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, and Dr. Kate Mihevc Edwards 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. Raiser highlights why femoral neck stress fractures are among the most serious running injuries often requiring urgent imaging and complete rest. Dr. Edwards 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. Reiser 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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