The Lane 9 Podcast

What does it actually take to diagnose REDs, and what happens after? If you've ever wondered what's going on behind the scenes when a sports medicine physician suspects REDs, this episode is your inside look. Host Heather Caplan, RDN, sits down with Dr. Rosa Pasculli, a non-operative sports medicine physician based in Atlanta, to walk through the full medical picture: how REDs gets diagnosed, what labs actually matter and why, and what treatment looks like in practice. It's a masterclass in multidisciplinary care, and a reminder of just how important it is to have a physician on your team who knows how to ask the right questions. Dr. Pasculli is a former competitive dancer turned sports medicine physician with a particular clinical interest in bone stress injuries and REDs. She is the head team physician for Emory University, overseeing 450+ varsity athletes, and serves as a consulting physician for the Atlanta Ballet, the Georgia Ballet, and the Atlanta Falcons Cheerleaders. She also sees runners, weekend warriors, and masters athletes, including, as she mentions in this episode, an 80-year-old woman doing an Ironman. 07:59- How Rosa got into sports medicine and the female athlete space 12:44- What she's seeing in the clinic: awareness of REDs and where education still falls short 14:47- REDs as a diagnosis of exclusion: what that means and why it takes a team 15:51- Lab work 101: CBC, CMP, ferritin, thyroid, and what Rosa is actually looking for 21:48- DEXA scans: who needs one and when, including the Female Athlete Triad Coalition's updated guidelines 24:22- Medical management of REDs: risk stratification, the REDs CAT2 tool, and keeping athletes in sport where possible 25:26- When it becomes dangerous: bradycardia, orthostatic changes, and the malnourished heart 28:34- Setting expectations with patients and parents around timeline and testing frequency 30:31- The Emory Women's Sports Medicine program and the cross-institutional community behind it Resources mentioned: IOC RED-S CAT2 Tool (2023)- free Excel-based risk stratification tool for clinicians Female Athlete Triad Coalition- updated DEXA scan guidelines for adolescent and adult athletes Emory Women's Sport and Wellness Conference- Saturday, August 15th, in-person and virtual; registration opening soon Connect with Dr. Pasculli through the Lane 9 Directory at lane9project.org/directory Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What if we stopped treating sport like entertainment and started treating it like healthcare? That's the question at the center of this conversation with Mary Cain: professional middle-distance runner, Stanford medical student, and New York Times Bestselling author of the new memoir This Is Not About Running. Host Heather Caplan, RDN, and Mary Cain talk about what it would actually take to change sports culture, including how we coach youth athletes, how providers diagnose and treat REDs, and what it means to find yourself outside of sport. Chapters 09:10- What hope actually looks like in women's sports right now 11:32- Reframing athletics through a healthcare lens 14:01- What is an athlete? Rethinking youth sport, PE, and why kids drop out 18:49- Detaching from outcomes- what coaches, parents, and teammates can actually do to support athletes 23:28- Periods, pressure, and getting her first period in 10th grade 29:59- Flexibility and fueling across seasons 31:37- REDs vs. the Female Athlete Triad 32:34- Talking to athletes with body dysmorphia: a more trauma-informed approach 38:36- How Mary got diagnosed with REDs and navigated the healthcare system 44:47- When a non-sport therapist was exactly the right call 47:44- Writing This Is Not About Running while in med school Resources mentioned: This Is Not About Running by Mary Cain is available now The Rich Roll Podcast Another Mother Runner Podcast Follow Mary on Instagram: @runmarycain Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

"The [symtpoms] of under-fueling, and REDs, make it a lot harder to meet your [calorie] needs," shares dietitian KC Stockmon. "It's kind of this vicious cycle." We're here to talk about how many calories an athlete actually needs to be eating, WHY it's important to eat enough, and the symptoms of under-fueling. The problem is, under-fueling is so common in athletics that athletes are quick to dismiss their symptoms as just "part of training". When actually, if the body has the energy—aka calories—that it needs to function well *and* recover from your training sessions, you might feel great. You just don't know what you don't know. That's why we're here, in Lane 9, with reminders to eat enough, fuel before during and after training sessions, and connect with sport-specialized healthcare providers when you need to! Build your sport healthcare team—support with fueling, injuries, mental health, and medical support— by going to Lane9Project.org/directory Follow Lane 9 on Instagram @Lane9Project, and subscribe to our newsletter at Lane9project.substack.com If you're a clinician looking to join our Directory and clinical membership, head to Lane9project.org/join

"I had girls come up to me and say, 'I haven't had my period in X amount of time, how do I get it back?'" Gracen Key, head coach for the Women's Distance program at Fort Lewis College (FLC) in Durango CO joins us to talk about creating a team culture where athletes feel comfortable asking questions like that. Key joined FLC about two years ago, and is working hard to create a team cuture that celebrates fueling, regular periods, and self expression. After struggling with injuries, and eventually having surgery for a severe hip labrum tear, her personal athletic career seemed over but she was drawn to coaching by mentors in the sport. She's been at three programs so far, and feels strongly about her athletes having regular periods, eating enough, and performing in a way that feels best for them. We got to bring a Lane 9 workshop to her team last year, and wanted to reconnect with Key to learn more about her coaching philosophies and approach. We hope it's helpful for you, too! If you're looking for sports nutriton and marathon fueling support for your next training cycle, and/or a coach informed in REDs and women's health, go to our Lane 9 Women's Sport and Health Directory at lane9project.org/directory. Follow Lane 9 on IG @Lane9Project, and contact us anytime via Lane9project.org

"There are a lot of outside influences that challenge the way we experience our body, which accumulates to our own personal body image," shares Dr. Krissy Ladner, a sports dietitian in the Lane 9 Women's Sport & Health Directory. Dr. Ladner joins us to talk about how body image dissatisfaction may impact our fueling and nutrition, our mental health, and our performance in sport. It's a very common thing for people socialized as women to struggle with, and of course athletes and people of all genders may struggle with body image concerns. She speaks to the importance of coaches (and athletic staff that frequently interact with athletes at various levels) being able to recognize behaviors and changes in an athlete's demeanor, or fueling habits, and how it may be tied to body image dissatisfaction. We also cover some ways to balance body image dissatisfaction with building positive body experiences. We share some resources for learning more about this topic, including books, podcasts, and social media accounts (or general tips for shifting your algorithm!), and also acknowledge that we come to this conversation with our own body and societal privileges. So, maybe this is a place to start, but there are many more resources out there to continue learning! Connect with Dr. Krissy Ladner via Lane9project.org/directory. If you're looking for sports nutriton and marathon fueling support for your next training cycle, and/or a coach informed in REDs and women's health, go to our Lane 9 Women's Sport and Health Directory at lane9project.org/directory. Follow Lane 9 on IG @Lane9Project, and contact us anytime via Lane9project.org

" It's interesting looking back because I normalized being hungry, normalized being super tired... and when you don't know that that's not normal, you're also not necessarily open to hearing otherwise because it sounds like somebody wants to hold you back from your performance." Justine Fédronic immigrated to the US from Europe in elementary school. Before she learned English, she found a way to connect with her classmates at recess—through running. She showed talent on the run early, and a coach suggested she try for an athletic scholarship to college. She competed at Stanford, but not without some highs and lows. Fédronic signed a professional running contract before graduating college, but her running career before and after this point was riddled with chronic bone stress and soft tissue injuries. She struggled with underfueling, irregular periods, and constantly having to take time off. " A lot of college and high school, I really struggled with my mental health. And there was definitely a correlation between my stress injuries and my depression," she shares. In this conversation with Lane 9, she shares how her running story didn't go as planned, and how she's found her way back to the sport without the pressures of performance and outcomes. She has worked with some of the brands you know and love, and is now working with the nonprofit For All Mothers+. Connect with her on Instagram @jfedronic. If you're looking for sports nutriton and marathon fueling support for your next training cycle, and/or a coach informed in REDs and women's health, go to our Lane 9 Women's Sport and Health Directory at lane9project.org/directory. Follow Lane 9 on IG @Lane9Project, and contact us anytime via Lane9project.org

" Consider why you want to do this. What are the motivating factors for completing the marathon right this second? What are your long-term health and movement goals, and does this get you closer to them or further away?" Lane 9 co-founder, and dietitian, Heather Caplan RDN takes on two more listener questions in this episode. 1) How do clinicians navigate what may be REDs, with an athlete who has an IUD and doesn't get periods? 2) If I'm undertrained and experiencing symptoms of REDs (haven't had a period in about a year), but I want to run marathon, what should I do? As always, remember that all of our episodes cover these topics to raise awareness and engage in the converastion around REDs and women's health in sport, but they are NOT intended to (nor do they) provide individualized medical, nutrition, or mental health care. Please check in with your clinicians before you make any changes. If you are looking for a healthcare team to support you as a woman in sport, navigating REDs or not, go to Lane9Project.org/directory to match with a clinician in our Women's Sport and Health Directory. Connect with Lane 9 Project via Instagram @lane9project, or visit Lane9project.org. Submit a question for our next Q&A episode by sending us a DM, or a message on our site!

"I'd rather suck at running and have my life back," Erin McDonald, who just won the 2025 Detroit Free Press International Half Marathon in 1:16. She objectively does not suck at running, but she does have her life back! Erin McDonald recently opened up about her struggles with restrictive and rigid eating in college as a runner at Michigan State University. She was primed and favored to make nationals her senior year—staying "disiplined" with her food, rest, and training routine—but the race went totally awry. With a job lined up after graduation, she was ready for a long break from running. Four years, in fact. When she came back to the sport, she had gained weight from fueling adequately and listening to her body, as well as taking care of her mental health. She was curious about the marathon, and was about to find out, she was pretty good at it! But as she shares in this episode, her motivation for recovering from restrictive eating and chronic injuries had nothing to do with fast times. She just wanted her life back, and in this case, the rest came together. Follow Erin on Instagram to cheer her on as she tackles another marathon this year, @sunkistErin. Follow @Lane9project on Instgram, and subscribe to our weekly newsletter here. Connect with a clinician near you, and find your full team of women's health and sport providers, by going to Lane9Project.org/directory. If you don't see what you're looking for, fill out our Athlete Match Form, and we'll find someone for you!