Sport Specialization in Youth: A Literature Review

Journal of the American Chiropractic Association, Apr 2004 by Hecimovich, Mark

Sexual maturation. Athletic girls tend to experience menarche at a later age than non-athletic girls, leading to concern that intensive sports training may delay sexual maturation. The average age of menarche in North America is 12.3 to 12.8 years, while that of athletes in a wide variety of sports is typically one to two years later. Poor nutrition, training stress, and low levels of body fat have been hypothesized to account for this delay. Alternatively, it is possible that the later age of menarche in athletes simply reflects a pre-selection phenomenon.56 For instance, girls who have narrow hips, slender physiques, long legs, and low levels of body fat-advantageous characteristics in many girls' sports-are more likely to experience later menarche, regardless of sports participation.10 Elite gymnasts, however, are often involved in serious, regimented training by the age of 10 that may make inappropriate physical demands with consequential long-term effects on sexual maturation.42

Secondary amenorrhea, or cessation of menstrual cycles after menarche, can occur as a result of intense athletic training. Prolonged amenorrhea may cause diminished bone mass from the associated decrease in estrogen secretion, augmenting the risk for stress fractures and the potential for osteoporosis in adulthood. Efforts to improve nutrition or diminish training volume in these girls may permit resumption of menses and diminish these risks.10

Cardiac Issues. Potential concern exists with regard to cardiac problems, but based on limited data, there is no indication that intense athletic training of the child athlete results in heart injury. Closer study of the cardiac characteristics of children training at elite levels, however, is necessary before this conclusion can be verified.10 Although child athletes have superior cardiac functional capacity compared with non-athletes, data obtained from studies using animals and humans indicate that myocardial function can be depressed, at least transiently, after intense exercise. Echocardiographic studies have indicated a transient decrease in left ventricular contractility after extremes of athletic competition.57

Psychological Factors

Young children who have played in structured sport programs tend to have higher levels of pre-competitive anxiety that predisposes them to emotional trauma and injuries. Also, higher levels of pre-competitive anxiety have been linked to low levels of enjoyment. Sport psychologists have determined that a lack of fun and enjoyment is the No. 1 reason children leave organized sport. Intensive sports participation may take time away from normal social and developmental activities and can lead to isolation or other problems, including depression, anxiety, conversion reactions, and eating disorders.45-46,48-49,58-60

A few athletes develop overtraining syndrome and may leave sports completely. A youngster who is too embarrassed to quit or who is pressured to continue may incur a sports-related self-injury in order to leave gracefully.61 Children who leave sport tend to be sedentary adults.43 Also, children who specialize in a sport and experience a great deal of success at an early age may have difficulty coping with athletic failure later in life.62