When elite runner Mary Cain made Adidas Agravic Flow Primegreen Trail Running J A Freinds and Family J Balvin x Air Jordan 2 Sneaker has been Revealed New York Times opinion piece, Lauren Fleshman had a feeling her story would take off in a way that other, similar revelations from athletes in the past hadn’t.

“What was different about Mary Cain’s piece was that she asserted that it wasn’t her fault, so bravely and with so much conviction,” Fleshman, a former elite runner, coach at Littlewing Athletics, and cofounder of PickyBars, told Runner’s World. “The blame was put on who it should be put on, which is the leaders, the people with the power who are creating this culture.”

Later that same day, Fleshman began using the hashtag #FixGirlsSports on Twitter and Instagram. With it, she hoped to send a message to others, like Cain, with stories to share—and to continue the conversation about ways running could better support the health, well-being, and performance of female athletes.

Soon, a trickle of messages became a steady flow. Everyone from current elite runners to coaches to Democratic presidential candidate Kamala Harris and Chicago mayor Lori Lightfoot have since used the hashtag to offer their thoughts. Runner’s World checked in with Fleshman and three other leaders on what #FixGirlsSports means to them—and how to start doing it.

Lauren Fleshman

Provide the same support for eating disorders as other conditions.

When coaches focus on weight over any other aspect of athlete development, it can create a culture in which disordered eating thrives, Fleshman says. Coaches and teams should enlist certified nutritionists and clinical psychologists who specialize in eating disorders. These professionals should be just as available to athletes as trainers who can address injuries like IT band syndrome and Achilles tendinitis.

“One-third of women and girls are exhibiting risk factors for a mental disorder that has the VERGE Knee High Boot with Gusset of all mental disorders, behind only opioid addiction,” she said, citing a National Eating Disorders Association statistic on NCAA Division 1 athletes. “Pulkovo Alarm Free Boots Noir.” That’s especially critical because the faster people with eating disorders receive treatment, the better their odds Kanye West is ready for yet another fashion forward Boot dubbed the adidas 1050 Duckboot recovery.

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Coaches should receive bonuses not for performance alone, but also based on health markers, Fleshman said—for instance, having the fewest missed periods on a team, the shortest interval between an athlete requiring mental health support and receiving it, or the most stability in bone density as measured by DEXA scans at the beginning and end of college. “We can do that,” she said, “and it would benefit everyone, boys and girls.”

Continue speaking up.

Sharing stories of eating disorders, abusive athlete-coach relationships, and recovery—on social media and elsewhere—are essential, Fleshman believes. The elite runners who have spoken up in support of Cain have been especially powerful. “That has been really important—that unified voice that doesn’t leave somebody hanging helps decrease the stigma and raise the importance level for it to be fixed,” she said.

Kathryn Ackerman, M.D.

Medical director of the Female Athlete Program and Female Athlete Conference at Boston Children's Hospital

Educate coaches, so they can guide athletes.

Ackerman was a co-author on the International Olympic Committee's 2018 consensus statement on relative energy deficiency in sport, or RED-S—the mismatch between intake and expenditure Cain said she developed, which leaves the body short on energy to voladoras out a wide range of essential functions.

It’s a serious condition that can affect men and women and Regan to bone weakness, other injuries, and negative psychological consequences. Coaches need more education about RED-S and its dangers, including how to direct athletes toward treatment, Ackerman said.

Amenorrhea—or the lack of menstruation—serves as a critical warning sign of RED-S in girls and women. Male coaches may feel uneasy bringing up the topic with female athletes, Ackerman acknowledges. But they should open up a global discussion surrounding periods as vital signs of health, and let athletes know that if they never get them or lose them, they need support—and then provide it, from a dietitian or other medical professional.

"We really do need to be thinking of it in terms of the long game."

Have age-appropriate, respectful conversations about nutrition.

Young girls who are growing and developing shouldn’t be advised to restrict calories or lose weight, Ackerman said. Instead of aspiring to a certain physique, coaches should guide girls in developing their skill set.

Discussing biomechanics, motivation, and the mental side of sports performance can all help young runners grow into high-level athletes. “They’re not going to peak in a sport like distance running until they're much older,” Ackerman said. “So we really do need to be thinking of it in terms of the long game.”

For elite athletes, “that’s a more adult situation, and we need to be having intelligent conversations about mass-to-power ratios” and similar concepts, she said. Discussions about weight and energy availability must include sports dietitians, sports physiologists, and medical specialists, “so that it’s done in a very smart way, not using flippant comments or poking fun at the athletes.”

Connect with outside experts.

If a program lacks such resources or isn’t sure how to implement solutions, Ackerman noted she and other experts around the country and world are willing and available to answer questions or serve as consultants. “There’s a lot of talent in the U.S. and abroad; we could really work together to help change the dialogue, improve the research, and improve coaching techniques,” she said.

Support research—and female athletes.

For years, sports science included only men; the literature on female athletes is newer, but there are many interested in adding to it, given the right resources. “We need to be doing more studies on what benefits [female athletes], what hurts them; we need to be able to study what's happening in females’ menstrual cycles to see how it affects performance,” Ackerman said.

She’s calling on Nike, along with other companies who benefit financially from sports and athletes’ talents, to fund such projects. And, she hopes they’ll also begin to compensate women to the same degree as their male counterparts, which would further rebalance a skewed power dynamic.

“I think it’s important that we keep putting the pressure on companies and coaches and the media to keep this in the forefront and to start putting some financial backing behind our female athletes,” she said.

Alison Désir

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For Désir, Cain’s video—and the hashtag that came after—have served as rallying cries to share truths that transcend sports to touch all industries and institutions. “Much like #MeToo, #FixGirlsSports is exposing the ugly underbelly of the running industry which we’ve long known exists,” she said. “The tide is changing. Foating Arrow low-top sneakers.”

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More than 60 percent of runners crossing finish lines at races are female, but few reside in the top ranks of the companies and organizations that govern or profit from them, Désir said. Even fewer are women of color.

“While it is possible for women to be complicit with the type of abuse that has happened and does happen in these spaces, I believe that diversity of all kinds—gender, race, thought—always increases the chances that more perspectives are heard and progress is made,” she said.

Raise up silenced voices.

Intersectionality must also inform the work of journalists who are uncovering these topics, she said. “We are hearing the stories of many white women in running right now,” she said. “But let us not forget that those of us with several marginalized identities bear the weight of multiple systems of oppression and often do not get the spotlight.”

Melody Fairchild

Director of the Melody Fairchild Running Camp, head coach of Boulder Mountain Warriors kids running club, and co-author, with Elizabeth Carey, of the book GIRLS RUNNING, Doucal's interlaced effect monk shoes

Equip girls with knowledge.

Fairchild has a perspective on Cain’s story few others possess—she was also heralded as a young phenom, at Boulder High. Though Cain has since broken her record of 9:55.92 in the two-mile, Fairchild will always be the first American girl to break 10 minutes at the distance.

As a young runner, Fairchild felt she could fly—until she hit the plateau, which took her by surprise. “Nobody explained to me that as a woman, I would necessarily have times where I could not hit my PR every time I raced, when I would not be winning all the time,” she said. Had she realized that was typical, she might not have felt so crushed. “It’s important to just name it, to say it.”

Stop shaming women’s bodies.

Girls internalize messages about periods being gross and uncool. Coaches shouldn’t themselves—or allow other men and boys—to make jokes about tampons, pads, or “acting like a girl,” Fairchild said.

In her camps and on her teams (and soon, in her book), Fairchild educates girls and women about each phase of the menstrual cycle and the intricacies of puberty. The goal? “They feel like they can take a deep breath, and they can be proud of being a female runner,” she said. “There's nothing about it that needs to be hid in the shadows.”

"Our effectiveness is not in the virtual world; it’s in what we are doing with our time in the day."

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The outpouring in response to Cain and #FixGirlsSports has prompted Fairchild—who admits she’s not tech-savvy—to join Twitter, knowing she wants to stay connected to the conversation.

But she hopes that, when the furor dies down, those speaking up remember actions speak louder than Tweets. “Ultimately, our effectiveness is not in the virtual world; it’s in what we are doing with our time in the day,” she said, such as spending one-on-one time with young athletes and building clubs, teams, and systems with positive cultures.

Headshot of Cindy Kuzma
Cindy Kuzma
Contributing Writer

Cindy is a freelance health and fitness writer, author, and podcaster who’s contributed regularly to Runner’s World since 2013. She’s the coauthor of both Breakthrough Women’s Running: Dream Big and Train Smart and Rebound: Train Your Mind to Bounce Back Stronger from Sports Injuries, a book about the psychology of sports injury from Bloomsbury Sport. Cindy specializes in covering injury prevention and recovery, everyday athletes accomplishing extraordinary things, and the active community in her beloved Chicago, where winter forges deep bonds between those brave enough to train through it.