“You’ve got a stress fracture.”
They’re the words no athlete ever wants to hear.
I knew my foot was sore. I told myself it was just an aggravated tendon. I kept running on it, convinced it would disappear and it wasn’t as bad as it felt. I was wrong. The pain grew steadily worse until I couldn’t run at all and finally sought help. An MRI - followed by a CT scan - delivered the news I’d been dreading: a stress fracture in my navicular bone.
For years, my body has been both my ally and my adversary. As an athlete, I’ve learned how to push it to its limits, but I’ve also learned how vulnerable it can become. Sitting here in a boot, unable to bear weight, is a reminder of that fragility.
It’s tempting, when you’re injured, to chalk it up to bad luck - to absolve yourself of responsibility. But that’s not the truth. This stress fracture is the consequence of ignoring my body’s cues, of waiting until its whispers turned into a foghorn. It’s the product of stubbornness, of addiction to training, of short-term thinking (“I’ll just get through today’s session and deal with tomorrow when it comes”), and of years spent running on half-empty.
Running on empty
For a long time I didn’t realise that what I was experiencing had a name: REDs: Relative Energy Deficiency in Sport.
REDs occurs when your body doesn’t get enough energy from food to fuel both the demands of exercise and essential daily functions like breathing, digestion, and repairing tissues. Think of it like running your phone on low battery: when there isn’t enough charge, non-essential functions start shutting down.
Over time, this energy mismatch can lead to serious physical and mental health issues and limit your ability to perform, train, or even live well. And the truth is: it can happen to anyone, regardless of age, gender, body size, or activity level.
REDs isn’t always the result of deliberate restriction. It can creep in gradually, from underestimating how much energy you need, increasing training volume, poor timing of meals, or simply having a suppressed appetite. Life changes, stress, lots of travel, or striving for a ‘healthier’ lifestyle can all tip the balance too.
As someone who has lived through it, I know how subtle and deceptive it can be.
For me, it started with disordered eating as a young adult: restricting how much I ate while increasing the amount and intensity of exercise. I started missing my periods, my sleep was disturbed and also my hair started thinning. When your periods are disrupted or stop altogether it’s a major warning sign: your body is shutting down essential functions that it cannot sustain. My body was fighting for balance while I was depriving it of the energy it needed.
The mental toll of disordered eating, and of REDs, can be just as heavy. Obsession with food and fear of rest - these were often my companions. For me, the generic (and often non-athlete specific) dietary advice or ‘fads’ - such as low-fat and, more recently, low carbohydrate or intermittent fasting - can infiltrate my brain. Once they take hold, it’s as if they grow roots, spreading quietly and relentlessly until they begin to dictate my choices, overriding rational thought and instinct. We are told that these diets are more ‘healthy’, but for me they are anything but.
Why am I susceptible to this messaging? At the heart is body dissatisfaction, control and normalisation of habits (both behaviours and thoughts).
You don’t often hear people say “I love my body.” It feels like an arrogant thing to admit. But why? For years, I looked in the mirror and compared myself to others, convinced that being leaner, smaller, ‘better’ would somehow make me happier. It didn’t.
My triathlon journey helped refocus my energy, to fuel myself for performance rather than deprivation - but it didn't enable me to heal completely. Managing the energy balance was - and is - an ongoing battle and one that I didn’t always win. It manifested in hormonal dysregulation, missed periods, and yes - a few stress fractures after my professional career ended. It’s important to remember that the effects of low energy availability on bone health aren’t always immediate and stress fractures, with me being a case in point, can develop years later.
Many athletes believe being leaner will also make them faster, but my experience is that when my weight was too low my performance suffered - even if that wasn’t always apparent to those watching me race. For example, my strength, power and buoyancy in the pool. I also found myself getting cold, finding it difficult to regulate my body temperature - and meant that I struggled in races with lower ambient temperatures.
It took time, and the support of others, to understand that strength isn’t about control or self-denial. Real strength is knowing when to rest, what, when and how much to eat, and when to ask for help.
It’s one thing to know you need help, but for me, shame and embarrassment and fear of change made asking for it really difficult.
A turning point
Having our daughter has been a huge turning point: giving me a new perspective of my body, its capabilities, strength and beauty – as well as providing the impetus to be a positive role model for her. But I am still paying the price for the behaviours of the past and, to some extent, the present too.
My body has done incredible things. It’s carried me through races, healed from injuries, and even brought new life into the world. For the years I criticised it, it never truly gave up on me. Learning to respect it - not for how it looks, but for what it does - has been one of the hardest and most liberating lessons of my life. However, recovery isn’t always straightforward. There are relapses, doubts, and learning moments, but that doesn’t mean failure.
Yes, REDs has impacted me and other professional athletes who have spoken about their challenges publicly and bravely. But it would be wrong to think of it as only an ‘elite athlete issue’ or as a female specific problem. Anyone, male or female, who is active at whatever level can fall into energy deficiency. However, too often, symptoms are brushed off as ‘overtraining’ or ‘stress’, when in reality the issue is energy availability.
We need more awareness, more research, and better education for athletes, coaches, parents, and medical professionals alike. Project RED-S, set up by former elite runner Pippa Woolven, is doing a fantastic job of doing just that. I applaud them for their incredible work, and urge everyone reading this to check out their website and the valuable resources they have available.
Collectively, we need to make the invisible visible. We need to ensure that we:
- Avoid commenting on someone’s body size or weight: compliments like “you look great for having lost weight” or advice such as “you’d be faster if you were lighter” reinforce the idea that our bodies’ worth is tied to appearance, not long-term health or function.
- Focus on how people feel, how their energy is, how training or life is going. In other words, shifting the conversation from body size to body experience and encouraging a culture of function over form: celebrating what bodies can do rather than what they look like.
- Make a conscious effort to listen to our body’s signals: low energy, disturbed sleep or missing periods are not signs of ‘just training harder’ or a ‘price to be paid’ they are signals that something isn’t right and those signals must be heeded.
- Ensure that dietary advice for athletes is grounded in sound, evidence-based science and tailored to the individual, accounting for their age, sex, training load, and sport-specific demands. Nutrition guidance should also address the psychological relationship with food and exercise, recognising that even well-intentioned advice can fuel disordered thoughts or restrictive behaviours. Support should come from qualified professionals who understand both the physical and mental dimensions of athlete health.
- Adopt a zero-tolerance policy for weight and shape teasing and be gentle if you think someone you know has REDs: ask how you can help, and avoid making assumptions about weight, food, training or bodies.
- Raise awareness that REDs is not limited to elite athletes, and that proper nutrition and rest are foundational to performance and to health. Performance improves when the body is fueled, not when it’s deprived. If you have dealt with, or are dealing with REDs, use your story to invite openness around this topic.
- Advocate for more research and better education among coaches, parents, healthcare professionals, schools and other settings. Help increase the profile of initiatives, like Project REDs and communities that are supporting those impacted by energy deficiency.
- Create a culture of respecting all bodies: different sizes, shapes, activity-levels. Let’s stop equating ‘leaner = better’, ‘lighter = faster’ or ‘smaller = healthier’: instead, honour the body that works for you in the short and the long term, the body that carries you, the body that heals, the body that races.
As I sit here with a stress fracture I have confidence that I will heal, but I also know that I need to take better care of this beautiful body of mine. The body that has achieved great things, but the body that needs to be treated with the respect it deserves.
And to those who may be dealing with REDs: you are not alone. You are not weak. Recovery means responding with kindness, nourishment and support - and that support is out there.
