RED-S (Relative Energy Deficiency in Sport)

From Female Athlete Triad to RED-S

The term “Female Athlete Triad” has traditionally been used to describe a syndrome in female athletes characterised by three interrelated components: disordered eating, menstrual dysfunction, and decreased bone mineral density. However, as research progressed in this field, it became clear that this condition was not exclusive to females and involved more than just three systems. Thus, the term RED-S is used to reflect a more comprehensive understanding of the condition.

What is RED-S?

RED-S is defined as a state of impaired physiological functioning caused by exposure to prolonged or severe low energy availability. Low energy availability occurs when the athlete’s energy level does not meet the demands of daily body function and their sport/exercise. Athletes considered to be at high risk of RED-S may include those who compete in aesthetic sports (e.g., gymnastics), long distance runners, or weight-related sports (e.g., lightweight rowing, jockeying). Athletes/active people with disordered eating are commonly associated with a high risk of RED-S, however we must also consider the impact of factors like food insecurity, post-exercise appetite suppression, or even highly busy individuals who lack the time for proper dietary intake during the day. RED-S can affect multiple body systems and lead to various problems, including:

• Impaired menstrual/reproductive function

• Impaired bone health

• Impaired cardiovascular function

• Mental health issues

• Urinary incontinence

• Reduced skeletal muscle function

• Impaired growth and development

• Impaired energy metabolism

• Impaired haemotological function

• Sleep disturbances

• Reduced immunity

• Impaired gastrointestinal function

• Impaired energy metabolism

• Impaired glucose and lipid metabolism

• Impaired neurocognitive function

So, as you can see RED-S includes far more than just a triad of body systems – and, as you can imagine, these impairments can have a serious effect on an athlete’s performance. RED-S is commonly seen when someone is ‘pushing the boundaries’, beyond what your body is capable of at teh time, and can have significant health effects.

If you think that your getting increasingly tired, injured, or getting other musculoskeletal problems, then it is important to speak to a GP or Specialist Physiotherapist. You can get assessed, and given advice or treatment to prevent further issues/complication.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.