Katie Rainsberger is a 13-time NCAA All-American, an NCAA steeplechase bronze medalist, a former University of Oregon athlete, and University of Washington graduate. Born into an athletic family (her mom Lisa being a celebrated winner of the Boston Marathon), Katie's initiation into the world of running began as a means to maintain fitness for her first love, soccer. Her fond memories of running include racing to the creek with her teammates and embracing the camaraderie that would shape her love for the sport she now pursues professionally with New Balance and Team Boss, based in the athletic hub of Colorado.

Yet, much like any successful athlete's, Katie's journey hasn't followed a linear trajectory. She’s experienced her fair share of injury and illness, including a partially torn achilles tendon and a foot stress fracture. Notably, Katie has not merely rebounded from these setbacks; she has leveraged her experience as a platform for openness and shared vulnerability, particularly following her diagnosis with RED-S (Relative Energy Deficiency in Sport).

Katie reached out to us upon being diagnosed with RED-S as she sought to assemble her support network and it's been inspiring to witness not only her triumphant return to running, but also the incredible influence of her openness, resonating with many others in similar situations.

Now, in a candid conversation, Katie delves into her experience, emphasizing how rediscovering the intrinsic joy of running helps her navigate the pressures and expectations that often accompany our athletic endeavours, at any level of sport. Katie's Q&A serves as a reminder that each small step taken to appreciate and support our bodies, coupled with open conversations, contributes to a collective effort to create a positive and supportive athletic environment. Here's what she shared:

Q: What were some of the early RED-S symptoms you remember creeping in?

Katie: I actually made a list in retrospect because I mistakenly thought my signs weren't severe enough to warrant action. They included a racing heart, some anxiety, mood swings, waking up hungry in the middle of the night, full body fatigue, craving sweet foods, not waking up feeling refreshed, low iron, anovulation (the absence of the ovulation/egg release part of a menstrual cycle), gut issues, and difficulty ‘changing gear’ in training. I was also lacking motivation and feeling indifferent about training and racing.

Q: Was there a moment or event that helped you recognize that you had gone wrong?

Katie: Two moments stood out. By some stroke of luck, I was involved in a research study where they tracked ovulation and discovered that my LH never surged, indicating anovulation. Even though I was getting a light bleed each month, I was not ovulating, which is a key component of a healthy menstrual cycle. The second moment was during a workout three months later, when I suddenly felt powerless in my legs. I was unable to hit previous paces, and it wasn’t just a normal, "Oh, I’m tired. It was an oh sh*t, something is wrong” type of feeling.

Q: What do you think influences others to begin restricting their food intake or training too much without sufficient rest?

Katie: I wouldn’t presume to know everyone’s influences or assume they are all the same. For me, it was driven by a desire to be great and get the most out of myself, whatever the cost. My unhealthy habits began after observing unhealthy habits around me and thinking that this was what was necessary to take it to the next level. It became a vicious cycle because, for a while, I saw success, but the important thing I remind myself of is that I was great despite the restricted intake and overtraining, not because of it. These unsustainable habits may have led to some short-term success, but it was at the expense of long-term health and longevity.

Q: What kind of support did you receive that helped you recover and get back to training and racing?

Katie: I feel fortunate to have an incredibly supportive environment from my teammates, my coach, family, and a team of health professionals. I noted pretty early on that RED-S is complex, and I would need to assemble a team of support in order to approach recovery from all angles. For me, that included a sports physician, coach, dietician, and psychologist.

Q: What have you learned about yourself as a person and as an athlete from your experience with REDs?

Katie: RED-S has been the toughest challenge I’ve had to navigate as an athlete. Even talking about it brings up a sense of vulnerability because I have never felt less in control than I have recovering from RED-S. I’m fortunate in that I've faced setbacks before, and I learned the hard way that my sense of self is not tied to running. That doesn’t mean running poorly is fun or enjoyable, but it makes me firm in my belief that I’m here because I chose to do this. That has allowed me to show up every day, even when things are difficult.

Q: What one piece of advice would you give your former self, who had just started out on their sporting journey?

Katie: I would tell early collegiate Katie that in your kid body, you did kid training, and in your adult body, you will do adult training. Fuel your training, not your body image.

Q: Looking ahead, what goals are you excited about chasing? What do you hope to accomplish outside of sport along the way?

Katie: My biggest goal is to get my mind and body in sync on the track. Now that I’m feeling healthy again, I'm relearning how to trust myself to dig deep. This process has been anything but linear. Beyond running, I'm pursuing a master's in Applied Physiology, and someday, when I am done racing, I would love to get a PhD so that I can keep researching females in athletics, a very exciting field if I do say so myself. ☺

Our takeaways

• Tackling RED-S takes a team. Katie acknowledges the instrumental role played by her support network during her recovery, encompassing teammates, her coach, family, and a team of healthcare professionals.

• Every setback is a setup for a comeback. While RED-S has posed the most formidable challenge in Katie's athletic career, it's also underscored the resilience she possesses, separate from her identity as a runner. She's now using this experience to focus on achieving synchronization between mind and body. As per our previous article, no coach, stopwatch or smartphone can interpret our body’s own cues like we can. The sooner we can all learn to hear its feedback, the sooner we can harness our own potential.