Hannah Ballowe: Elite Runner, PhD Student, and REDs Researcher

What would change if we gave athletes a real framework for understanding REDs, before something went wrong? That's the question driving Hannah Ballowe's entire career right now. Hannah is an elite middle-distance runner, PhD student at NC State, and women's health researcher whose dissertation is focused on creating and validating a REDs-specific screening tool. She's also a former Virginia Tech runner who, despite training with a coach who presented on nutrition, didn't learn what REDs actually was until she was out of college, and noticed she wasn't alone in that. Heather and Hannah talk through what the culture around fueling, periods, and body image actually looked like on her college team, the comparison trap that nearly consumed her freshman year, the summer she tried eating less and almost passed out at the finish line, and what she's building now to make sure the next generation of athletes has better tools. They also talk about her path to training professionally with coach Laurie Henes in Raleigh, what it's like to balance a PhD and elite training, and her goal to one day run 100 miles! Chapters [00:07:00] The comparison trap: why "I'm doing everything right" can be the most dangerous thought in college sport [00:10:00] COVID, anxiety, and the year things got harder than she expected [00:11:00] What a good fueling culture actually looked like at Virginia Tech — and what was still missing [00:12:00] Periods on the team: comfortable in a flippant way, but never substantive [00:16:00] The professional path she almost didn't see coming — and the fifth year that didn't go as planned [00:20:00] Why she's building a REDs screening tool — and what's wrong with the ones we already have [00:23:00] The summer she tried eating less, almost passed out at the finish line, and turned her season around [00:25:00] Inside her dissertation: how the REDs screening tool actually works and who it's designed for [00:28:00] Balancing a PhD and professional training — and why it's more doable now than it was in college [00:34:00] Training with Laurie Henes and the NC State group: adjusting to a whole new level of volume Resources mentioned: Voice in Sport — athlete advocacy platform Hannah joined in 2025 WISP — Women's Health and Sport Performance Institute — Founded by Dr. Kathryn Ackerman, Hannah contributes science communication and social media copy IOC RED-S SCAT-2 — the current IOC screening and clinical assessment tool for REDs LEAFs-Q — one of the current LOW energy availability screening tools for female athletes NC State's dissertation is targeting completion spring 2028; the screening tool is expected to be available by end of 2027 Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What if the leaking, the urgency, the butt pain, and the pressure weren't just things you had to live with? Heather sits down with Mbong Henry, a pelvic floor and orthopedic physical therapist based in Durham, North Carolina, to talk about the pelvic health symptoms that athletes — runners, weightlifters, CrossFitters, gymnasts, and everyone in between — are normalizing when they really don't have to. Mbong specializes in female athletes during the perinatal and perimenopausal stages of life, but as she makes very clear in this episode: you don't have to have had a baby, or ever plan to, for your pelvic floor to need attention. They talk about what symptoms are actually worth addressing, why leakage isn't always a weakness problem, how low energy availability connects to urinary incontinence, and why establishing care with a pelvic floor PT before something goes wrong is one of the smartest things an athlete can do. Mbong also shares her own postpartum return-to-run story, her journey into Olympic weightlifting, and what she's learned about training, recovery, and capacity at 41. Chapters [00:03:00] Mbong's background: from running to CrossFit to Olympic weightlifting [00:13:00] How she got into pelvic health — and her own postpartum return-to-run story [00:20:00] What pelvic floor symptoms actually look like: beyond leakage [00:25:00] Intimacy, perimenopause, and the symptoms athletes are quietly living with [00:27:00] Pelvic floor issues in the weightlifting and CrossFit world [00:29:00] If you've never had a baby, this still applies to you [00:34:00] Why it's never too late — and why you shouldn't wait until something breaks [00:37:00] Establishing care with a PT before you need one: the dentist analogy [00:41:00] What Mbong's practice at Radiance looks like and how she works with athletes Resources mentioned: Radiance Physical Therapy — Mbong's private practice in Durham, NC; in-person and telehealth options available NICE Guidelines (UK, 2021) — recommends pelvic floor PT beginning at 20 weeks of pregnancy Find Mbong Henry, PT in the Lane 9 Directory: lane9project.org/directory Follow Mbong on Instagram Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What does it look like to build something for almost a decade — not because you had a perfect plan, but because you kept showing up? For the 100th episode of the Lane 9 podcast, host Heather Caplan, RDN, sits down with her co-founder Alexis Fairbanks to talk about where Lane 9 started, where the conversation around REDs and period health actually stands in 2026, and what they're still working on. This one is equal parts reflection and real talk — about what it felt like to learn about the Female Athlete Triad after the fact, why athlete stories still matter more than clinical presentations, and why the work is nowhere near done even though the conversation has come a long way. If you've been around since the beginning, this episode is for you. And if you're new here, welcome — this is a good place to start. Chapters [00:03:00] How Alexis and Heather met — and the conversation that started it all [00:04:00] Alexis's experience as a collegiate athlete: stress fractures, irregular periods, and being told it was normal [00:06:00] What it felt like to finally have a name for what happened — and still feel frustrated about it [00:11:00] Why Lane 9 started: the gap in knowledge, the birth control band-aid, and wanting to do something about it [00:16:00] The state of the conversation now: more resources, but thinness is coming back strong [00:22:00] What young athletes actually need — and why peer connection beats clinical education [00:28:00] The Lane 9 athlete ambassador program: how it works and what's changed going into year two [00:34:00] The Lane 9 directory and the clinical arm: building one place to find your full healthcare team Resources mentioned: Lane 9 Athlete Ambassador Program — open to collegiate athletes in women's sport programs; reach out anytime if the application window has closed Lane 9 Substack — Friday morning notes on REDs, fueling, period health, and women's sports Stanford FASTR — Dr. Emily Kraus's lab studying RED-S and female athlete physiology The Moth — storytelling event series; the inspiration behind early Lane 9 in-person events Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What do you actually eat when your body is healing — and you're not allowed to move? That's the question Shira Evans, RD, CSSD, found herself living through after a significant cycling accident left her with a concussion, road rash, and a scapula broken in two places. As a sports dietitian who specializes in REDs and disordered eating in athletes, she knew exactly what to do nutritionally — but navigating the mental health piece, the unsolicited body comments, and the slow, humbling process of returning to sport? That was a whole other conversation. Shira is a registered dietitian and board-certified specialist in sports dietetics based in Oregon. She's a lifelong athlete, Boston Marathon qualifier, and cross-country cyclist who works virtually with athletes and active individuals throughout the US. She specializes in sports performance nutrition, REDs, and disordered eating and eating disorders in athletes — including gender-affirming nutrition support for non-binary and trans athletes. She is also a Lane 9 Directory dietitian. Chapters [00:04:00] How Shira got into sports nutrition — and why she created her own path [00:06:00] Her sports nutrition philosophy: finding the gray space when everything feels black and white [00:09:00] Cycling across the country — twice — and why the bike unlocked a different kind of adventure [00:11:00] The accident: concussion, broken scapula, and road rash — what happened and what came next [00:12:00] Unsolicited body comments: navigating them in real time and the parallel to athletes with REDs [00:18:00] Why injury increases energy needs — and why that's hard to honor when you're not moving [00:21:00] What eating actually looked like: 3 meals, 4–5 snacks, and the pre-breakfast snack strategy [00:25:00] Starting sports psych and ERP to get comfortable being near her bike again [00:29:00] Supplements that helped: Juven, HMB, calcium, vitamin D, and higher-dose fish oil for concussion [00:34:00] Return to run: getting cleared doesn't mean it's going to feel good — and that's okay Resources mentioned: Juven — amino acid supplement for wound healing; contains collagen, vitamin C, and protein HMB (beta-hydroxy beta-methylbutyrate) — leucine derivative shown to help maintain muscle mass during limb immobilization Fairlife milk — lactose-reduced option Shira used in calorie-dense smoothies during recovery Find Shira Evans, RD, CSSD at https://shiraevansrd.com/ or in the Lane 9 Directory: lane9project.org/directory Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory.

What does it look like to chase a goal and then permit yourself to let it breathe for a season? Host Heather Caplan, RDN, is joined by her Lane 9 co-founder Alexis Fairbanks for an informal midsummer catch-up. They talk travel, food culture in Spain and Portugal, the very real struggle of treadmill running, women's sports they're following right now, and what Alexis is training for after deciding to take a much-needed break from marathon training. They also check in on Alexis's sub-3 marathon goal (where she's gotten as close as 3:02) and what it looks like to stop forcing it and let the training come to you instead. It's the kind of conversation they don't get to have nearly enough, since they live in different time zones and their schedules are constantly pulled in different directions. But when they do, it's a good one. Chapters 07:57- Food culture while traveling and eating without overthinking it in Barcelona and Mallorca 12:15- What Alexis is training for now, and why taking a break from marathon training felt like a relief 20:45- Heather on having no running goals right now, and why that's okay 21:00- Checking in on Alexis's sub-3 goal: how close she's gotten, what's worked, and what hasn't 25:00- How to hold a big goal without letting it haunt you 25:45- What's exciting in women's sports right now 31:30- Bar IX Detroit, a women's sports bar in crowdfunding mode Resources mentioned: Megan Rapinoe's Podcast — World Cup-focused episodes with Rose Lavelle, Lindsey Horan, and more Bar IX Detroit — a women's sports bar in crowdfunding; follow along on Instagram Taylored Training Run — Becky Anthony's coaching group, now featuring Alexis; find her in the Lane 9 Directory Lane 9 Substack — Alexis writes monthly training missives; Heather sends Friday notes on REDs, fueling, and women's sports Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

"I have no doubt you could run that half-marathon, but I understand the hesitation." That note from her physical therapist is what Host Heather Caplan, RDN, needed to hear, and this episode is her passing it along to you. It's midsummer. Schedules are chaotic, training cycles are in-between, and sometimes the most useful thing a podcast can do is just pause and remind you: you've come further than you think.  In this solo episode, Heather reads a Substack essay she wrote in May after a long season of navigating plantar fasciitis, a hamstring tweak, a race she almost didn't run, and the slow, non-linear work of rebuilding. She reflects on why acknowledging the progress we've made is just as important as chasing the next goal. Whether you're in the middle of REDs recovery, returning from injury, navigating a hard training cycle, or just feeling like you're far from where you want to be, this one's for you! Resources mentioned: Lane 9 Substack - Friday morning notes on REDs, periods, nutrition, women's sports, and more Stephanie Flippen - Heather's running coach Nancy Boyd, DPT - Heather's physical therapist and Lane 9 Directory member Extra credit - If this episode hit home, here are a few ways to pay it forward: Send this episode to a friend who needs this message right now Leave a rating or review on Apple Podcasts or Spotify; it genuinely helps more people find us Reach out and tell us what you're celebrating; we mean it! Email us at [email protected].  Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What does it take to reach sub-3 with your period intact and your body well-fueled? That's the question Coach Laura Filla can now answer from experience. After four years, ten marathons, low ferritin, grief, a coaching business, and two kids, Laura crossed the finish line at Bayshore 2026 in 2:58:43. Host Heather Caplan, RDN, sits down with Laura to talk through the whole arc: what changed, what didn't, and why the breakthrough finally came when she stopped white-knuckling her training and started thriving through it. Laura Filla is a marathoner, mom, RRCA Level 2 Certified Running Coach, and ACE Certified Personal Trainer. She founded Filla Endurance in 2021 with a focus on helping runners get the best out of themselves in a way that supports their long-term health. She's also a Lane 9 Directory coach. Chapters 03:58- Laura's first marathon and what made her want to go faster 08:20- When sub-3 first felt possible: the 3:06 breakthrough at Indianapolis 12:31- What people don't see behind a fast marathon time 13:52- Fueling in the early seasons and working with a dietitian for the first time 17:58- Navigating grief, setbacks, and a ferritin of 14 19:32- How low ferritin showed up in training and how she finally fixed it 26:31- Tracking cycles and fueling through high-mileage weeks 29:41- Process-based goals and celebrating wins before the finish line 35:26- Race day at Bayshore: the pace group, recalibrating, and the ducks 40:33- The pain cave during the last couple of miles, the mantra, and crossing sub-3 43:46- Race fueling strategy: 84 grams per hour Resources mentioned: Filla Endurance - Laura's coaching business; follow her on Instagram at @coachlaura.run Laces and Legends Podcast - Laura's podcast highlighting women runners in the St. Louis running community Garmin app (cycle tracking) Connect with Laura through the Lane 9 Directory at lane9project.org/directory Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!  

What does it actually take to diagnose REDs, and what happens after? If you've ever wondered what's going on behind the scenes when a sports medicine physician suspects REDs, this episode is your inside look. Host Heather Caplan, RDN, sits down with Dr. Rosa Pasculli, a non-operative sports medicine physician based in Atlanta, to walk through the full medical picture: how REDs gets diagnosed, what labs actually matter and why, and what treatment looks like in practice. It's a masterclass in multidisciplinary care, and a reminder of just how important it is to have a physician on your team who knows how to ask the right questions. Dr. Pasculli is a former competitive dancer turned sports medicine physician with a particular clinical interest in bone stress injuries and REDs. She is the head team physician for Emory University, overseeing 450+ varsity athletes, and serves as a consulting physician for the Atlanta Ballet, the Georgia Ballet, and the Atlanta Falcons Cheerleaders. She also sees runners, weekend warriors, and masters athletes, including, as she mentions in this episode, an 80-year-old woman doing an Ironman. 07:59- How Rosa got into sports medicine and the female athlete space 12:44- What she's seeing in the clinic: awareness of REDs and where education still falls short 14:47- REDs as a diagnosis of exclusion: what that means and why it takes a team 15:51- Lab work 101: CBC, CMP, ferritin, thyroid, and what Rosa is actually looking for 21:48- DEXA scans: who needs one and when, including the Female Athlete Triad Coalition's updated guidelines 24:22- Medical management of REDs: risk stratification, the REDs CAT2 tool, and keeping athletes in sport where possible 25:26- When it becomes dangerous: bradycardia, orthostatic changes, and the malnourished heart 28:34- Setting expectations with patients and parents around timeline and testing frequency 30:31- The Emory Women's Sports Medicine program and the cross-institutional community behind it Resources mentioned: IOC RED-S CAT2 Tool (2023)- free Excel-based risk stratification tool for clinicians Female Athlete Triad Coalition- updated DEXA scan guidelines for adolescent and adult athletes Emory Women's Sport and Wellness Conference- Saturday, August 15th, in-person and virtual; registration opening soon Connect with Dr. Pasculli through the Lane 9 Directory at lane9project.org/directory Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!  

What does it actually take to build a girls' running program from three athletes to a full roster, and what does it cost the coach who gets it there? That's at the heart of this conversation with Miran McCash: high school cross country and track head coach at Highline High School, and owner of ANA Run Coaching, an all-women adult running coaching business based in Seattle. Host Heather Caplan, RDN, and Miran talk about what it's really like to be a woman in a head coaching role, how she's creating space for girls to talk about their bodies and their periods, and why representation on the coaching staff is the reason girls stay in sport. 08:54- Teaching girls' weight training and building confidence in the weight room 11:11- Growing up with all-male coaches and how it shaped her 15:31- Growing the girls' cross-country team from 3 athletes to a full roster 16:29- Incentives, belonging, and why cross-country culture matters 23:28- How Miran talks to her athletes about periods, REDs, and changing the language around bodies 29:18- Balancing the financial and emotional load of coaching at a Title I school 36:59- Why women aren't signing up for coaching positions 40:16- Over-scheduling, under-recovering: the injury surge Miran is watching in real time 46:09- Going part-time teaching to grow ANA Coaching, and South End Running Exchange Resources mentioned: Bras for Girls: the organization Miran brought to her school to provide sports bras to female athletes across all spring sports Better, Faster, Farther by Maggie Mertens- includes the story of Bobbi Gibbs running the Boston Marathon before Katherine Switzer, in a bathing suit (no sports bras yet) Lane 9 Episode with Mary Cain mentioned Follow Miran on Instagram Follow Miran's business, ANA Coaching, on Instagram Follow the South End Running Exchange on Instagram Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!

What if we stopped treating sport like entertainment and started treating it like healthcare? That's the question at the center of this conversation with Mary Cain: professional middle-distance runner, Stanford medical student, and New York Times Bestselling author of the new memoir This Is Not About Running. Host Heather Caplan, RDN, and Mary Cain talk about what it would actually take to change sports culture, including how we coach youth athletes, how providers diagnose and treat REDs, and what it means to find yourself outside of sport.  Chapters 09:10- What hope actually looks like in women's sports right now 11:32- Reframing athletics through a healthcare lens 14:01- What is an athlete? Rethinking youth sport, PE, and why kids drop out 18:49- Detaching from outcomes- what coaches, parents, and teammates can actually do to support athletes 23:28- Periods, pressure, and getting her first period in 10th grade  29:59- Flexibility and fueling across seasons  31:37- REDs vs. the Female Athlete Triad 32:34- Talking to athletes with body dysmorphia: a more trauma-informed approach  38:36- How Mary got diagnosed with REDs and navigated the healthcare system 44:47- When a non-sport therapist was exactly the right call 47:44- Writing This Is Not About Running while in med school Resources mentioned: This Is Not About Running by Mary Cain is available now The Rich Roll Podcast Another Mother Runner Podcast Follow Mary on Instagram: @runmarycain Connect + get support: Are you an athlete? Find a sports dietitian, DPT, therapist, or coach who understands athletes at lane9project.org/directory. Are you a clinician or coach? If this conversation resonated with you professionally, Lane 9 Membership was built for you. Join a community of dietitians, DPTs, psychologists, sports medicine providers, and coaches who are doing this work, and get listed in the Lane 9 Directory so athletes can find you. Future clinicians and coaches are welcome too. Follow us on Instagram and get in touch anytime!