06: Femoral Neck Stress Fracture, Reactive Hypoglycemia in a Male Marathon Runner

In this episode of Interdisciplinary Case Miles, hosts Dr. Sara Raiser, Kelsey Pontius RD , and Dr. Kate Mihevc Edwards PT break down a complex real-world case of a male marathoner caught in a cycle of injury, underfueling, and recovery.

When multiple stress fractures, low testosterone, and low ferritin collide with emotional stress and high training volume, the team dives deep into how Relative Energy Deficiency in Sport (RED-S) affects performance, hormones, and bone health.

Kelsey unpacks the concept of within-day energy deficits and the athlete’s struggles with reactive hypoglycemia. Dr. Sara Reiser highlights why femoral neck stress fractures are among the most serious running injuries often requiring urgent imaging and complete rest. Dr. Kate Mihevc Edwards PT shares the detailed process of returning safely to running, from load management and biomechanics to rebuilding strength and confidence.

This episode showcases the power of an interdisciplinary approach where nutrition, medicine, and physical therapy work together to help runners heal fully and sustainably.

Episode Highlights
00:00 Welcome & introductions

01:10 Kelsey presents the case: male runner with recurring stress injuries

07:45 Understanding reactive hypoglycemia and RED-S

10:20 Dr. Raiser explains femoral neck stress fractures & key lab work

16:50 Dr. Edwards on rehab, biomechanics, and safe return-to-run

23:30 The importance of interdisciplinary collaboration

28:40 Top takeaways for clinicians & athletes

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