and how we can do better
Just this week, we watched the world of elite sports get ripped open yet again after U.S. runner Mary Cain publicly shared the psychological and physical abuse she experienced at Nike’s elite running program, the Oregon Project. Cain stated that during her time at the Oregon Project, she was constantly being pressured by her coach, Alberto Salazar, to get “thinner, and thinner, and thinner,” in order to perform well. Due to being in a state of constant caloric restriction, she lost her period for three years and broke five bones during that time.
This story comes as a major blow to the track community, and follows in the footsteps of other athletes, both male and female, whom have exposed the toxic and abusive culture prevalent at some of the most glorified and well-respected training programs in elite sports.
In 2018, we saw hundreds of former elite gymnasts come forward to testify against Larry Nassar, the former U.S. Olympic Training Doctor who was sentenced to 175 years in prison after being found guilty for multiple cases of sexual assault of minors. The girls’ stories were not only riddled with the sexual abuse they endured at the hands of Nassar, but also the extreme psychological and physical pressure they were put under to be extremely thin to get approval from their coaches and mentors in the sport. This culture of toxicity made the girls vulnerable to anyone who would empathise with how they were feeling, making them the perfect victim for grooming by a potential predator like Nassar. Nassar groomed the girls for his abuse by giving them bread, candy and other ‘treats’ they weren’t allowed to have in their strictly regimented diets.
Nassar was given constant access to the young athletes at Marta and Bela Korlyi’s national gymnastics training camp in Houston, Texas, called the Korolyi Ranch. Every young U.S. Olympic hopeful since the early 1980’s has trained at the Korolyi Ranch (usually between the ages of 10–16) to prove themselves to the Korolyis and fight for a spot on the olympic team.
Mckayla Maroney, at the Vault finals in the 2012 London Olympic games.
Mckayla Maroney was the first to discuss the abuse she faced at the hands of Nassar at the Ranch and at the olympics in a piece she wrote and released on twitter in October of 2017. She described in detail the extent of both her sexual and psychological abuse while training at the Korolyi ranch.
Mckayla mentioned that her coaches were constantly pressuring her to eat less, be thinner and constantly be restricting herself. Approaching the olympics, she fractured a bone in her foot, which Nassar claimed was an old break coming up on the X-ray, and despite the injury, approved her ability to compete in the 2012 London Olympics, where he molested her almost daily. Nassar was known to frequently permit athletes to train with injuries, which is one of the reasons it is suspected the Korolyis kept him around as the on-site doctor at the Ranch and as the Olympic Team Doctor. Following the olympics, Maroney fractured her tibia in her left leg less than two months after fracturing the bone in her foot at the Olympics.
Mattie Larson. Source: Olympic Effect
Mattie Larson, one of the gymnasts whom testified during Nassar’s trial, experienced tremendous psychological and physical abuse during her time at the Korolyi Ranch. She said that she would go through 6–7 hour long practices without eating anything or drinking a single drop of water to ensure she was ‘light enough’ to perform well. She recalled taking laxatives every day for six years starting at age 10 without missing a single day, to maintain the weight her coaches expected from her. In her victim statement against Nassar, she recounted memories of him giving her food and allowing her to talk about how cruel her coaches and the Korolyis were to her, as he molested her. Nassar cleared Mattie to train on multiple injuries, including an ankle which turned out to be fractured. After stopping gymnastics, she battled with an eating disorder for years, and is still recovering from the physical trauma of training so intensely while being injured and constantly underweight.
“We have the bodies of old people,” — Mattie Larson, now 25.
Sara Tank Ornelas, another elite gymnast who trained at the Karolyi national training camp as early as 1985, claimed that the girls were, “treated like a business plan.” She recalled her memories of the camp darkly, stating that “being hungry was a part of life.” She suffered 13 broken bones while training at the Karolyis’ ranch from ages 11 to 15.
Domonique Moceanu, competing on the American team at age 14 in the 1996 Olympics.
Dominique Moceanu is one of the famous members of the 1996 Olympic Team, also known as the Magnificent Seven, whom helped secure gold for the United States when she was just 14 years old under Marta and Bela Korolyi’s leadership. She competed in those olympics with a 4-inch stress fracture in her right leg, which can be seen bandaged with exercise tape in the image above. In 2008, more than a decade after the olympics, she publicly accused the Korolyis of emotional and physical abuse during her training at their Korolyi ranch.
“The pressure to stay thin, which included being called ‘fat’ in front of teammates, was also humiliating. You’re just hanging by a thread by the time the Olympics rolled around”. — Dominique Moceanu
A choreographer whom worked with the Karolyis said that the strategy they used in their national training camp was to limit girls’ calories despite long, exhausting workouts in order to “delay the girls’ puberty.”
“Gymnastics is an aesthetic and athletic sport so there is sometimes pressure from coaches, judges and teammates to ‘not get fat’ or to stay lean because they believe it will keep them competitive and enhance performance. The facts show that these strategies have the opposite effect and lead the athlete into unhealthy eating patterns or even anorexia and bulimia.”
— Dr. Jay Binder, former USA Gymnastics board member, warned in a 2010 report for the Federation of International Gymnasts
Mckayla Maroney has said that she constantly thinks about whether her entire gymnastics career was worth it due to the issues she has to deal with now — psychologically, emotionally and physically. Mary Cain mentioned how she was having suicidal thoughts and self-harming by the time she quite the Oregon Project and stopped running competitively. Many other gymnasts and runners who began to share their stories after courageous athletes like Cain and Maroney started the conversation, claimed that they also often consider whether their athletic careers were worthwhile because of how beaten up they were when they ended up leaving the sport. The current systems in place are often designed to push diligent, talented, high achieving and driven young female athletes past their limits with almost no protection in place to prevent them from going too far.
There is a deep-seated culture issue in how we treat young female athletes, specifically with regards to body image and nutrition. Girls in sports like gymnastics, running, swimming, dance and many others are constantly told that thinner is better and are praised for losing weight and restricting their eating. The problem, however, lies in the fact that girls’ bodies are not built the same as men’s bodies and it is much more detrimental to be at an extremely low body fat percentage as a young girl, especially during the formative age when puberty begins.
The issue of inadequate caloric intake affects much more than just bodyweight. You may have noticed that I’ve bolded all of the instances of broken bones in the athletes’ stories so far.
That’s because in high-intensity elite sports, there is a direct link between:
(a) under-consuming calories (b) loss of period (amenorrhea) © bone fractures
This tri-fecta is called Female Athlete Triad (also known as RED-S) and is the cause of many young girls’ fractured bones, frequent injuries and decline in physical development. If left untreated or unnoticed for extended periods of time, it can result in infertility or osteoporosis.
And in female elite athletics, it’s as common as a cough or cold.
By not consuming enough calories to maintain an adequate body fat percentage to continue getting a period, the female body begins to produce less estrogen, in turn making bones weaker and more susceptible to fractures.
In gymnastics, running and other competitive sports, it’s considered relatively “normal” to not get your period because of the intense training schedule and high caloric output, keeping athletes quite lean. However, in reality, a young female athlete losing their period for an extended period of time is not normal and should not be considered as such. As a young girl, having a regular period is one of the most important metrics to indicate that you are strong and healthy enough to sustain the level of physical activity you are under-taking.
As a competitive gymnast myself until age 16, my friends and I never thought twice about the fact that we all got our periods three to four years after our other friends, and would often lose our periods for extended periods of time (in my case, the longest stretch was a total of 18 months by the time I was 16).
I wouldn’t say losing our periods was glorified or encouraged in any way, but it certainly was not a major concern amongst us or any of the adults around us. I was lucky that for me it never resulted in extreme consequences and frequent injuries like fractured bones, permanent loss of period, or severe exhaustion, but unfortunately that isn’t the case for everyone.
One athlete I trained with kept experiencing unprovoked stress fractures. These weren’t injuries triggered by a bad fall or a weird landing, it just seemed like her bones were repeatedly fracturing for no reason. At the same time, she had stopped getting her period for a considerable amount of time and had lost weight due to food sensitivities which unintentionally resulted in a reduction in her caloric consumption. After seeing five doctors, not a single one could put together that these events were all linked together in the form of the commonly overlooked, and dangerously frequent condition known as Female Athlete Triad. The doctor that finally put it all together was a sports doctor specialising in elite female athletes. The doctor then sent her to a sports nutritionist whom helped her get back to the strength she needed to maintain a regular period and rebuild her bone health.
My friend was one of the lucky ones. But it took five doctors for someone to figure out what was happening to her. The signs were all there — competitive athlete, low body fat percentage, intensive training schedule, repeated bone fractures, lost period — but no one put it together. It shouldn’t take a doctor specializing in elite female athletics to recognize such a common and dangerous set of symptoms.
When I expressed concern to my doctor about losing my period for over a year, I was sent for blood tests and an ultrasound before anyone asked me about my diet or injury history, despite my 20+ hour-per-week training schedule. The lack of education and knowledge surrounding proper care and nutrition for female athletes is something we have failed to address enough in elite sports, in medicine, and in public.
In stringing these stories together and sharing my own experience as a young athlete in an intense sport, I’m hoping to highlight how we can create a safer and more educated future for young girls in these competitive sports.
A few things to take away from this:
- Having a regular period is a sign of a healthy body and is an essential aspect of maintaining bone strength and overall physical health as an elite athlete.
- Re-defining how we view and discuss body image in competitive sports is imperative to avoid creating emotional trauma and long-term mental health issues for girls.
- Education and awareness around topics like Female Athlete Triad, RED-S, eating disorders, proper nutrition and the basic needs of female athletes to remain healthy and fit needs to be more wide-spread in elite sports. Ideally, there should be a sports psychologist, dietitian or nutritionist seeing girls who train more than 12–15 hours per week in any competitive sport.
- Creating an environment where girls are supported, encouraged and praised for being healthy and strong rather than being pressured to be thinner is essential for producing athletes who will not break down and be forced to end their careers early due to pushing themselves too far.
Everyone who touches competitive sports has a part to play in creating a culture that supports healthy athletes. Whether you have been an athlete and have a story to share, a coach who has noticed an athlete beginning to change their behaviour, lose weight rapidly or speak negatively of their body image, or a parent who is concerned about the environment you might be placing your child in — it’s all of our responsibility to take part in this culture shift and educate ourselves on how we can create a healthy environment for young girls to thrive in. It is especially important for large organisations like USA Gymnastics, the U.S. Olympic Committee and Nike to be developing athletes who are able to leave the sport with the resilience, confidence and determination it’s meant to provide, not with scars of the trauma it’s been known to inflict in the past.
It starts with education and conversation. That can be as easy as sharing this with someone who might not have any clue about this topic, or someone who might be able to relate to it and have something interesting to share as well.
Thank you to Mary Cain, Mckayla Maroney, and all the other incredibly strong and courageous athletes who have shared their stories with us.
Courage ripples. Let’s keep the ripple going.