Knowledge on relative energy deficiency in sport among physiotherapists and physicians

Abstract

Relative energy deficiency in sport (RED-S) refers to an impaired physiological functioning caused by low energy availability in both male and female athletes. It may affect many physiological processes, causing, among others, stress fractures and disturbed menstrual cycles. Athletes may present these symptoms to different health care workers. The purpose of this research was to investigate the awareness and knowledge of physiotherapists, general practitioners, gynaecologists, sports physicians and orthopaedic surgeons on RED-S. An online questionnaire on awareness and knowledge of RED-S was developed for the above-mentioned health experts. A total number of 799 respondents were included for analysis, and 22.0% of the respondents had heard of the existence of RED-S. The highest percentage was reported by sports physicians (92.9%) and the lowest among general practitioners (10.1%). Sports physicians scored highest on knowledge questions about RED-S with a mean score of 8.9, and physiotherapists scored lowest with a mean score of 5.7. Of all respondents, 57.6% reported feeling competent discussing possible underlying problems of RED-S and 7.4% felt qualified treating RED-S. Of the responding gynaecologists, 46.6% would suggest starting oral contraception when presented a patient with symptoms of RED-S, thereby only masking the symptoms of amenorrhoea but not treating the underlying cause: a low energy availability. This research reports a low awareness and knowledge among participating physiotherapists, general practitioners, gynaecologists and orthopaedic surgeons on RED-S. Therefore, further education for these specialists on this topic is needed, since most athletes will initially consult these health care providers first.