• Sydney Johnson

An Invisible Injury

It began in 2017 when I was on the New Zealand Junior National Rowing team competing at the World Rowing Championships (prior to attending college). One day, I was on top of the world. The next day, I woke up hooked to an IV in a Lithuanian hospital, my coach telling me I had collapsed. Everything I had worked for was gone; my championships were theoretically over. The work I had done and the goals I had set had been stripped from me in the space of a day. My family wanted me to withdraw from the competition, but I didn’t want to let my crewmate and the team down. I was allowed to compete, but my performance was nowhere near the quality it once was. While overseas, I collapsed several more times after the initial incident. No one could give me a diagnosis; I was

ashamed and embarrassed of my underperformance.


Eventually, I returned home from my campaign. What happened was labeled as a couple of freak accidents, and the topic was somewhat taboo in our team. In the frenzy of my misfortune, my head was telling me I needed to “catch up.” I missed out on so much rowing! I was going to underperform! I came home and began training immediately, completely ignoring the fact that I had experienced serious collapses.


"Toxicity in performance comes when passion becomes desperation. I was desperate, and I was damaging myself."

In my first regatta representing my team in New Zealand, I collapsed again while walking to my parents after my race. My family urged me to stop competing as they knew this wasn’t right. After hearing news of my collapse, my coach called me “dramatic.” I was young; I listened to this feedback. I believed him, and I needed to prove him wrong.


What my coach had said disabled my ability to think about putting my health first. I hustled in order to prove myself as a serious athlete. I needed my performance to be excellent. I needed my recovery to be better than everyone else’s. I needed my nutrition to be exceptional. I hung a body-to-power weight chart on my board so that I could quickly calculate my efficiency and check my performance. I wrote my test scores and weight next to the same wall. Toxicity in performance comes when passion becomes desperation. I was desperate, and I was damaging myself.


My performance began to diminish very quickly, which only led me to spiral further into my maladaptive behaviors and patterns. With every new opportunity to perform, I saw how I would only get worse, strengthening the narrative in my head that I only needed to “do more” to be better. I didn’t go out; I didn’t see my friends. I slept most of the day. I began eating the same and little of these things every day. When my rowing scores get slower, my body-to-power weight chart would taunt me. I needed to be exceptional, but I was only getting worse. I had skin-folds done and only saw that my fat mass had increased and my lean muscle percentage had decreased. I was frustrated; my family started to see my maladaptive behavior and pushed me to stop rowing, but I was adamant in continuing.


After one of my final races of the season, I returned home and sat down next to my father. Rowing by then had become a taboo conversation in our household because I personally didn’t want to talk about it; I was unaware that my unwillingness to talk was really because it was straining my physical and then mental health. My relationship with rowing was mimicking a toxic relationship; I was defensive of it. However, that day, my Dad asked me how my race went. Even though I had medalled, I told him it was torture. I had completely lost my love of my sport. I began to cry. At this point, I started to believe in the concerns people had around me, and I was no longer ignorantly blind to my performance drops. I allowed myself the space to seek help, and after struggling for some time, a doctor diagnosed me with an “increasing in awareness” syndrome, namely RED-S.


"It was the worst injury I’ve ever had in my life, mainly because it was invisible. "

RED-S stands for Relative Energy Deficiency Syndrome in Sport. The main symptoms focus on the female athlete triad: a combination of low bone density, loss of menstrual cycle (amenorrhea) and disordered eating. RED-S occurs due to a low energy availability caused by being in a constant caloric deficit. Other symptoms include emotional, mental and physical tolls. I collapsed and was sent to the hospital several times over my competitive season. It was the worst injury I’ve ever had in my life, mainly because it was invisible.



Everyone can see a broken leg in a cast, but most people do not notice disordered eating behaviors and toxic relationships with sports performance. Before I was initially diagnosed, RED-S wasn’t well known and so my experience was drawn up to a couple of “freak accidents”. This is incredibly worrying. Female health should be taken incredibly seriously, but many of us are overlooked. Luckily, with more female athletes coming forward with their personal RED-S experience, the syndrome is gaining awareness in the athletic medicine community. Losing your menstrual cycle is not winning a medal; losing your period signifies that your body is not able to function the way it needs.

"When I was eventually diagnosed, I remember being so relieved that I cried. A doctor finally had an answer for me. I wasn’t crazy. I was heard."

I hope my story helps to raise awareness of RED-S in athletic medicine. Before I was diagnosed with RED-S, I was too young to advocate for my health in a highly competitive environment. RED-S is a syndrome that debilitated not only my performance but broke my love for my sport at the time. When I was eventually diagnosed, I remember being so relieved that I cried. A doctor finally had an answer for me. I wasn’t crazy. I was heard. I completed my recovery prior to attending college and so I’m incredibly passionate about rowing again, but it is saddening to think back to a time where I lost it all. I hope this story helps other female athletes, whether that be with performance, nutrition, body image and/or weight. You are definitely not alone. If you are not struggling, someone who you really care about could be, and your support goes a long way.



- Sydney Johnson


Photo Credits: Raegan Lunn & Sydney Johnson

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