An Athletes Perspective on Relative Energy Deficiency in Sport – by Pippa Wolvern
Pippa Woolven, Project RED-S Founder, former Team GB athlete, and Active Women’s Clinic advocate, shares her experience with Relative Energy Deficiency in Sport.
Facing illness or injury is an inevitability in sport and we don’t often get to chose how it happens. Usually it’s plain to see what is happening and when, which can help you identify the ‘why’, but in my experience with an energy imbalance, neither the how, what, when or why was clear.
It had started subtly at first: the odd cold that took too long to shift; recurring injuries I had never previously been prone to; uncharacteristic low moods; and an inconsistent and unfamiliar form of fatigue. It had made no sense to me at the time. On the outside, I had it all: the scholarship, the sponsorships, the success; but on the inside, I was fighting a losing battle with a condition I didn’t even know existed.
Just a few weeks earlier I had been flying in training, feeling faster and fitter than ever and I was ready to reap the rewards of my hard work. Yet, it seemed some kind of invisible force was against me. As the weeks went by, the fatigue started seeping into every day life and running was becoming a struggle. It was finding it hard to get out of bed in the morning, yet equally difficult to fall asleep and y characteristic enthusiasm had been replaced by an inexplicable sadness. Yet, there were no other obvious symptoms to account for it and for fear of appearing weak or taking time off, I simply pushed on and kept it quietly to myself.
Months later and with no improvement, I was forced to share my woes with a doctor who seemed to think I was as crazy as I felt. A regular set of blood tests had come back clear, other than low iron levels which I was already taking tablets for, yet if anything my problem was getting worse. With no choice but to stop and consider the root cause, I did what many of us would and took to the internet. A quick Google search offered up two possible options: Overtraining Syndrome (OTS) or something called the Female Athlete Triad.
As far as OTS was concerned, yes – I was training hard, but no harder than my teammates. Surely if they could handle it then I could too? Yes, despite the rest, I was still exhausted and permanently on the verge of tears, but I didn’t feel demotivated. In fact, I would’ve done anything to get back to training. So OTS, overruled.
The Female Athlete Triad surrounded three criteria: disordered eating, low bone mineral density and menstrual disturbance. When it came to eating, I admitted perhaps I was taking my team’s ‘clean eating’ policy a bit too seriously, but I still ate three solid meals a day and hardly stuck out on a start line…how could I qualify for any type of disorder? Bone density wise, I had no idea, but neither my physio or any medical professional seemed concerned, so why should I be? As for my menstrual health, well – I was on the Pill, so no worries there, I naively thought.
I wrapped up my search blaming the low iron (a convenient culprit) and resolved to get back to training. With no obvious explanation for my symptoms, I saw no reason not to and I was desperate not to let my fitness decline any further. But, my body had other ideas and soon, I was right back to square one, searching the internet in all the same places as before.
It took well over a year before I found the answers to my problem. At the time, RED-S was a relatively new term and information about it online was sparse. Yet, what I had eventually stumbled upon was the most precious resource of all: a blog written by another athlete describing MY issue in words that could easily have been my own. In the end, all it had taken was hearing someone else’s explanation of the subtle, yet shattering, symptoms I was facing in order to line up the pieces of my own RED-S puzzle.
I had spent years dismissing so many warning signs in ignorance or denial, unable to believe that a competitive athlete like me could seriously be suffering from an energy-related issue; that someone who ate so ‘healthily’ could actually be disordered; that bone density problems can take years to reveal themselves; or that suppressing my natural menstrual cycle with the Contraceptive Pill was masking a critical indicator of my condition: amenorrhea.
Almost a decade on, I am all too aware of how many others are now, where I was back then. Through mentoring and coaching countless athletes with RED-S, I have witnessed how easily this can occur in anyone, at any time. I have seen what happens when it’s overlooked and how dangerous it is to dismiss the importance of sex hormones, or not too look beyond the surface level of ‘health’. Now, my aim is to create the resource I so desperately needed at the start of my struggle: a community of other athletes and experts coming together to share knowledge, experience, and support. I feel privileged to have an opportunity to turn share what I learned on my road to recovery; provide details of the doctors, dieticians, physios and psychologists who helped along the way; and raising awareness of this condition which is estimated to affect up to 58% of the athletic population.
For specialist medical and physiotherapy support, you’re in the best hands at the Active Women’s Clinic. For further information, athlete-to-athlete advice or supporter resources, feel free to check out www.RED-S.com.