Young female athletes: Balancing performance with healthy development

For girls and young women in sports, it's important to understand the benefits and risks of serious training.

It's game on for the girls. Millions of young women across the world are participating in sports, including soccer, track and field, lacrosse, basketball, hockey, volleyball, and tennis. At the highest levels of their sports, young female athletes are bringing home Olympic medals, setting world records, capturing championships and dominating the field.

In the United States, the number of girls who are playing high school sports has jumped more than tenfold since 1971, when fewer than 300,000 girls were involved in sports. The rise is due in part to the passage of Title IX, a 1972 federal law designed to protect women from discrimination within federally funded educational activities, including sports.

For young female athletes — and their parents, coaches and other mentors — it's important to understand both the benefits and risks of performance training. When girls challenge their bodies to the limits, this shouldn't come at the expense of healthy physical development, especially during the crucial adolescent years.

Benefits of sports

Sports and girls are a good match. Multiple studies have documented the health benefits of sports participation for girls and young women, including improved fitness, increased lean muscle mass and, often, better eating habits.

There are social and emotional benefits, too. Interacting with teammates and coaches can sharpen social skills. The discipline involved in mastering a sport can promote a sense of control, competence and self-esteem. Studies also show that young female athletes are more likely than nonathletes are to avoid risky behaviors such as smoking, drinking alcohol, and having early or frequent sexual intercourse. Female athletes are also less likely to say they're trying to lose weight and are less likely to be hit by a partner or contemplate suicide.

Sports participation can have a positive effect on academics as well. Athletes often achieve higher grades than nonathletes do and have a higher graduation rate.

Why balance matters

Along with the benefits of sports come some risks, too — especially for girls and young women who compete at higher levels. Elite athletes, in particular, can train for several hours a day. As demands on the body increase, so do the health risks, both immediate and long-term.

One of the main problems that can occur is inadequate nutrition. With intense exercise, calories (energy) burned can exceed the amount of calories consumed through eating. Persistently shortchanging the body's energy balance can lead to changes in hormone production, with serious health consequences, including menstrual irregularities and bone weakness.

Chronic energy deficiency, or low energy availability, tends to be most common among girls or young women who compete in sports that emphasize leanness, such as marathon running, dance, gymnastics and figure skating, although it can occur in any athlete.

In sports medicine parlance, the combination of low energy availability, menstrual irregularity and bone weakness is often called the "female athlete triad," although young female athletes aren't the only ones who are affected. Nor do all three components have to be present for health to be compromised.

Intense physical training can set the stage for other problems as well. Any competitive sport carries an increased risk of injuries, such as stress fractures, knee problems, and foot and ankle injuries. But not eating enough calories also contributes to bone weakness and fractures. Bouts of intense, vigorous exercise — especially long-duration endurance exercise — also can temporarily dampen the immune system. This means that athletes engaging in such strenuous activities are more prone to getting a cold, the flu or some other infection.

Caring for a young athlete

Both male and female athletes have unique needs for nutrition and training, and each sport has its own nuances. Unfortunately, however, young athletes don't always receive tailored information to help them understand how to stay healthy while also staying on top of their game.

Most teens and adults have misconceptions about the nutritional needs for training and performance. Research has shown that adolescent girl athletes in particular are not aware of the risks associated with overtraining. For example, one warning sign of an underlying problem — such as having an irregular period or no period at all — is often viewed as a normal part of being a female athlete or even as a bonus.

To ensure that girls who play sports develop in a healthy, normal way, both athletes and the adults in their lives need to know about the few, but potentially serious, health risks of training and performance. Making sure girls and young women engage in appropriate levels of physical training and receive proper nutrition can go a long way toward preventing problems.

Nov. 04, 2016