Have you heard of Relative Energy Deficiency Syndrome AKA Female Athlete Triad?
Pronouns: she/her
By Emily Borders, DWC Ambassador
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Over 80% of athletes, including dancers and figure skaters are unaware of a highly prevalent condition known as Female Athlete Triad or sometimes, more recently termed Relative Energy Deficiency Syndrome (RED-S)(Tosi & Dodson, 2019). You may find that you are in this category. It was many years until I got a first-hand experience of the manifestations of RED-S. Three weeks before my dance company’s spring recital I broke my arm in multiple places while mat tumbling in acro class. Since then, I have learned a lot about RED-S from my physical therapy education and my own desire to learn about and spread awareness of this condition. This injury likely could have been prevented if I had been taking care of my body the way I should. RED-S is a form of energy deficiency that occurs due to excessive energy output or inadequate energy input. Basically, this occurs if someone is not putting enough fuel (energy) into their body to support their daily physical activity or they are doing so much rigorous physical activity that they are using up all their stored energy; both of these situations lead to an energy deficit and sometimes this can result as a combination of both. As you can imagine, these situations are common in dance training. Many hours of high-intensity dance training, a desire to maintain a certain body aesthetic and lack of proper nutrition, all contribute to RED-S being highly prevalent amongst dancers.
For me, proper nutrition and taking rest days was not strongly emphasized in my dance training. I developed a strong work ethic in dance, which I am grateful for and has shaped me into the person I am today. Due to this work ethic, I found myself extremely dedicated to my dance training. I would train for many hours a day 5-6 days a week, which would often turn into 7 days a week on a competition or convention weekend. I would sometimes even go to the gym after dance or on my day-off to get an extra workout in. If this sounds like you, or even if it doesn’t but you are still involved in dance or another form of physical activity at a high volume, I encourage you to read further and look at the following components to RED-S.
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RED-S or Female Athlete Triad includes a triad of symptoms. These symptoms include low energy availability, menstrual disturbances including lack of menstrual cycle or irregular menstrual cycle and decreased bone mineral density. Low energy availability can cause increased fatigue, weakness, mood changes, and increased risk of injuries. Decreased bone mineral density increases one’s risk for fracture, which is what happened to me. Injuries and chronic fatigue can be detrimental to a dance career, but these things can often be prevented by fueling one’s body with a proper diet to support high-intensity dance training and incorporating rest days. Endurance athletes including dancers need about 1.4 g/kg of body weight of protein per day, which I can guarantee is a lot more protein than most young dancers are getting. Another way to decrease your risk of this condition is making sure to add rest days and strength training into your routine. Rest days are vital to restoring energy that has been depleted during physical activity and allowing bones and muscles to recover and adapt. Rest days don’t have to look like sitting on your couch. Going on a walk or doing another form of light activity can be a great way to “rest” but still move your body. Furthermore, bones become stronger through weight bearing activities; lifting weights can be a great way to increase bone mineral density and decrease injury risk. Keep in mind that if you are already dancing many hours, nearly every day of the week, I am not encouraging you to add a day of weight training, but having your instructors add some weight training into class or replacing some dance time with cross-training will be beneficial to dance and overall health. If this doesn’t seem possible, making sure to get some weight training in during dance breaks or off-season is another great idea!
Factors that may increase one’s risk for developing this condition include endurance athletes, female gender, having an eating disorder, ages 12-24, and people who feel pressured to maintain a certain body aesthetic for their sport. If any of these seem to apply to you or you think you may be experiencing some of the symptoms described above, I hope you look further into this condition and take steps to prevent it. Don’t wait until a major injury occurs to make a change for your health. Feel free to email emily.stadt@outlook.com if you have any questions or check out the resources below!
Sources:
https://dancenutrition.com/relative-energy-deficiency-in-sport-dancers/
Reference:
Tosi M, Maslyanskaya S, Dodson NA, Coupey SM. The Female Athlete Triad: A Comparison of Knowledge and Risk in Adolescent and Young Adult Figure Skaters, Dancers, and Runners. J Pediatr Adolesc Gynecol. 2019;32(2):165-169. doi:10.1016/j.jpag.2018.10.007
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