Anyone and everyone who works with athletes (physical therapists, coaches, athletic trainers, mental health specialists, parents, etc.) also works with Relative Energy Deficiency in Sport (REDS), whether you realize it or not. Because of this, it is crucial that all members of the team are REDS-informed.
What Is Relative Energy Deficiency in Sport and Why It Matters
Relative Energy Deficiency in Sport (REDS) occurs when an athlete’s energy intake doesn’t meet the energy demands of their training and daily life. This mismatch can affect every system in the body, from hormones and bone health to metabolism, immune function, and mood.
While many associate REDS with disordered eating, it can develop even in well-intentioned athletes who simply aren’t fueling enough to support performance and recovery.
The effects are far-reaching, including:
- Decreased strength, endurance, and training adaptation.
- Increased injury risk.
- Poor recovery and chronic fatigue.
- Impaired mood and focus.
- Long-term bone and hormonal issues.
Why REDS Awareness Goes Beyond Dietitians
While it is incredibly important that registered dietitians, especially those working with athletes and active people, are REDS-informed, the work of the dietitian is limited by the knowledge of the rest of the team of providers. As registered dietitians, we need the interdisciplinary team to be REDS-informed for prevention, early detection, referrals, reinforcement, culture change, etc.
Read on to learn how key members of the team play a role and why each need to understand REDS.
How Different Providers Play a Role in REDS Prevention and Detection
Physical Therapists
Athletes with REDs are more prone to overuse injuries, stress fractures, and delayed healing.
Key signs include:
- Insufficient energy and key nutrients needed for remodeling injured tissues (impaired healing).
- Decreased estrogen and thyroid hormone, negatively impacting bone health.
- Decreased responsiveness to physical therapy adaptations.
When physical therapists understand REDs, they can recognize when injury recovery is inconsistent with the athlete’s effort and refer for a nutrition or medical evaluation.
Coaches and Athletic Trainers
Coaches and athletic trainers are often those who work most closely with the athletes day to day, which positions them perfectly to notice early warning signs of REDS in athletes.
They should be able to:
- Identify when an athlete may have REDS and needs clinical attention.
- Understand the false beliefs around fueling and training that can lead to REDS.
- Ensure the athlete continues to feel they are a valuable part of the team during recovery.
- Support a team culture that encourages proper fueling and rest.
A REDS-informed coach reinforces that worth is not tied to body composition or playing time and ensures athletes in recovery still feel valued on the team.
Mental Health Providers
REDS and mental health struggles can perpetuate each other.
It’s important to assess:
- Does the athlete have an eating disorder or disordered eating?
- What is their motivation for training?
- Is it depression or could it be an under-fueled brain?
- Are their nutrition choices supportive of sport or are they rigid, as is seen in orthorexia?
A REDS-informed mental health provider can help determine whether symptoms stem from under-fueling or from primary psychological concerns, or both. They can also support the athlete in challenging rigid food and training beliefs that perpetuate energy deficiency.
The Impact of REDs on the Athlete’s Whole Self
REDS doesn’t just affect physical health, it impacts every dimension of performance and well-being:
- Physical: fatigue, injuries, decreased strength.
- Mental: irritability, low mood, poor concentration.
- Performance: loss of speed, endurance, and consistency.
- Longevity: shortened athletic careers and long-term health risks.
Preventing and managing REDS in athletes requires an informed, interdisciplinary team that communicates and collaborates. When each provider understands their role, athletes are better supported in fueling properly, managing stress, and performing at their best.
You owe it to your athletes to know better, do better, and provide better.
Become a Certified REDS-Informed Provider
For providers who want to deepen their expertise, my REDS Informed Provider™ Masterclass Certification Program offers comprehensive training to become a certified REDS-informed provider.
This course helps professionals:
- Identify REDs early.
- Use athlete screening tools effectively.
- Communicate with athletes and parents.
- Work with other members of the care team.
- Provide effective, athlete-centered care.
- Support recovery and long-term performance.
Join the LIVE cohort of the REDS Informed Provider™ Certification Program today!
If you’re an athlete looking for support, explore the directory of REDS-informed providers who have completed the certification and are ready to help.