Health Red Alert or RED-S Syndrome?

In the pursuit of health and fitness, it’s easy to fall into the trap of “more is better” when it comes to exercise. Many believe that pushing harder, going longer, and sweating more will always improve well-being. However, as a chiropractor with a focus on holistic health, I’ve seen firsthand the consequences of too much exercise, especially when it leads to a condition known as RED-S syndrome.

What is RED-S Syndrome?

RED-S, or Relative Energy Deficiency in Sport, is a complex and multifaceted condition that can affect both male and female athletes. Formerly known as the Female Athlete Triad, RED-S extends beyond just female athletes and encompasses a broader range of symptoms resulting from low energy availability. It occurs when the energy intake from food is insufficient to support the energy expenditure required for exercise and basic bodily functions.

This mismatch between energy intake and expenditure can lead to a cascade of problems, affecting not only physical health but also mental and emotional well-being. RED-S can impact hormone levels, bone health, menstrual function in women, cardiovascular health, immunity, and overall performance.

One of the more common injuries on the back of RED-S syndrome would be bone stress fractures in runners which we see in the office from time to time. 

Recognising the Signs of Too Much Exercise:

One of the primary contributors to RED-S is excessive exercise, often combined with inadequate nutrition. Here are some signs that someone might be pushing their body too far:

1. Persistent Fatigue: Feeling constantly tired, despite getting enough sleep, can be a sign of overtraining.
2. Increased Injury: Overuse injuries like stress fractures, tendonitis, or muscle strains can indicate that the body is not getting adequate time to recover.
3. Changes in Menstrual Cycle: For women, irregular periods or the absence of periods (amenorrhea) can be a red flag for RED-S.
4. Mood Changes: Overtraining can lead to irritability, anxiety, or depression due to hormonal imbalances and stress on the body.
5. Decreased Performance: Surprisingly, pushing too hard can result in decreased athletic performance rather than improvement.
6. Recurrent Illness: A weakened immune system from excessive exercise can lead to frequent colds or infections.

As a chiropractor, I often see patients presenting with these symptoms, not realizing that their dedication to exercise might be doing more harm than good. You might have heard me say, “The rest/recovery days are just as important, if not more important than the training itself.”

Prevention and Treatment:

Preventing RED-S starts with education and awareness. Athletes, coaches, and healthcare professionals should all be informed about the signs and risks associated with overtraining. It’s crucial to emphasize the importance of rest, proper nutrition, and listening to the body’s signals.

Treatment for RED-S involves a multidisciplinary approach:

1. Rest and Recovery: This includes reducing training volume and intensity to allow the body to recuperate.
2. Nutritional Support: Working with a nutritionist or dietitian to ensure adequate energy intake to match energy expenditure.
3. Hormonal Evaluation: For women with menstrual irregularities, hormone levels should be evaluated to assess the impact on bone health and overall well-being.
4. Psychological Support: Dealing with the mental aspects of RED-S, such as the pressure to perform and body image issues, is crucial for recovery.
5. Monitoring: Regular check-ups with healthcare professionals can help track progress and adjust treatment plans as needed.

As a chiropractor, I also emphasize the importance of proper biomechanics and movement patterns. Overuse injuries are common in those with RED-S due to fatigued muscles and bones, so ensuring proper alignment and movement mechanics can aid in recovery and prevent future injuries.

As a side note, this month we are raising funds for the Fred Hollows Foundation and sight restoration. The goal is to run 100km in August. Now for me, this is a lot more running in a month than what I normally do (I’ve ran 100km in the previous 6 months combined) and it’s been interesting to see the effects this had had on my body. I have definitely had periods of more tiredness, I have definitely upped my calorie intake due to exercise and I have felt more irritated than normal which can all be signs of over-training. I will look forward to returning to a normal exercise regime.  

The Bottom Line

Exercise is undoubtedly beneficial for health, but like most good things, it’s about finding the right balance. As a chiropractor, I encourage my patients to view exercise as a form of self-care, not punishment. It’s about listening to your body, giving it the rest and nourishment it needs, and recognizing that more isn’t always better. We like to talk about quality of quantity.

RED-S syndrome is a serious condition that can have long-lasting effects on health and performance. By being aware of the signs, promoting a healthy approach to exercise, and seeking help when needed, we can work towards a future where athletes of all levels thrive in a balanced and sustainable way.

Remember, your body is your greatest asset, and it deserves to be treated with care and respect. As a chiropractor, I’m here to support my patients on their journey to optimal health, helping them find that sweet spot where exercise enhances life without compromising it.

If you or someone you know is suffering and needs help, please reach out. 

Kind regards 

Dr Matthew Gooch (Chiropractor)