While awareness about the harmful implications of RED-S has grown over the past few years, many young women and girls experiencing it don’t know about the recovery process. They do not want to give up their sports, but given that RED-S results from some combination of underfueling and overtraining, balancing RED-S recovery and sports proves difficult. We talked with VIS Expert Maddie Alm, MS, RD, and VIS Mentor Allie Ostrander to learn more about balancing RED-S recovery with athletics.
Every Case is Different
The RED-S recovery process varies depending on the severity and how long an athlete has been dealing with it. If the RED-S is accompanied by a severe eating disorder or osteoporosis, an athlete should temporarily reduce or take a break from training while increasing their energy intake. But Alm has seen that it’s generally possible to recover from RED-S without taking a break from competitive athletics or reducing training.
Ostrander has opened up about her experience recovering from an eating disorder and RED-S as a professional runner. She decided to leave her team to train on her own because she knew that the high-pressure environment would make it difficult for her to prioritize recovery. She balanced the two “by taking a slight step back from the competitive athletics side and seeing my recovery as another training block, but the goal of that block was to learn to properly fuel myself, heal my body, and change my mentality around food and performance,” Ostrander explains. She also worked with a sports dietitian, doctor, and therapist to help her stay on track during this process.
Change is Necessary to Recover
All women with RED-S need to address their energy imbalance to recover from it. This involves some combination of reducing energy expenditure via exercise, increasing fuel, and reducing stress. If an athlete wishes to keep training through RED-S recovery, Alm recommends that she incorporate an off day, make her workouts shorter, prioritize strength training to help rebuild bone density, and stick to a consistent eating schedule. She also emphasizes the importance of overall stress reduction because when we experience too much stress, our bodies produce an excess amount of cortisol. This hormone can worsen RED-S and its symptoms, interfering with recovery.
“I doubted myself and my body every step of the way…But even amidst doubt and lack of faith in myself and my ability, I've been able to recover and become faster than ever.”
Challenges of Recovering While Competing
Recovering from RED-S is a difficult process, and it’s especially hard in competitive environments. Women athletes that develop RED-S often struggle with body image even if they don’t have eating disorders because of unrealistic expectations set by competitive environments and social media.
“The professional running world is a difficult place to be as someone who struggles with body image. There are so many lean and thin bodies that it can be easy to think that looking that way is the path to success…and the line between disordered and disciplined can be blurred,” Ostrander admits. Many athletes feel that eliminating dessert is a great way to show discipline, but as Alm points out, dessert is actually a great way to increase energy availability!
Maintaining RED-S Recovery While Competing
Athletes who have dealt with RED-S are prone to developing it again, so once they recover from RED-S, it’s essential to stay on top of fueling and recovery. Alm recommends that athletes write down the symptoms they experience when dealing with RED-S so that they know what to look out for in the future.
“I doubted myself and my body every step of the way. But even amidst doubt and lack of faith in myself and my ability, I've been able to recover and become faster than ever,” Ostrander says. Ostrander’s story proves that pursuing RED-S recovery as an athlete is difficult, but it’s possible with proper guidance and diligence with fueling. You may need to take a step back from training or competition for some time, but following Alm’s guidance and Ostrander’s advice will make it all worth it.
