Welcome to Lane 9’s hub for information for athletes, coaches, and parents in women's sports wanting to learn more about Relative Energy Deficiency in Sport (REDs). REDs happens when athletes aren't eating enough to support their training, and start experience negative health impacts (more on that below!). In Lane 9, we aim to empower women in sport, like you, to both recognize and understand the risks of REDs and eating disorders, in themselves and in others, and take learned information into action.
REDs is a syndrome of negative health impacts and declining athletic performance from the effects of Low Energy Availability (LEA). This happens when athletes don’t
eat enough to support the energy demands of their sport, and daily life.
REDs impacts athletes across the gender and sex spectrum. In Lane 9, we focus on raising awareness of REDs in women’s sports, but are here to support all athletes as they seek care and REDs treatment.
There are many signs and symptoms to be mindful of when it comes to REDs. First thing to note: REDs doesn’t have a “look”, and it's not specific to one sport— it can impact athletes from any sport, and all body shapes and sizes. We’ve included common warning signs below, but take notice, not everyone will present with all of these signs at once. Often, these symptoms happen gradually and are only clear to athletes in hindsight, as they realize how long they’ve been feeling a little “off”.
- Irregular or missed menstrual cycles
- Frequent injuries, including stress fractures and delayed healing
- Low mood, anxiety, or difficulty concentrating
- Persistent exhaustion, even with enough sleep (and/or trouble sleeping)
- Recurrent illnesses
- Slow recoveryUnexpected weight changes
- Digestive issues (bloating, constipation, loss of appetite)
- Reduced strength, endurance, or progress in training
- Pelvic Health changes (Urinary incontinence, dyspareunia & vaginal dryness)
If you notice any or several of these symptoms (especially with missed periods), it’s important to take action. Step one: Consult with a healthcare provider. You can search in our Lane 9 Directory for someone in your city or state.
Without enough energy (caloric) intake to support both training and activities of daily living, our bodies adapt by adjusting our metabolism and energy expenditure through various body systems. It does this so that we survive the low energy intake adapting however it needs to, to keep the body alive.
What happens as a result, may include (but is not limited to):
- Compromised bone and muscular health, which increases the risk of osteoporosis, fractures, and other musculoskeletal injuries
- Hormonal imbalances, which disrupt menstrual cycles and may have a long term impact on fertility (if applicable/desired), and regardless of a pregnancy, this hormonal balance is important for overall health
- Weakened immune system (i.e. getting sick often)
- Vitamin and/or mineral deficiencies
- Impaired cardiovascular and digestive health
- Disturbances in mood and memory (e.g. trouble concentrating or irritability)
- Changes in mental health, for example an increase in depressive symptoms and/or anxiety
- Pelvic floor dysfunction (e.g. leaking during movement/exercise, pain, etc.)
Often athletes enter a state of REDs while trying to improve their sports performance—maybe they've heard that losing weight or eating "healthier" will help them perform better. And the tricky part it, sometimes athletes do see a brief improvement, maybe faster running times or feeling more disciplined in their training. But eventually, Low Energy Availability catches up to us and starts to negatively impact our health and performance.
Experiencing REDs may impact your performance in many ways, some examples include:
- Plateauing performance, stagnant or worsening race times and decreased endurance, and/or decreased strength
- Struggling to build or maintain muscleInability to recover after workouts
- Frequent illness and injuries
- Gastrointestinal distress that impacts movement
- Unreliable energy levels, “bonking” or hitting the wall more often; increased fatigue or effort with training that once felt easy
- Difficulty concentrating and/or delayed reaction times
- Exercise-induced stress urinary incontinence
If you’re reading through this page and finding that many of the signs and symptoms of Low Energy Availability, and/or REDs are familiar to what you’re currently experiencing (or have experienced before), we encourage you to seek support from an informed healthcare provider who has extensive training in sport and health.
This is why we built the Lane 9 Women’s Sport and Health Directory. We know how hard it is to find a competent, specialized provider who feels like the “right fit”, as an athlete and a woman. Our goal is to make it easier for athletes to find their REDs care team.
Whether or not you’re ready to work with a provider, here are some next best steps if any of the above is familiar to your experience:
Listen to your body. Notice signs like persistent fatigue, irregular or missed periods, irritability or mood changes, frequent injuries, or a drop in performance. Write down any symptoms you’re experiencing and how often you’re experiencing them. Sometimes it’s hard to see the big picture, or how bad you’re really feeling, in the moment. Keeping a log of symptoms provides clarity and honest reflection about your symptoms.
Reach out for support. Connect with a healthcare professional who understands REDs, such as a sports medicine doctor, physical therapist, registered dietitian, or mental health counselor. (REDs is often missed by healthcare providers who don't have extensive experience working with athletes.) Use Lane 9’s clinician directory if you need help locating a provider, or simply fill out our Clinician Match form, and we’ll match you with someone from our Directory.
Adjust nutrition and training. REDs recovery plans begin with increasing food intake to meet your body’s energy needs, and often includes modifying your training plan. Professionals will help guide you through this process. The long term goal is to keep you feeling good, enjoying and thriving inin the sport you love! Again, this is where a clinician and a team of support will be helpful.
Don’t wait to get help. Early steps toward change, and treating REDs, can make a big difference in an athlete’s longevity in sport, and overall health. Seeking advice and building a team to support you helps you heal and prevent further damage to your body, to stay in your sport(s) you love!
This Lane 9 REDs Resources and Information page was reviewed by the following Members of our Lane 9 Directory:
Becky Anthony, Dr. Katherine Hill MD, Dr. Kelsey Varzeas LMHC CMPC, Nancy Boyd DPT, Stevie Lyn Smith RDN, and Heather Caplan RDN.
