Tuesday, May 23, 2023

Cleveland Marathon 2023: I'm not half bad at this distance (3:11:55)

Results: Cleveland Marathon 

I've run six Boston qualifying marathons with a time range of 3:07 to 3:18 and I've never even registered for Boston, let alone run it. Every time I qualify, I tell my running buddies I'll think about signing up. As September draws near I get overwhelmed with the cost and the logistics and the truth that I don't even want to go to the city of Boston, let alone run my least favorite race distance there. Each year I watch the iconic event unfold on television and tentatively consider signing up some day. This year as I watched the pros and many friends finish the race, I felt slightly more favorable towards signing up. One catch, I still needed a qualifier. My Towpath Marathon time from 2020 had expired and I was in a completely different age group. I didn't even know what the qualifying time for my age group was! Good thing I was signed up for the Cleveland Marathon and training for a 3:15 with my training partner, Amanda Jamil. 

We trained a solid base all winter together. She joined me for my Wednesday workouts and Sunday long runs. We usually ran the incredibly hilly "Silvercreek" route for our long runs and I reached a point where a 1000 feet of gain in a 15 mile long run was NBD. My mileage went from about 50 on average, to closer to 60. We didn't start our 20 milers until March, but we managed five of them, with the last one on the Towpath, three weeks before the race. She ran the HOF half marathon two weeks before the race and I ran the 10 mile drop. Based on these distances I thought I could run between 3:10 and 3:15 and she could run 3:05-3:07. With Cleveland, it all comes down to the weather though!


The week of the marathon was also the week of districts for my track team. I ran as little as possible on my daily runs but I still needed the stress relief of a run. I also have to run my dogs every day and I don't always count that mileage. The course looked strange on a map. Many twists and turns and the potential for some good hills. I wasn't worried about the hills or the turns. For me, the rough surface of the repaired city streets is what does my feet in. I wore my Saucony Endorphin Speed 3s to make sure my feet were as comfortable as possible. The weather looked perfect! Low 50s, clear and humid. My absolute perfect racing weather. This was a similar scenario as the 10 mile drop and I ran that at 6:34 pace. 

Miles 1-14: 7:09 7:01 6:42 7:15 7:21 7:08 7:19 7:17 7:06 7:11 7:16 7:13 7:04 (halfway in 1:34:21)

These were my 3:10 pace group miles. I started out at an easy effort but with the weather so nice, I knew it was faster than it felt. I bumped into Lindsey and Meryl for a few strides, who planned on running about 3:20 for their BQs. After that, I found myself sneaking into the 3:10 pace group. After a few seconds of consideration, I decided to hop in with them and committed to 14 miles. I made a lot of game-time decisions in this marathon because it's been a long time since I've run one while trained. I'm a very different, better runner than I was in 2016. Athens marathon in 2017 was untrained and I was just trying to win and had to slow down in the last 10k, Towpath in 2020 was completely untrained and I ran with Teresa for the first 16 miles at a too fast pace. 

The course was well-marked, there was good crowd support and I chatted with the pace group as the miles clicked by. The elevation changes and the fact that we had people running very conservatively in good weather, kept lowering the pace of the group. One of our group, a lady named Leah, ended up running 3:03 and Adam, a fellow Medina resident ran 3:06. Another game-time decision was made when the GU station came up. I grabbed one and sucked it down before I could taste it. It still tried to come back up but I clamped my mouth shut and swallowed it again. I had two fruit snack packs before this but I could feel that I needed more calories. GU and any other sort of slimy race nutrition has been my nemesis but I really, really wanted a good marathon. I ended up taking 4-5 GUs along with 4 packs of fruit snacks, water at every station except the last one and Nuun or sports drink at every aid station they offered it. At one late aid station, I stopped in my tracks and drank two full cups of water, gulping it down like I was parched in a desert. 

Miles 15-19: 7:33 7:26 7:45 7:30 6:54 

I was feeling tired and was weary of the fluctuating pace by about 14 miles. I tried to hang on in the 14th mile but I lost the 3:10 pace group going through an aid station and didn't try to surge to catch back up. I relaxed a bit in the 15th mile, did some positive talk after I saw my teammates in the 16th mile and even walked a few steps in the 17th mile (7:45). Then I hit an aid station in the 18th mile and stuffed in as much as I could handle. Fruit snacks, two cups of sports drink, two cups of water and a GU. I perked up almost immediately and realized that it wasn't the pace or distance that was getting me down, I just needed to eat! I found that if I didn't feel basically full of sugar, I couldn't maintain my pace, so I proceeded to stuff it down for the following eight miles. I felt ill, but it was worth it.

By mile 19 I was feeling GOOD and dropped a 6:54. I was going downhill onto the shoreway and the views were beautiful, the weather was beautiful and I was in my solitary phase of a marathon. I started passing men like they were standing still and I looked ahead and picked targets to catch to keep my mind busy. Even though I felt amazing, I didn't enjoy this marathon: 26.2 is far too long!

Miles 20-26.2: 7:30 7:39 7:37 7:14 7:12 7:50 7:20 6:44 for 0.2

I relaxed the effort in miles 20 and 21 to make sure I was conserving some energy. We still had seven miles to go! Every time I felt relief about how well the race was going, the intrusive thoughts of how far we had to go entered my mind. Maybe if I wasn't so cautious, I could have run a 3:10 but I'll save that for another marathon. This was my favorite section of the race. The shoreway had some nice rolling hills, the neighborhood was picturesque, the roads were in much better shape and there weren't as many turns. I kept catching men, especially when I upped the effort in miles 23 and 24 and came down into the lower 7s. Mile 25 was the formidable hill on the shoreway and I tiptoed up that, making sure I didn't tank myself by taking my heartrate too high. 

I felt great again for the 26th mile and we finally hit the bridge that signaled less than a mile to go. I knew I was crushing it but I peeked at my watch to see what kind of time I was looking at. I knew if I kicked, I could make it a 3:11. An older guy went by me at a solid pace and I followed him. The bridge was nice because it gave us some solitude before we hit the crowds of the last 0.2. I saw Michaela and Becca one more time on the bridge and I was so happy that I got emotional. Finally, I took the left hand turn off the bridge and it was the home stretch. Unbelievably, I was still passing men through these final turns. I passed 20 men in total from 21.1 to the finish. I was emotional again as we kicked into the finish line, so happy and pumping my fist, I crossed the mats and it was over. I think the relief and joy of the finish is why we run marathons. The more intense the hostage situation, the more joy we have in being released, right?



I found Amanda and the teammates who were done, pretty quickly after the finish. Also got to see Dr. Leo who crushed the full! I got this picture of Amanda before she booked out of there. She ran an amazing time but was pretty sick for the second half of the race. Lindsey and Meryl beat their 3:20 goal time by a full three minutes and now have that BQ all wrapped up and are free to chase faster wave times in the fall. It's definitely a relief to have the Boston qualifier in the spring because you never know what can happen with marathon training or in the marathon itself. We go the awesome picture below of us all. Ashton won and Catherine got 5th! This was my seventh marathon and the strongest marathon I've ever run. My time range for marathons is still 3:07-3:18. I really should try to lower that PR!





Thursday, October 15, 2020

That Time I Ran a Marathon Untrained. Again.



     My goal race for fall 2020 was supposed to be the Youngstown Peace Race 10k. Once that went virtual I basically told myself “f it, I’m racing a half marathon.” I chose Made in America Half in Massillon as my goal race and figured I would race the Towpath 10k as a prep race. I’ve been running 14 miles for my long runs with long run workouts of 7-9 miles at 6:50 pace to prep for a strong half marathon, not just one that I can try to finish. Last summer I ran a half very unprepared and I didn’t enjoy it so I want to make sure I’m prepared to race a good effort in November. I also have four senior high school athletes joining me for this race and it wasn’t even my idea! Shout out to Julia for dragging three of her teammates into the long distance road racing cult. The girls and I all have matching orange t-shirts, so if you see bright orange running by on the Towpath on November 8th, scream “Go Bucks!”


Picture this: I had the day off of work in mid-September and was feeling wildly motivated, overconfident in my running ability (as usual) and the Towpath registration had just opened up. I’m clicking through my options and don’t feel like racing a 10k. I’m kind of slow right now and would rather not huff and puff through a 40:00 10k. A half would be better. It’s $75! I check the marathon price. $85. I might as well do the full. Several clicks later, I’m signed up for 26.2. Thankfully, my overconfidence carried me all the way through an 18 mile long run a few days later, three weeks of half marathon training and about 18 miles of the Towpath marathon. My main goal was to finish the race and I did not ask myself to suffer. I could do what I needed to be comfortable and finish with a smile.


     The week of Towpath, Teresa Ferguson (yes that Teresa Ferguson) texted me to see if I would like to run the full with her. She was thinking 7:40s, I said we should do 7:30s, she agreed and the plan was set. You know what they say about conservative plans and very competitive women. 




     Race morning came and I was in the Cinemark parking lot by 7 a.m. I was launching in the first wave with Teresa at 7:50. After finding what i thought was the starting line, I found a place to pee in the woods because I hadn’t brought a mask and the porta potty line was long. Speaking of masks, it’s the one criticism I have of Towpath’s Covid guidelines. They asked runners to bring masks to the start but I noticed there was no direction on what to do with it when you got there. Sure enough, there was nowhere to dispose of a mask and people were carrying them. This led to a good number of masks being scattered along the Towpath. Otherwise, all guidelines made sense, kept runners safe and led to a very pleasant race.




First 10 miles splits: 7:21, 7:03, 7:06, 7:03, 7:12, 7:07, 7:09, 7:05, 7:03, 7:09


I almost missed the start because I wasn’t at the right start line but I got there just in time and stood on my X across from Teresa. We started with the clock and I told her I thought we were running too slow. There was one lady running in our wave that was close behind and looked comfortable. The first mile was 7:21 and felt like butter. Without increasing the effort we went 7:03 the second mile and immediately I could see how things were going to go. We would not be running 7:30s today. We kept heading north on the Towpath and clicking off 7 O’s, talking most of the time and taking water and Gatorade at every aid station. I saw quite a few people that I knew and cheered for them as we passed. Rachel was running the 10k and Todd and the boys were out cheering her on so I got to see them in the first few miles. Keegan was racing the half and his dad took the pics below. I said a couple times that we should slow down and we did try each time it came up, but it was like we were locked into an effort and couldn't change it. That is perfect marathon pacing when you’re trained for the distance, but I knew there was no physical possibility that I could run a PR marathon on my limited training. This is not my mind being negative. I felt very positive the whole race but the marathon is not a distance you can fake and I know what it takes to run a low 3:00 marathon.






     The new Towpath course takes place in Valley View near lock 39 and the full uses several loops, with the far north one to be completed twice. I saw mile markers for 17 and 20 on our first pass through and that felt so far away at mile 6 and 9. We even got to see the finish line around mile 11. At the turn around here, we saw the woman who was in the lead and I estimated she was running around 3:00 pace at the time. She won the race in 3:04. The lady in our wave was still close behind and looking good. Then there was literally no one, not even a man, for many minutes between us.




11-20 mile splits: 7:17, 7:04, 7:20, 7:04, 7:16, 7:15, 7:25, 7:40, 7:57, 8:06


We were still cruising at about a 7:10 average through the half but you can see above that the splits were not as steady. We were naturally slowing down a bit but I would see the split and try to pick it up to the previous pace. This was a sign that I was feeling it, but if you asked me at the time I would have said I felt fine. Teresa was quiet but she wasn’t struggling. Just an experienced veteran working her way through yet another stellar marathon. As we headed back north, I started to drop her a bit, not willing to let go of 7:15s and letting impatience get the best of me. We headed north again, crossing back over the small bridges that are almost the only hills on the course (only 295 feet of gain). As we ran north I knew that this final stretch would be brutal for me. My legs started to feel worn out at about mile 14 and it wasn’t as easy to eat my Honey Stinger chews because I was slightly thirsty. We saw all the half marathoners come through in this stretch and were lapping marathoners and half marathoners but the traffic never got out of hand. Throughout the first 16 miles I did not fully consider what I was trying to do. I was running my first marathon since April 2017 on no marathon training and running a low 3:00 pace. Ignorance is bliss until it forces you to jog at mile 18! As we came back south for the second time, nausea set in after an aid station Gatorade and my calves started screaming at me. I kept my promise to myself that I would not suffer for this race and began jogging. Teresa passed me within a few minutes and asked me if I was okay. I told her I was completely fine and needed to slow down. No more than a minute went by and the other lady who went off in our wave came flying by, running about 6:50 pace. She ended up running a 3:10 in what I believe is her first marathon.


21-26.2 splits: 8:22, 8:30, 8:21, 8:35, 8:50, 7:55, 7:54 for 0.31




When I started to jog I also allowed myself to walk through most of the aid stations and drink a whole cup of water. When I was running through them I only got a couple sips before throwing the rest over my face. My stomach was upset and I couldn’t eat my Honey Stingers or take Cliff gel from my gel flask that I only had for an emergency. I also started my period but I figured that I would be okay until after I finished and didn’t stop at a porta potty. I shuffled north one more time for the small loop that takes you through 21 miles and this was the only time I considered dropping out. Fortunately, that seemed like a long walk and I figured I might as well jog back and finish the race. I was well over 8:00 for these miles and there were a couple of stretches where I basically tiptoed in order to not shake my stomach up more. I finally turned south to head back to the finish and thanked the loud volunteers that were directing the runners on the proper loops.


As I hit 23 miles, I realized I was going to finish a marathon. I still felt nauseous, a little sleepy and sore but I knew I was finishing. During the 25th mile I stopped in my tracks, grabbed my last two Honey Stinger chews and forced myself to chew and swallow them so that I could have energy for the last mile. It worked and I ran under 8:00 for the last mile, passing Shari and Jennifer who ran the half and were walking back to their cars. I shouted at them, “I’m doing it!” I came into the finish and started crying because I couldn’t believe what I was doing. Teresa and the PLX crew were there and I sat and stretched with them as we cheered in a couple of their Boston qualifying finishers. That club has an impressive amount of Boston qualifiers. After a while, I realized I needed to leave because I had to coach Adrian’s soccer game at noon. It was a mile walk back to the car and my feet hurt so bad that I went barefoot. I drank about a gallon of Gatorade and water on the way to the soccer game and made it for the second half. 

     After my last full, I peed blood, was sick for three days with an electrolyte imbalance and further damaged my back and hip, leading to an interrupted summer training cycle and a tibial stress fracture. This was such a positive experience that I’m considering doing another marathon next fall. If I just keep training with Teresa, Amanda, Greer and PLX, I’ll always have long run buddies and it won’t be such a chore to get 20 milers in. I won’t ever love 26.2 and I know my body isn’t built for it, but this experience may have me coming back for more despite that.


An analysis of VO2 Max as a Performance Indicator for Collegiate Cross-Country Athletes

 

An analysis of VO2 Max as a Performance Indicator for Collegiate Cross-Country Athletes

COED 6330 Final Assignment

October 9, 2020

April Greer, Renee Harden, Kris Jones, Samuel Owens 

      This report will be focusing on the importance of VO2 max in endurance athletes, how to reasonably assess an athlete’s VO2 max, and provide guidance for further improvement. VO2 max, as described by Ungvarsky (2020), is the amount of oxygen a person can intake during strenuous exercise. Measuring an athlete’s VO2 max throughout the season is to A) assess athlete’s fitness, B) use the information to improve the quality the athlete’s training, and C)  allow for the athlete to improve, not only throughout the season, but to achieve their best performance at the end of the year.


  1. Athlete’s Fitness

Measuring the athlete's VO2 max throughout the season is imperative, as the information obtained is one of the tools that can be used to improve the athlete's training. The recommended time to calculate the athlete’s VO2 max is at the start of the season and once a month during the season (Christensen, 2010). Further, the ideal distance to measure the athlete's VO2 max is the two-mile or using a race distance (Christensen, 2010). For our athletes, we measure their VO2 max after the first two weeks, then at weeks 6, 10, and 15 (shown in table 1). We use their 5k race time to calculate VO2 max as it is 97% of maximal effort which is converted to predict maximal effort.   

 

Table 1

Time table of when to measure athlete’s VO2 max during the season

When

Event

Week 2

Two-mile Time Trail

Week 6

5K Race (one)

Week 10

5K Race (two)

Week 15

5K Race (three) - Conference Championship

 

  1. Using VO2 max for Training

      To improve their VO2 max, athletes will do a maximal workout once a week (Christensen, 2010; Favero and Stoll, 2016). Once the VO2 max is established for the athlete, the coach will use the predicted maximal effort time to give the athletes a performance goal for the workout. For example, in Table 2, Athlete 1 has a predicted maximal effort of 6:08/mile. Coaches will create a workout plan for the athlete based around 6:08/mile effort. VO2 max testing will be repeated a month after the initial test to track training adaptations. In the college setting, the best way is to measure VO2 max is with race effort. In this case, Athlete 1 is shown to have made a :07 improvement in her maximal effort mile time. Once the new VO2 max time is converted, the coach will use the predicted maximal effort for the next few weeks of training before the next race to predict another new VO2 max. This pattern will continue throughout the remainder of the season. 

 

Table 2

5K Group Women

Two-Mile Time Trail

Predict VO2 max/mile pace effort

5K Race (one)

Predict VO2 max/mile pace effort

5K Race (two)

Predict VO2 max/mile pace effort

5K Race (three)

Predict VO2 max/mile pace effort

Athlete 1

12:16

50.9 / 6:08

19:21

51.77 / 6:01

19:14

52.13 / 5:59

19:01

52.83 / 5:55

Athlete 2

11:39

53.98 / 5:49

18:22

55.01 /5:43

18:40

53.98 / 5:49

18:11

55.60 / 5:40

Athlete 3

11:30

54.78 / 5:45

18:06

55.96 / 5:39

17:25

58.52 / 5:25

17:21

58.78 / 5:24

 

  1. Recommend training for improvement

      As stated above, it is recommended that the VO2 max workout needs to be done once a week for athletes to improve their maximal effort (Christensen, 2010; Favero and Stoll, 2016). There are also several types of training intensities for coaches to use, including but not limited to: race pace, lactate threshold, and zone training (Kenneally et al., 2018). Athletes in this designs examples performed one VO2 max workout and a race pace workout (5k) per week. For all other runs including the long run, the athletes would run at recovery pace. All paces and percentages of effort levels are listed in Table 3. 

Christensen (2010) and Mackenzie (2001) both advise using training durations of 3-5 minutes or 800-1600m repetitions at a high intensity to increase VO2 max.

 

Table 3

 

Distance

Percetage of VO2 max

5K Race Pace

97% of VO2 max

VO2 max Effort

100% at Max

Recovery run

65-75% of VO2 max

 

Considerations

 

One of the most important considerations when training athletes is that environment and extraneous physiological factors affect them during the VO2 max test and during any given race day. It is not often that athletes will get faster each time they step on the line. In table 2, Athlete 2 had a race where they seemed to slow down. In their first race, they ran an 18:22 for the 5k, and for her second 5k, she ran an 18:40. Many factors can affect the athlete on race day, such as stress, nerves, disrupted sleep, and weather (Weinberg, 2019). Coaches need to talk with their athletes to see what happened during the race or maximal effort test. Talking with the athlete will help the coach determine how to progress the athlete in future workouts. 

Age is a significant factor when it comes to training adaptation. Green and Pate’s (2015) book Training Young Distance Runners argues that young athletes’ VO2 increases even when the athlete only moderately increases their training. This means that replications of this design may not provide detail adequate to coaches who are training younger runners as it makes causation less clear.

Conclusions

            The design covered in this report gives coaches and trainers the tools to assess and enhance VO2 max in their endurance athletes without the need for expensive or intrusive equipment. This design is tailored to be incorporated within a training program and to be used alongside competitions allowing it to be accessible for wide use. While coaches need to be aware of the systems limitations listed above, they will be able to use it effectively with strong athlete communication.

References

Christensen, S. (2010). The profiling and preparation of an elite junior miler. Retrieved from http://www.ustfccca.org/assets/symposiums/2010/Scott-Christensen_Preparation-Elite-Junior-Miler.pdf

Favero, T. & Stoll, K. (2016). Seasonal improvements in VO2 max among women’s college soccer players with one day per week aerobic interval training. Kinesiologia Slovenica, 22(2), 14-21.

Green, L. & Pate, R. (2015). Training young distance runners. Champaign, IL: Human Kinetics.

Kenneally, M., Casado, A., & Santos-Concejero, J. (2018). The Effect of Periodization and Training Intensity Distribution on Middle- and Long-Distance Running Performance: A Systematic Review. International Journal of Sports Physiology and Performance, 13(9), 1114-1121. doi:10.1123/ijspp.2017-0327

Mackenzie, B. (2001). VO2 max [WWW] Retrieved from https://www.brianmac.co.uk/VO2max.htm [Accessed 8/10/2020]

Ungvarsky, J. (2020). VO2 max. Salem Press Encyclopedia of Science.

Tuesday, August 18, 2020

RED-S (Relative Energy Deficiency in Sport) quick take for endurance coaches

 

     My personal experience with RED-S covers most of my lifetime and for the majority of those years, I did not have an eating disorder. I simply wasn't keeping up on replenishing what I burned through training. Because my training volume is less that it has been in the past, I have not struggled with symptoms of RED-S since 2018. With a possible start in triathlon in 2021, I'll need to stay vigilant to keep it from coming back. The short paper below is a synopsis about what RED-S is, who is vulnerable to it and how coaches can prevent it.

     In 2014, the International Olympic Committee re-defined the term “female-athlete triad” to update the term with current and relevant information that acknowledges the role that the condition also plays in male athletics. They re-coined the condition as “RED-S” or “relative energy deficiency in sport.” They defined the condition as “impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency” (Mountjoy et. al., 2014). The cause is a depletion of energy that is available for optimal functioning due to an imbalance between training loads and nutritional intake.

     The IOC agrees that “EA (energy availability) is calculated as EI (energy intake) minus the energy cost of exercise relative to fat-free mass (FFM) and in healthy adults, a value of 45 kcal/kg FFM/day equates energy balance” (Mountjoy et. al., 2014). This precise measurement allows physicians and coaches to accurately define exactly how much their athletes need to take in to support healthy functioning while engaging in intense training.

2018 UPDATE: Relative Energy Deficiency in Sport (RED-S) | BJSM ...

BMJ Blog

Who Is at Risk?

     All athletes, regardless of gender are potentially at risk of developing RED-S. This was part of the IOC’s mission in re-defining the term because it became obvious that men were being affected by the phenomenon as well. A 2019 study found that men who had high levels of exercise dependency were more likely to display eating disorder tendencies and lower energy levels due to their reduced energy intake. They also had higher cortisol vs. insulin levels, indicating a catabolic state (Torstveit et. al., 2019). Although we now know that men are at risk of RED-S, alongside women, it is female British teenage running phenom, Bobby Clay’s case that shows the significant impact of the IOC’s terminology change. Clay was one of the top junior runners in the world, claiming the 2015 European 1500m championship title after years of national domination. After breaking her foot from simply pushing off the wall in the pool in 2017, she underwent bone density tests that revealed she had osteoporosis (Athletics Weekly, 2017). This was followed by a series of stress and full fractures in her lower extremities that would happen during mundane activities like cycling and jogging on grass. She maintains that she never struggled with an eating disorder and that the main culprit to her hormonal disorder was overtraining combined with accidental under fueling (Let’s Get Running, n.d.). In my own personal coaching experience, it has been male athletes that struggled with RED-S. I had a series of athletes who trained together for at least a season who had unhealthy relationships with food and an extreme focus on remaining thin and lean during the season. I referred two of them to speak with their doctors about the obsessive behavior.    


 

What are the Signs of RED-S?

     It is important to note that only medical professionals can diagnose and treat RED-S but it equally important for coaches to be aware of the signs:

·         Decreased glycogen stores

·         Decreased muscle strength

·         Decreased endurance performance

·         Increased injury risk

·         Decreased training response

·         Impaired judgment

·         Decreased coordination

·         Decreased concentration

·         Irritability

·         Depression

(British Journal of Sports Medicine, 2015).

 

Because RED-S may be exacerbated by an eating disorder, coaches should also be aware of unhealthy relationships with food. This is not easy to recognize as a coach. Parents, siblings and teammates may have better insight into this. Athletes do not have to have all of the markers to land in the “moderate risk” zone as defined by the British Journal of Sports Medicine. They could have only one or two risk factors and qualify for intervention by a team of health care providers including a dietician, sports medicine doctor and psychologist. It is important not to stigmatize RED-S and approach recovery in a positive manner, emphasizing how important recovery is to performance and overall health.

What are the Consequences of RED-S?

     The ultimate consequences for an athlete are reduction in the level of performance due to the body breaking down and being unable to sustain endurance training. But there are also consequences outside of sport that may affect an athlete’s health for the rest of his or her life.

·         Immunological

·         Gastrointestinal

·         Cardiovascular

·         Psychological

·         Growth + development

·         Hematological

·         Menstrual function

·         Bone health

·         Endocrine

·         Metabolic

 

(British Journal of Sports Medicine, 2015).

 

     Because hormonal function is integral to the body’s entire system, RED-S victims can see a wide range of health consequences, with the most severe cases leading to bradycardia (low heart rate) and dangerously low bone density that may lead to osteoporosis.

What Can Coaches do to Combat RED-S?

     Information combined with a healthy approach to training is the best defense against RED-S becoming a problem on your team. Ply your team with information about healthy eating habits that support endurance training and emphasize the need for adequate nutrition for optimal performance. Print out team USA’s “Athlete’s Plate” handouts and post them in the locker room for athletes to use as a guide (Team USA, n.d.). Bring in a sports nutritionist to speak with the athletes and answer their questions. Gradually increase their training load as they age in order to help them keep an AE equilibrium. Youth athletes are an inspired, driven bunch who are always looking for ways to improve their performance. If they know that taking care of their energy needs will lead to increased performance, they will follow those guidelines. Finally, be a good example for them by taking care of your own nutritional needs. If they watch you counting calories at a team spaghetti dinner or conversely, downing a coke and candy bar while overseeing practice, they may conclude that fueling is not an important factor.

Team USA Athlete's Plate

    

References

Bobby Clay – my osteoporosis nightmare. 2017. Athletics Weekly. Retrieved from https://www.athleticsweekly.com/performance/bobby-clay-my-osteoporosis-nightmare-70422/

Coping with RED-S and disordered eating: Bobby Clay. (n.d.). Let’s Get Running Podcast. Retrieved from https://www.letsgetrunning.co.uk/coaches-log/reds-bobby-clay

Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R. & Ljungqvist, A. (2014). The IOC consensus statement: beyond the female athlete triad – relative energy deficiency in sport (RED-S). British Journal of Sports Medicine, 48, 491-497.

Mountjoy, M. et. al. (2015). RED-S CAT. British Journal of Sports Medicine. Retrieved from https://bjsm.bmj.com/content/bjsports/49/7/421.full.pdf

Nutrition. (n.d.). Team USA. Retrieved from https://www.teamusa.org/nutrition

Torstveit, M., Fahrenholtz, I., Lichtenstein, M., Senqvist, T., & Melin, A. (2019). Exercise dependence, eating disorder symptoms and biomarkers of Relative Energy Deficiency in Sports (RED-S) among male endurance athletes. BMJ Open Sport Exercise Medicine, 5(1), doi: 10.1136/bmjsem-2018-000439