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Intensive training of the young athlete

Risks of Intensive Sports Training on Young Athletes

By Thomas W. Rowland, M.D.

Baystate Medical Center


Children are becoming involved in 

intensive athletic training at increasingly

younger ages. Many experts have

been concerned that the stresses

placed on the body by early athletic

training in childhood might interfere with

normal growth of the child as well as

impair his or her psychological and

social development. Their concern is

that the child athlete is different from

the adult in one important way: the

bones, heart, lungs, and muscles of the

child are all growing. They worry that

the high work load placed on these

organs during athletic training and

competition might impair their normal

functional development.

Research by exercise scientists has

indicated that, for the most part, these

concerns are ill-founded. The body of

the healthy child is strong and appears

to handle the stresses of exercise train-ing

without ill effects. Still, there are

special issues when a child becomes

involved in intensive sport training that

are important and bear careful



Child athletes, like their adult counter-parts,

suffer from overuse injuries such

as muscle strains, shin splints, and lig-ament

strains. There has been con-cern,

however, that excessive training

that causes such minor injuries might

also affect the portion of the bones that

are responsible for normal bone growth.

Current research has failed to docu-ment

that this is a serious considera-tion.

Child athletes demonstrate normal

increases in height as they train, and

injuries to growth areas of bones are

exceedingly rare. Still, serious muscu-loskeletal

damage has been seen in the

elbows of Little League pitchers as well

as the wrist bones of intensively trained

child gymnasts. So some caution

appears to be justified. Reducing risk

of overuse injuries through proper

equipment and training regimens, and

not training through muscle and joint

pain make good sense for young


There is some evidence that the growth

process itself may predispose to

overuse injuries. The muscles, bones,

and tendons of adolescents may not

develop at the same rate, and this can

result in a significant loss of flexibility

during the adolescent growth spurt.

This can be prevented by proper

stretching exercises.



Most experts recommend that children

participate in diverse sports activities

prior to puberty, even if a special tal-ent

is discovered early. Too early spe-cialization

often results in burn out of

the child before prime competitive age.

Young Olympic hopefuls must commit

major portions of their time developing

the skills necessary for elite-level com-petition.

The risk of interfering with nor-mal

social and psychological develop-ment

particularly in those youngsters

who reach stardom status at an early

age provides additional argument for

delaying intensive participation in a

particular sport during childhood.


Girls who are actively training often

reach menarche at a later age than

those who are not athletes. Also, girls

who continue to train heavily have a

greater chance of experiencing men-strual

irregularities or even ceasing

menstruation altogether. These effects

of training do not appear to have any

adverse effects on future reproductive


There is less research information avail-able

in males but sexual development

does not appear to be impaired by

intensive training in young boys. In

contrast to females, boys with early

sexual maturity tend to be better ath-letes,

particularly those involved in

sports that favor a large muscle mass

(football, wrestling).


Children have a greater body surface in

respect to their body weight, and they

also sweat less than adults do. For

these reasons young athletes may be at

higher risk for developing hyperthermia

when training in very hot, humid cli-mates.

Therefore, adequate replenish-ment

with fluids is particularly important

for children training in these conditions.


Young athletes can safely participate in

intensive sports training regimens, but

only if their involvement is carefully

monitored. Following these guidelines

will help assure a healthy and mentally

satisfying experience for the young


1. The child himself or herself should

have the desire to participate. Sports

involvement for the young athlete

should not serve solely as a vicarious

pleasure for the parent or family.

2. To prevent injuries and optimize train-ing,

the child should be supervised

by an individual who is knowledge

able about proper training techniques

and equipment (usually not a


3. Early specialization in a sport at the

cost of exclusion of other athletic

activities should be discouraged at

least until the time of early


4. Injury prevention is particularly

important in growing children.

This will help protect against the

possibility of more serious injuries

occurring to bone growth centers.

5. The child athlete who is training

should have regular visits to a

physician. Information concerning

the possible medical complications

from training is far from complete,

and the young athlete should be

monitored for any unforeseen

adverse effects.

The Coaches Corner is a service of the

Gatorade Sports Science Institute .

For more information, contact:

Gatorade Sports Science Institute

617 West Main Street

Barrington, Illinois 60010

800-616-GSSI (4774)


Thomas Rowland, M.D., is director

of Pediatric Cardiology at Bay State

Medical Center Childrens Hospital in

Springfield, Mass.. He also serves as

a board member of the Gatorade

Sports Science Institute .