistage Fitness Test (Beep test).  Normally, she performs at a very high standard.  However, she performed poorly in this test.

Beep Test Fitness Result Norms

Men

Women

Excellent

> 13

> 12

Very good

11-13

10-12

Good

9-11

8-10

Average

7-9

6-8

Poor

5-7

4-6

Very poor

< 5

< 4

As mentioned above it is a syndrome that presents with three symptoms; a disorientation in

eating, amenorrhoea and osteoporosis. It is as a result of caloric deficit or energy drain. The

low energy is as a result of underfeeding which is done consciously or unconsciously. This

causes a disruption of the hypothalamic-pituitary-ovarian axis that causes a reduction in the

gonadotropin releasing hormone (GnRH), follicle-stimulating hormone and the luteining

hormone. This causes a decrease in estrogen production which inturns causes menstrual

dysfunction. Low estrogen affects the calcium resorption and the bone accretion which inturns

reduces the bone health. The treatment modalities include a diet regime that aims at

increasing the caloric intake by 20-30% and raising the weight by 0.5kg to 0.7kgs per week.

Patient education is also important as she needs to understand the importance of her caloric

intake as her caloric expenditure is high.

Growth and development

Impacts

Physical

One symptom is disoriented eating. This causes Anorexia Nervosa in which the

expected body weight is not attained. The body weights less than 85% of the expected

body weight. This slows down growth rates.

Due to lack of energy, as a result of reduced body intake, this makes the person to get

fatigue easily.

Osteoporosis is another symptom to the syndrome. The weakening of bones makes the

person prone to fractures which takes long to heal. This causes physical disabilities.

Social

With anorexia the female feels and looks thin and wasted. This makes them to be

isolated and withdrawn.

The lack of energy and easy fatigued makes them anti-social and disengaged with

others as they cannot tolerate activities.

The lack of energy and intolerance to activities makes them not participate in sports as

they used to. This affects their social life.

Emotional

There poor performance in sports frustrates them as they used to perform exemplary.

As a results of anorexia, their body images gets disfigured. This affects their self-image

and self-esteem.

They get depressed as a result of anorexia, disrupted menstrual cycles and they easily

get fatigued.

Beep test is the multistage fitness level test that is being performed for measuring the fitness of

cardiovascular as well as the maximum amount of oxygen uptake in the human body. It is also a

20meter shuttle run test that is being performed for the tennis players. Beep test is useful in

the tennis because it provides 20meter shuttle run test which is helpful to determine the

aerobic power of the tennis player. The primary reason for the use of beep test for the tennis

player because the movement that is involved within this test are quite similar to the tennis in

the respect of the stop, then start as well as the change within the direction.

Jenny poor performance in the beep test is due to the female athlete triad. Age of Jenny is only

17 years old and at this age it is quite possible to become the patient of female athlete triad

due to the body fitness as well as performance level in the field. It can be clearly seen that in

the case of Jenny, she used to take pills to reduce her weight and also maintain a fit body for

providing high performance level. These are all the facts which create female athlete triad

within Jenny and this is the major reason for her poor performance level.

Program one – Home program

Client name:

Jenny

Client age:

17yrs

Session length:

30 min

Goal:

Improve confidence and self-image, improve aerobic fitness.

Warm-up

Activity: Jumping jacks

Duration: 5 mins

Intensity: 10% intensity on body

Conditioning phase

Exercise

Intensity 1 RM%

Sets

Reps

Rest

Notes

1.       Forearm Plank

100% intensity on body

Hold for 1 min

3-5

1 min

Keep your back straight

2.       Plank with arm and leg lift

100% intensity on body

5

20

1 min

Hold top position for 2 secs

3.       Plank with hip twists

100% intensity on body

5

20

1 min

Do not lift your elbows from the ground

4.       Side planks

100% intensity on body

Hold for 30 sec on each side

15-20

1 min

Keep shoulders down

5.       Bicycle

100% intensity on body

50

5

1 min

Keep lower back touched on ground, touch knee with alternate elbow

6.       Reverse crunch

100% intensity on body

Hold for 1 min

15-20

1 min

Do not swing your legs

Exercise

Intensity HR max%

Time

Dist.

Rest

Notes

1.       Windshield wiper

100% intensity on body

Hold for 30 secs on each side and top

1 min

Don’t swing the legs and keep your feet together

2.       Sprinting

100% intensity on body

5 min

500 meters

2 min

Maintain pace

3.       Staircase running

100% intensity on body

5 min

100 steps

2 min

Maintain pace

Cool-down

Activity: Stretching

Duration: 5 mins

Intensity: 0% intensity on body

Notes for next session

Exercises for strengthening the hip muscles will be done in next session

Client feedback

Rory is 15. His dads, Drew and Bruce, are Ironmen in their own right, and Rory follows in their footsteps.

12 months ago, Rory tore his lateral meniscus.  Pre-injury, he was very healthy, and because of his reduced physical activity, he has lost his fitness level and gained weight.  Kids at school have started calling him Rory Porky.

Rory’s dad has employed you as an unbiased party to assist in boosting his confidence and fitness and to help him lose his excess weight.

The doctor has cleared Rory for all exercise activities, but he would like him to start with lower intensity training.  Indeed, Rory is very excited about having his very own trainer.

This is a profile of Rory’s latest baseline measurements:

·         BMI – 26

·         Blood pressure – 126/82

·         Weight – 73kg

·         Sit and reach test – 0cm(minus)

·         Resting heart rate – 80 bpm

Rory’s dads explain that their son’s road to recovery should begin with losing the excess weight as a preventative to tearing his lateral meniscus again.  Rory has been through the following rehab measures:

·         Soft tissue massage

·         Electrotherapy

·         Taping or bracing to support the knee

·         The use of crutches

·         Dry needling

·         Hydrotherapy

 Considering the history of Rory’s medical condition and the gap that has occurred due to it in his physical and exercise routine, it is not recommended that Rory begins with very high intensity exercises. On the other hand, it is important for Rory to start working in the direction of loosing weight in order to gain not only his health and physical shape back but also to re gain his lost confidence.

To begin with, the exercises that Rory will be doing will not be more than 50% intense on his body. The idea is to make up for the lost stamina and enthusiasm to work out. Also, it is important to keep in mind that Rory does not strain his body too much so that he can restart with an exercise routine that he follows on a regular basis.

The exercise routine that will be followed with him in the beginning phase will include running, cycling and swimming for short distances. The intensity of these workouts will not be more than 30% on body, in an average.

In the first session, a few other exercises that will help him to work harder in the direction of weigh loss will be introduced. These will be simple exercises like crunches, planks and other less strenuous exercises of the legs and knee joints like bicycle. It will be kept in mind that the intensity of these exercises will be not more than 30% on his body, for each individual work out program.

There will also be an adequate amount of rest between these exercises. It will be done to make sure that Rory is not putting too much stress on his muscles and ligaments to avoid any further medical condition.

Active fitness appraisal

Result

20m Run Test

50 Shuttles

Push up Test

21 push-ups

Age

17-19

20-29

30-39

40-49

50-59

60-69

Excellent

> 56

> 47

> 41

> 34

> 31

> 30

Good

47-56

39-47

34-41

28-34

25-31

24-30

Above average

35-46

30-39

25-33

21-28

18-24

17-23

Average

19-34

17-29

13-24

11-20

9-17

6-16

Below average

11-18

10-16

8-12

6-10

5-8

3-5

Poor

4-10

4-9

2-7

1-5

1-4

1-2

Very Poor

< 4

< 4

< 2

0

0

0

20m Run test over 5 minute results

Shuttles

<33

33

35

37

39

41

43

45

47

49

>52

Rating 0/10

0

1

2

3

4

5

6

7

8

9

10

Age

Very poor

Poor

Fair

Average

Good

Very good

9

< 2/2

2/2-3/4

3/5-4/4

4/5-5/4

5/5-6/4

6/5-7/7

10

< 2/2

2/2-3/5

3/6-4/5

4/6-5/5

5/6-6/6

6/7-8/1

11

< 2/2

2/2-3/6

3/7-4/7

4/8-5/8

5/9-6/10

7/1-8/6

12

< 2/2

2/2-3/8

4/1-5/1

5/2-6/4

6/5-7/6

7/7-9/3

13

< 2/4

2/4-4/2

4/3-5/6

5/7-6/9

6/10-8/3

8/4-10/1

14

< 2/6

2/6-4/5

4/6-6/1

6/2-7/4

7/5-8/9

8/10-10/9

15

< 2/7

2/7-4/7

4/8-6/3

6/4-7/7

7/8-9/2

9/3-11/3

16

< 2/8

2/8-4/9

5/1-6/6

6/7-7/10

8/1-9/6

9/7-11/8

17

< 3/1

3/1-5/2

5/3-6/8

6/9-8/3

8/4-9/9

9/10-12/1

Active fitness appraisal

Explain what the result means to Rory?

20-metre run test

He has an average tolerance to activity as 20-meters run tests for

oxygen uptake

Push-up test

The push up tests were rated as average meaning that his upper body

strength and endurance is average.

Program one – Home program

Client name:

Rory

Client age:

15yrs

Session length:

30min

Goal:

Boost confidence and fitness and lose excess weight.

Warm-up

Activity: Stretching

Duration: 5 min

Intensity: 5% intensity on body

Conditioning phase

Exercise

Intensity 1 RM%

Sets

Reps

Rest

Notes

1.       Jumping the rope

30% intensity on body

100

2

1 min

Do not stop before completing 100 jumps

2.       Crunches

30% intensity on body

10

5

30 secs

Keep your feet on ground

3.       Planks with arm and leg lift

30% intensity on body

4

5

30 secs

Keep your body straight

4.       Bicycle

25% intensity on body

50

3

30 secs

Be as fast as possible

5.      

6.      

Exercise

Intensity HR max%

Time

Dist.

Rest

Notes

1.       Jogging

20% intensity on body

5 mins

500 metres

2 min

Speed should be moderate but maintained

2.       Cycling

25% intensity on body

5 mins

500 metres

2 mins

Maintain body posture, keep back straight

3.       Swimming

50% intensity on body

5 min

200 metres

1 min

Try to use as many stroke types as possible

Cool-down

Activity: Breathing exercises

Duration: 2-3 mins

Intensity: 0% intensity on body

Notes for next session

The exercises done in this session were comparatively moderate to make sure that Rory does not strain his body. In the coming sessions, the intensity will be increased.

Client feedback