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London NHS RED-S Clinic

Royal National Orthopaedic Hospital (RNOH) 

Bolsover Street, London W1W 5AQ 

Founded in partnership with NIDMS and One Dance UK

Download referral information as PDF

What is Sport/Dance Endocrinology? What is Relative Energy Deficiency in Sports (RED-S)?

Healthy hormones are essential not only to optimise health, furthermore to achieve your full potential as a dancer or athlete. Issues with hormones can be due to a medical condition per se, or as result of mismatch between exercise training, nutrition and recovery.

 

Imbalance between the amount of energy provided from food and energy demands from exercise/dance training and maintenance of health, results in low energy availability. Low energy availability can arise unintentionally, or intentionally in an attempt to improve athletic performance. Problematic relationships with eating and/or training can cause this mismatch of energy intake and energy demand. Long-term low energy availability results in the clinical symptoms of relative energy deficiency in sports (RED-S) such as fatigue, problems with sleep, mood and illness, which can be precursors to soft tissue and bone injury.

 

Those at risk of RED-S are exercisers, dancers and athletes of all ages and levels. In particular those involved in activities where low body weight confers an aesthetic or performance advantage. This includes dancers and gravitational sports such as cycling, climbing, running, triathlon, gymnastics, aquatic sports, winter sports and many more.

If you are concerned that you may be at risk of RED-S, please seek a referral to the RED-S Clinic by following the below information.

Symptoms which may require a referral to the RED-S clinic include;

  • Weight loss, sudden or gradual

  • Periods stopping

  • Periods less regular and infrequent

  • Periods much lighter

  • Increased frequency of injuries (either soft tissue or bone)

  • Any bone stress injury

Want information on a different
NHS Dance Injury clinic? 

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How can I get an appointment?

  • You must first visit your GP, explain your concerns relating to risk of RED-S or hormone imbalance and ask for a referral to Dr Wolman's RED-S clinic

  • Please print this information (PDF above) or show this information on your phone during your GP appointment to help them make the referral.

  • Please note this service is a Secondary service, not Tertiary. Due to this service being an NHS service it is free at the point of use and as an NHS patient it is your legal right to choose where you would like to be referred

Referral options/details

From 1st October 2018, all GP referrals are now done electronically through the e-Referral System (e-RS). GPs, who are not familiar with the clinic, can search the electronic address using the key terms “Dr Roger Wolman” and “Royal National Orthopaedic Hospital” 

Referrals can also be made by Consultants and Medical Specialists from other hospitals. These can be done via letter, fax or email.

Secretaries names, emails and phone numbers

Laura Park and Pauline Lenihan

020 3947 0044.

rnoh.rheumatologyadmin@nhs.net

Full postal details:

Dr Roger Wolman, Consultant Rheumatologist, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP

What to expect at your first appointment

You will be sent a letter and also a text with the date/time/location of your first appointment. If you cannot make this appointment please cancel and re-schedule the appointment giving as much notice as possible. The slot can then be used for another patient on the waiting list.

To cancel or reschedule an appointment phone: 020 3947 0044

 

The 1st appointment usually takes between 30 - 45 minutes and  you will be seen by either Dr Wolman (Consultant in Sport and Exercise Medicine (SEM) or Dr Nicky Keay (dance and Sports endocrinologist).

What to expect after your first appointment 

 

Further investigations (where required)

These can include the following:-​

  • Blood Tests - are performed on the 1st floor of Bolsover Street and will usually be performed on the same day, again the consultant will advise you

  • DEXA Scan - To assess bone health

 

To arrange a follow up appointment in clinic phone: 020 3947 0044

 

Follow up appointment

After your first appointment you will be asked to take a form to the reception desk to make a follow up appointment. This is to ensure that you have a pre-arranged appointment to follow up with the consultant where you can review progress made in your rehabilitation without having to go back to your GP to start the referral process from scratch, particularly helpful if you need further treatment.

If you cannot or do not want to attend your follow up appointment, for whatever reason, PLEASE CANCEL IT! Missed appointments mean that other dancers have to wait longer to be seen.

 

To cancel or reschedule an appointment phone: 020 3947 0044

 

Results

Blood tests - You will only hear from the doctor if there is a problem with your blood test.

 

If you have any problems or questions regarding your referral please contact the NIDMS Manager on: 020 7713 0730 or manager@nidms.co.uk 

About the RED-S clinic

The dance injury clinic at the Royal National Orthopaedic Hospital was set up in 2012 and has gradually expanded since then, with the inclusion of a specialist, monthly dance endocrine/RED-S clinic from January 2019.  The clinic is run by Dr Wolman, Consultant in Sport and Exercise Medicine who has carried out extensive research into bone health, Female athlete Triad (RED-S). For those dancers requiring emotional support while recovering from their injury we are able to work with the Psychology department within the hospital.

Meet the team

Dr Roger Wolman MD (Res) FRCP FFSEM

Consultant in Rheumatology and SEM.  

Medical advisor to One Dance UK

Dr Roger Wolman MD (res) FRCP FFSEM is a consultant in Rheumatology and SEM. He has worked at the Royal National Orthopaedic Hospital since 1994 having previously worked at the British Olympic Medical Centre. During that time he carried out research on bone health the Female athlete Triad (RED-S) which included studying the bone problems that occur in dancers. Since then he has worked with many dance companies and schools including Central School of Ballet, Riverdance, Rambert Dance Company, English National Ballet and Birmingham Royal Ballet. More recently he has focused on the relationship between vitamin D and bone health and muscle function in dancers. 

 

He has been a medical advisor to Dance UK for over 15 years and continues to work as medical advisor to One Dance UK. He is a founding partner of the National Institute of Dance Medicine and Science and as part of that venture set up the NHS Dance clinic at the Royal National Orthopaedic Hospital in 2012. The holistic management of the dancer forms a core principle in the clinic where the emphasis is on non-surgical treatment. There is also a recognition of the importance of psychological factors in the management of injury. Dr Wolman has developed the clinical service to help meet these principles.

Dr Nicky Keay BA, Ma (Cantab), MB, BChir, MRCP

Dance and Sports Endocrinologist

Dr Nicky Keay has extensive clinical and research experience in dance and sport Endocrinology,  including a special interest and expertise in relative energy deficiency in sports (RED-S) in both dancers and athletes, which she presented at the IADMS conference 2018. This includes research in dancers and athletes in this area of sports/dance medicine. Nicky recently was invited to chair the British Association of Sport and Exercise Medicine (BASEM) conference on “Health, Hormones and Human Performance” and has written the BASEM website Health4Performance which is world first educational resource to raise awareness of RED-S amongst dancer/athlete, coaches/teacher, parents/friends and healthcare professionals. Nicky provides medical clinical input for the #TrainBrave campaign launched on BBC. As a keen Ballet dancer and sports enthusiast, Nicky understands the demands of these activities.

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