Why "Push Through It" Is the Worst Advice for Autoimmune Athletes with Mireille Siné, MPH

In this episode, Dr. Erin Ayala sits down with Mireille Siné, MPH — a certified running coach, lupus endurance athlete, and advocate for athletes living with autoimmune and chronic conditions.

Mireille has lived with lupus for 13 years and now coaches athletes who are navigating autoimmune disease, chronic illness, flares, fatigue, and identity shifts — while doing endurance sports.

Together, Erin and Mireille discuss:

• Why autoimmune athletes carry a “double load”
• How training stress can interact with immune dysregulation
• How to distinguish overtraining from a possible flare
• Why “push through it” can be harmful advice
• The importance of symptom tracking and medical self-advocacy
• What coaches should ask athletes with autoimmune conditions
• How to build flexible training plans
• Why performance is not just pace, PRs, and finish lines
• How to stop chasing the athlete you used to be and build toward who you can still become

Mireille Siné is a USATF and 80/20 Endurance-certified run coach, 14-time marathoner, and ultramarathoner based in Los Angeles. She is the founder of Coached by Mireille LLC, a virtual coaching practice specializing in runners and endurance athletes managing autoimmune conditions and chronic illness. Mireille coaches with the philosophy "train with compassion" — building training plans that account for the full reality of her athletes' lives, not just their race goals. She has been featured in Runner's World and has spoken at the AIP Summit and Skadi Sports Psychology Athlete Summit. Living with lupus herself, Mireille brings both professional expertise and lived experience to her work, helping athletes redefine what strength and performance can look like with a chronic illness diagnosis.

Follow Mireille on Instagram

FeistyFest Info: https://livefeisty.com/events/feisty-fest/

Register for FeistyFit: https://livefeisty.com/training/running/feistyfitfall/

Courses and Coaching: https://livefeisty.com/courses/

Women's Mechanic Camp in Tucson: https://livefeisty.com/events/bike-mechanic-school-tucson/

Sign up to Receive The Feisty Women's Performance Newsletter:

Feisty Women's Performance Newsletter: https://livefeisty.com/newsletters/feisty-womens-performance/

Follow us on Instagram:

@feisty_womens_performance

Support our Partners:

Momentous: Head to https://www.livemomentous.com/ and use promo code PERFORMANCE for up to 35% off your first order

Wahoo: Learn more about Wahoo Fitness Products at: https://wahoofitness.pxf.io/0GAByR

Tifosi Optics: Use code FEISTY2026 for 20% off at https://tifosioptics.com/

Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/

Orca: Use the code FEISTY15 for 15% off at https://orca.avln.me/c/HzUkzIfxsmYo