Syndrome of disordered eating, oligomenorrhoea and osteopenia
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7 episodes with female athlete triad
3 episodes with female athlete triad
4 episodes with female athlete triad
4 episodes with female athlete triad
3 episodes with female athlete triad
3 episodes with female athlete triad
2 episodes with female athlete triad
2 episodes with female athlete triad
4 episodes with female athlete triad
In this episode, Laura Moretti Reece, lead sports dietitian for the Female Athlete Program at Boston Children's Hospital, discusses her journey as a sports dietitian specializing in eating disorders and disordered eating among athletes. Laura highlights the foundational significance of personalized and evidence-based nutritional recommendations for athletes. We also explore the impact of diet culture, menstrual phase, and Relative Energy Deficiency in Sport (RED-S) on nutrition for female athletes. Trends like intermittent fasting, fasted workouts, and sports supplements are also discussed. Laura Moretti Reece completed her Master's Degree in clinical nutrition at New York University. As a Certified Specialist in Sports Dietetics, Laura specializes in sports performance-based nutrition as well as treating REDs, disordered eating and eating disorders in athletes. Laura has an extensive amount of experience in consulting and collaborating with Olympic and professional athletes, local colleges and universities, as well as professional sport and dance facilities. Laura currently serves as the Lead Dietitian for the Female Athlete Program at Boston Children's Hospital, as well as serving as the consulting dietitian for the Boston Ballet Company. She also runs a Boston Based virtual group nutrition practice, Laura Moretti Nutrition LLC. Laura served as the Co-Chair for the International Academy of Eating Disorders Sport and Exercise Special Interest Group, and was also the Co-Chair of the 2019 Female Athlete Conference. 00:00 Introduction and Career Beginnings 00:13 Specializing in Eating Disorders 00:52 Joining the Female Athlete Program 01:07 Building a Team and Current Role 02:15 Advice for Aspiring Dietitians 03:54 Discussing REDS: Recent Research and Opinions 07:26 The Importance of Nutrition in Athletes 13:06 Menstrual Health and Nutrition 17:44 Intermittent Fasting and Female Athletes 19:00 Listening to Your Body: Intuitive Eating for Athletes 19:41 The Problem with Dietary Restrictions 21:20 Coaching Female Athletes: Unique Challenges 25:37 Supplements for Female Athletes: What to Consider 32:25 The True Meaning of Fitness: A Personal Perspective 36:56 Conclusion and Upcoming Events
The term RED-S or 'Relative Energy Deficiency in Sport' is fairly well known within the endurance community. Previously termed the Female Athlete Triad, it's name now better represents an issue that affects both men and women. Lack of a menstrual cycle, disordered eating, low body mass, stress fractures and osteopenia are some of the more commonly associated signs and symptoms when it comes to RED-S, but what about the lesser known symptoms? Today Kriss talks from personal experience, as a coach and husband, about the less common symptoms of low energy availability, and why having accountability around your energy intake is such a vital part of getting past what can become a very serious problem. (00:00) Introduction to SFE Athlete Pathway (01:13) Welcome to the Strength for Endurance Podcast (01:53) Identifying Low Energy Availability (05:01) Personal Experience with Low Energy Availability (06:57)The Importance of Proper Nutrition (09:55) Consequences of Ignoring Energy Needs (14:07) Solutions and Final Thoughts Join our SFE Inner Circle to receive weekly 5 minute masterclasses and top coaching tips
Get ready, because this episode will completely change the way you think about weight loss! Dr. Ashley Lucas joins me to uncover the surprising science behind stubborn belly fat—did you know it's not just sitting there, but actively working against you?We're busting some of the biggest myths out there—like why calories in/calories out is a complete lie—and diving into how stress and cortisol might be the sneaky culprits behind your weight gain. Dr. Ashley also reveals why lifting weights beats those endless cardio sessions (hint: you don't need to kill yourself on the treadmill!) and shares her tips for breaking free from food addiction.If you're ready to reset your metabolism, tackle those cravings, and finally understand what's really going on with your body, this episode is for you. Press play and let's get started!Dr. Ashley Lucas, PhD, RD, is the founder of PHD Weight Loss and Nutrition and a leading expert in weight management and behavior change. A former professional ballet dancer, she earned her PhD in Sports Nutrition and Chronic Disease from Virginia Tech, with research focusing on energy metabolism and the Female Athlete Triad. Combining over 15 years of expertise in nutrition and metabolism, Dr. Lucas developed the PHD Approach, a transformative program that addresses the metabolic, psychological, and behavioral aspects of weight loss. Her innovative methods have helped thousands nationwide achieve lasting wellness.Website: https://myphdweightloss.com/Facebook: https://facebook.com/DrAshleyLucas/Instagram: https://www.instagram.com/dr_ashleylucas/?hl=enLinkedIn: https://www.linkedin.com/in/ashley-lucas-phd-rd-5560b0162/PODCAST Thank you for listening please subscribe and share! - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Shop supplements: https://healthybydrjen.shop/ CHECK OUT a list of my Favorite products here: https://www.healthybydrjen.com/drjenfavorites WATCH THIS:https://www.youtube.com/watch?v=2lSyAFy5U4U&list=PLaDiqj0yz1eeCOATXPoUDt8HEJxz1_lfW - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FOLLOW ME: Instagram :: https://www.instagram.com/integrativedrmom/ Facebook :: https://www.facebook.com/pflegmed Tik Tok :: https://www.tiktok.com/@integrativedrjen YouTube :: https://www.youtube.com/@integrativedrmom - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FTC: Some links included in this description might be affiliate links. If you purchase a product through one of them, I will receive a commission (at no additional cost to you). I truly appreciate your support of my channel. Thank you for watching! Video is not spons...
In this episode, fellow sports and eating disorder dietitian, Leslie Schilling, shares insights into the damaging effects of diet culture, especially when within safe spaces like schools, churches, athletic teams, and healthcare settings. We cover a range of topics from the harmful impacts of chronic dieting, the intersection of sports nutrition and eating disorders, and how messages from diet culture influence athletes and general health practices. Leslie is a seasoned dietitian who specializes in disordered eating, sports nutrition, family nutrition, and weight concerns. She has worked with recreational, high school, collegiate, and professional athletes and performers, including the 2014-2015 NBA Memphis Grizzlies and performers of Cirque du Soleil in Las Vegas, NV. Leslie has been accepted into The National Speakers Association (NSA) and has been invited to provide nutrition programs and presentations to teams and professionals across the nation. She reviews and writes for national media outlets like US News & World Report, professional and consumer publications. She is also the creator and co-author of the book Born To Eat and the owner of Schilling Nutrition, LLC, a private consulting practice in Las Vegas, NV. Leslie's latest book Feed Yourself is available everywhere books are sold. 00:00 Introduction to Mind Your Fitness Podcast 00:50 Meet Leslie Schilling: A Journey from Gymnastics to Dietetics 02:16 Leslie's Professional Path and Private Practice 03:48 Nutritional Challenges in Performance Arts 06:07 The Intersection of Sports Nutrition and Eating Disorders 09:14 The Importance of Asking the Right Questions 13:58 Leslie's Book: Feed Yourself and Diet Culture 22:07 Diet Culture Myths and Their Impact 25:18 The Impact of Nutrition on Health and Performance 25:58 Grief and Realizations in Nutritional Therapy 28:47 The Connection Between Dieting and Eating Disorders 30:47 The Dangers of Diet Culture 33:09 Navigating Misinformation in Nutrition 36:43 Advocating for Healthy Nutrition in Athletics 43:34 Personal Reflections on Fitness and Wellness 46:54 Conclusion and Final Thoughts
In this episode, we dive deep into a health at every size approach to diabetes, pre-diabetes, and blood sugar management for active people and athletes. We're joined by Danielle Bublitz, owner of @FoodFreedomDiabetes, who helps us bust common myths and take a balanced approach to diabetes management. Our discussion covers Danielle's personal experiences with Type 1 Diabetes and the benefits of managing diabetes through a health at every size perspective. Key topics include misconceptions about prediabetes, the benefits of carbohydrates, the complexities of blood sugar management, and the importance of personalized healthcare. Emphasis is placed on intuitive eating, destigmatizing certain foods, and the significance of joyful movement in sustainable health behaviors. Danielle Bublitz, MS, RDN, is a Registered Dietitian Nutritionist and Certified Intuitive Eating Counselor. She specializes in working with people with diabetes and binge eating in a Health At Every Size(R)-aligned lens. Danielle earned her bachelor's degree in nutrition and dietetics from California State University at Chico and received her Master's degree from California State University at Northridge while completing the dietetic internship program. Danielle is passionate about guiding her clients with diabetes towards feeling more at peace with their food decisions and blood sugar management, as well as making peace with their bodies.
In this conversation, Dr. Amanda Smith discusses the unique physiological aspects of female athletes, including the impact of hormones on performance, the effects of birth control, and the importance of understanding the menstrual cycle in training. She emphasizes the need for tailored training strategies for women, the prevalence of injuries, and the adjustments needed during menopause. Amanda shares her personal experiences and insights, advocating for knowledge as a powerful tool for female athletes to optimize their performance and health.Thank you, Amanda! Find her on IG here:https://www.instagram.com/drxsmithx/ https://www.strava.com/athletes/1048211Chapters:00:00 Welcome!01:03 Amanda's Ironman Training02:02 Amanda's Background and Expertise03:03 The Importance of Understanding the Female Physiology06:28 The Menstrual Cycle and Hormones12:02 Birth Control and Exercise17:52 Injuries and Ailments23:08 Hormone Effects on Performance30:58 Menopause and Training37:48 Junk Miles and Training Intensity43:02 Lessons Learned and Personal Experiences46:13 The Female Athlete Triad and Stress Fractures49:28 Dairy, Pizza, and HRV50:07 Seeking Truth and Evolving as an Athlete52:05 Final Thoughts and Farewell
In this episode we're chatting with Dr. Nicky Keay, a medial doctor and sport endocrinologist, all about the role hormones play in health and performance. Dr. Keay shares her journey from aspiring professional dancer to a passionate hormone specialist, emphasizing the importance of "harnessing your hormones" to reach your goals. She covers topics like the role of hormones in health, misconceptions about carbohydrates, and the importance of balancing your behaviors. Dr. Keay also dispels myths surrounding insulin, oral contraceptives, testosterone injections, and eating for phases of the menstrual cycle. Additionally, she highlights the importance of recovery and sleep for athletes (and all active individuals)! Dr. Nicky Keay is an Honorary Clinical Lecturer in Medicine at University College London and previously Research Fellow in the Department of Sport and Exercise Sciences at Durham University. She conducts clinical research in sports/dance endocrinology, resulting a range of research publications and awards. She is a member of the British Association of Sport and Exercise Medicine and the British Menopause Society. She is also a speaker on Dance Endocrinology for National Institute of Dance Medicine and Science and International Association of Dance Medicine and Science. Her book “Hormones, Health and Human Potential: A guide to understanding your hormones to optimise your health and performance” informs how hormones play in important part in both our health and fitness. https://www.linkedin.com/in/nickykeay/ www.nickykeayfitness.com https://www.sequoia-books.com/catalog/keay/ 00:00 Introduction and Guest Introduction 00:12 Dr. Nikki Keys' Journey to Medicine 01:59 Understanding Hormones 02:29 Harnessing Hormones for Health and Performance 05:18 Writing the Book: Hormones, Health, and Human Potential 07:49 Debunking Hormone Myths 09:20 Practical Tips for Athletes 12:15 The Importance of Recovery and Sleep 16:40 Common Misconceptions About Hormones 35:54 Final Thoughts and Conclusion
In Episode 38 of The Sports Nutrition Playbook podcast, host Amy sits down with Dr. Jane Chung to explore the complexities of Relative Energy Deficiency in Sport (RED-S) and its impact on female athletes. They dive into the key differences between RED-S and the Female Athlete Triad, explaining how each condition uniquely affects young female athletes. Dr. Chung shares insights from her practice on the early warning signs of these conditions and the serious long-term health consequences if left untreated. The conversation emphasizes the importance of proper nutrition to prevent under-fueling, balancing the pressures of body image with the need for adequate energy intake. Dr. Chung also discusses the role of parents, coaches, and athletic trainers in proactively addressing these issues and offers guidance on developing effective treatment plans for athletes recovering from injuries related to under-fueling.Dr. Jane Chung's Bio - https://scottishriteforchildren.org/staff/our-experts/jane-s-chung Scottish Rite for Children - scottishriteforchildren.org/sports The Female and Male Athlete Triad Coalition https://femaleandmaleathletetriad.org/ Find a Sports Medicine Physician - https://femaleandmaleathletetriad.org/find-a-physician/ To learn more visit @thesportsnutritionplaybook and thesportsnutritionplaybook.com.Check out our YouTube channel for more sports nutrition tips and tricks. Have questions to ask our sports dietitians? email us at info@thesportsnutritionplaybook.com
In today's episode of The Female Fitness Podcast I have the pleasure of being joined by Dr Ash Cox who is the clinical lead at Red On, an Epidemiologist, Researcher, and Performance Analyst. Myself and Bec were introduced to Ash through the Red On event that we went to in Liverpool, and subsequent fitness testing that we had done over there (lactate threshold, back squat 1RM, vertical jump, and hand grip test). Today we chat about the fitness testing above and what the results mean/how they can be used in practice. We also discuss RED-S/the female athlete triad and the consequences of insufficient energy availability, whether there should be differences when it comes to programming between the sexes, whether we should program in line with the menstrual cycle, and so much more Whether you're a coach or someone interested in learning more about training for your own personal development this podcast is for you! Thank you so much for listening as always. I'd LOVE to hear from you whether this is your first listen or you've been here for years, so please drop me a message on instagram if you have any questions, requests, or feedback. I'd absolutely love to hear from you! Where you can find Ash: @dr_a_cox on IG @redonpc Resources: Athlete diet index tool: https://sportsnutritionassessment.com/adi/ Nutrition knowledge tool: https://sportsnutritionassessment.com/peaks-nq/ BJSM RED-S paper: https://bjsm.bmj.com/content/54/7/369 Female Cycle Training Considerations: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00346.2023 See you next week! Email: danni@thefemalefitnesscollective.com
Kelly Slovin is a Sports Dietitian and expert on Relative Energy Deficiency in Sport (REDs) with a background in helping athletes, and active individuals fuel their bodies for peak performance. After navigating her journey with hypothalamic amenorrhea (HA), which she now identifies as REDs, Kelly has become a passionate advocate for educating others about the critical importance of proper nutrition and menstrual health.In this episode, Kelly and I discuss the nuances of REDs, how it differs from the older concept of the Female Athlete Triad, why maintaining a regular menstrual cycle is vital for athletes, the detrimental effects of over-exercising and under-fueling, signs and symptoms of REDs to be aware of, challenges in researching female athletes, strategies for long-term management and prevention of REDs, and more. Enjoy the episode!To learn more, visit https://nicolejardim.com/podcasts/understanding-reds-what-active-women-need-to-know-kelly-slovin/.Podcast Production Support: Amazing Gains | https://listenerstoclients.comMentioned in this episode:Join the Fix Your Period CollectiveAre you ready to transform your menstrual health? Get started with the Fix Your Period Collective by taking my new and improved period quiz, which will translate your responses into a personalized period dashboard that gives you all the answers and solutions you've ever wanted for your cycle and hormone problems. Get started at https://fixyourperiod.com/quiz/.FYP Collective
It wasn't that many years ago that co-host Sara Gross was told by a coach that to perform better she needed to lean-up and lose additional weight — despite already training huge hours as a pro triathlete. Ultimately, she ended up in such an energy deficit that she collapsed and blacked out on the race course. This happens all-too-frequently across all levels of competition for female athletes, especially at the elite level. In this episode, Sara and Kelly delve into the critical topic of energy availability and fueling for female athletes - including the unique challenges women face. Female athletes are often encouraged to be lean, but not too lean. Muscular, but not too muscular. They should eat, but not too much. These societal pressures too frequently prioritize leanness over health, impacting not just athletes' well-being but also their performance. Additionally, long-term deficits in energy — ie. higher energy output than intake — can have bigger health impacts for women. The Female Athlete Triad, for example, refers to the interconnectedness of menstrual dysfunction, low energy availability, and decreased bone density. As a result, female athletes are much more susceptible to REDs (Relative Energy Deficiency in Sport) — which can lead to numerous health issues.This week's expert, Melissa Lodge from the FED Collaborative, discusses these challenges and the consequences of long-term energy deficiency.She also proposes several strategies to mitigate these risks, including: The need for a balanced approach to nutrition that supports both performance and health.A multidisciplinary approach involving coaches, nutritionists, and medical professionals to address the many aspects of underfueling.Continued education and resources around REDs and Low Energy Availability to promote sustainable performance.Standardized screening and assessment tools to detect early signs.The need for protocols and policies within organizations and governing bodies to promote fueling for female athletes.For more guidance, check out Feisty's Fueled educational course.Sign up to Receive The Feisty 40+ Newsletter:https://www.feistymenopause.com/blog/Feisty-40-plus Sign up to Receive The Feist Newsletter:https://www.womensperformance.com/the-feist Follow us on Instagram:@feisty_womens_performance Feisty Media Website:https://livefeisty.com/ https://www.womensperformance.com/ Support our Partners:Hettas: Use code FEISTY20 for 20% off at https://hettas.com/ Tifosi Optics: Use code FM20! for 20% off at https://tifosioptics.com/ The Amino Co: Shop Feisty's Favorite 100% Science-Backed Amino Acid Supplements. Enter code PERFORMANCE at Aminoco.com/PERFORMANCE to Save 30% + receive a FREE gift for new purchasers! MOTTIV: Get two months of full premium access with the code FEISTY at mymottiv.com
Dr. Joy is the Chief Medical Officer for Lore Health. Prior to that, she served as Senior Medical Director for Wellness and Nutrition at Intermountain Health in Salt Lake City, UT. She received her B.S. and M.D. degrees at the University of Minnesota, and M.P.H. from the University of Utah. She completed her Family Medicine Residency and Sports Medicine Fellowship at Hennepin County Medical Center in Minneapolis, MN. She is an adjunct faculty member at the University of Utah School of Medicine in the Department of Family and Preventive Medicine, and in the College of Health Department of Nutrition & Integrative Physiology. Dr. Joy is the Past President of the American College of Sports Medicine (ACSM), and the Female Athlete Triad Coalition. She Chairs the Exercise Is Medicine Governance Committee for the ACSM, and serves on the Board of Directors, and Chairs the Healthcare Sector for the National Physical Activity Plan. Her research interests lie in the areas of diabetes prevention, physical activity promotion, and the Female Athlete Triad.For information about my upcoming Online Yoga For Dudes, Brand-New Beginner's Course - email me directly at jpanasevich@gmail.com, or call or text me at 267.275.3890.
A new weight loss mindset is critical to navigating the shifting sands of midlife. Just eating less or in moderation might not work for us like it used to, and it's important to understand why. Instead of sticking to old ideas, we need to rethink how we approach food and weight loss. Let's talk about the myths that hold us back and discover the truths that can help us move forward. Starting with a new weight loss mindset is key. We can find better ways to take care of our bodies and manage weight. So when the doctor says, "Start with the mindset," believe it. It's true. My Guest: Dr. Ashley Lucas is the owner, founder and advisory consultant for PHD Weight Loss and Nutrition. She has over 15 years of education in the field of nutrition and metabolism. In her mid-20s, she retired from her professional ballet career. While understanding the importance nutrition played in her sports performance, she earned her Ph.D. in Sports Nutrition and Chronic Disease from Virginia Tech. Her research throughout her six-year post-graduate doctoral training focused on energy metabolism and the Female Athlete Triad. She was awarded the Academy of Nutrition and Dietetics Scholarship and completed her dietetic internship at The Ohio State University. She passed the national examination, which registered her as a dietitian offering expert food, wellness, and nutrition services. Dr. Lucas is a nationally renowned speaker, columnist, and leading expert in weight management and behavior change. Through a scientific method that focuses not only on the metabolic consequences of fat gain but also on the behavioral and psychological aspects, she created and continues to innovate the PHD Approach, which has helped thousands of people nationwide achieve their peak wellness once and for all. Questions We Answer in This Episode: What do we do at PHD? [00:04:29] Most common myths re: weight loss [00:19:11] 5 steps to reset the scale [00:23:02] Thoughts on Ozempic? [00:29:19] Connect with Dr. Ashley Lucas: Website: https://myphdweightloss.com/ On Social Instagram: https://www.instagram.com/dr_ashleylucas/ YouTube: https://www.youtube.com/@drashleylucas Resources: PHD Weight Loss Program: https://myphdweightloss.com/our-approach/ Academy of Nutrition and Dietetics Scholarship: https://www.eatrightfoundation.org/foundation/apply-for-funding/scholarships Other Episodes You Might Like: Midlife Weight Loss: Burn Body Fat, Balance Your Hormones https://www.flippingfifty.com/midlife-weight-loss/ The Genetics of Metabolism and Weight Loss for Women Over 40 https://www.flippingfifty.com/genetics-of-metabolism/ Why Menopause Weight loss is So Hard and How Your Brain is Taking Over https://www.flippingfifty.com/weight-loss-is-so-hard/
Girls and young women who specialize in sports and dance are vulnerable to the female athlete triad – an interconnected set of risks which include eating disorders, amenorrhea (loss of menstruation), and osteoporosis. We explore these issues and the reasons why they post long term physical and mental health dangers to young people. Even more, we examine how many of these risks are not particular to females, but affect male athletes as well.Show Notes:Go to FACTORMEALS.COM/puberty50 and use code puberty50 to get 50% off your order.Get 25% off your first order of Phyla, when you visit PhylaBiotics.com and use the code PUBERTY at checkout!Order our book This Is So AwkwardCheck out all of our speaking and consulting work at www.Orderofmagnitude.co and all our super comfy products at www.myOOMLA.comTo bring us to your school or community email communications@orderofmagnitude.coTo submit listener questions email thepubertypodcast@gmail.comWatch the full episode on Youtube!Produced by Peoples MediaTranscript Hosted on Acast. See acast.com/privacy for more information.
I am delighted to welcome Dr. Ashley Lucas back to the show today. Having her expertise and insights grace our platform again is wonderful. She is the owner, founder, and advisory consultant for PHD Weight Loss and Nutrition. She has over 15 years of education in the field of nutrition and metabolism. In her mid 20s, she retired from her professional ballet career. While understanding the importance nutrition played on her own sport performance, she went on to earn her PhD in Sports Nutrition and Chronic Disease from Virginia Tech. Her research throughout her six-year post-graduate doctoral training, focused on energy metabolism and the Female Athlete Triad. She was awarded the Academy of Nutrition and Dietetics Scholarship and completed her dietetic internship at The Ohio State University. She passed the national examination registering her as a dietitian offering expert food, wellness and nutrition services. Dr. Lucas is a nationally renowned speaker, columnist, and leading expert in the field of weight management and behavior change. Through a scientific method that focuses not only on the metabolic consequences of fat gain, but also on the behavioral and psychological aspects, she created and continues to innovate the PHD Approach which has helped thousands of people nationwide achieve their peak wellness once and for all. In this episode, Dr. Lucas comprehensively explores key factors influencing weight loss success and metabolic health. Dr. Lucas draws upon her expertise and research findings to shed light on the detrimental effects of extreme dietary habits and chronic mistreatment of metabolism. Despite the grim realities presented, she provides optimism by highlighting the possibility of rehabilitating a damaged metabolism. Additionally, Dr. Lucas dives into emotional barriers, emphasizing the power of mindset in achieving weight loss goals and cultivating supportive environments. She stresses the significance of quality sleep, exercise beyond weight loss, and informed consumption of food additives, advocating for stricter regulations. This approach underscores Dr. Lucas's holistic perspective on achieving overall wellness and sustainable weight loss.
欢迎收听跑者日历，本节目由【OUTOPIA品牌】独家冠名赞助播出！OUTOPIA 是一家专注于越野跑的户外服装品牌。OUTOPIA 注重物料开发。透过自然物料于纺织科技，打造最适合越野跑选手和户外爱好者的户外服装。=======================本期节目我们再次邀请到了运动医学硕士在读的王洋（大猫），以及 PB计划 的学员小谢（谢博士）来和大家一起讨论这一针对女运动员才会有的现象。希望通过她们的分享，能让更多的人认识且预防女运动员三联征的发生。如果发生了，也知道如何科学应对。三联征概念1992年美国运动医学会首先提出“女运动员三联征”概念。指女性运动员在能量供应、月经 功能和骨密度三者之间的相互关系、其临床表现为进食障碍、下丘脑功能性闭经、骨质疏松。运动员在健康和疾病之间在有一个较宽的过渡地带，大多数情况下，这三种症状不一定同时 出现，只要有 FAT 的任何一个征象，都应被视为该综合征的潜在风险人群。当每天获取的能量（摄入热量-运动消耗热量）少于30kcal/kg去脂体重时，就会出现由于能量供应低造成的很多负面影响。去脂体重：体重-所有脂肪成分。瘦体重：去脂体重+基本脂肪（大约占体重3%）更新概念：2014 年国际女性运动员三联征联盟申明，FAT是在女性运动人群中观察到涉及下列三个征象中任何一个的医学问题：伴有或不伴有饮食失调的低可用能量、月经紊乱、低骨密度。12014年国际奥委会更新——运动相对能量缺乏（尚存在争议）为了更准确地描述女运动员三联征的临床症状，2014 年国际奥委会引入一个更全面更广泛的术语即运动相对能量缺乏（relative energy deficiency in sport，RED-S）来说明能量利用的负平衡，用运动相对能量不足（RED-S）综合征来代替FAT。2 RED-S 导致的功能受损包括但不限于代谢率、月经功能、骨骼健康、免疫、蛋白质合成和心血管健康等方面[6]。男性运动员RED-S导致的低能量利用、低性腺激素和低骨密度现象同样十分常见，尤其是强调瘦体重为主的项目以及体重级别或耐力性项目，被描述为“男性运动性腺功能减退”（exercise-hypogonadal male condition，EHMC）或男运动员三联征（male athlete triad，MAT）34，但其临床表现没有女性运动员明显而常被忽视。国际奥委会的运动相对能量不足综合征不仅扩大了定义范围，且将两性均包括在内能量利用（EA）：健康成人每天 45 kcal/kg 去脂体重相当于能量平衡，对于从事体育活动的女性，建议每天至少 45 kcal/kg去脂体重的能量摄入以确保身体所有生理功能5。非故意低可用能量摄入常源于缺乏饮食知识，不知日需多少能量能满足生理功能和训练需求，或没意识到随运动水平提高和运动负荷上升而需相应增加能量摄入。长期可用能量降低会引起慢性疲劳，贫血，抑郁焦虑、免疫力降低。可用能量降低伴随的脂肪和糖类物质缺乏会导致激素及代谢异常、不良的 血脂检查结果和内皮功能紊乱，导致心血管疾病风险增加。饮食紊乱通常伴随的生理症状为：闭经、缺水、胃肠问题、低体温症、应力性骨折、体重快速减轻、肌痉挛/肌无力/ 肌疲劳、牙齿/牙龈问题等 。在能量供应不足的情况下，身体启动补偿机制并对能量进行重新分配，将有限的能量供给 分配到对其而言最重要的代谢活动中（如体温调节、细胞修护和移动），而相对不太重要的功能（如生殖功能）则会因能量不足受到影响。月经紊乱低能量利用首先扰乱下丘脑的促性腺激素（GnRH）释放激素的脉冲频率，随之引起垂体黄体生成素（LH）和卵泡刺激素（FSH）释放异常，继而导致卵巢分泌雌激素与孕激素异常，最终表现为月经紊乱。包括排除其他病理原因之后的继发性闭经（月经初潮后连续3个周期或6个月无月经来潮）、月经稀发（周期大于35天）、 无排卵月经、黄体功能失调（黄体期持续时间少于11天或者黄体期孕激素水平较低）等。月经紊乱通常是女性运动员能量危机的首要线索之一。恢复正常月经可能在 EA 改善后仍需一年以上的时间。低骨密度低能量利用和月经失调状态下，骨沉积减少，骨吸收增加，骨矿物质流失增多。如果 FAT 出现 在青少年时期，还将严重影响峰值骨量的形成，而这种影响是不可逆的，其后果便是骨质疏松和应力性骨折的增加。月经紊乱如不进行治疗，将以每年 2%～3%的速度丢失骨量。当出现三联征的一个征象时，应力性骨折发生率为15%～21%，出现2个征象时，骨折发生率为21%～30%，而三个征象同时出现时，应力骨折达29%～50%ACSM将低骨密度定义为Z评分－1.0至2.0间，骨质疏松为Z评分≤－2.0进食障碍伴随的许多心理障碍则需要特殊心理治疗。目前认为，下丘脑功能性闭经引起的骨 量丢失或骨代谢异常是不可逆或不完全可逆的。闭经的出现并不会立即造成骨质疏松症， 但会使骨密度朝着骨矿丢失的方向移动。恢复正常月经周期并不能立即恢复最佳的骨骼健 康状况，但骨矿沉积的增加，有利于改善其骨密度 。进食障碍还常常伴随心理问题如躯体自尊下降，抑郁，焦虑等 。供筛查与诊断的 临床建议实验室检查、心电图检查、骨密度检查（Dexa金标准）在出现明显三联征症状的情况下不建议继续维持当前的运动量及参加比赛低可用能量摄入的改善目标：恢复到月经正常的体重，建议BMI≥18.5 kg/m2月经紊乱改善：建议咨询医生并告知自己有能量摄入不足问题低骨密度改善建议：首要目标恢复正常月经周期，抗阻训练，检查维生素D含量后遵医嘱补充维生素D和钙，尤其是冬天日照不足或室内训练时间长、使用防晒霜的情况下参考文献(1) De Souza, M. J.; Nattiv, A.; Joy, E.; Misra, M.; Williams, N. I.; Mallinson, R. J.; Gibbs, J. C.; Olmsted, M.; Goolsby, M.; Matheson, G.; Expert Panel. 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference Held in San Francisco, California, May 2012 and 2nd International Conference Held in Indianapolis, Indiana, May 2013.Br J Sports Med2014,48(4), 289. https://doi.org/10.1136/bjsports-2013-093218.(2) Mountjoy, M.; Sundgot-Borgen, J.; Burke, L.; Carter, S.; Constantini, N.; Lebrun, C.; Meyer, N.; Sherman, R.; Steffen, K.; Budgett, R.; Ljungqvist, A. The IOC Consensus Statement: Beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S).Br J Sports Med2014,48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502.(3) Tenforde, A. S.; Barrack, M. T.; Nattiv, A.; Fredericson, M. Parallels with the Female Athlete Triad in Male Athletes.Sports Med2016,46(2), 171–182. https://doi.org/10.1007/s40279-015-0411-y.(4) De Souza, M. J.; Koltun, K. J.; Williams, N. I. The Role of Energy Availability in Reproductive Function in the Female Athlete Triad and Extension of Its Effects to Men: An Initial Working Model of a Similar Syndrome in Male Athletes.Sports Med2019,49(Suppl 2), 125–137. https://doi.org/10.1007/s40279-019-01217-3.(5) De Souza, M. J.; Koltun, K. J.; Etter, C. V.; Southmayd, E. A. Current Status of the Female Athlete Triad: Update and Future Directions.Curr Osteoporos Rep2017,15(6), 577–587. https://doi.org/10.1007/s11914-017-0412-x.=======================微博 / 小程序 / 服务号 / 小红书：@跑者日历公众号： 跑者日历RUN365各音频及播客平台：跑者日历跑者日历播客矩阵：跑者日历/装备说/PB计划/跑圈速递商务合作请添加微信号：janicegooner加入听众群：请添加客服微信号 run365cs=======================
Those undergoing IVF sometimes hear they shouldn't exercise or they might put the process at risk. However, we know a sedentary lifestyle isn't healthy for your fertility either. For many, exercise doesn't just keep their bodies healthy, it's also critical to managing stress, aiding with sleep, and managing mental health — which can also impact fertility. So how much exercise is too much when trying to conceive and in early pregnancy? In this episode, Dr. Shahine helps us understand the facts and decide what is right for your personal situation. In this episode you'll hear: [00:00] Intro [01:36] The controversy around exercise and fertility [02:38] Reviewing the research [04:01] Exercise during IVF – what's the worry? [07:50] Fertility Story: Exercise extremes, the stress of cutting back for many patients, and the Female Athlete Triad [12:09] Outro Resources mentioned: Studies mentioned referenced in these blog posts by Dr. Shahine My Recommendations on Exercise and Fertility IVF and Fitness: What You Need to Know Stay Up to Date in Fertility News and Events: Weekly Newsletter Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books
We wrap up season 1 of the Tread Lightly podcast by answering some of your questions! Eating disorders/disordered eating in younger athlete population (0:50) Can you go too easy/slow on your easy runs? (7:40) Reducing fiber intake around races (11:20) Gel recommendations for sensitive stomachs (16:00) Isotonic gels and carbohydrate absorption rates (21:25) Blackcurrant/CurraNZ supplements (25:00) Distance vs time when cross-training (29:00) Weekly runs when not training for a race (31:25) Our thoughts on Apple watches for running Strength training machines for runners (36:20) If you enjoyed this episode, you may also like: - Episode 29: Listener Q&A - Episode 10: How do you train when not preparing for a race? References: Jeukendrup & Gleeson. (2016). Sport Nutrition. 3rd Edition. Human Kinetics. PMID: 32460873 We will be taking a one-week winter break. We will return on January 6 with season 2! Thank you to everyone who listened - we appreciate you!
No doubt you too are trying to help clients combine intermittent fasting and exercise. I'm sure it's come up. You may be attempting to do it. You may know their doctor is suggesting it. But here's the incongruence for midlife women. Low Energy Availability (LEA) and exercising while fasting are one and the same. If you've been involved in fitness or nutrition for a minute, you know of the Female Athlete Triad. Generally, young active women essentially become menopausal when they should be having regular cycles because of energy insufficiency. LEA is right back to that and yet more detrimental for women over 40 trying to maintain muscle, also push performance, who can't afford to lose bone density but will, and have already depleted adrenals and hormone chaos occurring. In this episode, I respond to a question from one of our Food Flip programs. If you're helping clients, or yourself through the conflicting information on intermittent fasting and exercise, this may help. Right now, if you aren't yet, consider the Flipping 50 Menopause Fitness Specialist and kickstart your year with more knowledge about hormones, their function relative to exercise and understand when a client asks, what they should do, exactly how to help. Intermittent Fasting and Exercise for Midlife Women Polly, “Debra I have been wanting to incorporate fasting into my health regime. However with your current recommendations of working out in a fed state I have found it is very difficult to get enough protein and to maintain the fasted state. I read the book Feast Fast Repeat and it goes against a lot of the information you recommend. It's difficult for me to fast for 18 to 20 hours and feel good. Just wondering what your thoughts are on fasting?” Start earlier. It's pretty simple! You don't have “dinner” at dinner time.. You have a last high protein meal at 3 or 4pm. Fasting has a purpose. Getting off a plateau. You can kickstart with an 18 or 20 hour fast but there is NO reason if you're an active person to do this regularly. Rotate.., 12, 14, 15, 18 …. And the amount of carbs you do. If this was your first book? Keep reading. Your week should NOT ever look the same every day or you lose metabolic flexibility. If your goal is to stay active and gain muscle and bone density … tell me in a 20 hour fast how you manage to get micronutrients in. What we all have to do is prioritize. Are you inflamed? Need to reduce that and kick up the autophagy? Fasting for a short time may be your priority But high intensity exercise and fasting long are NOT going to coincide together well. That leaves you energy deficient. That puts you in stress. That causes a loss of muscle. Resources: WellPros Mentorship Group https://www.flippingfifty.com/store/uncategorized/fit-pros-health-coaches-monthly-membership-founder/ Your Business Scorecard: https://www.fitnessmarketingmastery.com/business-scorecard/ Flipping 50 Menopause Fitness Specialist™ Course: https://www.flippingfifty.com/menopause-fitness-specialist-program-2022/ Other Episodes You Might Like: Training Midlife Clients | Zone 2 Training For Menopause: https://www.fitnessmarketingmastery.com/zone-2-training-for-menopause/ 7 Tips to be a Personal Trainer Every Midlife Woman Wants to Work With https://www.fitnessmarketingmastery.com/be-a-personal-trainer/ 5 Menopause Exercise Programming Tips from Recent Exercise Studies https://www.fitnessmarketingmastery.com/menopause-exercise-programming/
Es kommt schleichend und kann jede:n treffen: das Energiedefizitsyndrom RED-S. Die Ursache: Zu viel Training, zu wenig Energiezufuhr. Betroffen sind vor allem Ausdauersportler:innen (nicht nur Frauen!) und die Symptome reichen von Hormonstörungen, Müdigkeit und Leistungsabfall bis hin zu Laufverletzungen und Ermüdungsbrüchen. Bei vielen Betroffenen bleibt es lange unentdeckt, weil immer noch zu wenig darüber aufgeklärt wird - und um das zu ändern, haben wir Sport- und Ernährungswissenschaftler Prof. Dr. Karsten Köhler in dieser Folge zu Gast. Wir erfahren nicht nur, was RED-S genau ist, sondern auch, wie wir uns als Hobbysportler:innen davor schützen können.(00:01:47) - Intro Ende(00:06:10) - Was ist RED-S? (ehem. "Female Athlete Triad")(00:11:22) - Sind Frauen häufiger von RED-S betroffen?(00:15:28) - Betrifft es auch Kinder und Jugendliche?(00:19:18) - Ursachen von RED-S(00:22:41) - Tritt RED-S nur bei Leistungssportler:innen auf?(00:27:40) - Sind normalgewichtige Sportler:innen weniger gefährdet?(00:29:15) - Symptome von RED-S: Leistungsabnahme?(00:34:00) - Welche Trainigsformen begünstigen RED-S?(00:37:19) - Auf nüchternen Magen laufen: Risiken(00:41:35) - Führt eine Lowcarb-Ernährung zu RED-S?(00:43:40) - Was sind Folgen von RED-S?(00:51:03) - Einfluss von RED-s auf die mentale Gesundheit(00:52:18) - Diagnose & Behandlung(01:01:26) - PräventionMusik: The Artisian Beat - Man of the CenturyFoto: TUM/HeddergottHier geht's zur Website von Prof. Dr. Karsten Köhler.Weitere Anlaufstellen für Betroffene:RED-S Sprechstunde bei Dr. Christine Kopp (Uni Tübingen)Charité Abteilung Sportmedizin (Berlin)Hier findet ihr unsere aktuellen Gewinnspiele & Rabatt-Aktionen! Hosted on Acast. See acast.com/privacy for more information.
In episode 22 of HUB Life, we dive into the world of female athletes, celebrating their remarkable strength and endurance. It's a story that defies the old narrative of "Man the Hunter" theory and instead, uncovers a tale of resilience, dedication, and the remarkable science behind it all.https://www.scientificamerican.com/article/the-theory-that-men-evolved-to-hunt-and-women-evolved-to-gather-is-wrong1/Join us as we cover the pivotal role played by estrogen in their journey toward excellence. We'll delve into the often-overlooked hormone, discovering how it becomes a game-changer in their athletic achievements. This episode will explore the physiological advantages of estrogen, its impact on long-term health, and why it stands as a crucial component in the performance of female athletes.We'll also shed light on the Female Athlete Triad, a syndrome that casts a shadow on the long-term health and performance of female athletes. Throughout the episode, we'll emphasize the critical importance of meeting the energy demands of rigorous training to ensure that estrogen levels remain strong, contributing not only to their physical well-being but also to their success in sports.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702454/We celebrate all the female warriors who continually push boundaries and redefine the possibilities in the world of sports.
Discuss the etiology of relative energy deficiency in sport (RED-S) and the female athlete triad, the evaluation and treatment of a patient suspected of having RED-S and/or the female athlete triad, and return to play process after a diagnosis of RED-S/female athlete triad Timestamps 2:27- What are RED-S and the female athlete triad 6:38- Consequences of RED-S 8:34- RED-S and the female athlete triad 15:00- The male athlete triad 19:43- Evaluation and treatment of RED-S and the female athlete triad 26:22- Multidisciplinary approach to treatment 32:00- Return to play guidelines -- ARTICLE CITATIONS used for this episode: https://atcornerds.wixsite.com/home/blog AT CORNER FACEBOOK GROUP: https://www.facebook.com/groups/atcornerpodcast Instagram, Website, YouTube, and other links: atcornerds.wixsite.com/home/links EMAIL US: atcornerds@gmail.com SAVE on Medbridge: Use code ATCORNER to get $150 off your subscription SAVE on Precision AT: Use code ATCORNER for 15% off all home study courses Music: Jahzzar (betterwithmusic.com) CC BY-SA CEU Quiz & Course Evaluation: https://www.precisionat.com/product-page/relative-energy-deficiency-in-sport-and-the-female-athlete-triad-where-are-we Season 1 CEU Multi-pack: Get all of your season 1 CEUs in one pack! CEUs brought to you by Massachusetts General Brigham Massachusetts General Brigham (#P8644) is approved by the Board of Certification, Inc. to offer continuing education for Certified Athletic Trainers. -- -Sandy & Randy
This week Riley & Dawsen want to discuss the elephant in the room, or dance studio for that matter, which is female health. So fellas, feel free to stay and be educated, but this is a chat for the GIRLS! Riley & Dawsen start conversation about their experience with the Female Athlete Triad, advocating for your body, being on the pill, and habits that have helped them take care of their health as female dancers. We believe there needs to be space to advocate for the female athletic body and this episode is exactly that. Disclaimer: We are not medical professionals. Please seek your doctor or medical professional about any questions or concerns. We are simply speaking from personal experience and sharing what we have learned from extensive research at the university and 1-on-1 work with our nutritionists, athletic trainers, therapists, and OBGYN's. --- Send in a voice message: https://podcasters.spotify.com/pod/show/dancerschoicepodcast/message
Clinical Journal of Sport Medicine - The Clinical Journal of Sport Medicine Podcast
We review a study published in the July 2023 issue of CJSM with the senior author Emiley Sweeney, MD, pediatric sports medicine physician at the University of Colorado. The study evaluated the association between disordered eating, menstrual irregularity, and injury in collegiate gymnasts. We also spoke with CJ Keuneke, current elite level 10 gymnast, and her mother, Kelly Carfora, former gymnast at the University of Michigan about their experiences.
Female Athlete Triad (FAT)….do you know what it is or what the potential health and running performance implications are of this syndrome? You are not alone…many runners, and athletes in general, have very little knowledge of FAT and how nutrition and energy availability may impact its development. So, here we update you on the current research into FAT syndrome and outline some recommended nutritional approaches to help reduce the risk of it becoming a concern for you!A BIG thank you to our Show Sponsor AMAZING JANE ACTIVE WEAR. Please use discount code RHH10 for 10% off ALL purchases at www.amazingjane.com SHOW NOTES(04:03)Outlining WHY we are talking about this subject:FAT is a syndrome that is known to be prevalent in runnersTo educate our listeners and followers on this condition and the signs and symptoms to observe for, in themselves or in fellow runners, so they can take actionFAT focuses on JUST the female athlete…therefore research is carried out on female athletes only, which is rareTo highlight a 2022 research paper, which focuses on aspects of FAT in RECREATIONAL female runners, which is also rare! (06:29)Defining FAT, which is a syndrome that was first acknowledged in 1992. At this time, it was understood to be a condition found in girls and women and consisting of THREE interrelated conditions(10:27)Outlining some of the key findings from recent research into FAT Syndrome. Some of the observations include:Low energy availability could occur intentionally or unintentionallyEarly recognition of LEA in female athletes and an understanding of FAT syndrome and its progression is really paramount in preventing the short- and longer-term health consequences of itOnly one component of the Female Athlete Triad needs to be evident in order for FAT to be established (15:54)Outlining the highlights from a 2022 research paper looking at FAT in recreational runners, all of which were related to menstruation. The researchers found that female recreational runners: Had fewer regular monthly cycles per yearTheir menstrual bleeding was shorterThey had slightly more spotting between menstrual periodsThey had cycles every 24 days (which was more than the control group experienced)(19:18)FEMALE FACTORSThe only observation the 2022 research paper mentioned was that:Older runners are less likely to experience menstrual disorders besides their younger counterparts The difference was quite significant at 67% of younger runners vs only 9% of older runners experiencing menstrual disordersThe study did not state at what age the participants were recognised as “old” but the oldest participants were approx. 40yrs of age (23:19)Highlighting some dietary and nutritional observations from the 2022 research paper on female recreational runners including: recreational runners following a “special diet” e.g. paleo, ketogenic, vegetarian showed higher incidence of amenorrhoea (absence of menstrual cycle) besides those following a “normal” diet(35:10)Looking at ideas and strategies to put into place to help limit the risk of FAT Syndrome becoming a concern for you including:Think about the following questions:• Do you frequently train and forget to eat immediately...
Have you found yourself "stuck" with dieting and aren't sure how to go about eating more? In this episode, you will learn:What influences your metabolism and some steps to increasing itWhy 1200 calories is not enough foodThe dangers of under eating and what can happen from increasing food too fastThe mental struggle of increasingSurprising benefits of eating more food APPLY FOR COACHING HEREFOLLOW ON IG
Today Blu interviews Drew Mulvey MS, CDN, CNS, CLT, PNL1, CISN. Drew graduated Summa Cum Laude from the University of Bridgeport with a Master of Science in Human Nutrition in 2018 and received a Bachelor of Arts in Biology in 2012. She is currently certified by the state of Connecticut as a Certified Dietitian/Nutritionist as well as a Board-Certified Nutrition Specialist, Certified Leap Therapist, Precision Nutrition Level 1 Coach, NASM Certified Personal Trainer, Certified Integrative Sports Nutritionist, and has her own practice Redeeming Life Nutrition, LLC. Drew has gained her nutrition experience working in several arenas including weight loss clinics, personal training, interning under a naturopathic doctor, through her personal practice, and a competitive residency program under a functional medicine nutritionist. She prides herself in helping active women transform their mindsets and beliefs around food, find their true selves, and empower them to ignite their true athletic potential. Her passion stems from my struggles with disordered eating and multiple health battles during my teens, such as Fibromyalgia, Chronic Fatigue Syndrome, Autoimmunity, and bulimia. In her twenties, from overactivity and disordered eating patterns known as orthorexia, she developed the Female Athlete Triad, a complex stemming from low energy intake and leading to a loss of menses and decreased bone density. All these significantly impacted on her athletic career and could have all been avoided. She decided to enroll in her Master of Nutrition program so that her eyes were open to other avenues such as Naturopathic Medicine, Acupuncture, Nutrition, Supplementation, Food Sensitivity Testing, Traditional Chinese Medicine, and Mindset Reformation. By incorporating these principles, entering a 12-step program known as Celebrate Recovery, and reshaping her relationship with food and herself; she was able to break the chains of disordered eating and regain her athletic ability back. Today, she has now found a deep passion for endurance sports and has an Ironman 70.3 set in her future endeavors. Her goal is to get to the root cause of the problem spiritually, emotionally, and physically to create new foundations, leading these women to transformation and success in their athletic careers and their lives. It is an incredibly individualized approach that captures their strengths and uses them to "break the cycle."
Drew Mulvey MS, CDN, CNS, CLT, PNL1, CISN Drew Mulvey graduated Summa Cum Laude from University of Bridgeport with a Master of Science in Human Nutrition in 2018 and received a Bachelor of Arts in Biology in 2012. She is currently certified by the state of Connecticut as a Certified Dietitian/Nutritionist as well as a Board-Certified Nutrition Specialist, Certified Leap Therapist, Precision Nutrition Level 1 Coach, NASM Certified Personal Trainer, Certified Integrative Sports Nutritionist, and has her own practice Redeeming Life Nutrition, LLC. Drew has gained her nutrition experience working in several arenas including weight loss clinics, personal training, interning under a naturopathic doctor, through her personal practice, and a competitive residency program under a functional medicine nutritionist. She prides herself in helping active women transform their mindsets and beliefs around food, find their true selves, and empower them to ignite their true athletic potential. Her passion stems from my struggles with disordered eating and multiple health battles during my teens, such as Fibromyalgia, Chronic Fatigue Syndrome, Autoimmunity, and bulimia. In her twenties, from overactivity and disordered eating patterns known as orthorexia, she developed the Female Athlete Triad, a complex stemming from low energy intake and leading to a loss of menses and decreased bone density. All these significantly impacted on her athletic career and could have all been avoided. She decided to enroll in her Master of Nutrition program so that her eyes were open to other avenues such as Naturopathic Medicine, Acupuncture, Nutrition, Supplementation, Food Sensitivity Testing, Traditional Chinese Medicine, and Mindset Reformation. By incorporating these principles, entering a 12-step program known as Celebrate Recovery, and reshaping her relationship with food and herself; she was able to break the chains of disordered eating and regain her athletic ability back. Today, she has now found a deep passion for endurance sports and has an Ironman 70.3 set in her future endeavors. Her goal is to get to the root cause of the problem spiritually, emotionally, and physically to create new foundations, leading these women to transformation and success in their athletic careers and their lives. It is an incredibly individualized approach that captures their strengths and uses them to "break the cycle."
You don't want to miss this! Special guest episode with my past client Eliza. In this open, raw, real conversation - we discuss the biggest fears of recovering from disordered eating, detaching your identity from struggling, why dieting keeps you stuck and so much more! APPLY FOR COACHING: https://www.emmysyummysnutrition.com/Instagram: https://www.instagram.com/emmysyummys/
In this episode of the Female Athlete Nutrition, I sit down with a leading expert in bone health and female athletes, Dr. Emily Kraus. Dr. Kraus is also the Director of the Stanford Female Athlete Science And Translational Research (FASTR) Program. Together we chat about the basics of bone health and its interplay with the Female Athlete Triad, Relative Energy Deficiency in Sport (RED-S) and Low Energy Availability. Nutrition and bone health are closely linked, and Dr. Kraus and I discuss bone-related consequences of underfueling like bone stress injuries, fractures, and missing periods. Dr. Kraus explains the involvement of hormones in RED-S, bone health and injuries. We highlight warning signs of underfueling and imbalanced hormones in all athletes, like missing periods, known as amenorrhea, and reduced libido, as well as the importance of addressing these to maintain bone health and prevent injuries . We touch on supplementation and medical treatments for improving bone health, debunking myths about calcium pills, contraceptives and hormonal therapies. Dr. Kraus is a world-renowned researcher in the field of athlete health and we discuss her latest project: The Healthy Runner Study. Dr. Kraus shares insights gained about the bone health of high performing female athletes, screening tools and red flags for identifying at-risk individuals, and strategies for preventing injuries and improving performance. We talk nutrition for bone health and healing from RED-S, as well as other potential causes of injury like training errors, biomechanics, and improper equipment. Dr. Kraus and I reflect on personal experiences as underfueled athletes and the negative impacts they had on our health and performance. We finish off with the usual end of the podcast questions and how listeners can find out more about Dr. Emily Kraus and her incredible work. For more on Dr. Kraus' current work, check out the Stanford Female Athlete Science And Translational Research (FASTR) Program https://fastr.stanford.edu/ where Dr. Kraus is the Program Director. https://www.elitecompetitor.com/ and access her free training for moms of athletes www.trainhergame.com Follow Dr. Emily Kraus on Twitter @emilykrausmd and Instagram @emilykrausmd and @emilykrausmd_sportscience and me, your host Lindsey Cortes, @female.athlete.nutrition We have a huge announcement! We are launching patreon! Female Athlete Nutrition podcast patreon is now LIVE and we are excited to offer our community unique perks. Join today and receive bonus episodes, merch, monthly recipes, access to an exclusive community message board, and have the chance to ask Lindsey your questions and get a podcast shoutout, and more! Head to patreon today patreon.com/femaleathletenutrition Need help with your fueling? Want to get in touch with Lindsey? Interested in the Female Athlete System of Transformation? Head to www.RiseUpNutritionRUN.com to learn more & book a call! THANK YOU TO OUR SPONSORS: Previnex: https://www.previnex.com/ use code RISEUP for 15% off at checkout InsideTracker: www.insidetracker.com/riseup for 20% off the entire store for a limited time only! THIS PODCAST IS ALSO SUPPORTED BY: Orgain, head to www.orgain.com and use the code RISEUP30 for 30% off your first order. Repeat customers can use the code OA2203 for 25% off future orders. Practice Better Click the link below to view plans and get a 14-day free trial. Then use the code RISEUP20 for 20% off your first 4 months: https://practicebetter.grsm.io/runp Jen & Keri: https://jenandkeri.com/ use code RISEUP10 for $10 off your order In this episode we talk about: 1:40 About this episode 6:40 Understanding bone health and growth 10:40 Calcium supplements and nutrition for bone health 11:50 RED-S, energy balance, and their impacts on hormones and bone 19:50 The power of the menstrual cycle; Amenorrhea and missing periods 23:30 Underfueling, hormonal imbalances, injuries and impaired bone health: red flags and warning signs in athletes 27:10 Treating RED-S, missing periods, and poor bone health; Contraceptives and hormonal therapies 32:45 The Healthy Runner Project: understanding and preventing bone injuries in athletes 45:25 Bone injuries and stress fractures 49:25 Personal experiences as underfuelled athletes 53:35 End of the podcast questions; Where to find Emily
Do you feel like you have made some progress in your recovery and are not as "bad" as you used to be... but are feeling like you hit a plateau with your journey to a healthy relationship with food. Today we get in to what it looks like being in quasi recovery and why this is important to know. Apply to Nourished to ThriveFollow on InstagramWebsite
Do you believe that you are addicted to sugar? Let's unpack WHY you might feel like you are addicted to sugar and how restriction plays a role in feeling out of control with food. Links:Join The Nourished to Thrive CommunityFollow Emily on Instagram
Fuel the Routine: Unlocking Optimal Performance + Recovery with Nutrition
Welcome to the Fuel the Routine, a five-episode series dedicated to unlocking optimal performance and recovery with nutrition. My goal during this series is to break down how to fuel your gymnast and help them learn to use nutrition to support their performance and their longevity in the sport WITHOUT the stress or overwhelm with actionable steps you can start immediately. During this episode, I'll teach you why what your gymnast eats isn't actually the issue, and what really is. In this episode we cover:• 3 case studies of gymnasts struggling with different symptoms, but same cause [0:19]• The Female Athlete Triad vs Relative Deficiency in Sport (RED-S) [5:18]• RED-S effects on an athlete's heath and performance [6:32]Connect with me:Instagram: https://www.instagram.com/the.gymnast.nutritionist/Website: https://christinaandersonrdn.com/
Today, I am blessed to have here with me Dr. Ashley Lucas. She is the owner, founder and advisory consultant for PHD Weight Loss and Nutrition. She has over 15 years of education in the field of nutrition and metabolism. In her mid 20s, she retired from her professional ballet career. While understanding the importance nutrition played on her own sport performance, she went on to earn her PhD in Sports Nutrition and Chronic Disease from Virginia Tech. Her research throughout her six-year post-graduate doctoral training, focused on energy metabolism and the Female Athlete Triad. She was awarded the Academy of Nutrition and Dietetics Scholarship and completed her dietetic internship at The Ohio State University. She passed the national examination registering her as a dietitian offering expert food, wellness and nutrition services. Dr. Lucas is a nationally renowned speaker, columnist, and leading expert in the field of weight management and behavior change. Through a scientific method that focuses not only on the metabolic consequences of fat gain, but also on the behavioral and psychological aspects, she created and continues to innovate the PHD Approach which has helped thousands of people nationwide achieve their peak wellness once and for all. In this episode, Dr. Lucas discusses the inspiration behind her studies in what happens to our bodies when we continually undereat. Then, Dr. Lucas explains how burning sugar is just like constantly stuffing wood into a fireplace. Plus, Dr. Lucas talks about visceral fat and how it can prevent you from reaching your ideal health goals. Tune in as we chat about the importance of mindset on your health journey, finding mindfulness to make the best meal choices and all about the PHD Weight Loss Program. 90 Day Detox Program: http://www.ketokampdetox.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E S P ON S O R S Good Idea Functional Sparkling Water Drinks. Visit http://www.goodidea.us and use the coupon code BEN at checkout. Get Bioptimizers Magnesium Breakthrough for the best night of sleep, ever! Nurture your mind and body with this all-natural, full-spectrum magnesium supplement. Visit www.magbreakthrough.com/ketokamp and use code ketokamp10 for 10% off. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. [00:40] The Inspiration Behind Studying What Happens To The Body When We Undereat Lucas had some challenging times while training as a classical ballet dancer. She struggled to make her body do what it needed to do. As a result, Dr. Lucas had major stress fractures in her back and had stress fractures in her feet. To be healthy, Dr. Lucas would eat five grams of fat a day. After going to a doctor, she found out that she was over-exercising and not eating enough. Eventually, Dr. Lucas earned her Ph.D. in sports nutrition and chronic disease. She wanted to study what happens to the body when we undereat. [08:30] How Burning Sugar Is Like A Wood Fireplace Generally, we are carbohydrate or sugar burners. Carb burners are like wood-burning fireplaces. You constantly have to stuff wood in it, so it doesn't burn out. When people have to eat every three hours, they are running out of sugar to keep their energy up. Fat-burning is like a propane tank; it can go for hours or maybe days. Every cell in the body prefers to burn fat for its fuel. [13:15] What Exactly Is Visceral Fat and What You Need To Know About It Visceral fat isn't something you can see or pinch. Visceral fat actually fills up in the organs. This fat really gets in the liver. Visceral fat grows its own blood vessels, and it starts to secrete its own hormones. The number one goal of visceral fat is to grow larger. This type of fat will wake you up in the middle of the night and send you to the fridge to eat something. It secretes aromatase, which increases the risk for breast cancer significantly. Overall, visceral fat messes with every aspect of our bodies. [20:30] How To Stop Your Yo-Yo Dieting Habits The first thing you need to do is to recognize why the yo-yo is happening. When you start to lose weight, you will feel better. However, you will still have excess fat that's active and metabolically working against you. When you have that excess fat, your risk of weight regain is really high. You need to understand the importance of fully collapsing the fat mass and getting the body truly where it needs to be. As we age, we're not supposed to get fatter. We actually tolerate fat less because fat is toxic. The next step is to get accountability and get support. [26:50] About PHD Weight Loss and How The Program Works Check out PHD Weight Loss: https://myphdweightloss.com/ First, Dr. Lucas will determine your fat mass and customize a meal plan to fit your goals. They like to provide 85% of their client's food. That way, you can break sugar addiction, and there will be no withdrawals. 80% of weight loss comes from mental and emotional aspects. Overall, the PHD weight loss program is a multi-therapeutic approach. [34:55] How We Create Better Stories That Are Going To Serve Our Health and Our Future You only have to tell yourself something 50 times before you create a neural pathway. We get locked into these stories that we tell ourselves. There's also so much fear wrapped around losing weight. The body can go down physically in weight, but if it's not accompanied by mental and emotional work, that weight loss will not stay. [40:50] Why Dr. Lucas Hates The Term “Cheat Meal” A cheat meal will make you feel full of shame and guilt. Instead, you should enjoy the food and feel good about it. Your new diet will be a new lifestyle. So, you're never “cheating.” What good are you gaining from cheating on yourself? Remember, eating is not about feeling bad! [46:45] Are You Really Hungry? Find Mindfulness To Make The Best Decision Understand the different aspects of what common triggers of overeating or binging can be. When you're having problems with food, bring yourself to the present moment. If your emotions are out of whack, then you may find yourself eating something. Being tired is another trigger for making bad choices when it comes to food. The evening meal can be the hardest when you're tired. Instead, bring yourself to the present moment and find some sort of mindfulness. That way, you can decide what will make you feel the best. AND MUCH MORE! Resources from this episode: Check out PHD Weight Loss: https://myphdweightloss.com/ Follow Dr. Lucas on Instagram: https://www.instagram.com/dr_ashleylucas/ Follow PHD Weight Loss Facebook: https://www.facebook.com/PHDWeightLoss/ Instagram: https://www.instagram.com/PHDWeightLoss/ YouTube: https://www.youtube.com/channel/UCS0GA_W0c21QulWop-EkUdQ Take the Metabolic Quiz: https://myphdweightloss.com/the-phd-story/ Call PHD Weight Loss: 800.674.8991 Join theKeto Kamp Academy: https://ketokampacademy.com/7-day-trial-a WatchKeto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ 90 Day Detox Program: http://www.ketokampdetox.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E S P ON S O R S Good Idea Functional Sparkling Water Drinks. Visit http://www.goodidea.us and use the coupon code BEN at checkout. Get Bioptimizers Magnesium Breakthrough for the best night of sleep, ever! Nurture your mind and body with this all-natural, full-spectrum magnesium supplement. Visit www.magbreakthrough.com/ketokamp and use code ketokamp10 for 10% off. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.
RED-S, LEA, The Female Athlete Triad, Overtraining, Overreaching, Underfueling…These words and acronyms are pervasive in endurance sports circles but, quite frankly, still cause much confusion and debate. Often, they are mistakenly used interchangeably when the definitions and symptoms do differ significantly.Today's guest, Dr. Alex Coates, demystifies each of these concepts and explains them in a way that all active people can understand in order to remain healthy and active throughout their lives.Dr. Coates is a postdoctoral fellow at McMaster University where she studies systems-level integrative exercise physiology. As a former elite triathlete at the national level, Alex trained and raced on multiple world championship teams and saw first-hand the repercussions of what would eventually become her areas of primary focus - overtraining, underfueling, and insufficient recovery from training.In fact, she and her sister, Kyla, actually were one of the first to document the existence and definition of RED-S, or Relative Energy Deficiency Syndrome, which presents in both men and women.In this episode, she and Sara discuss:The differences in the terms Female Athlete Triad, RED-S, and Low Energy AvailabilityWhy the Female Athlete Triad needed an update to include RED-SThe multiple hormonal symptoms of RED-S and the personal impact it had on Alex's sister, KylaThe nuances of LEA and RED-SThe differences between overtraining and overreaching and the ability to recover (or not)The impact of underfueling on recovery on all types of performanceAn outline of The FUELED course modules, including the body's various energy systemsFemale Athlete Development from Puberty to AdulthoodDr. Coate's work hopefully connects the dots for any athlete suffering from extreme fatigue, thermal regulation issues, performance plateaus, and other hormonal imbalances that may be brought on by extreme training.Alex is also the lead Exercise Physiologist on the Feisty FUELED course that is launching in April. To learn more visit fueledcourse.comFueled: A comprehensive nutrition course for active women by Feisty Media | Register Nowfueledcourse.com Download the Feisty Female Athlete Guide:https://www.womensperformance.com/ Learn More about the Feisty Kona Tri-Cation:https://www.feistytriathlon.com/trication Follow us on Instagram:@feisty_womens_performance Feisty Media Website:https://livefeisty.com/ Support our Partners:The Amino Co: Shop Feisty's Favorite 100% Science-Backed Amino Acid Supplements. Enter code PERFORMANCE at Aminoco.com/PERFORMANCE to Save 30% + receive a FREE gift for new purchasers! InsideTracker: Get 20% off at insidetracker.com/feisty Previnex: Get 15% off your first order with code PERFORMANCE at https://www.previnex.com VJ Shoes: Use code FEISTYVJ for $20 off a pair of shoes at https://vjshoesusa.com/pages/feisty
Similar to my own journey, Eden has had her own journey in disordered eating recovery and transitioning from selling weight loss to intuitive eating coaching. If you want to hear more about the important revelations that led to Eden's decision, plus how sports nutrition fits into intuitive eating, you cannot miss this week's episode! Eden is a registered dietitian, former collegiate athlete turned mountain athlete, recovered disordered eater, and Intuitive Eating counselor (in training - she's in the process of becoming a Certified Intuitive Eating Counselor). Eden majored in Psychology at Texas A&M, and after she was diagnosed with Female Athlete Triad in 2012, she decided to combine her undergraduate degree with a Master's Degree in Nutrition and Dietetics from Georgia State University. For Eden, the overlap between our psychological health and our nutrition choices is way more important than "eating healthy." Now, Eden helps active individuals realize that a fueled body performs better than a starved body, confidence comes from body acceptance (not weight loss), and we are capable of so much more than we realize when we finally stop trying to shrink our bodies and our personalities to please others. In this episode we discuss: Eden's journey growing up as an athlete, becoming a college athlete and then choosing dietetics as a profession. How athletics influenced her disordered eating, including her diagnosis of Female Athlete Triad. Eden's decision recently to leaving selling a popular weight loss program and what led to that decision. Red flags Eden indicates that the weight loss program wasn't true “food freedom” as its often promoted. 1-2 tips for how to approach sports nutrition from an intuitive eating lens. How Eden lives wellness without obsession. Learn more from Eden: Email: eden@tetonperformancenutrition.com, Social media handles: @gardenofeden_rd (Instagram) @gardenofeden_rd (TikTok) Eden's Weekly Newsletter: Pocket Snacks Fearlessly Fueled Society, Eden's signature 8-week Intuitive Eating program, starts March 7th! You can learn more about business mentorship here, I currently have two spots for business mentorship open for March! Right now, we are currently booking March spots for private coaching! Private coaching is the highest level of care we offer at Nourishing Minds Nutrition, and is certainly the fastest way to reach your goals of food and body peace, leaving food (and wellness) obsession behind in 2023. Resources for you: Join our FREE support group for like-minded women, the Nourishing Women Community for more community & support. Take a look at our online shop, the Wellness Without Obsession Shop to have all the resources you need to make peace with food and your body, and live wellness without obsession. Interested in private coaching? Click here to learn more about our breakthrough sessions and 3 and 6 month packages. Let's hang out! Connect with Victoria and the staff at NMN: Victoria's Instagram Victoria's Website Nourishing Minds Nutrition Instagram Nourishing Minds Nutrition website
Www.Run4prs.com for a free week or personalized workouts! Many people show off their monthly mileage totals on social media. It is a great way to track your progress in some respects, but in other respects, it is easy to get ‘caught up in the numbers game' of running. Two runners of the same abilities might run vastly different peak mileages in marathon training yet run the same finishing time. It is less about what your weekly mileage is and more about finding the sweet spot of mileage for you during this season of your training. 1. Progressive overload: more usually is better until it's not 1. Aerobic base: science Legendary coach Arthur Lydiard's philosophy was that it all starts with mileage. That's because endurance training stimulates many physiological, biochemical and molecular adaptations. All his training programs would consist of an 8-10 week base building phase. 1. stimulates more fuel (glycogen) to be stored in your muscles 2. increases the use of intramuscular fat at the same speed to spare glycogen 3. improves your blood vessels' oxygen-carrying capability by increasing the number of red blood cells and hemoglobin 4. creates a greater capillary network for a more rapid diffusion of oxygen into the muscles 5. increases mitochondrial density and the number of aerobic enzymes through the complex activation of gene expression. This increases your aerobic metabolic capacity. 2. Time of feet: science Time on Feet follows the principles of Lydiard training to reach peak performance. This is achieved by using a systematic approach to training. The emphasis is on conditioning in the early stages of a programme, in order to give the individual a feeling of a 'tireless state.' This is looked at as a crucial phase if achievements are to be made later. 2. There becomes a point where running more is not productive 1. Overtraining signs Constant niggles Feeling run down Mentally feeling down in the dumps Train smarter not harder: How much running can you physically and psychologically handle? For example, the mitochondrial enzyme content of rats has been shown to reach its maximum adaptation with running 60 minutes per day, five days per week. A study published in European Journal of Physiology in 1998 on horses training for 34 weeks found that increases in muscle fiber, # of capillaries number of capillaries per fiber plateaued after 16 weeks of training. After the first 16 weeks, the horses were divided into two groups: a control group and an overload training group, which trained with higher mileage. Both groups increased mitochondrial volume and VO2 max with the increased mileage over the next 18 weeks, but there was no difference in those variables or in muscle fiber area and capillarization after 34 weeks despite the two-fold difference in training volume between groups over the final 18 weeks. Clearly, there is a limit to muscles' adaptive response to training. If you look at the training data of elite athletes, you find that the optimum training volume for the world's best athletes lies somewhere between 75 and 110 miles per week What is REDS syndrome? Relative Energy Deficiency in Sports (RED-S) syndrome, or what's more commonly known as the Female Athlete Triad. Not eating appropriately for the amount of energy an athlete expends
Do you ever feel like you are addicted to exercise? Is it hard for you to take days of working out? Are you unsure of what is too much exercise? Today we are discussing some of the sneaky signs you may have an unhealthy relationship with exercise and some tips to help you overcome this. LET'S WORK TOGETHER: https://www.emmysyummysnutrition.com/FOLLOW ON IG: https://www.instagram.com/emmysyummys/
In this weeks epiosde, Han is joined by Elle Kelly. Elle is a registered sport, eating disorder, and disordered eating dietitian. Elle works with clients with eating disorders and disordered eating to improve their relationship with food, and has excellent knowledge on this specifically in the athletic community. As we move into a challenging time of year, where diet and gym culture thrive, we thought it would be good to navigate these challenges together and the impact of certain behaviours. In this weeks episode, we discuss:Navigating the festive period, and the movement into the new year, and how to work through the normalisation of disordered eating behaviours. The difference between eating disorders and disordered eating, and how disordered eating has become normalised in society. The presence of disordered eating in sports and athletes, and the difficulty of identifying this due to external pressures, goals, training routines etc. The prevalence of eating disorders in lean vs non-lean and weight vs non-weight dependent sports.The Female Athlete Triad and Low Energy Availability (LEA) in athletes, what it is, how this can present, and the long term impacts of these issues. To find out more about Elle, you can find her on Instagram @ellekellynutrition or visit her website https://www.eknutrition.com/.Please note that this podcast discusses a number of eating disorder and disordered eating behaviours that some individuals may find challenging. Please tread lightly and check in with yourself along the way. It should also be noted that this podcast should not be replaced by clinical support.
In this episode, I sit down with recurring guest and fellow Rise Up Nutrition dietician Jenna Stranzl. Jenna is a marathon runner, doggie lover, registered dietitian and sports nutritionist. We revisit a topic at the heart of Riise Up Nutrition, relative energy deficiency in sports (RED-S). This is a topic I first covered way back on episode 2, “What is RED-S?”, which I recommend you check out, alongside episode 5 “Eating Disorders, To Exercise or Not to Exercise?”. First, Jenna and I breakdown relative energy deficiency in sport, defining key characteristics like underfueling and energy needs for athletes. We discuss how RED-S differs from the female athlete triad: all genders, body sizes, and ability of athletes can be diagnosed with RED-S, highlighting the key signs and symptoms, touching on the importance of working with a dietitian throughout the diagnosis and recovery processes. In the second part of this episode, Jenna and I each talk about our own journeys with nutrition and exercise: from past eating disorders, disordered eating and exercise patterns, RED-S and poor health, to finding food freedom and joyful relationships with movement. We leave listeners with a promise that RED-S recovery IS worth it and you will be better off for it! We're here to help you or anyone you know overcome nutrition-related and fueling concerns, reach out and start your path to recovery now! For more on RED-S, check out episode 2 “What is RED-S?” https://podcasts.apple.com/us/podcast/what-is-red-s/id1537395854?i=1000499401138 And episode 5 “Eating Disorders, To Exercise or Not to Exercise?” https://podcasts.apple.com/us/podcast/eating-disorders-to-exercise-or-not-to-exercise/id1537395854?i=1000501202202 Follow Jenna on Instagram @_jennalee @glycojennalysis and me, your host Lindsey Cortes, on Instagram @female.athlete.nutrition Need help with your fueling? Want to get in touch with Lindsey? Interested in the Female Athlete System of Transformation? Head to www.RiseUpNutritionRUN.com to learn more & book a call! THANK YOU TO OUR SPONSORS: InsideTracker: www.insidetracker.com/riseup for 20% off the entire store for a limited time only! THIS PODCAST IS ALSO SUPPORTED BY: Orgain, head to www.orgain.com and use the code RISEUP30 for 30% off your first order. Repeat customers can use the code OA2203 for 25% off future orders. Practice Better Click the link below to view plans and get a 14-day free trial. Then use the code RISEUP20 for 20% off your first 4 months: https://practicebetter.grsm.io/runp In this episode we talk about: 5:00 What is relative energy deficiency in sports (RED-S)? How does RED-S differ from the Female Athlete Triad? 8:00 Understanding energy balance, energy availability, and nutritional needs for athletes 11:00 Signs and symptoms of underfueling 12:50 Broadening the diagnosis criteria: RED-S can occur at any weight, age, and performance level 17:00 Bringing men into the conversation: all genders can suffer from RED-S 19:30 Diagnosing RED-S and the importance of working with a sports dietitian. Nuances of RED-S, within day energy deficits and accidental underfueling. 24:15 What we mean by “underfueling”, with or without RED-S 29:30 Nutrition fundamentals and guardrails to avoid underfueling 31:00 Weight loss and underfueling 40:30 Jenna's personal experience with weight gain: coping with the RED-S recovery process and body changes 42:15 Optimal health and fitness comes in different body shapes, sizes, and weights 44:05 Eating disorders and disordered eating 48:15 Jenna's past experiences with eating disorders, disordered eating, and RED-S. Relapse, diet culture, marathon training, ADD/ ADHD, and comparison to a younger self. 57:15 Lindsey's past experiences with nutrition and exercise, potential RED-S and disordered eating beginning in high school. From injuries and an eating disorder, to underfueling for athletics, to stopping exercise and gaining weight. 1:05:05 Gut health as a symptom of RED-S and underfueling 1:05:55 The importance of RED-S awareness and diagnoses for recovery 1:06:55 Exercise during and after RED-S recovery 1:09:00 You can feel better! RED-S recovery IS worth it!
Susan Sotir, PhD coaches with Breakthrough Performance Coaching, she has a PhD in Sport Physiology and Exercise Psychology and is an assistant professor at Springfield College. Susan brings over 25 years of experience in sport coaching. She has worked with endurance athletes of all levels from recreation to competitive to professional athletes. She is a Level III triathlon coach with USA triathlon. Susan was a DIII swimmer at Tufts University and her first triathlon was in 1989. Since then, she has raced triathlons from sprint to IRONMAN distances, some years racing near the front. She is a certified strength and conditioning coach (NSCA-CSCS), and is a Precision Nutrition Certified Coach. In addition to sport coaching, Susan serves as a consultant for elite athletes and coaches developing and integrating mental skills into sport practice and performance. We have a conversation about psychological factors that typically impact athlete performance, and some of the mental skill building approaches she employs to help athletes. We talk about the heightened awareness on providing tailored training and racing protocols for female athletes and considerations she explores with female athletes. (e.g., 28-day cycle, menstruation, contraception implications, Female Athlete Triad, RED-S, menopause, and perimenopause). Dr. Sotir weighs in on the question of sports physiology research being conducted on mostly men and the resulting impact on the solutions for women. Dr. Sotir gives her advice on improving swimming skills for triathletes, pool swimmers and open water swimmers and some of the tactics and strategies she uses with athletes. Finally, we talk about strength, nutrition, and body composition and how she approaches the conversation with athletes, and what she recommends, if anything, through the training cycle. About Susan Sotir, PhD and Breakthrough Performance Coaching https://breakthroughperformancecoaching.com/coaches/susan-sotir/ Twitter https://twitter.com/spsotir Instagram https://www.instagram.com/team_bpc/ Follow Us:Facebook: https://Facebook.com/EventHorizon.TvTwitter: https://twitter.com/EventHorizonTvInstagram: https://instagram.com/eventhorizon.tvYouTube: https://youtube.com/c/EventHorizonTvSupport Us:https://Patreon.com/Endurancehttps://paypal.me/EnduranceExperience
Sports medicine physician Aubrey Armento, MD, and sports nutritionist Amanda McCarthy discuss treatments for Female Athlete Triad in part 3 of our 3 part interview.
Dr Richard Lehman is joined by Bob Ramsey to discuss the Female Athlete Triad. What is it, and how can women avoid suffering from this disorder.
The Female Athlete Triad is important to consider for ortho PAs and NPs treating athletes. Sports medicine physician Aubrey Armento, MD, and sports nutritionist Amanda McCarthy cover more on disordered eating and bone health in part 2 of a 3 part interview.
What does low energy availability mean and how is it relevant in the female athlete triad? In Part 1 of 3, Sam speaks with sports medicine physician Aubrey Armento, MD, and sports nutritionist Amanda McCarthy about what to look for as ortho PAs and NPs treating athletes.
In episode 134, Kirsty Elliott-Sale, Professor of Female Endocrinology and Exercise Physiology at Manchester Metropolitan University, joins us. Specifically Kirsty will be looking at: Impact of the menstrual cycle in sport Key phases and their importance in sport How/whether to adjust training around the menstrual cylce About Kirsty "I completed my undergraduate degree and PhD [Exercise Physiology] at Liverpool John Moores University. My PhD examined the effects of female reproductive hormones on muscle strength and since then my work has primarily focused on female athletes. I worked as a Lecturer at Brunel University and the University of Brighton, before undertaking a four-year Post-Doctoral Research Fellowship at Kings College London. I worked at Nottingham Trent University between 2009 and 2022. I joined the Institute of Sport at Manchester Metropolitan University this year as a Professor of Female Endocrinology and Exercise Physiology. In addition to my research on female athletes, which includes the menstrual cycle, hormonal contraceptives, the Female Athlete Triad and Relative Energy Deficiency in Sport, my work in recent years has involved designing and implementing exercise interventions during and following pregnancy in a variety of populations including servicewomen (i.e., military personnel), athletes, and women with obesity. I have co-authored numerous peer-reviewed journal articles, book chapters, expert statements, and editorials on/for sportswomen. In addition, I work with many organisations such as the English Institute of Sport, the Football Association, The Australian Institute of Sport, The European Club Association, and The Wu Tsai Performance Alliance and am on several special interest groups and advisory boards related to female athletes." Twitter: @ElliottSale FREE 7d COACH ACADEMY TRIAL SIGN UP NOW: https://bit.ly/sfsepisode134 Learn Quicker & More Effectively, Freeing Up Time To Spend With Friends And Family Optimise Your Athletes' Recovery Position Yourself As An Expert To Your Athletes And Naturally Improve Buy-In Reduce Your Athletes' Injury Ratese Save 100's Of Dollars A Year That Would Otherwise Be Spent On Books, Courses And More Improve Your Athletes' Performance Advance Forward In Your Career, Allowing You To Earn More Money And Work With Elite-Level Athletes Save Yourself The Stress & Worry Of Constantly Trying To Stay Up-To-Date With Sports Science Research
Authors: K.J. Pantano
I had a completely different topic I planned on talking about in today's episode but after seeing countless Q&A questions and reflecting on my own experience with today's topic, this felt too important not to talk about today. I see many women specifically come into the Level TEN coaching community that have chronically dieted for years (much like I did) and think the issue is overtraining. The REAL issue we're facing is under-recovery and I have a great model and examples to explain this concept and a lot more! Time Stamps: (0:40) Implications of Long Term Dieting (3:06) Under-Recovery vs Overtraining (4:40) My Past Issues with Missed Periods (5:45) Betty the Client Example (7:24) Signs of Poor Recovery (8:45) RED-S and Female Athlete Triad (16:54) Quick Side Story (25:10) RED-S and Menstral Cycle Issues (28:20) Primal Instincts Kicking In (33:07) Telling the Body It's Safe (34:25) More Rest and Recovery (36:40) My Woo Woo Side is Coming Out (40:47) Everyone Is Different (44:00) Leave You With This Message --------------------- Check Out the RED-S Graph Mentioned in the Episode - https://bjsm.bmj.com/content/bjsports/49/7/421.full.pdf --------------------- Where You Can Find Me: @joellesamantha Nutrition & Fitness Coaching: @leveltencoaching Fitness Coaching Software: @fitcoachpro
If you menstruate and have ever experienced pain or discomfort associated with your cycle, you've likely been told that it's normal, and to take hormonal birth control as a treatment option. While this is certainly a viable and beneficial option for some, for others this answer can feel dismissive, especially if you're looking to avoid hormonal birth control or want to dig into WHY you're experiencing these symptoms. These experiences can leave those seeking to better understand their bodies feel as though they have no control, and in a society where access to reproductive care (and even information) is increasingly hamstrung, this loss of control is especially disempowering. Enter Lisa Hendrickson-Jack. She's a Holistic Reproductive Health Practitioner and Fertility Awareness Educator, and in 2019 she sat down with Erin to get into the nitty gritty of everything you ever wanted to know about your period. Tune in to hear Lisa highlight why your cycle is a vital sign, the role blood plays, what's considered “normal” with periods and PMS, how to know your fertile window, differences in birth control options, and how cycle tracking can not only give you insight into your reproductive and overall health, but also help you plan your life. Whether you're trying to get pregnant, trying to NOT get pregnant, or just trying to understand your body better, this is an especially relevant episode that offers up powerful information to take charge of your fertility. Reproductive health affects EVERYONE, so share this episode with anyone you care about! In this episode: -When things feel out of control [1:29] -Additional fertility resources [5:09] -All about Lisa [15:24] -The power of cycle tracking [17:05] -What is a vital sign? [19:02] -What does it mean when you skip periods [23:03] -The Female Athlete Triad [24:03] -Osteoporosis risk factors [25:40] -What a normal, healthy cycle looks like (and why you need to know) [28:06] -Why PMS is NOT NORMAL [30:22] -What to do if you have severe cramping and bleeding [37:11] -How your diet and personal care products contribute to your PMS symptoms [41:00] -How to start paying attention to your cycle [47:03] -The best ways to track ovulation [54:16] -The best ways to track your hormones [56:46] -3 main signs of fertility [57:57] -Rhythm Method vs. Fertility Awareness Method [1:01:46] -IUDs and Copper IUDs [1:07:43] -Using your cycle to plan your life [1:15:44] FOR OUR FULL LIST OF LINKS + RESOURCES, HEAD TO: https://www.thefunktionalnutritionist.com/podcast/213-understand-your-cycle
In this episode, Founder of Enhanced Recovery After Delivery™, Dr. Rebeca Segraves, Co-Founder of Entropy Physiotherapy, Dr. Sarah Haag, Owner and Founder of Reform Physical Therapy, Dr. Abby Bales, and Co-Owner of Entropy Physiotherapy, Dr. Sandy Hilton, talk about the consequences of overturning Roe v. Wade. Today, they talk about the importance of taking proactive measure in communities, and the legal and ethical obligations of healthcare practitioners. How do physical therapists get the trust of communities who already don't trust healthcare? Hear about red-flagged multipurpose drugs, advocating for young people's education, providing physical therapy care during and after delivery, and get everyone's words of encouragement for healthcare providers and patients, all on today's episode of The Healthy, Wealthy & Smart Podcast. Key Takeaways “Our insurance-based system is not ready to handle the far-reaching consequences of forced birth at a young age and botched abortions.” “We do need to know abortive procedures so that we can recognize when someone has been through an unsafe situation.” “We really need to take into consideration the ramifications of what this will do.” “This is not good healthcare and we need to do more.” “We're going to have to know our rules, our laws, and what we're willing to do and go through so that we can provide the care that we know our patients deserve.” “We're looking at the criminalization of healthcare. That is not healthcare.” “We know who this criminalization of healthcare is going to affect the most. It's going to affect poor, marginalized people of color.” “We can no longer choose to stay in our lane.” “We need to have a public health physio on the labour and delivery, and on maternity floors.” “We don't get to have an opinion on the right or wrongness of this. We have a problem ahead of us that is happening already as we speak.” “We need to create more innovators in our field, and education is the way to do that.” “This is frustrating and new, and we're not going to abandon you. We're going to figure it out and be there to help.” “Our clinics are still safe. We are still treating you based on what you are dealing with, and we will not be dictated by anybody else.” “If you need help, there is help.” “If we believe in the autonomy of an individual to know all of the information before making a decision, then we still believe in the autonomy of an individual to know all of the information that is best for their body.” “This affects everyone. We're dedicated to advocating for you.” More about Dr. Rebeca Segraves Rebeca Segraves, PT, DPT, WCS is a physical therapist and Board-Certified Women's Health Clinical Specialist who has served individuals and families within the hospital and home during pregnancy and immediately postpartum. She has extensive experience with optimizing function during long-term hospitalizations for high-risk pregnancy and following perinatal loss and pregnancy termination. In the hospital and home health settings, she has worked with maternal care teams to maximize early recovery after delivery, including Caesarean section, birth-related injuries, and following obstetric critical care interventions. She is the founder of Enhanced Recovery After Delivery™, an obstetrics clinical pathway that maximizes mental and physical function during pregnancy and immediately postpartum with hospital and in-home occupational and physical therapy before and after birth. Her vision is that every person will have access to an obstetric rehab therapist during pregnancy and within the first 6 weeks after birth, perinatal loss, and pregnancy termination regardless of their location or ability to pay. More About Dr. Sarah Haag Dr. Sarah Haag, PT, DPT, MS graduated from Marquette University in 2002 with a Master of Physical Therapy. She went on to complete Doctor of Physical Therapy and Master of Science in Women's Health from Rosalind Franklin University in 2008. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women's and men's health, becoming a Board-Certified Women's Health Clinical Specialist in 2009 and Certification in Mechanical Diagnosis Therapy from the McKenzie Institute in 2010. Sarah joined the faculty of Rosalind Franklin in 2019. In her roles at Rosalind Franklin, she is the physical therapy faculty liaison for the Interprofessional Community Clinic and teaching in the College of Health Professions. Sarah cofounded Entropy Physiotherapy and Wellness with Dr. Sandy Hilton, in Chicago, Illinois in 2013. Entropy was designed to be a clinic where people would come for help, but not feel like ‘patients' when addressing persistent health issues. More About Dr. Abby Bales Dr. Abby Bales, PT, DPT, CSCS is the owner and founder of Reform Physical Therapy in New York City, a practice specializing in women's health and orthopedic physical therapy. Dr. Bales received her doctorate in physical therapy from New York University and has advanced training through the renowned Herman and Wallace Pelvic Rehabilitation Institute, Grey Institute, Barral Institute, and Postural Restoration Institute, among others. She also holds her Certified Strength and Conditioning Specialist certification from the NSCA and guest lectures in the physical therapy departments at both NYU and Columbia University, as well as at conferences around the country. Dr. Bales has a special interest in and works with adult and adolescent athletes with a history of RED-S (formerly known as the Female Athlete Triad) and hypothalamic amenorrhea. A lifelong athlete, marathon runner, and fitness professional, Dr. Bales is passionate about educating athletes, coaches, and physical therapists about the lifespan of the female athlete. Her extensive knowledge of and collaboration with endocrinologists, sports medicine specialists, pediatricians, and Ob/gyns has brought professional athletes, dancers, and weekend warriors alike to seek out her expertise. With an undergraduate degree in both pre-med and musical theatre, a background in sports and dance, 20 years of Pilates experience and training, Dr. Bales has lent her extensive knowledge as a consultant to the top fitness studios in New York City and is a founding advisor and consultant for The Mirror and the Olympya app. She built Reform Physical Therapy to support female athletes of all ages and stages in their lives. Dr. Bales is a mom of two and lives with her husband and family in New York. More About Dr. Sandy Hilton Sandra (Sandy) Hilton graduated with a Master of Science in Physical Therapy from Pacific University in 1988. She received her Doctor of Physical Therapy degree from Des Moines University in 2013. Sandy has contributed to multiple book chapters, papers, and co-authored “Why Pelvic Pain Hurts”. She is an international instructor and speaker on treating pelvic pain for professionals and for public education. Sandy is a regular contributor on health-related podcasts and is co-host of the Pain Science and Sensibility Podcast with Cory Blickenstaff. Sandy was the Director of Programming for the Section on Women's Health of the American Physical Therapy Association from 2012 - 2017. She is now on the board of the Abdominal and Pelvic Pain special interest group, a part of the International Association for the Study of Pain. Suggested Keywords Healthy, Wealthy, Smart, Roe v Wade, Abortion, Trauma, Sexual Trauma, Pregnancy, Advocacy, Pelvic Health, Healthcare, Education, Treatment, Empowerment, To learn more, follow our guests at: Website: https://enhancedrecoverywellness.com https://enhancedrecoveryafterdelivery.com https://www.entropy.physio https://reformptnyc.com Instagram: @sandyhiltonpt @reformptnyc @enhancedrecoveryandwellness Twitter: @RebecaSegraves @SandyHiltonPT @Abby_NYC @SarahHaagPT LinkedIn: Sandy Hilton Sarah Haag Abby Bales Rebeca Segraves Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts: https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify: https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927 Read the Full Transcript Here: 00:07 Welcome to the healthy, wealthy and smart podcast. Each week we interview the best and brightest in physical therapy, wellness and entrepreneurship. We give you cutting edge information you need to live your best life healthy, wealthy and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now, here's your host, Dr. Karen Litzy. Hey everybody, 00:36 welcome back to the podcast. I am your host, Karen Litzy. And on today's episode, I am very fortunate to have for pretty remarkable physical therapists who also happen to be pelvic health specialists. On to discuss the recent Supreme Court ruling in the dobs case that overturned the landmark ruling of Roe vs. Wade. How will this reversal of Roe v Wade affect the patients that we may see on a regular basis in all facets, facets of the physical therapy world. So to help have this discussion, I am very excited to welcome onto the podcast, Dr. Rebecca Seagraves and Dr. Abby bales and to welcome back to the podcast Dr. Sandy Hilton, and Dr. Sarah Hague. So regardless of where you fall on this decision, it is important that the physical therapy world be prepared to care for these patients. So I want to thank all four of these remarkable physical therapists for coming on to the podcast. Once the podcast starts, they will talk a little bit more about themselves, and then we will get right into our discussion. So thank you everyone for tuning in. And thanks to Abby, Rebecca, Sandy, and Sarah. 02:03 I, my name is Rebecca Seagraves, I'm a private practice pelvic health therapist who provides hospital based and home based pelvic health services and I teach occupational and physical therapists to provide their services earlier in the hospital so that women don't have to suffer. 02:20 Perfect Sarah, go ahead. 02:22 I am Sarah Haig. And I'm a physical therapist at entropy physiotherapy in Chicago, and I'm also assistant professor and at a university where I do get to teach a variety of health care providers. 02:35 Perfect, Abby, go ahead. My name is Abby bales. I'm a physical therapist, I specialize in pelvic health for the pregnant and postpartum athlete. I have my practice in New York City called perform physical therapy, and I do in home visits and I have a small clinic location. 02:54 Perfect and Sandy. Go ahead. 02:56 Sandy Hilton. I'm a pelvic health physical therapist. I'm currently in Chicago with Sara entropy. And I'm in Chicago and online. Because we can see people for consultations wherever they are, and we may be needing to do more of that. 03:13 So the first question I have for all of you lovely ladies, is how will the recent Supreme Court ruling in the dobs case, which was overturning Roe v. Wade? How is that going to affect people who give birth that we see in our clinics in the hospital setting in an outpatient setting in a home setting? So let's start with Sara, go ahead. I'll start with you. And then we'll just kind of go around. And and and also feel free to chime in and you know, the conversation as you see fit? Got? 03:58 That's such a big question. And I get to go first. So the question was how, how is this decision going to affect people who give birth? And I would say it just it affects everyone in in kind of different ways. Because I would say what this will undoubtedly do is result in us seeing people who didn't want to give birth. And and I think, you know, the effects of that are going to be far reaching and that we I think maybe we in this little group can have an idea of, of the vastness of this decision, but I think that even we will be surprised at what happens. I think that how it will affect people who give birth. Gosh, I'm kind of speechless because there's so many different ways. But when we're looking at that person in front of us with whatever they need to do For whatever they need assistance with after giving birth, we're going to have to just amplify exponentially our consideration for where they are and how they felt going into the birth, how they got pregnant in the first place. And, and kind of how they see themselves going forward. We talk about treating women in the fourth trimester. And it's, I mean, I'm in that fourth trimester, myself, and I can tell you that it would be harder to ask for help. And I'm really fortunate that I, that I have that I do have support, and that I do have the ability to seek help. I have a million great friends that I can reach out to for help, but I'm just how the how it's gonna affect the women, I'll say, I'm scared, but it's not about me. I'm very concerned for other women who won't be able to access the care that they that they need. 06:05 Yeah, Sandy, go ahead. What do you think? How do you feel this decision will affect people who can give birth, especially as they come to see physical therapist, whether that be during pregnancy? As Sarah just said, the fourth trimester, or perhaps after a procedure, or abortion that maybe didn't go? Well? Because it wasn't safe? 06:30 Yeah, so I work a lot with pain. One of my concerns is, but what is the future gonna hold for some people who did not want to be pregnant not added some sort of convenience or concern for finances, both of which, you know, your spot in life determines whether or not you have the the ability to raise another person at that moment. So there are individual decisions that people should make, in my opinion, but also, there's the if something happens to you, that you did not give permission to happen. And then you are dealing with the consequences. In this instance, pregnancy, and you happen to have back pain or have hip pain, or have a chronic condition, or a pelvic pain history, where you didn't not want to be pregnant. How's that going to affect the pain and the dysfunction that you're, you are already happening? And will it sensitize people to worse outcomes and recovery afterwards, because this is a, you know, there's a perceived injustice scale, I want to pull that back out. I hadn't been using it very often in the clinic just didn't seem to change the course of care. But I think that when I'm working with the people pre post, during pregnancy, I think I'm going to pull my perceived injustice scale back out and see if that might be a nice way to find out. If I need to hook someone up to a counselor, a financial counselor, psychologist, sexual therapist, anyone who might be able to support this person, we already don't have good support systems for pregnancy. I just am astounded at how much what a bad choice it is to add more need to a system that isn't currently handling the demand. I know we're gonna need to get creative because these people will need help. But I am a little awestruck at the possible quantum s we're gonna walk into 08:51 an abbey you had mentioned before we started recording about you know, some of the folks that you see that may have a history of different kinds of trauma, and how that may affect their abilities are to kind of wrap their head around being pregnant and then being forced to give birth because now they don't have any alternative. So how do you feel like that's going to play out in the physical therapy world, if they even get to physical therapy if they even get to a pelvic health therapist? 09:34 Yeah, that's, that's one of the things that I was I was thinking about as everyone was chiming in was, we really are just at the precipice in our niche of our profession, where people who give birth are seeking or even hearing about pelvic health and postpartum care, pregnancy care there. Just barely hearing about it. And my I have, you know, a concern, a very deep concern that these people will go into hiding if they have had an abortion in the past, because are we obligated to report that, and what is the statute of limitations on that, and the shame that they might feel for having had an abortion, or having had give birth and didn't want to, and the trauma that my patients who have, for the most part, not everyone who have wanted pregnancies that either the birth is traumatic, the pregnancy is traumatic, they get to a successful delivery, or they have a loss during the pregnancy, the trauma that they are experiencing, and for the most part, I'm seeing adults, and I cannot comprehend children, because it's this gonna be a lot of children who are forced to give birth, or who are having unsafe abortions, and the trauma that they're going to experience, and how, how much it takes for a person who has sexual trauma or birth trauma to get to my clinic, how these young people how these people who feel that shame, I don't know how they're going to get to me, or any of us, except for a real team based approach with pediatricians, with hospitals, with OB GYN, with your gynecologist with people who might see them first before us. I just don't know how they get to us to be able to treat and help treat that trauma. And like Sandy said, that pelvic pain that might be a result of the trauma if if it's unwanted sexual intercourse, I just don't know how we get to them. And that is something that we struggle with now, with, for the most part, wanted pregnancies. And I don't know how we get there. And I don't think we're prepared as a profession. for that. I think the advocacy for getting ourselves into pediatricians offices into into family medicine offices, is going to be so crucial in getting to these patients. But there aren't enough of us. We are not prepared. And our insurance based system is not ready to handle the far reaching consequences of forced birth at a young age and botched abortions. It is not ready to handle that. 12:52 Rebecca, go ahead. I'm curious to hear your thoughts around this because of your work in acute care systems. 13:00 Absolutely. I believe that I'm beyond the argument of whether this is right, or whether this is wrong. I think that as a profession, we're going to have to quickly change to a mindset of can we be prepared enough to handle what Abby was saying the amount of trauma, the amount of mental health I think, comes to mind when when someone's autonomy is taken away from them in any regard. I was very vocal as to how dangerous it was to force, you know, mandates on people even last year. And now here we are, we're at a point in our profession where we have to now separate our own personal beliefs and be committed to the oath of doing no further harm because this will result in harm, having treated individuals after an unplanned cesarean section or a cesarean hysterectomy, because of severe blood loss. They had no choice in those procedures. And they had no choice in the kind of recovery or rehabilitation they would get. I had to fight an advocate for our services, physical and occupational therapy services to be offered to individuals. So when you're looking someone in the eye who has lost autonomy over their body as last choice has gone through trauma that changes you it changes me really as a profession, even on this a professional or even on this issue. I'm now pivoting as quickly as I can't decide, do I have the skills that's going to be needed to address maybe hemorrhage events from an unsafe abortion that's performed? Maybe the mental health of having to try All across state lines so that you can find a provider that will treat you maybe the, you know, the shame around, you know, even finding Well, you know, is there a safe space for me to be treated for my pelvic health trauma from you know, maybe needing to carry this pregnancy longer than then I would have wanted to, there's, there's so much around this that we really have to start looking at with a clinical eye with a very empathetic or sympathetic eye as pelvic health therapists because of the fact that there's so few of us. And because now we're in a scenario where there will be more people who will be needing services but not knowing who to turn to. So my my biggest hope from this conversation, and many more that we'll have is that there's some how going to be a way to designate ourselves as a safe space for anyone, no matter what choice they've made for their body, period, I'm really done with being on one end of the spectrum with this, I'm a professional that doesn't have that opportunity to just, you know, be extreme on this, I advocate for the person and for their choice over their body period. 16:17 I think we need to, and it's just beautifully, beautifully said, the the getting getting some small systemic procedures in place in the communities we live in, is most likely the first step is reach out to the pediatricians and the chiropractors and the massage therapists and the trainers and the school athletic trainers and whoever you find that can have a connection with people and let them know on an individual basis. So like how do you tell people hey, I'm a trustworthy clinic to come to is not usually by writing it on your website. But if you can make connections in your community and be a trusted provider, that's going to go further, I suspect. I'm assuming there's going to be a fair bit of mistrust. And we have to earn it once it's lost. We've got to earn it back. So yeah, I like the proactiveness of that. 17:22 I, I totally agree on something you said Sandy sparked something that I would love for a health care lawyer to start weighing in on is we want, I am a safe space. I think every patient I have ever met who sees me cries. And I hold I hold that part of what I do. Very close to me, it's it's an honor to be someone that my patients open up to. And I know all of you on this call feel the same way because we we are that place that they they I love hearing birth stories. I love it. Even it just gives me an insight into that person into that experience. I feel like I'm there with them. And I understand better what they have gone through. But what happens when the legal system is going to come for us? Or them through us? What happens to that? How do we continue to be a safe space where they can share their sexual trauma, their birth trauma, their birth history, their pregnancy history, their menstruation, history, their sexual history? All of those really, really intimate things? How do we continue to be that for our patients? 18:56 I think we've had to do this I've had to do this previously, for in some very, in situations of incest in for the most part, we need a trigger warning on this. But, you know, there you have an individual that is a minor, or, or for some reason not independent that is being abused in what is supposed to be their safe space. And then that person, the abuser can be like, Oh, look, I'm helping you get better. And they're actually not safe. So there's some things and if the person you're treating is a minor, that adult has access to their records. And so I've worked in places not I don't know how to do with an EMR but I've worked in places where we have our chart that we write down the official record and sticky notes, which are the things that will not get put in the official record. But we need to have written down so people know it. And we've had to do that in situations where the patient wasn't safe. We all knew the patient wasn't safe. was being worked on to get them safe, but they were not yet safe. And you had to make sure there was nothing in their records that was going to make them more unsafe. I don't know how to do it as an EMR, if someone has a clever way to do that, that'd be great. Or we go back to EMR plus paper charts. 20:18 Even to to add to your point, Abby, if we're looking now at possible, you know, jurisdiction, you know, lead legal their jurisdiction or subpoena of documentation, you know, after having intervened for someone who may have had to make a choice that their state did not condone? Yeah, no, I, I'm completely, you know, on guard against that now, and that those are things that I'm thinking about now and thinking about, well, what would my profession do? Would we back, you know, you know, efforts on Capitol Hill to advocate for, you know, someone who, who has lost their, their autonomy, or lost their ability to, to at least have a safer procedure, and we've had to intervene in that way. You know, I think about that now, and I, that makes me fearful that this is such a hot topic issue that, you know, we might not as an organization want to choose size, but we as professionals on the ground as pelvic health therapists, I don't think that we have that luxury and turning someone away. And so So yeah, I think more conversations like this need to be had so that we can form a unified front of at least, you know, pelvic health specialists that can really help with the the after effects of this. 21:38 And I think a big barrier to that legal aspect of it is, you know, what is our legal responsibility. And what happens, if we don't do XYZ is because a lot of the laws and a lot of these states, some of these trigger laws and other laws being that are being passed, the rules seem to be a bit murky. They're not clear. And so I agree, I think the APTA or the section on pelvic health needs to come out with clear guidelines as to what we as healthcare professionals, can and should do. But here's the other thing that I don't understand and maybe someone else can. What about HIPAA? Isn't that a thing? Where did the HIPAA laws come in to protect the privacy between the provider and the patient? And I don't know the answer that I'm not a lawyer, but we have protection through hip isn't that the point of a HIPAA HIPAA laws? I don't know what 22:44 you would think so. But unfortunately, one of the justices who shall not be named has decided that abortion does not fall under HIPAA, because it involves the life of another being in so I can only state what has been stated or restate. But yes, the those are the very things that I'm afraid we're up against as professionals. 23:12 Yeah, I think they're going to try to make us mandatory reporters. for it. I think they're gonna try to make all healthcare we are mandatory. For some things, the thing that's good for some things. Yeah, the 23:24 thing that bothers me about that is the where I'm in Illinois right now, Illinois is a designated, look, we're not, we're not going to infringe on people's right to health care. Just great. But some of the laws and I've lost track, I was trying to keep track of how many have are voting on or have already voted on laws that would have civil penalties, penalties of providers from other states, regardless of the Practice Act of that provider, to be able to have a civil lawsuit against that provider. So that's fun. And then we go back to what ABBY You had mentioned before we started recording about medicine, that that is considered an abort efficient, I have a really hard time with that word. But that is also used for other conditions that we see in our clinics for pain for function and things like that. And then where's our role? 24:33 Right, so does someone want to talk about these more specific on what those medications are and what they're for? So that people listening are like, Okay, well, what medications, you know, so do you want to kind of go into maybe what those medications are, what they're for and how they tie back into our profession. Because, you know, a lot of people will say, well, this isn't our lane. So we're trying to do these podcasts. so people understand it's very much within our lane. 25:03 Well, I yeah, it's just from a pharmacology standpoint, the one of the probably most popular well known drugs that's used for abortion is under the generic name of Cytotec misoprostol, and that's a drug that's not only only used for abortion, but if individual suffers a miscarriage is used to help with retained placenta and making sure that the uterus clears. What other people don't know is is also used for induction. So the same drug is used for three or four different purposes. It's also used for postpartum hemorrhage. So measle Postel, or Cytotec is a drug as pelvic health therapists we should be very familiar with. And we should be familiar with it. Not only you know, for, you know, this this topic, but it's also been a drug that's been linked with the uterus going into hyperstimulation. So actually putting someone at risk for bleeding too heavily. And all of this has a lot of implications on someone's mental health, who's suffered a miscarriage who's gone through an abortion that maybe was not safely performed, which I have had very close experience with someone who's been given misoprostol Cytotec, it didn't take well, she continued bleeding through the weekend, because she lived in a state where emergency physicians could opt out of knowing a board of medications. So as professionals, we do need to know, a board of procedures so that we can recognize when someone has been through an unsafe situation it is, it is our oath as metal as medical professionals to know those things, not to necessarily have a stance on those things that will prevent us from providing high quality and safe care. 26:52 Another one of the medications is methotrexate, and it's used to treat inflammatory bowel disease. And as public health specialists, we'd see people who have IBD, Crohn's and Colitis, who have had surgery who are in flareups who are being treated like that treated with that medication. And it is again used in in abortions. And when you're on that medication, you have to take pregnancy tests in order to still be able to get your prescription for that medication. And as a person who I myself have inflammatory bowel disease and have been on that medication before, I can tell you that you don't go on those medications lightly. It is you are counseled when you are of an age where you could possibly get pregnant, and taking those medications. And it's very serious to take them. And you also have to get to a certain stage of very serious disease in order to take that it's not the first line of defense. So if we start removing medications, or they start to be red flagged on EMRs, or org charts, and we become mandatory reporters for seeing that medication, God forbid, on someone's you know, they're when they're telling us what type of medications they're taking, that there would be an inquiry into that for for any reason is just it's it's horrifying. I mean, it's, we treat these patients and they trust us, and we want them to trust us. But as we get farther and farther down this rabbit hole of, of going after providers, pharmacists, people who help give them information to go to a different state, I just it is. Like I said before, the breadth and the depth of this decision, reverberates everywhere. And if if PTS think that they are in orthopedic clinics, that they are somehow immune from it, you're absolutely not. And for those clinics who have taken on or encourage one of their one of their therapists to take on women's health because it's now a buzz issue. It's really cool. You are now going to see that in your clinic. And you know, like Rebecca was saying before, you know any number of us who have really strong and long term relationships with patients who are pregnant who are in postpartum I have intervened and sent patients to the hospital on the phone with them because they have remnants of conception and they have a fever and someone's blowing them off and not letting them into the IDI and sending them home. And we we are seeing those patients, they have an ectopic they're, they're bleeding, is it normal, they're calling me they're not calling their OB they can't get their OB on the phone. They're texting me and saying what should I do? And they have that trust with me and what happens when they don't? And they're bleeding and they're not asking someone that question and they don't know where to go for help. And so I know I took this in a different direction and we talked about pharmacology, but I just thing that I have those patients whose lives I have saved by sending them to the emergency department, because they are sick, they have an infection, they are bleeding, they have an ectopic, it is not normal. And I don't know what happens when they no longer have that trust with us not not because we're not trustworthy, but because they're scared. 30:26 The heavy silence of all of us going 30:31 you know, it's, it's not wrong. And I think the like, it just keeps going through my head. It's just like, so what do we do? I mean, Karen, you mentioned like, it'd be great if somebody came out with a list of, of guidance for us. And I just, that just won't happen. Because there's different laws in different states, different practice acts in different states. And no one, you know, like you even if you talk to a lawyer, they're going to say, this would be the interpretation. But also, as of yet, there's no like case law, to give us any sort of any sort of guidance. So that was a lot of words to say, it's really hard. I can tell you in Illinois, like two or three weeks ago, I'd be like, like, I'm happy, I feel like Illinois is a pretty safe space. We have, we have elections for our governor this year. And I have never been so worried, so motivated to vote. And so motivated to to really make sure to talk to people about it's not just like this, this category or this category, it's like we really need to take into consideration the ramifications of what this will do, I think there was a lot of this probably won't affect me a whole lot. But I think I'm guessing I think a lot of us on this call maybe I think all of us on all of us on this call, have lived our lives with Roe v. Wade. And, as all of this is coming up, and just thinking about how it impacts so many people, and how our healthcare system is already doing not a good job of taking care of so many people, the fact that we would do this with no, no scientific, back ground, no support scientifically. Like I pulled up the ACOG statement, and, and they condemn this devastating decision. And I really, I was like, it gave me gave me goosebumps. And this was referred to in our art Association's statement. And it makes me sad that we didn't condemn it. Hope that's not too political. But I'm really sad that we didn't take a stronger stance to say, this is not good health care. And we need to do more. Again, and that's like, again, so many words, to say we're gonna have to make up our own minds, we're gonna have to know, our rules, our laws and what we're willing to do, and go through, so that we can provide the care that we know our patients deserve. And that's going to be really hard. Because, you know, if I talk to someone, and if I call Rebecca in Washington State, she's going to have something different than if I talk to Abby in New York. And you know, that so it'll be, it'll be really hard even to find that support. That support there's going to be so much support, I think, from this community, but that knowledge and that, that confidence, we have to pull together so we have to pull together with all the other providers, but also we're gonna have to sit down and figure this out to 33:59 the clarity. So it's, I think a practical step forward would be each state to get get, like, every state, come up with a thing. So pelvic health therapists in that state come up with what seems to work for them get a lovely healthcare lawyer to to work with them with it. And then we could have a clearinghouse of sorts of all of the state statements. I don't know that that needs to go through a particular organization. I I know that they're in the field of physical therapy, two thirds of PTS aren't members. And we need this information to be out there for every single person so that they know 34:44 that we'll have to be grassroots there's I don't think that there's going to be widespread Association support from anywhere. But that being said, I think it's a great idea. 34:58 What are we going to do about it? Hang on issues that are too divisive, you're absolutely right, individual entities are going to have to take this on and just put those resources out to therapists who need them need the legal support, need the need to know how and how to circumvent issues in their states. And, you know, like I said before, even how to just provide that emotional support, there's going to be needed for their, their, their patients, so, and that's okay, if the organizations that were part of are not willing to take a heavy stance, you know, even like last year, if you're not willing to take a heavy stance, on an issue where someone feels their autonomy, and their choice is being threatened, then it's okay, well, we'll take it from here. But, you know, that's, that's really where these grassroots efforts come from and abound, because there are a group of individuals who are willing to say, No, this is wrong. And I'm going to do something about this so that our future generations don't have to suffer. 36:02 Yeah, and I think, you know, we're really looking at the criminalization of health care. 36:09 That is not healthcare. 36:12 And we also know who this criminalization of healthcare is going to affect the most. And it's going to affect poor, marginalized people of color, it is not going to affect the wealthy white folks in any state, they'll be fine. So how do we, as physical therapist, deal with that? How do we, how do we get the trust of those communities who already don't trust health care, so now they're going to stay away even more, we already have the highest mortality, maternal mortality rates in the developed world, I can only imagine that will get worse because people, as we've all heard today are going to be afraid to seek health care. So where do we go from here as health care providers? I, 37:10 Karen, you're speaking something that's very near and dear to my heart, I act as if you had to take this on, I am very adamant that we can no longer choose to stay in our lane, we do not have that luxury. And I as a black female, you know, physical therapist, I don't have the luxury to ignore that because of the color of my skin, and not my doctor's degree, not my board certification and women's health, you know, not my faculty position, I when I walk into a hospital, and I either choose to give birth or have a procedure, I will be judged by none other than the color of my skin. That is what the data is telling me is that I am three times likely to have a very severe outcome. If I were to have a pregnancy that did not go as planned or or don't choose a procedure, you know, that affects the rest of my function in my health. And so given the data on this, you're absolutely right there, there is going to be very specific populations that are going to receive the most blowback from this. And as a pelvic health therapist, I had to go into the hospital to find them, because I knew that people of color and of marginalized backgrounds, were not going to find me in my clinic. And we're not going to pay necessarily private pay services to receive that care. But I needed to go where they were most likely to be and that was the hospital setting or in their home. And so, again, as a field of a very dispersed and you know, not very many of us at all, we're going to have to pivot into these areas that we were not necessarily comfortable in being if we're going to address the populations that are going to be most affected by the decisions our lawmakers are making for our bodies. 39:11 You know, there's something that I think about, often when I hear this type of conversation come up in, in sexual health and in in whenever I am speaking with one of my patients and talking about their menstruation history, and, and them not knowing how their body works from such a young age is I just wonder if we should be offering programs for young people like very young pre ministration you know, people with uteruses and their parents, and grandparents and online, online like little anonymous. Yep. nonnamous 39:51 for it's just 39:52 Yes. Yes, it's it's just, you know, Andrew Huberman talks a lot about having data Back to free content that scientific, that's factual. And I think about that a lot. And I think, to my mind, where I go with this, because I do think about the lifespan of a person, is that creating something that someone can access anonymously at any age, and then maybe creating something where it's offered at a school? You know, it's it's ministration health. And it doesn't have to be under the guise of, you know, this happened with Roe v. Wade, but this it could be menstruation, health, what is a person who menstruating what can you expect? What you know, and going through the lifespan with them, but offering them? You know, I think I think about this with my own children, as our pediatrician always asks the question of the visit, who is allowed to see under your clothes who is allowed to touch you? And it's like, you and my, I have a five year old. So it's Mom, when when when I go number two, a mom or dad when I go number two? And that's it. And you know, I think about that, and I think about how we can educate young people on a variety of things within this topic, and kind of include other stuff, too, that's normal, not normal, depending on their age. Absolutely, there 41:22 was what I was excited about in pelvic health. Before this was people like Frank to physician and his PhD students and postdocs are working on a series of research about how if we identify young girls that are starting their period, and having painful periods, treat them and educate them, then that they will not go on to have as much pelvic pain conditions and issues in the future. So we look at the early childhood events kind of thing, but also period pain. And How exciting would it be if we could get education to young girls about just how their bodies work. And to know that just because you all your aunties have horrible periods doesn't mean that you're stuck with this, just like maybe they just didn't know, let's help you out and constipation information and those basic health self care for preventative problems. So I was super excited about all that. And now it's like, oh, now we have to do it. Because in that we can do little pieces of information. So people have knowledge about their body, that's going to be a little bit of armor for them, that they're going to need and free and available in short, and you know, slide it past all the YouTube sensors. This is this is doable, but it's gonna take time money doing, but we can do it. Well, it sounds like, ladies, 42:52 we've got a lot of work to do. One other thing I wanted to touch upon. And we've said this a couple of times, but I think it's worth repeating again and again and again. And that's that expanding out to other providers. So it's expanding out, as Rebecca said, expanding out to our colleagues in acute care, meaning you can see someone right after a procedure right after birth right after a C section. And, and sadly, as we were saying, I think we they may start seeing more women, I'm not even set children under the age of 18. In these positions of force birth on a skeletally immature body. So the only place to reach these children would be maybe in that acute care setting. How what does the profession need to do in order to make that happen? And not not shy away from it, but give them the information that they need. Moving forward? 44:07 I was just gonna say that I've given birth in the hospital twice. Not at any time was I offered a physical therapist, or did a physical therapist come by and I am in New York City. I gave birth in New York City, planned Solarians because of my illnesses. And nobody came by I did get lactation nurses, any manner of people who were seeing me I was on their service. But that has been something that we needed anyway. We mean to have a pelvic health physio on the labor and delivery and on the maternity floors, who is coming by educating as to what they can start with what they can expect. When can they have an exam if they want to have one? Who is a trusted provider for them to have one. And we need to get the hospitals to expand acute care, physical therapy to labor and delivery and, and the maternity floors. As a routine, it's not something you should have to call for, it should be routine clearance for discharge the same way you have to watch the shaking baby video to get discharged. 45:27 I'm happy older than all of you. I don't have it either. But taking baby video is not something that even existed back in the day. But that makes sense. I mean, I once upon a time was a burn therapist, and I was on call at a regional Trauma Center. And you know, it's like you're needed your, your pager goes off, because that's how long ago it was. And you just came in, did your thing, went back home went back to bed. There is no reason other than lack of will, that PTS couldn't be doing that right now. 46:03 I'm now of the opinion where it's unethical to not offer physical or occupational therapy within 24 to 48 hours of someone who had no idea who did not have a planned delivery the way they expected it who has now and a massively long road to recovery. After a major abdominal surgery, I'm now of the opinion that is unethical for our medical systems to not offer that those rehabilitative services. And I've treated individuals who had a cesarean section but suffered a stillbirth. So the very thought of not providing services to someone who has any kind of procedure that's affecting, you know, their their their not only their pelvic health, but their mental function. That to me is now given the you know, these these, this recent decision on overturning Roe v Wade, is now now we're never, you know, either we're going to now pivot again as pelvic health therapists and start training our acute care colleagues, as we did with our orthopedic colleagues, as we've done with, you know, our neurology colleagues, whatever we've had to do as pelvic health therapists to bring attention to half of the population, you know, who are undergoing procedures, and they're not being informed on how to recover, we will have to start educating and kind of really grow beyond just the clinics and beyond what we can do in our community or community. But we are going to have to start educating our other colleagues in these other settings, we don't have a choice, we know too much, but we can't be everywhere. And not all of us can be in the hospital setting, we're going to have to train the individuals who are used to seeing anything that walks through the door and tell them get over to the obstetric unit. Okay, there's someone there waiting for you. 48:06 Yeah, I totally agree. I mean, when I think back I remember as a student working in acute care and how we had someone who's dedicated to the ICU, we had someone dedicated to the medical floor, we had somebody who was dedicated to the ortho floor, and most of the time they had their OCS, their, their, the one for for, for ICU care, the one for NeuroCare, or they have a specialty. And I think it is just remnants of the bygone era of it's natural, your body will heal kind of BS from the past. It's just remnants of that and it's just, we don't need the APTA to give us permission to do this, this is internal, this is I'm going into a hospital, and I'm presenting you with a program. And here is what this what you can build this visit for here's the ICD 10 code for this visit here is here is here are two people who are going to give you know, one seminar to all of your PT OTs, to you know, so that you are aware of what the possible complications and when to refer out and that kind of thing. And then here are two therapists who are acute care therapists who are going to also float to the maternity floor one of them every day, so that we can hit the we can get to these patients at that point, and that is just that's just people who present a program who have an idea, who get it in front of the board that that it is not permission from anybody else to do it. And, you know, it really it fires me up to to create a world in which you know, when you know people who are the heads of departments and chairs and you know on the boards of directors You know, being in big, big cities or small cities, when you know those people, you know, you can, your passion can fire them up. And if you can fire people up, and you can advocate for your patients and you can in that can spread, you can make that happen. And this is, you know, I feel radicalized by this, I mean, I'm burning my bra all over the place with this kind of thing. And I just feel like, if we can, if we can get to young people, and if we can get to day zero, of delivery, day one, post delivery, or post trauma, then then maybe we can make a dent, maybe we can, maybe we can try, maybe we can really make a go of this for these people. Because, like I keep feeling and saying I, we are not prepared for the volume. 50:54 If individuals are going to be forced to carry a pregnancy, that they may not want to turn because it's affecting their health, we're going to have to be prepared for this. Again, this is not an option really, for us as pelvic health therapists, because we know what's down the road, we've seen mothers who have or you know, or individuals who have suffered strokes or preeclampsia or seizures, or, you know, honestly, long term health issues because of what pregnancies have done to their body. And now if they want the choice to say, you know, I'm not ready, they don't have it anymore. So we really don't have a choice. We have to start expanding our services into these other settings, making our neurologic clinical specialists in the hospital, see people before they have a stroke before they have a seizure actually provide services that can help someone monitor their own signs and symptoms after they've had now a procedure or given birth or even had, you know, a stillbirth, unfortunately, because the doctor had to decide, well, yes, now we will perform the abortion because you know, your health is like on the cliff, I mean, we're going to be seeing these and we just have to prepare. And if it's not our organizations that are laying the foundations, we will, we'll take it from here, 52:15 we need to reach out across so many barriers, like athletic trainers, they're gonna see the young girls, they're gonna see their track stars that is not reds, it's pregnancy. And it could be a very short lived traumatic pregnancy, in girls that are just not develop. They're developed enough to get pregnant, they're not developed enough to carry a healthy baby to term. Kind of just makes me like. But Rebecca is right as we don't get to have an opinion on the right or wrongness of this, we have a problem ahead of us now, that that is happening already, as we speak, that people are going to need help. I love that we have more technology than my grandma did when she was fighting this battle. And we have YouTube and we have podcasts and we have ways to get information out. But we need to use every single one of them in our sports colleague or athletic trainer colleagues. They need to know the signs. Because they may be the ones that see it first. 53:21 Yeah. And Sarah as being the most recent new mother here. What kind of care did you get when you were in the hospital? 53:36 I was sitting here thinking about that. And I mean, I will say that the care I had while I was there, that I had an uncomplicated delivery in spite of a very large baby. And I was fortunate enough to leave the hospital without needing additional help. But I wasn't offered physio. Nobody really they're just really curious to make sure you're paying enough. And that's about it if you're the mom and my six week visit was actually telehealth and that was the last time I had contact with a health care professional regarding my own health so it is minimal even if you're a very fortunate white woman in a large metropolitan area and but I'm working now further north and with a pro bono clinic clinic and in an area where we do a lot of work with communities of color and I'm I'm like I honestly don't even know the hospitals up here yet. But I'm gonna I have so many post it notes of things that are gonna start happening and start inquiring because Rebecca like we need to get into the hospitals like if if I can Do that. And honestly, up until now, like my world and entropy was, and pre this decision was it, there's so many people out there who need help with pelvic issues in general, like we can do this forever. And we set our clinic up so that people who weren't doing well in the traditional health care system could find us and afford us. At least some people could, I realized that it wasn't in companies, encompassing everybody who could possibly need help, but we were doing trying to figure out another way. And so again, like, like, again, the offer of assistance I got was minimal. But also I didn't need much. And I was in a position where also, I knew I could, I could ask for it if I wanted it. And I could probably get it if I needed it. And I'm just thinking about, again, some of the communities I'm interacting with now, in some of my other roles and responsibilities, and I cannot wait to take a look and see, how can we get in there? How can we be on that floor? How can we? What What can we make, make happen like, because it needs to happen, these are these, this is the place where I'm scared to start seeing the stats, 56:21 wouldn't it be amazing if you can get the student clinic part of that somehow somehow and get, you know, young beyond that bias, but younger, most younger but but like the physicians the the in training the PTs and training the PAs the you know, and get like Rebecca had said, let's get let's get the team up to speed here, because there aren't enough pelvic health therapists already. And they're heavens, we need, we need to get everybody caught up. 56:58 And there's so much I was telling you that being around student health care, providing your future health care providers is really energizing and also really interesting. I mean, the ideas that come up with in the in the connections they make and and the proposals they make are just amazing. But two things that I've noticed that I think probably we run into in the real world, real world, outside school world as well, is one. The that's being able to have enough people and enough support to keep it sustainable. So you have this idea, you have the proposal, you made the proposal, how are we going to keep it going and finding the funding or the energy or the volunteers to keep it going. Things ebb and flow, you get a great proposal, you're like yes. And then I literally today was like, I wonder what's up with that one, because it was an idea for a clinic to help was basically for trans people to our tree transitioning and might not have the support that they need. And also I was reached, they come up here for women's health clinic. And I'm going to reach out to them now. Because this again, this decision changes that because it is a pro bono clinic that they would like to set this up in and before it was going to be much more more wellness. And now it could turn out to be essential health care. So that's one thing. But then the other thing is still the education, that in school, we're not taught about what everyone else can do. And I think again, figuring out a way to make sure that future physicians really know what physical therapists have to offer, especially in this space. Most people know that if their their shoulder, their rotator cuff repair, they should send them to pt. But really, we need to get in with OB GYN news, we need to get in with the pediatricians. And I don't want to say unfortunately, but in this regard, unfortunately, we're going to have to really make sure that they know what we're doing. And again, I'm already kind of trying to think like how can we make this just part of how we do health care. 59:20 So I think I'm following in your footsteps by going into education and by by being a part of our doctor of physical therapy programs. You know, I especially chose the program in Washington state not because you know, of just the the the opportunity to teach doctors or incoming doctors but it was also an opportunity to teach doctors of osteopathic medicine and occupational therapy therapists. It was you know, very intimate program and opportunity to make pelvic health or women's health or reproductive health apart of cardiopulmonary content, a part of neurology content, a part of our foundations a part of musculoskeletal and not a special elective course that we get two days of training on, I had the opportunity to literally insert our care, our specialized and unique care and every aspect of the curriculum, as it should be, because we are dealing with, you know, more or less issues that every therapist generalists or specialists should be equipped to handle. So in the wake of Roe v Wade, to me, this is an opportunity unlike any other for pelvic health therapists to really get into these educational spaces where incoming doctors are, you know, MDS or PA programs, or NP programs are our therapy practices, and start where students are most riled up and having those ideas so that they can go out and become each one of us, you know, go into hospitals and say no, to obstetric units being ignored, go into hospitals and give and services to physicians. You know, we need to create more innovators in our field and education is the way to do that. 1:01:12 I just wrote down check Indiana and Ohio, and then I wrote border clinics, because Because Illinois is a it's like a not a prohibition state. Having so many flashbacks, because Illinois, is, is currently dedicated to maintaining health care access for everyone. We have cities that are on the border. And I was thought of that when you were talking, Sarah, because you're up next to Wisconsin now. But we have we have the southern part of the state and the western part of the state. And those those border towns are going to have a higher influx than I will see in Chicago, maybe. But I would anticipate that they would, 1:01:56 you know, and again, this is where laws are murky. Every state is different. It's I mean, it's a shitshow. For lack of better way of putting it I don't think there's any other way to put it at this point. Because that's kind of what what we're dealing with because no one's prepared, period. So as we wrap things up, I'll go around to each of you. And just kind of what do you want the listeners to take away? Go ahead, Sandy, 1:02:33 this is this is frustrating and new, and we're not going to abandon you. We're gonna figure it out and be there to help. 1:02:41 I would say that our clinics are still safe, it is still a safe place for you to open up and tell us what you wouldn't tell anybody else. It's still safe with us. And we still have you as an entire person with all of your history. We are still treating you based on what you are dealing with and not. We will not be dictated by anybody else. Our care won't be mandated or dictated by anybody. Sarah, go ahead. 1:03:22 What I would say is I would echo your safe. If you need help, there is help. And I'm sorry, that that this just made it harder than it already was. And I would say to healthcare providers, please let remember, let us remember why we're doing what we're doing. And, you know, we do need to stand up, we do need to continue to provide the best care for our patients. Because to be honest, I've been thinking like, I think it's a legal question. It's a professional question. But ultimately, if we can't give the best care possible, I'm not sure I should do this. 1:04:01 Ahead, Rebecca, 1:04:02 for our health care providers, in the wake of Roe v. Wade, being overturned, wherever we are, you know, as an organization or on our stance, if we believed in the autonomy of an individual to know all of the information before making a decision, then we still believe in the autonomy of an individual to know all of the information that is best for their body. And that is the oath that's the that's the that's the promise that we've made as professionals to people that we're serving, and to the people that we're serving to those who are there listening to this. You have safe spaces with providers that you trust and we're going to continue to educate one another, our field and also you we're going to put together resources that really bring During this education to your families so that you don't have to feel like you're in the dark and you're alone. This is not something that is per individual or per person. This affects everyone. And we're dedicated to advocating for you. 1:05:18 Perfect, and on that we will wrap things up. Thank you ladies so much for a really candid and robust discussion. I feel like there are lots to do. I think we've got some, some great ideas here. And perhaps with some help and some grassroots movements, we can turn them into a reality. So thank you to Rebecca to Sarah to Abby and to Sandy, for taking the time out of your schedules because I know we're all busy to talk about this very important topic. So thank you all so so much, and everyone thanks so much for listening, have a great couple of days and stay healthy, wealthy and smart. 1:06:03 Thank you for listening and please subscribe to the podcast at podcast dot healthy, wealthy smart.com And don't forget to follow us on social media
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