The British middle-distance athlete tells Jessica Whittington about her journey during the past 12 months and the continued campaign to raise RED-S awareness
Bobby Clay’s track racing return might not have taken the form she initially imagined, but her competitive comeback in Manchester last month marked a significant step, or pedal stroke, in the right direction.
She will, she insists, always be a runner and the 21-year-old’s passion for athletics clearly still burns strongly. But, for now, cycling gives her training more purpose and provides an outlet in which she can unleash her “inner beast”.
“I’ve had so many people ask me ‘oh, so are you a cyclist now?’ and it kind of hurts my soul,” laughs Clay (pictured top, middle centre), who formed part of the Loughborough pursuit and sprint teams at the BUCS track cycling championships.
“I’m like, ‘no, I’m still a runner! I’m just a runner on a bike!’ I know athletics is where my heart is completely but I’m really respectful of cyclists, having just dipped my toes into their world.
“I kind of have this inner beast that has been caged for a long time now and I realise I need to compete. I slog myself on the watt bike. I got to the point where I thought, ‘wouldn’t it be nice if these sessions actually got put towards something?’ Because at the moment I’m not on the track and I’m not on the cross. I’m not racing. Yet day in, day out, I’m training as if I’m prepping for trials for something. I’m training as if I have that ‘thing’ and I just don’t have it.”
It has been more than two years since Clay last pulled on her spikes for a race on the athletics track, which coincidentally also took place in Manchester, in August 2016.
And it has been just over a year since the 2015 European junior 1500m champion first shared details of her osteoporosis diagnosis, with her honest and hard-hitting account in the pages of AW explaining how a regime of over-training combined with inadequate nutrition had led to the syndrome of relative energy deficiency in sport (RED-S).
“I am 20 years old and I have never had a period,” she wrote. “I’m 20 years old and I have osteoporosis. I’m 20 years old and I have become ‘that girl’. The girl who over-trained. The girl who under fuelled. The girl who we are all told about, yet we all just believe ‘it won’t happen to me’.”
The past 12 months have been far from easy. Working with her coach Rob Denmark, Clay believed that her patience was beginning to pay off, until she was dealt yet another blow.
“Over the summer I was increasing the amount of strides I could do at the end of my drill sessions and I was getting up to about 10 x 200m because we realised my form when I’m running a bit quicker is a lot more efficient and is a lot better for me than when I’m jogging,” explains the 2013 World Youth Championships fourth-placer.
“We were trying to get it to the point where I could run quicker but I wasn’t trying to do mile upon mile. It was more about my form and just getting my body used to my feet being on the ground again. I built it up so slowly and then, it was just out of the blue. One day I went out, did my drills, was two reps in, and I just felt something go. I knew straight away that I had snapped my shin again. When I got a scan it turned out I had broken one and had stress fractures in the other.
“I get to a certain point when I’m returning to running and, even though I’ve taken a different approach each time, I’ll be completely pain-free and then I just break again, which has been really difficult because I’ve been so patient,” she adds.
“It was just like I was banging my head against the wall.
“So, at the moment, I’m still on the watt bike a lot, I’m doing my walking drills and I’m track cycling just because it gives my watt bike a focus. It’s good for me, to remain sane, to have something competitive to do.”
Clay, who is studying psychology at Loughborough University, knows it is important not to put pressure on herself but she is doing all she can to prepare her body and mind for a running return. As well as her cycling, right now she is focused on the final year of her degree studies, which includes completing her dissertation on ‘the socially constructed male perception of a female period’.
“I’m going to keep doing my rehab until the new year, which is a bigger block of time for me not to be pushing myself back into trying to run,” she says. “It has either been ‘I’m coming back’ or ‘I’m injured’ but sort of, no in between.
“As much as I want to be back on the track racing and I would love to be in the mud doing cross country, I have realised that my body still isn’t ready. It is giving me all of the signs that it is but then I’m getting to a point and it’s just breaking again.
“I haven’t set a date or anything in my head. I’m almost treating it as, I’m lucky to have this time to put my body in a position where it is the strongest it could possibly be. Because when you’re in the season, you don’t always have the time or the energy to do that.
“I’m hoping that it pays off so that when I say ‘come on legs, let’s run’, they will finally be like ‘okay, actually yeah, we’re ready now!’ I’m trying to see it as a blessing.”
Clay had been keen to share her experience 12 months ago in the hope that it might help to raise awareness and act as a warning for others. Her article in AW prompted a huge reaction from the athletics community, with many offering well wishes and support and some others sharing stories of their own.
RED-S was formerly more commonly known as the female athlete triad of osteoporosis, disordered eating and amenorrhea, but a similar syndrome was also identified as affecting male athletes, leading to ‘relative energy deficiency in sport’ becoming the term to cover both.
Reading Clay’s story prompted former GB international Marina Stedman to respond and on Twitter, she wrote: “GB international distance runners including me and Shireen Higgins (her sister, fellow ‘Samy’ twin) were in a scheme to test for this over 30 years ago and girls were identified with osteoporosis even then, why has nothing changed?”
She later told AW: “I had to write in because it was so shocking that it is still going on today. This was 30 years ago – there were runners who suddenly got really thin and became international class but had to give up running because they were told they had the bones of an 80-year-old.”
Higgins is now an athletics coach herself and provides her athletes and their parents with nutrition information but recognises that striving too hard for early success can sometimes come at the cost of longer-term development.
“I think, because there’s quite a lot of (international) vests when they are young, they all want to train really hard, get the vest but then half of them stop,” she says.
“Do they say you can’t get a GB vest unless you’ve got a certain percentage of body fat or you can prove that you’ve had a period? I don’t know how you would do it but you almost need to make it a disincentive.
“You do run well in the short term, but you can’t last very long.”
In a statement, the national governing body said: “British Athletics works with a number of partner organisations, including the EIS (English Institute of Sport), to ensure awareness and treatment of the conditions that are part of the relative energy deficiency in sport (RED-S) syndrome. We are keen to increase awareness generally of this condition in track and field and can recommend the resources available at: health4performance.co.uk
“In addition to participating in workshops for athletes, coaches, sports science and medical staff, monitoring for menstrual health and energy availability is an integral part of supporting athletes on the World Class Programme. When issues are identified, athletes are supported in a number of ways with medical, nutritional and other specialist advice and intervention.”
For Clay, one of the main ‘tools’ she has used has been ‘talking’.
“People feel more comfortable to talk about it and I think that’s a massive step,” she says. “The more people that do talk about periods, over-training, under-eating – anything which is considered to be ‘taboo’ – is brilliant, because they are not taboo subjects, they are subjects which need to be discussed throughout the wider world as well as sport.
“There has been positive change but we can always do more.”
Anna Boniface, who ran for England at the 2017 Toronto Waterfront Marathon but was forced to drop out with injury, has been sharing her own story on her blog annaboniface.com/insights.
She agrees with Clay and believes her fellow runner’s initial openness about what she had been through acted as something of a catalyst.
“I’ve just been finding out as much as I can about it and then sharing my story with others because I think having this open discussion about it is really important,” says Boniface. “Hats off to Bobby who started that sort of process because that I think really got the ball rolling for other people to start talking about it as well.
“A lot of it comes down to changing attitudes within our sport because I think there is this attitude that you need to be a skinny athlete to be able to run fast,” she adds. “We need to really put out there that if you drop weight it’s not sustainable.
“I’m surprised how long I did sustain it. You get into this false sense of security, but it’s not a long-term situation. If you really want to be good at your sport you’ve got to think about longevity.”
Both Clay and Boniface have found support in #TRAINBRAVE (trainbrave.org) – a new campaign created to raise awareness of eating disorders and RED-S in endurance sports.
Launched by 2:34 marathoner Tom Fairbrother and sports dietitian Renee McGregor, #TRAINBRAVE has featured in the pages of AW as Fairbrother explained how he overcame his eating disorder.
The campaign provides resources and a community for discussion, with a free launch event having taken place in London in December and a second planned for February 17.
“It’s nice to know you’re not alone,” Clay says. “You can speak to an entire community of people where you know none of them are going to be judgemental and none of them are going to think you’re strange or anything like that.
“There’s a vast array of experiences – it’s not just all females or just all males. I think creating that community is really important and something that should have been done earlier but at the same time, you can always say what should have been done.”
Another tool being utilised by Clay is the FitrWoman app. Created by athlete and sports scientist Dr Georgie Bruinvels and Orreco’s product development manager Grainne Conefrey, the app is designed to let users track their menstrual cycle and symptoms, and to provide daily training and nutrition suggestions specific to their individual cycle.
The app helps exercising women work with their cycle, not fight against it.
“One of the findings from the first study of my PhD, where I surveyed over 1000 women who were running the London Marathon, was that a third of them reported that their menstrual cycle disrupts their exercise training and performance. This made me really want to establish why and what we can proactively do to reduce that impact,” explains Bruinvels.
“We’ve developed an app to help facilitate understanding, instil best practices around the menstrual cycle, actually use the changes in hormones to optimise training and performance and also enable women to monitor their own cycle, helping them to be prepared while also allowing them to see if their cycle changes, for example if they miss a period.
“Having someone like Emelia Gorecka (GB international and 2012 world junior 3000m bronze medallist) as an ambassador really helps because she depicts the positive body image around being a healthy, happy athlete. We’re trying to use positive role models to help people see that is possible and normal.”
FitrWoman features recipe ideas tailored to match specific menstrual cycle phases, as well as physiological explanations about what is happening in the body during the cycle. The hope is that, should users notice changes in things like body temperature, energy levels, breathing rate, strength or even tiredness, the app can help explain these and help stop any unnecessary concern or stress. Significantly, FitrWoman says the app is never designed to say ‘no’ – it helps girls and women be smart, aiming to help them perform on any day in their cycle.
“That’s what FitrWoman is designed for – to empower these women by giving them information and, if they are dealing with any kind of symptoms, suggesting actionable solutions,” says FitrWoman’s Esther Goldsmith.
“They can track exactly when they are bleeding, log any symptoms, see whether these happen every cycle, and then proactively manage them. FitrWoman enables them to be prepared. It helps them be aware of their body.”
See fitrwoman.com to access the app. Orreco is passionate about getting these important messages to girls and women so want to ensure it is freely available to everyone.