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Mary Cain raises women’s health issues in harrowing account of her time with Alberto Salazar

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In 2013, Mary Cain was the talk of the track and field world. The teenager with flowing hair and an irrepressible smile shattered high school records and became the youngest woman to qualify for a world championship 1,500m final. Surely Olympic glory and global athletics stardom would be next.

Instead, Cain’s performances dropped off. She had a solid year in 2014, winning the 3,000m world junior title, the Millrose Games mile and the U.S. 1,500m indoor title, and she took second in the U.S. 1,500m final. But in 2015, she was less competitive. Her struggles continued in 2016, and she finished 11th in her first attempt to make an Olympic team.

She enrolled in Fordham, near her Bronxville, N.Y., home, and took pre-med classes while dealing with a variety of injuries. In the last three years, her IAAF bio lists no results.

“Whatever happened to Mary Cain?” became a popular question among those who follow track and field, even casually.

On Thursday, in a devastating New York Times video, she answered. Her physical and mental health were destroyed — she claims, at the hands of Nike Oregon Project coach Alberto Salazar, who contacted the Cain family while she was in high school to say he wanted to coach the prodigy.

“I joined Nike because I wanted to be the best female athlete ever,” Cain said. “Instead, I was emotionally and physically abused by a system designed by Alberto and endorsed by Nike.”

Cain says she was told to lose weight — “thinner, and thinner, and thinner” — in order to get better, even to the point of taking birth control pills and diuretics. That staff, she points out, was all male. 

The problem was well-hidden. A March 2015 magazine piece, also in The New York Times, suggested Salazar was treating Cain carefully. The goal was to avoid ailments such as the “female athlete triad,” also called RED-S (relative energy deficiency in sport) syndrome, in which an eating disorder and the lack of a menstrual period are related to a weaker bone structure.

“Not eating appropriately for the amount of energy an athlete expends is really the root of this syndrome,” University of Wisconsin orthopedic surgeon Andrea Spiker said in an RED-S fact sheet that says missing just three cycles is a warning sign.

Cain said she missed her period for three years. And broke five different bones.

The mental toll was worse. She had suicidal thoughts and began cutting herself. She said she brought the latter to Salazar’s attention in May 2015, a couple of months after the magazine piece painted a rosy picture but a few hours after Salazar yelled at her in front of many athletes and meet officials gathered in a tent during a thunderstorm. Her parents soon brought her home to New York.

“I wasn’t even trying to make the Olympics any more,” Cain said. “I was just trying to survive.”

But she hid the depths of her problems. As recently as last year, Cain talked with Runner’s World about building back up to run in the outdoor season and expressed no regrets about her career choices.

The author of the 2015 magazine piece, Elizabeth Weil, says today she wishes she had spotted some red flags.

“I’ve thought a lot about the 2015 Mary Cain story I wrote over the years,” Weil said on Twitter. “[Because] in hindsight I got it so wrong.”

Former Nike runner Shalane Flanagan, who last month described her training group as distinctly separate from Salazar’s, also wondered aloud if she should have noticed the problems, reaching out to Cain on Twitter.

“I had no idea it was this bad,” Flanagan wrote. “I’m so sorry @runmarycain that I never reached out to you when I saw you struggling. I made excuses to myself as to why I should mind my own business. We let you down. I will never turn my head again.”

Coincidentally, soon after the 2015 magazine piece ran, Salazar’s program fell under heavy scrutiny. In June, the BBC and ProPublica reported that the Nike Oregon Project was under investigation by the U.S. Anti-Doping Agency. That investigation finally ended with a four-year ban for Salazar.

One of the former Oregon Project athletes who spoke out in the BBC/ProPublica piece, Kara Goucher, told NBC OlympicTalk she had hoped Cain would be treated better because of her age but that Cain simply wound up isolated.

“She was all alone,” Goucher said. “She had no one to support her.”

Officially, the Nike Oregon Project has been shut down, but several of the coaches and athletes are still working together. The athletes Salazar trained are a who’s who of distance running, including Galen Rupp, Jordan Hasay and Mo Farah. None of the athletes have been charged with doping, and U.S. Anti-Doping Agency chief Travis Tygart said this week he sees little reason for the World Anti-Doping Agency to investigate any further.

Now Cain wants to change the system.

“Young girls’ bodies are being ruined by an emotionally and physically abusive system,” Cain said.

Goucher agrees: “I think this is a broader problem of the way we treat women athletes as objects instead of humans.”

Cain gave a road map for reform: Change the culture at Nike, including a closer look at the coaches who worked with Salazar and continue to work with Nike athletes, and put more women in power.

And she says her running career isn’t over.

“Part of the reason I’m doing this now is I want to end this chapter, and I want to start a new one,” Cain said.

Left ambiguous is whether that statement applies only to herself or to her sport and sports in general.

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Alex Zanardi, auto racer turned Paralympic champion, has 5-hour surgery to rebuild face after crash

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SIENA, Italy (AP) — Italian auto racing champion-turned-Paralympic gold medalist Alex Zanardi underwent a five-hour surgery Monday to reconstruct his face following a crash on his handbike last month.

It was the third major operation that Zanardi has had since he crashed into an oncoming truck near the Tuscan town of Pienza on June 19 during a relay event.

Dr. Paolo Gennaro of Santa Maria alle Scotte Hospital in Siena said the operation required three-dimensional digital and computerized technology that was “made to measure” for Zanardi.

“The complexity of the case was fairly unique, although this is a type of fracture that we deal with routinely,” Gennaro said in a hospital statement.

After the surgery, Zanardi was returned to the intensive care unit in a medically induced coma.

“His condition remains stable in terms of his cardio-respiratory status and grave in terms of his neurological status,” the hospital medical bulletin read.

The 53-year-old Zanardi, who lost both of his legs in an auto racing crash nearly 20 years ago, has been on a ventilator since the crash.

Zanardi suffered serious facial and cranial trauma, and doctors have warned of possible brain damage.

Zanardi won four gold medals and two silvers at the 2012 and 2016 Paralympics. He also competed in the New York City Marathon and set an Ironman record in his class.

Last month, Pope Francis penned a handwritten letter of encouragement assuring Zanardi and his family of his prayers. The pope praised Zanardi as an example of strength amid adversity.

Shawn Johnson East shares struggles with body image, prescription drugs

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Shawn Johnson East, a 2008 Olympic gymnastics champion, detailed past struggles with body image and prescription drugs and reflected on her eating disorder as an elite athlete, to show there is hope to others in difficult situations.

“It all started with pregnancy and having my daughter,” East, who had daughter Drew in October, said on TODAY on Monday. “I had so many people asking me questions about how did pregnancy affect you mentally and how did you get your body back after having your daughter. I couldn’t answer that without giving a greater and a larger story.”

East first went public about her undiagnosed teenage eating disorders in 2015, three years after retiring from the sport. She said she limited herself to 700 calories per day and didn’t tell her parents.

In a June YouTube video, Johnson said she also binged and purged, including while dating future husband Andrew in the mid-2010s. And that she had depression and anxiety in 2011, when she returned to competition for the first time since the Beijing Games.

“I thought it would fix all of my problems,” East said of returning to gymnastics for a 2012 Olympic bid.

When East won “Dancing with the Stars” in 2009, she “hit a very low spot” going through puberty on national TV. She said she gained 15 pounds after the 2008 Olympics and started taking medications and drugs “to look like I did at the Olympics.” It included fad diets, diuretics and a three-week stretch of eating nothing but raw vegetables.

“Most pain of my entire life because I couldn’t digest anything,” she said.

At some point in 2011, East began feeling burned out. She was back to eating too few calories and overtraining. An unnamed USA Gymnastics doctor prescribed her Adderall “to lose more weight, have more energy and be more successful in gymnastics.” She took “heavy doses.”

“It helped my performances, but there were massive consequences to it,” she said. “I continued to compete into 2012, where I just started to get depressed.

“I was overdosing on Adderall. I was overdosing on any medication that wouldn’t be caught by USADA.”

Adderall was a banned substance in competition without a therapeutic use exemption, but was legal outside of competition.

“I was so controlled by other people’s opinions that I wouldn’t live up to that Olympic standard that I did anything to get it back and I could never have it back,” East said. “I didn’t learn that until later on.”

East’s mental hurdles re-emerged when she had a miscarriage in 2017. She blamed herself, believing her unhealthy lifestyle in the past was a contributor.

“Our natural inclination is to say, what did I do? And what did I do wrong?” she said. “It haunted me. I felt like I had sacrificed everything for an Olympic medal to not actually get the dream I had wanted my entire life [to have a child].”

With the help of a nutritionist and therapist and her husband, she conquered the demons through her 2019 pregnancy and childbirth.

“Having gone through a whole pregnancy and knowing that I felt confident through the whole thing, I feel like I’ve climbed Everest,” she said.

MORE: Why Nastia Liukin, Shawn Johnson went 8 years without talking

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