Listening to the Body’s Wisdom: Addressing REDs Through Sport Psychology and Somatics
In the last blog post, we began our conversation about REDs. It was research heavy and it maybe even caused some head spinning. Thank you for hanging in there with all the information. It was necessary in two ways. First, so we could understand REDs and maybe become advocates to change. And second, to set us up for today’s conversation about the somatic perspective and what it means in relation to recovery. So let’s go ahead and dive right in.
The Cost of Disembodiment: Way We need to Pay Attention
Sports culture can teach athletes how to ignore pain, fatigue, and sometimes even hunger cues (Miller et al., 2022; Perelman & Reel, 2023). In some cases, ignoring pain for example, there is a time and place. Like we know that at the end of a running race or cycling race as we sprint for the line our bodies are pushed to the limit. Pushing past that feeling makes sense. But there is a line that can be crossed. Before diving into that topic, let’s set the stage just a bit. Beginning with understanding body awareness.
Body awareness is a combination of subjective and phenomenological aspects of proprioception and interoception (There are previous blog posts that discuss these two concepts. Please feel free to reference them!) which may be modified via cognitive processes like attention, evaluation, belief, memory, regulation, attitude, and emotion, and brought to a person’s conscious awareness (Mehling et al., 2009). Thus, body awareness means paying attention to one’s body actively and inactively (Asan, 2023). It becomes clear why we need bodily awareness. We must know what is happening in our body so we can adapt and make changes if necessary. Having a connection with our body is essential!
Now let’s put body awareness in context using elite athletes as an example. In an article authored by Toner & Moran (2014) they make a compelling case, drawing on empirical evidence, that elite athletes' improvement in their performance is highly dependent on their ability to effectively use reflective modes of bodily awareness. Furthermore, they discuss how somaesthetic awareness also may play a role by allowing athletes to identify movements that invite discomfort or unusual or undesirable outcomes and that the research suggests that these types of self-awareness act as mediators of flow! So, in essence, having body awareness serves us in the long run even if we just consider what Mehling et al.’s (2009) says about what how being connected to our body has a role in attention, evaluation, belief, memory, regulation, attitude, and emotion and brought to a person’s conscious awareness. Body awareness may even have connection to master and performance avoidance where having an increased appreciation for one’s body limitations positively contributes to mastery and performance avoidance (Kesilmiş & Yıldız, 2018).
Now we come back to the cost of not paying attention to our bodies as athletes. If we are not connected to our bodies, we are missing an incredible amount of information that could help us take care of ourselves and help us be better athletes. So now we come back to ignoring or disconnecting from our bodies’ signals to take care of ourselves. We can now begin to see how problematic this is in general and how it has a role in female-identifying athletes developing REDs. We must begin to understand that body image is more than just thoughts in the mirror but how we feel in our own skin, remembering that body image can be a felt experience of our bodies (Petrucelli 2016). Thus, body image is not a machine to be controlled but rather a place of embodiment. If we miss this piece we can see how the risk for REDs could potentially increase.
Integrating Mind and Body: A Holistic Path
There has been much written about what needs to be done to change the path for female-identifying athletes in sports to help address the prevalence of REDs. For instance Ackerman et al. (2020) identified the following three things:
Raise awareness of the negative effects of chronic low energy availability (LEA) to empower athletes to make wise choices for their own long-term health.
Update and develop best-practice protocols and safe standards for monitoring body composition/weight.
Eliminate toxic training environments featuring abusive body shaming.
Furthermore, when it comes to the clinical care pathway there needs to be first the initial risk stratification, diagnosis, and team approach to management and referral pathways for athletes who present with REDs and how each member of the clinical team has an essential role at each step along with working together (Schulz et al., 2025). What is neat about Schulz et al. (2025) perspective is how they highlight the importance of each professional’s role. The examples that they give are the following:
Physical Therapist
Concomitant injury management
Registered Dietitian
Nutritional support
Sports Medicine Physician/Endocrinologist
Diagnosis and ruling out of other medical conditions
Sport Psychiatrist
Support any psychological factors that could interfere with recovery
It is very important that each professional stays involved and works with the other professionals. Why bring this all up? Because we need to come back to the idea of a bidirectional relationship with the mind and the body. There is also a previous post on this topic that anyone can go back and read. In this context think about how the brain needs to be re-fueled first so it has plenty of energy to address the psychological aspects and the psychological aspects can help work with building the needed skills to begin nourishing the body.
Building onto the above with some athletes it may be important to help them rebuild their interoceptive awareness, learning and connecting with their ability to accurately feel and honor their hunger signals, understanding what it means to be “full,” and what exhaustion feels like. Thus, potentially taking a polyvagal-informed (Porges, 2022) somatic approach may help the athlete reconnect with their body and build trust in what it is trying to convey. Athletes use their bodies day in and day out. Building a collaborative and trusting relationship with one’s body is essential. This could be done in conjunction with some more sport psychology or mental health counselor work to help expand the athlete’s self-worth beyond performance metrics, for example.
If we are going to look at true athletic resilience and longevity, we need to remember that deep body attunement to the mind-body connection is where it is at. It isn’t about running on empty or thinking of the body as a thing to be molded. Healing from REDs is an act of courage and an understanding that one is not defined by metrics.
Person with long blond hair wearing a black knit hat, black pants, and brown hoodie standing on grass. The person is wearing sunglasses and standing with hands on hips.
take action today moment:
There is a takeaway for all of us from this piece whether athlete, coach, parent, or teammate. Pay attention to the relationship between the body and the mind and nurture it rather than tear it down. Knowing what your body is trying to say is key as there are times it is telling you or athletes that it needs help just as there are times when it is okay to push the limits. It is important to pay attention to know which scenario one is facing.
Learn More About REDs:
Understanding the Female Athlete Triad and REDs
RED‑S in Young Athletes: A Parent’s Guide to Relative Energy Deficiency in Sport
What is relative energy deficiency? (YouTube Video)
References
Ackerman, K. E., Stellingwerff, T., Elliott-Sale, K. J., Baltzell, A., Cain, M., Goucher, K., ... & Mountjoy, M. L. (2020). # REDS (Relative Energy Deficiency in Sport): time for a revolution in sports culture and systems to improve athlete health and performance. British Journal of Sports Medicine, 54(7), 369-370. https://doi.org/10.1136/bjsports-2019-101926
Asan, S. (2023). Investigation of the relationship between body awareness and physical activity and strength levels of young athletes. The Online Journal of Recreation and Sports, 12(4), 502-507. https://doi.org/10.22282/tojras.1308696
Kesilmiş, İ., & Yıldız, R. (2018). The relation between body awareness and track and field athletes’ goal setting. Journal of Human Sciences, 15(4), 2454-2461.
Mehling, W. E., Gopisetty, V., Daubenmier, J., Price, C. J., Hecht, F. M., & Stewart, A. (2009). Body awareness: Construct and self report measures. PloS One, 4(5), e5614. https://doi.org/10.1371/journal.pone.0005614
Miller, P. K., Van Der Zee, S., & Elliott, D. (2022). Pain, culture and pedagogy: A preliminary investigation of attitudes towards “reasonable” pain tolerance in the grassroots reproduction of a culture of risk. Psychological Reports, 125(2), 1086-1102. https://journals.sagepub.com/doi/pdf/10.1177/0033294120988096
Perelman, H., & Reel, J. J. (2023). Using a culturally humble approach to examine and address disordered eating in sport. Journal of Applied Sport Psychology, 35(4), 643-657. https://doi.org/10.1080/10413200.2022.2078904
Petrucelli, J. (2016). Body-states, body image and dissociation: When not-me is ‘not body’. Clinical Social Work Journal, 44(1), 18-26. doi: 10.1007/s10615-015-0539-0
Porges, S. W. (2022). Polyvagal theory: A science of safety. Frontiers in Integrative Neuroscience, 16, 871227. https://doi.org/10.3389/fnint.2022.871227
Schulz, J. M., White, J., Edwards, C., Liu, S., & Thornton, J. S. (2025). Responding to Relative Energy Deficiency in Sport (REDs): a multidisciplinary care pathway for safe return to sport. Sports Psychiatry.
Toner, J., & Moran, A. (2014). In praise of conscious awareness: A new framework for the investigation of “continuous improvement” in expert athletes. Frontiers in Psychology, 5, 769. https://doi.org/10.3389/fpsyg.2014.00769