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Beyond the Female Athlete Triad: Relative Energy Deficiency in Sport & Implications for PTs Date: Friday, September 30, 2016 Session ID & Location: 4A: Ballroom H Time: 3:15 PM - 5:15 PM CEU Eligibility: 0.20 Presented by: Amanda Blackmon, PT, DPT, OCS, CMTPT Session Description: The “Female Athlete Triad” is well-known terminology for a spectrum of symptoms and pathology in female athletes that involve inadequate nutrition, low bone density and altered menses. However, in recent years, research has broadened in this area and has been renamed “Relative Energy Deficiency in Sport” (RED-S). This change in terminology and definition is meant to encompass a wider presentation of the syndrome and to include male athletes and over-exercisers. Additionally, athletes presenting with RED-S may or may not present with a traditionally diagnosable eating disorder (anorexia nervosa, bulimia, etc.) or with body dysmorphia. The symptoms of RED-S may be much broader than originally thought and can include dysfunction in a variety of systems including: gastrointestinal, musculoskeletal, endocrine, immunological, integumentary, reproductive, etc. Physical therapists may play an integral role in diagnosing, addressing and preventing RED-S and its multi-systemic and often long–term effects. Physical therapists must be equipped to identify the signs and symptoms of RED-S, utilize appropriate language and communication techniques, identify other healthcare practitioners, and to work in a team-based approach to rehabilitate theses athletes. This session will address these concerns and create dialogue regarding best practice for this unique population. Upon completion of this course, you will be able to: 1. Identify the multi-variable components of Relative Energy Deficiency in Sport (RED-S) and how if differs from the traditional definition on Female Athlete Triad. 2. Identify the immediate and long-term physiological and psychological impact of RED-S in the athletic population 3. Discuss strategies for identifying and treating RED-S in the athletic population, utilizing a team healthcare approach. 4. Discuss prevention strategies to be implemented at home and on the playing field in the athletic population. Presenter Bio(s): Amanda Blackmon, PT, DPT, OCS, CMTPT graduated from Emory University in 2005. Her specialty training includes osteopathic manual medicine, dance medicine, pilates-based rehab and dry needling. Mandy works at Motion Stability and is the lead PT at Atlanta Ballet. She is on faculty at Mercer University and is an instructor for Myopain Seminars. Mandy is the pastpresident and sits on the Advisory Board of the non-for-profit Eating Disorders Information Network (EDIN). BeyondtheFemaleAthleteTriad:RelativeEnergyDeficiencyinSport& ImplicationsforPTs PTAG&TPTAInsightMeeting2016 AmandaMBlackmon,PT,DPT,OCS,CMTPT Pre/PostTest 1.Identify3criteriaforbeingdiagnosedwithRED-S. 2.Identify4otherbodysystemsaffectedinpatientswithRED-S. 3.Identify3PTinterventionsthatmaybehelpfulinmanagingpatientswithRED-S. 4.Identify3otherhealthcareprofessionalsthatmayassistinthecareofapatientwith RED-S. 5.Name3long-termmedicalcomplicationsthatmaydevelopinapatientwithRED-S. BeyondtheFemaleAthleteTriad:RelativeEnergyDeficiencyinSport& ImplicationsforPTs PTAG&TPTAInsightMeeting2016 AmandaMBlackmon,PT,DPT,OCS,CMTPT Objectives: 1.Identifythemulti-variablecomponentsofRelativeEnergyDeficiencyinSport(RED-S) andhowifdiffersfromthetraditionaldefinitiononFemaleAthleteTriad. 2.Identifytheimmediateandlong-termpsychologicalimpactofRED-Sintheathletic population 3.DiscussstrategiesforidentifyingandtreatingRED-Sintheathleticpopulation,utilizinga teamhealthcareapproach. 4.Discusspreventionstrategiestobeimplementedathomeandontheplayingfieldinthe athleticpopulation. I.MovingawayfromtheFemaleAthleteTriad a.history b.definitions c.RED-S II.Multi-systemicimplicationsof(RED-S): a.Gastrointestinal b.Cardiovascular c.Hematological d.Metabolic e.Endocrine f.BoneHealth g.MensutrualFunction h.Imunological III.Psychologicalimplications IV.Screeninganddiagnosis V.Physicaltherapytreatmentstrategiesformulti-systemapproach VI.Clinicalmodelsforsportparticipationandreturn-toplay VII.HealthcareTeamapproachforaddressingRED-Sintheathlete VIII.Preventionathomeandonthefield References: Baxter-JonesAD,FaulknerRA,ForwoodMR,etal.Bonemineralaccrualfrom8to30years ofage:anestimationofpeakbonemass.JBoneMineralRes2011;26:1729-39. DeSouzaMJ,NattivA,JoyE,etal.2014FemaleAthleteTriadCoalitionConsensusStatement onTreatmentandReturntoPlayoftheFemaleAthleteTriad:1stInternationalConference heldinSanFrancisco,California,May2012and2ndInternationalConferenceheldin Indianapolis,Indiana,May2013.BrJSportsMed2014;48:289 DusekT.Influenceofhighintensitytrainingonmenstrualcycledisordersinathletes. CroatMedJ2001;42:79-82. KeenAD,DrinkwaterBL.Irreversiblebonelossinformeramenorrheicathletes.Ostoporos Int1997:7:311-15 Martinsen,M,Sundot-BorgenJ.Higherprevalenceofeatingdisordersamongadolescent eliteathletesthancontrols.MedSciSportsExerc2013;45:1188-97. Mountjoy,M,Sundgot-BorgenJ,BurkeL,etal.TheIOCconsensusstatement:beyondthe FemaleAthleteTriad—RelativeEnergyDeficiencyinSport(RED-S).BrJSportsMed2014; 48:491-497. NattivA,LoucksAB,ManoreMMetal.AmericanCollegeofSportsMedicinePositionStand. Thefemaleathletetriad.MedSciSportsExerc2007;39:1867-82. WentzL,LiuPY,IlichJZ,etal.Dietaryandtrainingpredictorsofstressfracturesinfemale runners.IntJSportNutrExercMetab2012;22:374-82 Resourcepage EatingDisorderInformationNetwork www.myedin.org NationalEatingDisordersAssociation www.neda.org BeyondtheFemaleAthleteTriad:RelativeEnergyDeficiencyinSport& ImplicationsforPTs PTAG&TPTAInsightMeeting2016 AmandaMBlackmon,PT,DPT,OCS,CMTPT Pre/PostTest 1.Identify3criteriaforbeingdiagnosedwithRED-S. 2.Identify4otherbodysystemsaffectedinpatientswithRED-S. 3.Identify3PTinterventionsthatmaybehelpfulinmanagingpatientswithRED-S. 4.Identify3otherhealthcareprofessionalsthatmayassistinthecareofapatientwith RED-S. 5.Name3long-termmedicalcomplicationsthatmaydevelopinapatientwithRED-S.