Early in December 2018, I developed a running injury – a sharp pain in my pelvis.  It came out of the blue with no warning. The only thing I could put it down to was that I’d overdone it in the previous few weeks and had also been under a lot of stress at the time. I did a couple of races (a PECO and the final Even Splits 5k) in the week before which I knew I shouldn’t have done so initially I blamed myself for simply overdoing it. What has unravelled is actually more significant.

Up until my injury I felt like I’d had a good return to running during 2018. I had some simple goals about taking part in the relays, being able to say yes to the off road weekend runs (ie being fit enough) and mostly to enjoy running. There were some real highlights. BMW, after a really tough time with my youngest being seriously ill, felt like a great achievement. It was just nice to be part of it and to have the top company of Cath Gray.

Northumberland Coastal run was probably one of my favourite running experiences ever. I had never done it before and despite promising the children a weekend of ice creams and the beach, which turned into wellies and raincoats, I absolutely loved the race. I opted not to race all out and just enjoy the views and experience and it paid off.  By the time it came to September I was feeling strong and was taking every opportunity to run. But over the next few months the cracks started to appear. Pressures mounted in what felt like every aspect of my life – more stressful events with my children, a change in jobs, start of a Masters, plus the usual demands of juggling everything. I didn’t want to let any of this get in the way so I went into superhuman mode and convinced myself I could do everything. For a while I actually felt like I was winning. I was really pleased I could do a long run having only had a banana and very little sleep because it fitted with the way my life was at the time. I had convinced myself I only needed to get to Christmas and then I could have a break from everything and rest up a bit.

Happy and healthy enjoying Northumberland Coastal Run (photo credit: Julia Day)

So I struggled on. I had a little meltdown in the mud in Calverley one Sunday afternoon and started to realise that maybe I couldn’t just keep going. I managed to make a few changes at work and got some extensions at university to ease the pressure.  But this all came a bit late. When the  injury happened In early December I spent a couple of weeks just hoping it would go away. I then went to see a Physio and came away with the intention of just getting back to running as soon as possible and trying to increase my mileage back to what it was, so I tried it. I had even more severe pain by Christmas Day, after trying to get to the car to get my trainers to go for a run. When I returned to the Physio in January, I could tell I wasn’t making the recovery that was expected. I continued to ignore any discussion about getting a scan but when she started to ask about nutrition I started to piece some of it together. I weighed myself for the first time in a couple of years and was shocked at how low my weight was. Fortunately a couple of friends from the club had been gently persuading me to get checked out so I finally decided to do something about it.

At PECO race just one week before the injury. Looking tired and less healthy.

Taking everything into account the sports injury specialist explained that I was suffering from Relative Energy Deficiency in Sport. (RED-S). We needed a scan to confirm but it fitted the picture. By early March I had it there in black and white: a stress fracture of my pubic ramus, plus inflammation around my pubic bone, and worse still a bone density scan showed I have osteopenia. It’s been a lot to take in.  The bone density scan is unlikely to be repeated for 2 years and I will be at some risk of further fractures until I have reversed the damage to my bones.

For those who may not know much about RED-S, there are lots of different elements to it and you don’t have to have all of the symptoms. It’s a complicated mix of physical and psychological behaviours and symptoms, some of which may be intentional, others unintentional or even sub-conscious. Thinking about it has pretty much blown my mind – I’ve made a lot of mistakes, misjudged things and got into some bad habits.

I am disappointed for many reasons but mostly because I feel like I’ve messed up. I knew I wasn’t getting it perfect but wouldn’t have anticipated such a huge impact on my health. Having said that I don’t think at the back end of last year, I was really in a position to question anything or make any changes anyway. And it’s likely at least some of the damage was already done by then.

But I also feel like my running has let me down. It was the thing I could rely on when everything else felt so out of my control. It helped me to regain some control and it made me feel good about myself. I became quite dependent on the hormone high and the buzz from running. But looking back, I had tipped from reaping the mental health benefits of running -which are great and a lot of people get – to having a pretty unhealthy relationship with running.

I now have a good recovery plan in place and lots of professional and personal support. It still pains me that I can’t just put my trainers on and go for a run but I have to be patient. I have seen the damage on the scans and know it’s not even worth trying.

This has been a big wake up call for me. If any of the risk factors resonate with you, don’t take a chance, and make sure you get some help. I think it’s also important to say that as a club we need to make sure we look out for each other and have ‘healthy’ conversations about some of these things: whether it’s body image, nutrition, your relationship with running, your volume of running, or anything else that doesn’t seem right.

There are a lot of resources and support if you know where to look. I’ve included a few here but they should signpost you to more information if you want or need it. It’s worth everyone having at least a basic knowledge of it because the running community needs that awareness and even if you don’t have full on RED-S there may be some things you can improve on. I thought it was just something that “proper athletes” got but my fractured pelvis is proof that runners of all abilities can get it.



Warning signs of RED-S from trainbrave https://trainbrave.org/risks



•Lack of three consecutive periods in females or a change to a previously regular menstrual cycle

•Decline in morning erectile function in male athletes

•Poor development of muscle mass

•Difficulties staying warm in the winter and cool in the summer months

•Downy growth of hair all over the body

•Constipation or feeling bloated


•Pre-occupation and constantly talking about food

•Poor sleep patterns

•Restricting or strict control of food intake

•Overtraining or difficulties taking rest days


•Irrational behaviour

•Fear of food and weight restoration

•Severe anxiety

•Becoming withdrawn and reclusive


•Poor recovery between training sessions

•Digestive issues –athletes often become constipated and bloated

•Recurrent injuries, including stress fractures

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Article by Marianne Burgess

Main image credit: Simon Cullingworth