"No pain, no gain." You probably hear this all of the time, but does pushing through physical pain really improve your performance?

Not likely. More often it can derail your training. By not listening to your body, you might be ignoring serious injury like a pelvic stress fracture, an overuse injury seen particularly in female runners. This tiny crack in the pelvic bone, if left untreated, can lead to a complete fracture.

Heather Moore, owner of Total Performance Physical Therapy, believes that often pelvic stress fractures go undiagnosed because they present as low back pain, hip pain or generalized weakness.

Know your risk factors: The prevalence of pelvic stress fractures ranges from 0-10.5 % of all stress fractures. According to Dr. Ellen Casey, physician with Drexel University Sports Medicine, athletes in endurance/running sports are more prone to these injuries, especially females.

Poor flexibility, muscle imbalance or weakness, running style, and ramping up training too quickly can cause pelvic stress fractures. Changing two facets of training like speed and distance at the same time will overload the body.

Treatment: Rest from training and manage the pain. Be patient. Full healing can take up to three or four months. See a sports medicine physician if pain is severe or not improving.

Before returning to your normal exercise routine, identify and fix what caused the injury in the first place. Experts recommend that all female athletes with stress fractures should be screened for the Female Athlete Triad.

Train smart: Dr. Rosemarie Boehm, attending physician at Albert Einstein Medical Center, offers these tips to avoid this injury:

  1. Cross-train to build strength and flexibility in all muscles.
  2. Give your body a day of rest.
  3. Eat right. Are you getting enough calcium and Vitamin D?
  4. Make changes to your training gradually.
  5. Wear appropriate footwear.
  6. Have your gait analyzed.

Are you at risk for the Female Athlete Triad?

Poor nutrition + lack of menstruation + low bone density = the Female Athlete Triad. Essentially, disordered eating and overtraining can lead to absence of menstruation and thinness of bones. According to Dr. Casey, while some women with the Female Athlete Triad have eating disorders, many of them are just not aware of how many calories they need to eat in order to maintain their high level of activity.

Bottom line: It is not normal to miss menstrual periods. If you have been, see a sports medicine physician for evaluation.

Read more Sports Doc for Sports Medicine and Fitness.