Loading…
Loading progress
Use the printable handout and keep the public thread available
If the Skool group is blocked logged out, keep moving with the checked public thread instead of stopping on the printable page.
handout_detail_live_thread school-day-snack-gap-what-breaks-first
Referral-first escalation sheet
RED-S Referral
Decision Guide
For coaches, parents, and athletic trainers
Use a calm, coach-safe escalation path when low energy availability signs stop looking isolated and start looking like a pattern.
Evidence-basedCoach-safeReferral requiredNot diagnosticCitations on sheet
The goal is fast support, not a debate over diagnosis.
Monitor + Support (Green)
A single soft signal with no clear performance drop or medical concern yet.
Action: reinforce fueling basics and watch for clusters instead of isolated moments.
Refer Soon (Yellow)
Two to three moderate clues or one clear health signal with training decline.
Action: refer this week and notify the athletic trainer or family now.
Pause + Refer Now (Red)
Bone pain, fainting, severe fatigue, or obvious restriction paired with health decline.
Action: stop the session and move to same-day medical support.
Risk Clusters
Fueling + Behavior
- Skipping meals, cutting carbs, or rigid food rules around training.
- Guilt around eating, fear of body change, or praise-seeking around restriction.
- Avoiding team meals or showing visible stress when fueling plans change.
- Compulsive extra training layered on top of the assigned work.
Health + Recovery
- Constant fatigue, slower recovery, or frequent illness.
- Missed periods, longer cycles, or delayed puberty milestones when relevant.
- Bone stress pain, repeat injuries, or unusual soreness that lingers.
- Low mood, irritability, or a sudden loss of spark around the team.
Escalation Clues
- Performance drop that continues even after normal recovery days.
- Rapid weight loss or obvious difficulty finishing normal sessions.
- Parent, trainer, or clinician concern already on the table.
- Multiple categories drifting together instead of one bad week.
Immediate Referral TriggersRefer to athletic trainer or physician today if you notice:
Bone pain or stress-injury history plus fatigue or cycle change
Rapid weight loss or visible restriction with a performance slide
Fainting, severe dizziness, or inability to finish easy training
Purging, compulsive exercise, or any immediate safety concern
What Not To Say
- Do not frame referral as punishment or a lack of toughness.
- Do not debate calories, weight, or appearance in the conversation.
- Do not promise the athlete they can keep training while serious signs are unresolved.
Coach Action Steps
- 1Name the pattern you are seeing instead of trying to prove the diagnosis.
- 2Document dates, symptoms, and who else is involved in the referral chain.
- 3Loop in the athletic trainer, parent or guardian, and sports medicine support early.
- 4Use private, factual language and remove the athlete from training when the pattern is urgent.
Need more family support?
Scan to join the free Aspire Runner Fueling Lab.
https://aspireperformancerd.com/runner-fueling-lab?source=handout-red-s-warning-signs-when-to-act-and-who-to-call-print