Why a Sports Dietitian Is Key to Beating Bone Stress Injuries (Especially Repeat Ones)
August 2026
By Essendon Sports Medicine Team
Struggling with a stress fracture that just won't stay away? The missing piece might not be your training load — it could be your plate.
Bone stress injuries (BSIs) — from early-stage bone stress reactions through to full stress fractures — are one of the most frustrating setbacks for runners, AFL players, netballers and other high-load athletes. Most people assume the fix is simple: rest, offload, rebuild strength, return to sport. But when a BSI comes back a second or third time, rest alone clearly isn't addressing the real problem.
It's Often Not Just a Training Load Problem
Bone is living tissue that needs consistent fuel to repair and remodel itself. When an athlete isn't eating enough to support their training — often unintentionally, through busy schedules, restrictive eating patterns, or simply underestimating fuel needs — the body enters a state called low energy availability. Left unchecked, this can progress to Relative Energy Deficiency in Sport (RED-S), which disrupts hormone function, weakens bone density, and dramatically increases the risk of stress reactions and fractures.
This is why so many athletes do everything their physio asks — graded loading, strength work, biomechanical correction — and still re-injure. If chronic underfuelling is driving the bone stress, the injury will keep resurfacing until nutrition is addressed too.
Why Repeat BSIs Are a Red Flag
A single stress fracture can happen from a sudden spike in training. But a repeat BSI — especially in a different bone, or without an obvious training trigger — is a strong signal that something systemic is going on: inadequate energy intake, low calcium or vitamin D, iron deficiency, menstrual cycle disruption, or a combination of these. These factors are easy to miss on a scan or an X-ray, but a sports dietitian is trained to spot them.
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What a Sports Dietitian Actually Does
An Accredited Practising Dietitian with sports nutrition experience will assess your energy intake against your training demands, review key bone-health nutrients like calcium, vitamin D, protein and iron, and screen for signs of RED-S or disordered eating patterns that often go unnoticed. They then build a practical, individualised fuelling plan — not a generic "eat more" instruction — and work alongside your physio, GP and coach so your recovery and return-to-sport plan are aligned across the whole team.
For athletes with a history of repeat BSIs, this team-based approach isn't optional extra care — it's often the missing link between healing and healing for good.
Get the Right Support at Essendon Sports Medicine
Our sports dietitians, Jess Purcell and Giulia Angelico, are Accredited Practising Dietitians and members of Sports Dietitian Australia, working with runners, AFL, netball, cycling, swimming and CrossFit athletes across Melbourne. If you've had one BSI too many, book a consultation and get a fuelling plan built around your body and your sport.
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References
van Dyk N, et al. Including the Nordic Hamstring Exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8,459 athletes. Br J Sports Med. 2019.
Bahr R, et al. Hamstring muscle injury prevention and management: a practical guide for clinicians and athletes. Br J Sports Med.
Green B, Bourne MN, van Dyk N, Pizzari T. Recalibrating the risk of hamstring strain injury (HSI): a 2023 systematic review and meta-analysis of risk factors for index and recurrent HSI. Br J Sports Med.
Orchard JW, Seward H. Epidemiology of injuries in the Australian Football League. Multiple peer-reviewed publications describing injury surveillance in the AFL.