• Kristin Bignell, PT, MScPT, BScES(hons), CMAG

Bringing Light to RED-S

No, we aren’t talking about Cincinnati’s MLB team. We are talking about an energy problem. An energy problem that is still relatively common, under recognized and one that has potentially dire consequences. If you want to perform at your best and minimize your risk of injury, you need energy. If you are running at an energy deficit, you have the potential of ending up with RED-S, Relative Energy Deficiency in

Sport. It should be noted that although RED-S was formerly known as “The Female Athlete Triad”, RED-S is NOT exclusive to females and the contributing factors and symptoms are more varied than the former definition.


Let’s paint ourselves a picture. Our cell phones use battery power to run. They use a base amount of battery power to remain in a dormant mode but when we use our phones to email, chat, cruise Instagram, they use more power. When our battery gets low, we charge it so that our phone has enough power to do both the necessary and fun things. If we let the battery run too low, we end up in “low power mode”. Our phone still works but not all of the functions are readily available. If we let the battery run out, the phone no longer works until it is recharged.


Like a phone, we need energy to be able to perform. If we don’t have enough energy to perform our sport, our body cannot perform at its full capacity. When there is a mismatch between energy availability (through the diet) and energy expenditure (through exercise), our body doesn’t have enough energy to carry out the functions necessary to maintain optimal health. We end up with impaired physiological functioning with significant consequences.

Low energy availability can be due to an intentional limitation of calories in order to change appearance or under the misguided belief that being leaner will improve performance. Or, it can be due to an unintentional mismatch between energy consumption and energy output. In other words: not increasing calories enough to match an increase in training. Unlike a phone, our bodies are much more complex and energy requirements are multifactorial. It is not enough to simply track caloric intake. We require a steady intake of water, quality macronutrients (fats, proteins and carbohydrates) and a balanced intake of micronutrients (vitamins and minerals). All these things are required in addition to proper sleep and mental rest. Our requirements for fuel increase as our activity level increases.


In the short term, if we have not taken in enough energy, our ability to compete at our full capacity is diminished. We aren’t as strong and we aren’t as mentally sharp.

Over the long term, if we are experiencing a consistent energy shortage, we may start to lose bone mineral density causing an increased risk for fractures or have changes in our metabolic ability. There may be alterations in hormones that impact performance and have long term impacts on reproductive function. In females, their menstrual cycles may become irregular and/or stop all together. Our immune systems may become dysfunctional and we may end up getting sick more often or developing autoimmune conditions. We may not be able to synthesize protein properly, a process necessary for tissue repair, healing and growth. The list goes on. No one is exempt. If you are using up too much energy and/or not taking in enough energy you have an energy deficiency and while the effects of this RED-S start silently, the consequences can be devastating and potentially career ending for athletes.


In terms of performance, athletes with low energy may experience: decreased muscle strength, decreased endurance, increased injury risk, decreased energy stores, depression, irritability, decreased concentration, decreased coordination and/or an impaired training response.


If you or someone you know is currently experiencing any of these symptoms, I would highly encourage you to reach out to a trusted health care provider who has experience with RED-S and can help develop a plan to correct this energy difference. If you aren’t experiencing symptoms, I challenge you to think of ways that you can to help your body best recharge so that you are able to perform and compete at your highest level without risking your health.



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