Mary Cain, RED-S, and the Female Runner
#107: Study Shows Training Based on Whoop Recovery Improves Performance, Reduces Injury. [Whoop Podcast]
Reasons To Listen:
45 min
Mary Cain’s story
Whoops Project PR
My Take Aways:
Who is Mary Cain? Until listening to this podcast I had no idea. Shame on me really. Her story is one that many can relate to yet she had the courage to speak up about her treatment while being an athlete at Nike’s Oregon Project. This was Nike’s collection of the worlds fastest and most gifted track athletes and their training program.
Mary showed up on the scene as one of America’s rising talents with the hype of potentially being the US’s fastest female athlete.
What happened throughout her time with Nike can only be described by her and was summarized in this 2019 New York Times Opinion Piece, with a video as well.
This is a must read/watch to understand her story better.
She highlights that women CAN train as hard as men, but they are not mini-men. They have numerous physiological differences and when those differences are not respected it can wreak havoc on the body. This is so clearly seen in the fact that she didn’t have her period for 3 years while with Nike and had 5 bone stress injuries (BSIs). She had RED-S (more on this later) and it was destroying her body and ruining her performance. As she describes it, she had lost the race before it had even begun.
She also speaks a lot about the double-standard around weight and training through-out Nike’s program. Nike took an elite female athlete and instead of supporting her to the podium, they trained her like a male, with no regard to physiological differences, shamed her about her weight in front of her peers and completely failed her in so many ways.
Mary is now running for Tracksmith and teamed up with Whoop to design a program to test if training based on Whoops recovery score was advantageous. This is Project PR.
The study was conducted over 8 weeks and was aimed at increasing 5km times. There were 2 training groups, one standardized group and one that slightly modified their training based on their recovery score. They had participants split into beginner, advanced, and elite (however, elite was excluded d/t low participation).
The workouts and runs were all identical except that if you were in the Whoop group you would reduce training (reps, distance etc) based on your score that day. They never increased training above the level of the standardized group.
Both beginner groups improved time by ~3.5min, both advanced groups improved time by ~1.5min. However, the beginner standardized group reported 30% more injuries and the advanced standardized group reported 15% more injuries, than their comparable Whoop group. The Whoop group also did it in ~2hr less training time.
The Whoop groups trained less, got similar performance results and did it with significantly less injuries.
Based on these results, they hypothesize that a longer term study may start to show an increase in performance for the Whoop group as you can’t train if you’re injured, thus performance differences will start to appear, and the results may be even more profound in an elite group of athletes as they are at high risks of overtraining.
This study showed similar outcomes as other HRV-based training programs in runners and cyclists.
#15: RED-S w/ Rebecca McConville [Runners Zone]
Reasons To Listen:
30 min
What is RED-S?
Warning signs
My Take Aways:
What is RED-S? Relative Energy Deficiency in Sport. It was formerly known as the female athlete triad but has since changed names to include males. The primary characteristics remain the same.
Disordered eating, amenorrhea (in woman) and a decrease in BMD leading to osteoporosis/osteopenia and/or BSIs.
“Where is the body getting it’s energy when you’re not paying the energy bills?” In other words, what is the difference between energy expended and energy available to recover and adapt from a training stressor.
The body begins to suppress energy to grow bone, to have a menstrual cycle, to digest a meal, to fight off a cold etc etc.
This means you should be aware of warning signs like new food intolerances, mood shifts, bone stress reactions, and other signs that suggest your athlete is struggling to recover properly.
There doesn’t need to be a significant change in weight for these processes to be taking place.
It is also important to not miss an eating disorder. This is not the same as disordered eating and will not be fixed with a new meal plan. It will likely require additional team members beyond a sport nutritionist to manage properly.
Those sports that have a culture focused around a body image of thinness are most at risk of having athletes with RED-S, as ideas and fads will spread around amongst the group.
Weight should not be a topic of focus within the team and coaches should not be bringing it up. That is for the correct healthcare professional to discuss and manage with the athlete.
Nutrient periodization is necessary with training periodization. An increase in training will require an increase in nutrition to match.
#33: Amanda Fisher [Runners Zone]
Reasons To Listen:
40 min
Pelvic health and what is ‘normal’.
Return to running post-pregnancy
My Take Aways:
6 weeks after child-birth is likely not a long enough time frame to return to running for most women. Somewhere between 6-12weeks is more realistic but will depend on a number of factors related to the pregnancy. Performing some form of pre-hab related to pelvic floor ‘strengthening’ or awareness will improve your ability to re-gain control post-pregnancy and perhaps speed up these timelines a little bit.
Kegels are not for everyone!! Which is why seeing a trained specialist in this area is so important. If you have an overactive pelvic floor, (which said professional can assess) performing kegels is not the correct exercise and may actually be perpetuating the problem. Athletes may be at an increased risk for this overactivity.
Urinary leakage, saddle pressure or prolapse, and pain during sex are NOT normal, for anyone, and should be assessed and treated by a trained clinician. These are signs of dysfunction in the pelvic floor and can be improved with treatment like any other muscular-based issue.
You should be able to sit, run, jump, cough, sneeze, and carry anything you need to without worry! If you can’t, or you experience these concerns part way through your activity or run, then you can and should get this looked at. Don’t accept these as normal and feel like it’s something you’re just going to have to deal with.
If you are symptom-free and training well, it is still worth your time to manage your hip/pelvicmobility and be aware of any increases in tension that may appear. You should connect with your pelvic floor daily through various awareness and breathing exercises.
This is certainly not my area of expertise but it is important to know when a referral to another, more specialized, practitioner is necessary and the importance of having those relationships in your community.
