What if you know or suspect that you have RED-S / REDs; you have amenorrhea (the absence of a menstrual cycle) or some other telltale sign, but you’re a competitive athlete in high school or college? You have three seasons a year, and you feel as though you can’t take time off to get your period back.. Maybe you’re a high school senior and you have a scholarship riding on your athletic performance…  Should you wait until you’re finished with school to address your health issues? 

Tina and certified strength and conditioning specialist Amanda Tierney weigh the options for student athletes and share their perspectives on how to navigate this difficult decision.


Read the transcript

[Tina]  I’m a competitive athlete in college or high school and I just can’t take time off in my season. I have three seasons a year; I’m on scholarship or I’ve committed to this. Do I have to wait until I’m finished with college or high school, or what else should I do?

[Amanda]  Oh, that’s so, so, so hard. I think just the fact that you have three seasons, and that you have to wrestle with this idea, I think please just know  you’re not alone. I think a lot of athletes end up feeling like they have to choose between, “Okay, my health is suffering, but 

I’m performing and I love this and I love my sports and I just want to keep going,” but my very transparent and loving, loving, loving advice would be to just really get some support now, so that you can do all of the things that you really want to be doing in the long term for your life. 

So, I would very highly recommend just taking some time off and getting help from a medical doctor or a sport dietitian and a therapist and anyone that would really be helpful for you in this  difficult time of just trying to navigate, “Well, what do I do?” Sometimes you might not have to take that much time off.  But addressing your health and your well-being is going to by far be a cornerstone of your sport performance and your sport identity long term. 

So, I really don’t want to say you have to take time off, but I have to be honest and transparent and I think sometimes just taking a little bit of time off now will be really helpful for you long term and maybe even in the short term. 

[Tina]  I want to add here, as I get a lot of emails about this, that it can often feel, especially if you’re towards the end of high school or if you are in your collegiate career, you’re trying to prove yourself, but especially at the end of high school, it can feel like, “Well, I can’t do it now because I’m trying to get a scholarship or I’m trying to get noticed; I’m trying to help my team; I promised my team; I don’t want to let my team down,” and while those things are important and I know this feels so important in the moment, like It feels like you absolutely cannot miss even a single race, when you think about your life as a whole and you think about being a 90-year-old woman, you are not going to think back to this moment and be like, “I’m so glad I did that extra race,” you are gonna think, “I am so glad I took care of myself, even though that was the hardest thing in the world to do, because now I know I got to live a rich life where I really got to be in the moment, and look at all these things that I accomplished.”

 And you see a lot of runners now, professional athletes, run their best in their late 20s, their 30s, even their 40s, and it can feel like you absolutely cannot miss, especially if you’re trying to get a scholarship, but, and I I get that if you’re in your senior year, that is even harder, but it really, as Amanda said, doesn’t have to take as long as you think, if you are that committed. If you are that committed to your running and you love it that much, or your sport, you can come back stronger and use that determination to work into your recovery to get yourself into that healthy place. Is there anything else you’d add there? 

 [Amanda]  I mean,I guess I have a follow-up question for you. Would you believe us right now, if you were a senior in high school trying to get a scholarship, because it is really important. Like, this is the most important time for you and you have been working really hard to get to where you’re at, so what would senior-in-high-school-Tina say, when you’re super driven, if you were being told, “Oh, you need to take time off”? 

 [Tina ] I’ll be honest; I think senior Tina would not listen. And I get that, and you know that, you asked that question for that reason. I would say if a scholarship is within reach, is realistic, and is something that you are in that stage of your senior year, that is maybe the only time I would say, “Okay, let’s hold out,” but if you’re gonna do that, you have to accept and acknowledge that you may have consequences down the road. That may mean you are playing with fire, and you end up with a pelvic stress fracture or a sacral stress fracture or you have long-term effects into your 40s; you have to wrestle with that. But I also understand that maybe a scholarship is the only way you can afford to go to college. Anything else, junior year, sophomore year, freshman year, or even once you’re in college, anything else, I would say, even though I understand it would be hard to wrestle with it, that is the only exception, I would say, is that senior year of high school, if you need that scholarship money to be able to just go to college at all. 

 [Amanda]  Can I add to that?

 [Tina]  Sure.

 [Amanda]  I think if you’re a senior and you are on the verge of getting a scholarship and you really do need that, the transparency piece with your new or potential coach, athletic program, is going to be so key. And there are lots of protections in place for people who are potentially injured and going through an injury, and I think that  relative energy deficiency is an injury.

So they are signing you for a scholarship because they want you, and they see potential in you, and they want to help you grow as an athlete over the potential next four years, so I think if you are trying to wrestle with that difficult decision as a senior, and if you feel like you have to push yourself because this is your only shot, I think your running history up until this moment where you’re making this decision, is going to speak for itself. Your times, your dedication, your ability to talk to people transparently about what your needs are, and your coachability, and all of that, is going to speak volumes for you as an athlete, moving forward. 

So I think that even if you’re in that situation where you’re like, “It’s this or I’m gonna lose my opportunity,” transparency and openness is going to be really important, and sometimes just being able to ask for the help needed and say, “I am committed to this and I want to be the best I can for your program and for myself,”  that’ll really help you align your health and well-being and your athletics.  

[Tina]  Yes, thank you so much, Amanda. That was really helpful.

check it out

Recovering from RED-S is hard. It’s even harder if you’re working through it alone. Even if you have professional support, they’re not available 24-7, and that can lead to going down search engine rabbit holes that have the potential to derail everything.

Our online resource, RED-S: Realize. Reflect. Recover, will answer all those questions swimming around in your head about recovery. It will give you the opportunity to connect with the experts you’ve come to know here, and to surround  yourself with a community of others who are going through it too.

THANK YOU! to Athletic Greens and Tracksmith for supporting this YouTube series and RED-S: Realize. Reflect. Recover.

Go to athleticgreens.com/reds to get five free travel packs of AG1 and a free one year’s supply of vitamin D3+K2 with your subscription!

When you go to https://tracksmith.com/tina and use the code TINA15 at checkout, you’ll get free shipping and Tracksmith will donate 5% of your order to Rising Hearts, the Indigenous-led nonprofit founded by Jordan Marie Daniels.

more about amanda:

Amanda Tierney, MS, CSCS, CEDS-S is located in St. Louis, MO and is originally from New Jersey/Philadelphia. She has two young kids, a wonderful husband, and a howling beagle mix. She is an eating disorder informed & sensitive fitness provider who works with athletes and general ED programming with safely integrating the movement/sport training/therapeutic recreation aspect to their recovery. Amanda has a private training practice,Discovering Balance: Fitness Coaching and Support, and is the director of The Victory Program and Fitness at McCallum Place. You can find her at https://www.rockthebalance.com/.

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