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Is High School Running in Need of a Reckoning?

As more programs encourage young athletes to train like professionals, female runners report problems with restrictive eating, irregular menstrual cycles, and long-term bone damage.

By Margie Cullen and Anne Marshall-Chalmers. This story appeared in Runner’s World on November 18, 2022.

(Photo illustration by Runner’s World using Getty Images)

Desiree Stinger ran her first race in hot-pink Crocs. She was 10 years old, and when she got dressed that morning, she had forgotten that the fourth-grade fun run that looped around her elementary school was that day. She wanted to win, even in those awkward shoes, and burst ahead, ignoring the pleas of a friend—“Desi, wait for me!” Classmates were left huffing in her wake as she claimed first place.

Stinger’s parents and her P.E. teacher saw the win as a glimmer of big things to come. She continued to run, off and on, with her middle school team. After clocking a 6:32 mile in eighth grade, she caught the eye of Doug Soles, the cross country and track coach who had taken Great Oak High School in her hometown of Temecula, California, from not qualifying for the state championship to winning it. Over the next few months, Soles emailed Stinger and her family repeatedly, and girls from the high school team crashed her middle school graduation party to drop off a T-shirt and a list of 10 reasons she should join the team. Stinger was overwhelmed. She had a vision of herself playing volleyball in high school, or doing theater. But the persistent requests from Soles eventually wore her down, and she plunged into the life of a distance runner on one of the country’s top-performing high school teams.

At the time, Stinger was 14. By the end of her freshman year, her weekly training would begin with a 13-mile run on Monday morning before school. In the afternoons, she and her teammates would usually return for another six miles. Experienced runners on the team averaged 60 to 80 miles a week. Some parents didn’t think twice—to be the best, the thinking went, you need to do more than the others.

But Stinger’s father, Craig, grew nervous. Distance running, he felt, could be “brutal” on the body. While he worried about Desi’s physical and mental health, he also wanted to support her and her Great Oak team. “How I looked at it was, we’re part of their program, so we’re following their program,” he says. “But at the time you don’t know how much of a toll it’s taking.”

Soles often spoke to his runners about “finding their why,” or the inner fire that would motivate them to run at an elite level. He was known for lengthy motivational speeches and would meet with runners individually at lunch so they could set goals and talk about running. He made runners feel important, and when he’d call a group of newbie freshmen “my future state champions,” they believed it. “Our coach had our full and undivided trust,” Stinger says. As her times improved, so did her trust in him. “Whatever he said, we did.”

Stinger’s father became a one-man support squad. To ensure his daughter was fueling well, he would hand her a protein-packed smoothie when she came home from practice. To treat her sore, depleted legs, he kept 10-pound bags of ice in the freezer for nightly ice baths. To prevent fatigue, he instituted an early bedtime of 9 p.m. Stinger embraced these habits; once she joined Great Oak, she never wavered on her commitment.

During her high school years, from 2012 to 2016, Great Oak won four state championships and placed second at Nike Cross Nationals. Stinger graduated with seven varsity letters and a sub-five-minute 1600-meter time, securing her an athletic scholarship at Washington State University. But she arrived in 2016 with a nagging pain in her lower leg. She felt tired, unable to run anywhere near her high school times.

Under the coaching of Doug Soles, Great Oak High School in Temecula, California went from not qualifying for the state championship to winning it.

A DEXA bone density scan revealed that her 18-year-old bones were on the borderline of osteopenia, a precursor to osteoporosis that generally occurs in postmenopausal women over age 50, putting her at risk for stress fractures and possibly hampering her ability to run well into adulthood. Many of her high school teammates had it worse: One would learn she had severely low bone density after developing three stress reactions in her hips, while another tore both of her labrums, the thick cartilage that acts as a bumper around the hip socket. Ultimately, both girls were so debilitated they had no choice but to quit their collegiate teams. Stinger’s best friend from Great Oak suffered similar problems, racking up a stress fracture in each of her femurs in high school. Burned out, she left her college team after just one season.

The likely culprit, Stinger’s WSU team doctors told her, was all the heavy training she and her friends did at Great Oak in their early teens.

Competitive runners often struggle to walk the line between training and overtraining, between fueling and the belief that extra pounds doom performance. Stakes are highest for runners in their early teens. At that age, athletes are rapidly building bone density, a process that requires a slew of hormones. Girls who pound out 40- or 60- or 80-mile weeks and don’t eat sufficiently can end up deprived of necessary hormones, sometimes to the point where they stop menstruating. According to one 2011 study, for every year menstruation is delayed, the risk of bone stress injuries increases by 34 percent.

Stinger says that at Great Oak, when some girls missed their periods, “We all thought it was normal.”

Through interviews with researchers, parents of athletes, a dozen running coaches, and nearly two dozen young women who participated in top high school running programs in the United States, we unraveled a youth running culture for girls that pushes the most promising young athletes into intense, year-round training that may batter their bodies with effects that last far beyond high school. Those who emerged from the sport without succumbing to restrictive eating patterns or repeated injuries would often describe themselves as “lucky,” as if mystified at how they threaded the needle just so.

Competitive running boomed in the U.S. in the 1970s and ’80s. As track and cross country grew in popularity, high school track programs became increasingly competitive, pushing high mileage and rigorous training. Coaches occasionally plucked speedy grade schoolers to race at the high school level. (In 1993, a fifth grader in Kentucky won the state’s 3-A Division cross country championship.)

In the early ’90s, researchers followed 60,000 high school athletes in 18 different sports—including football, wrestling, and soccer—and found that athletes in girls’ cross country had the highest injury rate of any sport. More recent research builds on these findings, showing that female cross country runners have the highest rate of bone injury of any U.S. high school athlete. (Male cross country athletes are third.)

Currently, around 1.2 million high school boys and girls compete in track and field and 500,000 in cross country (likely with overlap). The competition has only grown fiercer. Most of the high school girls’ distance records have been set in just the last decade. The number of high school boys who have broken the four-minute mile barrier has more than doubled in the last decade. New powerhouse teams keep popping up: Newbury Park in Thousand Oaks, California, achieved the unheard of when, in 2021, it crossed the boys’ state cross country championship finish line 1, 2, 3, 4. Its top runner in the 2021–22 season set three national high school records.

“It’s hard not to celebrate it,” says Emily Kraus, M.D., a sports medicine physician and researcher at Stanford University, as well as a runner. She’s also witnessing the downsides in her clinic.

Kraus says that over the past few years, she’s seen more and more young runners get injured and struggle under the intense pressure to perform. She’s noticed athletes commit to running year-round at an early age, presumably with the blessing of their parents. (A coach of a postcollegiate elite team in Minnesota says he has had parents of 9-year-olds ask to join.) Kraus is concerned that many of her patients are too restrictive in how much and what they eat. It stems from an old, misguided practice in which distance runners believe lighter is faster, only to put themselves at risk for anemia, relative energy deficiency in sport (RED-S), and a range of musculoskeletal injuries including suboptimal bone health prone to stress fracture. “These habits do have long-term consequences,” Kraus says.

In 2018, some of Kraus’s colleagues began organizing what they hoped might serve as a wake-up call for the sport. Adam Tenforde, M.D., director of running medicine at the Harvard-affiliated Spaulding National Running Center, along with two other doctors who specialize in youth running, believed that not enough was known about safe training levels for preteens and teens, whose bones are lengthening and whose muscles and tendons are conforming to a new body. They felt that youth running culture had become hypercompetitive, stocked with club teams and professional coaches for hire; some middle schoolers were training like high schoolers and many high schoolers were training like collegiate athletes or professionals.

Over several months, the trio recruited nearly 20 other researchers and doctors, including Kraus, to review and distill 1,602 scientific studies and articles into a youth running consensus statement published in the British Journal of Sports Medicine in the fall of 2020. It’s an imperfect document, and some findings seem obvious: The more hours that 9- to 15-year-old girls spend running, the greater their risk of bone injury. There was no clear answer as to exactly when and how much young athletes should train.

But the statement ends with a call for “essential tasks,” including further research on the diets of youth runners and the potential long-term risks of starting competitive running in middle school or younger, as well as better screening for runners who may be prone to injury, whether due to poor mechanics, undereating, or strenuous regimens.

Just as the sports medicine community galvanized attention around concussions in football 20 years ago, the hope was that the published consensus statement might spur similar concerns about the well-being of young runners. “From an education standpoint, you can see the shift on what happened with concussions,” Tenforde says. “There could be a tidal wave of change if enough people get upset and outraged.”

Nearly every region in the U.S. has its legendary coaches with dazzling accomplishments driven by a mysterious alchemy. Doug Soles was one of them. He won. A lot. Over his 17 years at the helm of Great Oak, his teams claimed 14 state cross country titles, six national podium finishes, and one national title. “I love what I learned from running under Soles,” one of his former runners says. “It was intense. It was hard, but it taught me self-discipline. It taught me dedication. It taught me how to work as a team. It taught me a ton of great things that I still use every day.”

“Our coach had our full and undivided trust,” Desiree Stinger, a former Great Oak runner, says. As her times improved, so did her trust in him. “Whatever he said, we did.”

Just west of Chicago, the late Joe Newton of York High School earned icon status—solidified by a 2008 documentary—for his 60 years of consistently producing strong male runners, some of whom logged 80-mile weeks. Outside of Syracuse, New York, there’s Bill Aris, longtime coach of Fayetteville-Manlius, whose “gender-blind” program preached a “Stotan” philosophy—a mix of stoicism and Spartan toughness. “Pain is the purifier,” Aris would repeat to his athletes. His methods have brought the Stotans to the national championship every year since at least 2006.

Aris, the subject of the 2019 book Amazing Racers, created a program that entailed two-hour runs and recovery runs at a pace of, as one runner put it, “if you could talk, you weren’t going fast enough.” Mackenzie Carter, a Fayetteville-Manlius alum, would often get anxious in workouts and fall behind. Now, at 30, she knows she was having panic attacks, but she recalls that her coaches did not take her condition seriously.

At Great Oak, Stinger and several other runners recalled that Soles required his athletes to wear GPS watches during practice; any runner who showed up without a watch wouldn’t be allowed to train with varsity, according to an early season handout. (Coaches could also use GPS data to tell athletes to slow down their runs, Soles said in a message responding to our questions, in which he requested that his answers remain off the record.) “No more my mom doesn’t want me to run for 3 days,” another one of his expectation sheets read. If they felt pains, Soles insisted that they talk to coaches first before a doctor.

Some girls on the Fayetteville-Manlius team would commit to highly regulated meals, like peanut butter and jelly sandwiches or salmon, sweet potatoes, and leafy green vegetables. No desserts. Come Thanksgiving, with the regional meet in two days, many runners heeded Aris’s advice to swap a large turkey dinner for pasta and vegetables. (Aris called this a “total misrepresentation” of his guidance, which “encouraged, not demanded… nutrient-filled eating.”) In Amazing Racers, a runner’s decision to avoid a big holiday meal two days before an important regional meet comes down to tryptophan, the amino acid that causes fatigue. “I use this old analogy: You guys are not Volkswagens. You’re Ferraris or Porsches. You need to put plenty of high-octane fuel in,” he says.

Soles offered similar guidance at Great Oak; many runners recall a seven-week plan leading up to the state meet that encouraged cutting back on bread and sugar. Nothing was enforced, and Soles and Aris say that some runners would devise their own strict diet plans. But as one runner put it, they restricted their eating to signal a commitment to the team’s goals.

Aris is aware that some college coaches won’t recruit his runners because they believe the athletes have already peaked. (It’s not uncommon for college coaches to research training load and injuries in high school to weigh a potential recruit’s future success.) But he also believes that his success unfairly made him a target. “One of the common accusations of our program, in me personally, is that I run kids into the ground to where there’s nothing left for them when they go to college,” he says. He calls that idea “ridiculous.”

“The kids I have coached are not overtrained nor run into the ground as has been insinuated,” he wrote in an email. “Many factors affect kids when they leave home (and our program) to go to college.”

Bill Aris, longtime coach of Fayetteville-Manlius outside Syracuse, New York, preached a “Stotan” philosophy—a mix of stoicism and Spartan toughness. His methods have brought the Stotans to the national championship every year since at least 2006.

Aris also believes that parental pressure, not coaching, is more often the source of unhealthy behaviors. While that may be true in some cases, several runners say that as young athletes, they believed success required complete obedience to their coaches. They also felt uncomfortable rejecting guidelines that they believed would lead to a coveted college scholarship. “I felt so stuck,” Carter says. “The idea hardly crossed my mind that I would be able to go to school for something other than running.”

In high school sports, there’s little outside oversight; it’s wholly unlike the NCAA, which requires compliance officers on campuses to enforce rules such as limited practice hours, or professional sports leagues that engage with player unions to hammer out guidelines that protect athletes. Most schools don’t have the money to hire nutritionists or team doctors. Coaches aren’t required to report injuries to any central governing body, team trainer, or athletic director.

Chris Lundstrom, a volunteer assistant high school coach and the head coach of an elite postcollegiate team, says the gap between science and coaching is troubling. “There’s this whole academic side, and that information is not generally consumed by coaches. It’s just not.”

Coaches learn their trade from many sources, but often from one another. Runners from Great Oak recall Soles scouring the internet for tips, while Aris researched notable coaches from the 1900s such as Arthur Lydiard and Franz Stampfl, as well as Percy Cerutty, an Australian coach from the 1950s and ’60s.

​​Lundstrom is concerned about what he calls “professionalized high school programs,” that produce “short-term results, sometimes at the expense of an athlete’s long-term health.” Tenforde says it’s hard to gauge how “early youth specialization” is impacting runners over the long term. Studies are hard to do; there’s not a lot of funding, and getting buy-in from coaches, parents, and athletes can be challenging. (Tenforde is among a group of researchers with the American Medical Society for Sports Medicine that plans to further study early youth sports specialization.)

As an elite coach, Lundstrom wants runners to peak in their 20s and 30s. High school coaches operate on a much more compact timeline. Athletes come and go in four years’ time, and coaches set the tone for how that time is spent.

Soles had a feverish desire to produce nationally ranked teams. In a 2018 coaching clinic, he framed coaching this way: Either you develop “wonderful human beings, life is great and whatever the results are we’ll live with it,” or you coach to win. “I want to win at the end of the day,” he said. “And we’re going to come up with a process that makes sure we do it whatever the work is.” (Soles, who resigned from Great Oak in 2021, did not agree to an interview for this story but sent a lengthy statement in response to our inquiries. He felt the subject matter would only make parents of runners scared and coaching more difficult, and he suggested that other high school sports are much more rigorous. He is now the head coach of Herriman High School in Utah.)

One parent, who did not want to be named, credits Soles with his daughter’s strong work ethic and confidence—traits she has carried into adulthood. Indeed, Aris said that his goal was to set up his athletes well for life. But there’s no standardized training for high school coaches. Elizabeth Carey, an assistant track and cross country coach in Washington state, believes that so much autonomy can be precarious. “There is such a thin line between disorder and things we praise,” she says. “Do you have a really strong work ethic or are you compulsive?”

When high school girls read online running forums, they see posts like these: “When women go hardcore about diet, they run fast” or “The most successful runners in college will be the girls with the best stride who weigh the least.” Runners also regularly encounter more subtle suggestions about their weight. A few runners recalled Soles repeating that once-speedy high school girls would often go to college and find boys, gain weight, and slow down.

During his 2018 presentation at the Boulder Running Clinic, an annual gathering of top-tier high school running coaches, Soles advised his colleagues to ignore those who frown at high mileage. “At the end of the day, guys, we run. We’re coaching runners. Don’t be afraid to get out there and get some mileage in.” He also praised his “fit” runners, reassuring the crowd that his runners weren’t skinny, but strong. “I’m always talking with the kids about burning calories, making sure that they are using up the extra stuff,” he said. “You get those girls who come in, and maybe they’re five or six pounds heavy. I’m never going to ask them to not eat. We eat a ton. But I’m going to do everything I can to make sure that we get rid of that excess weight through training.”

(“Cherry-picking quotes from videos and trying to apply them to a story like it was something said for the story is wholly incorrect,” Soles told us. “I’ve always said I want to win, but never at the expense of an athlete’s health.” Soles said he always kept protein bars, protein shakes, and Gatorade in his classroom for runners to snack on, and two of his former runners say they remember him as someone who was always trying to be the best coach he could be.)

A couple of years ago, Carey found a newspaper article from her high school running days in which she linked her success with not eating “bad” foods all season. “I probably wasn’t eating enough. That’s why I got stress fractures,” she says. “That language is so ingrained and intertwined with our sport that it’s very difficult for some folks to understand how that can be disordered.”

According to the National Eating Disorders Association, around 42 percent of high school athletes who compete in sports that place value on leanness—such as gymnastics, figure skating, or bodybuilding—reported developing restrictive or compulsive eating habits. Recent research at the collegiate level has shown that female distance runners are also at risk for disordered eating. Studies at the high school level are limited due to the need for parental consent, but a 2013 study of adolescent runners by Tenforde indicates that the risk of developing a stress fracture among female runners with an eating disorder is five times greater than that of runners without one. One coach we interviewed says they avoid talking about eating altogether out of fear that even a well-intentioned suggestion toward healthy meals can tip into restrictive eating.

“When you’re in high school and you’re a high school girl, you’re literally at your most vulnerable,” says Nicole Rice, a former Great Oak runner who’s now 23. “I measured how I felt about myself with how proud [Soles] was of me.”

Kids can run long distances safely. But, Bill Roberts, M.D., says, “they should be performing well in all aspects of life. They should be social, psychologically intact, they should be eating well.”

As a high schooler in the early ’90s, Melody Fairchild, the first U.S. girl to break 10 minutes in the two-mile, was hyped in the press as the greatest female high school distance runner of all time. She was described in newspapers as “waiflike” or a “feathery 5-foot-2-inch, 95-pound runner.” At 17 years old, though, she had lost her mother to cancer and was battling burnout, a desire to be “healthy” that she says she “took to an extreme,” injury, and a coach who wasn’t as attentive to her needs as she wished. “If you combine a highly motivated runner with a really ambitious coach, you can run yourself ragged as a young woman,” Fairchild said in a 1993 New York Times story.

Fairchild is now 49 years old and the coach of a youth running club in Colorado, and she worries that the pressure and intensity she felt all those years ago has only ramped up. “I was one of those girls who was afraid of her body,” she says, “afraid of my period, afraid of gaining weight.”

Though she coaches elementary and middle school kids, she keeps in touch with several successful high school runners. She says it seems as though they’re solely focused on scholarships, year-round racing, and rankings, forgoing a more well-rounded teenage life. “It’s out of control,” she says.

It doesn’t help, she says, that top-tier high school runners now amass thousands of social media followers. High school running “is in need of a reckoning,” Fairchild says. “We’re not raising a generation of runners for life. It’s not a sustainable approach.”

Research included in the 2020 youth running consensus statement showed that most runners of high school age (males and females) are not meeting their nutritional needs. In girls, that can cause a cascade of health problems such as RED-S. What starts as a lack of energy leads to a change in the part of the brain that releases hormones to organs. “When there is a suppression of hormones like estrogen, it actually promotes bone breakdown and prevents new bone formation, leading to bone stress injuries (stress reactions or fractures),” says Kraus, the sports medicine doctor at Stanford.

Even if a runner scales back and starts eating more, the consequences can last well into the future. “A young woman who didn’t have regular menstrual periods at the time when they were growing bone mass may not reach peak bone mass,” says Tenforde, who is also among the few researchers studying the relationship between energy deficiency and bone injury in male runners. “That loss may not be fully reversible.”

Coaches, especially men, aren’t jumping at the chance to talk about hormones and menstruation. Many interviewed for this story say it might be mentioned on a list of health tips; two coaches said they might point to a female assistant coach for such matters. Aris says he regularly discussed periods with his athletes, saying it was a “biological matter” that he could talk about “every day of the week without blinking an eye.” But Carter remembers being “expected to ride that line” of pushing herself as hard as possible while still getting her period.

Christie Rutledge, a former Fayetteville-Manlius runner, is adamant that it’s important for coaches to build trust and pay close attention to young girls. “They don’t always say when they’re hurting.”
Kraus is leading a team at Stanford that is trying to better educate athletes, coaches, and practitioners on the female athlete triad, puberty, and running. It’s called FASTR (Female Athlete Science and Translational Research) and offers resources on menstruation, development, and their relationship to injury. Kraus would like to see coaches and athletes modify their training during growth spurts and puberty to help ease the strain on rapidly changing bodies—perhaps more strength and agility training and less mileage. The goal, she says, should be to “prioritize developing strong, lifelong runners.” Teenage runners, she believes, would likely emerge healthier.

But it’s difficult to implement as long as there is an overall mindset in high school running (and all running, for that matter) that thin means fast, and fast is everything.

Kids should run. They can even run a lot. Bill Roberts, M.D., a professor of family medicine and community health at the University of Minnesota, has been studying youth running for nearly 40 years. In the mid-1980s, as medical director of the Twin Cities Marathon, he received a panicked call from the race director who reported that a 10-year-old had signed up for the race. Wasn’t that too young? Roberts wasn’t so sure.

He looked back at 19 years of Twin Cities marathon records and found 310 kids under the age of 18 who had competed. (One was only 7 years old.) Only four minors, or 1.2 percent, wound up in the medical tent due to fatigue and aches, compared to about 2.5 percent of adult competitors. That 10-year-old the race director was so worried about had a big smile at the end and looked a lot happier than his dad, who’d accompanied him in the race.

Roberts, who coauthored the consensus statement, is certain that kids can run long distances safely. But, he says, “They should be performing well in all aspects of life. They should be social, psychologically intact, they should be eating well.”

Over the last few decades, parents and coaches have put increasing value on choosing a sport early and sticking to it. A seminal 1993 study by the Swedish psychologist Anders Ericsson boosted the notion that musical greats were the product of thousands of hours of “deliberate practice.” Shortly thereafter, athletics embraced this idea.

Like Stinger with theater and volleyball, many of the girls we interviewed had given up other interests at a young age to commit to running. Carter wanted to try lacrosse in the spring of seventh grade, but Aris and her parents, she says, convinced her that it would be a waste of her talents. “And I’m 13, mind you, while these conversations are happening,” she says.

Christie Rutledge joined the modified Fayetteville-Manlius team in seventh grade before moving on to the high school team in ninth grade. During her first few years, Rutledge was admittedly slow. She would still be running as race organizers picked up the cones lining the racecourse thinking everyone had finished.

That changed under Aris. She enjoyed piling on the miles, and she loved life as a Stotan. In the summer before her junior year, she surprised everyone, including herself, when she won the intrasquad time trial. She had gone from being one of the slowest on the team to number one.

In 2010, Rutledge took second at Nike Cross Nationals, leading her team to a win with the lowest score in NXN history. In her interview, you can hear the joy in her voice as the wind whips through her straight brown hair, the braid leading into her ponytail still perfectly intact even after the grueling race. She describes that day as “euphoric.”

But Rutledge kept something to herself. Unintentional weight loss had reignited an eating disorder she’d first battled in middle school. After NXN, Rutledge’s parents realized something was wrong. They found mental health treatment for her, watched her eating closely, and weighed her every day.

A couple of months after her victory, Rutledge was on the last rep of a workout, 90 minutes with 90-second sprints, when she felt a sharp pain deep in her right hip. She limped back to her high school. Doctors couldn’t immediately diagnose the pain, and she had to sit out much of her senior year. Her parents didn’t know it, but she had started purging food to keep weight off, and by the time she started college at Dartmouth, she hadn’t had her period in three years.

“I think my coaches did a very good job for what they could do,” she says, citing Aris’s decision not to have her race cross country her senior year. But Rutledge is adamant that it’s important to build trust and pay close attention to young girls. “They don’t always say when they’re hurting.”

That may be changing. More runners are speaking up, building awareness about the sport’s effects on women’s health. Recently, six female runners at the University of Oregon, a school with one of the most storied running programs in the country, accused coaches of body shaming and using high-tech body fat and bone density scans to suggest when athletes needed to slim down. And in October 2021, the celebrated runner Mary Cain—who turned professional at age 17—sued her former coach, Alberto Salazar, and Nike over alleged emotional abuse largely involving her weight.

Jessie Magoto, who has coached a top-ranked cross country team at Minster High School in Ohio for 23 years, recently told her runners that she was looking for a nutritionist to speak with them. “One of my runners said, ‘Hey, coach, when you’re looking, can you find someone to talk to about food anxiety? For instance, when I’m finished with a season and I take two weeks off, I’m worried about what I’m eating and if I’m eating too much,’” Magoto recalls. “I said, ‘I am so glad you’re willing to say this out loud.’”

Stinger, who’s now 25 years old, graduated from Washington State in 2020. She works for Stanford University Athletics in the compliance department, the system that enforces NCAA rules such as the number of hours teams are allowed to practice each week. Her high school experience, she says, shaped her desire to protect athletes. “There is nothing wrong with wanting to be competitive or successful,” she says. “There is something wrong with chasing success at the expense of the athlete’s physical health, development and emotional and mental being.”

Stinger’s best memories from high school involve her teammates, not titles. Maybe, she thinks, programs need to better focus on that: less pressure and more fun. This is high school, after all.

Rutledge, now 28, competed in only three meets at Dartmouth before having to seek treatment for her eating disorder. “I don’t regret my experience. I wish things had turned out differently,” she says. “In high school, everything seems like it’s the most important thing to be at the very top and to do everything you can to get there, but I do look back and think I would give anything to just be able to go out for a few-mile jog right now.”

Rutledge doesn’t run anymore. She wants to, but at least for now, she can’t. That hip pain turned out to be ischial tuberosity avulsion fractures, a relatively rare injury usually caused by strenuous exercise in teenagers. Years out, she’s not fully healed. Carter doesn’t run either. “It gives me anxiety to this day to go out for a run,” she says. About half of the women we spoke to struggle to run. They lost the joy of the sport.

Support for this reporting was provided by the Investigative Reporting Program at the University of California, Berkeley.

Margie Cullen ran D1 cross country and track and field for Georgetown University and U.C. Berkeley. She was the 2018 Big East Conference steeplechase champion. Post-collegiately, she continues to race but has left her hurdling days behind. Cullen has a master’s degree in journalism from the U.C. Berkeley Graduate School of Journalism and is an editor at California magazine.

A California native, Anne Marshall-Chalmers spent several years working as a reporter, writer, and audio producer in Tennessee and Kentucky before returning to the Bay Area to earn a master’s degree from the U.C. Berkeley Graduate School of Journalism. Her work has appeared in the Los Angeles Times, Atlas Obscura, USA Today, Bay Nature, Earth Island Journal, NPR, Cal Matters, Inside Climate News, and Louisville Magazine. Marshall-Chalmers is a lifelong runner with two young children.

Production Staff & Crew

Margaret Cullen ( 2022 )


Anne Marshall Chalmers ( 2022 )