At the collegiate level, athletes will do anything to gain an edge.
For women, that often means counting calories.
But a new study out of Saint Louis University shows women athletes who don't eat enough set themselves up for more injuries and leg pain.
"This is not the first study that's demonstrated that young women athletes are not eating enough calories."
Dr. Greg Landry teaches sports medicine at the UW and says a low-calorie diet causes women to produce less estrogen, a key factor in bone development.
"Young women with lower leg pain are a little more likely to have inadequate caloric intake because some of them are experiencing boning injury."
Landry says missing menstrual cycles and low energy are two early signs that a woman isn't eating enough.
"Many of them are trying to survive on 1,500, 2,000 calories a day and many of them need 3 or 4 thousand calories a day."
As sports nutrition coordinator at UW, Patrick Welscher offers one on one counseling to the athletes, but it can be hard to convince them to take their diet seriously.
"Being that most of them are college students, they're looking for the quick grab. They're always busy so nutrition kind of goes by the wayside sometimes."
And while an injury could sideline an athlete today, Landry warns about even greater damage down the line.
"If they have inadequate caloric intake and are not carrying enough body weight, their menstrual cycle stops and they're at risk for osteoperosis."
Landry says women at risk need to start eating foods rich in protein and iron, like meat, peanut butter and beans.
He also suggests seeing a doctor, who can recommend hormone supplements to prevent further bone loss.