Efforts to improve nutrition or diminish training volume in these girls may permit resumption of menses and diminish these risks. Studies of males have indicated no evidence of an adverse effect on sexual maturation related to sports training. Progression of Tanner stages of pubertal development has not been observed to be retarded in athletic compared with nonathletic adolescents. Survey studies suggest, however, that while such adverse effects occur, they are experienced by only a small minority of intensely training athletes. 13 Most athletes find elite-level competition to be a positive experience.
Research supports the recommendation that child athletes avoid early sports specialization.
Those who participate in a variety of sports and specialize only after reaching the age of puberty tend to be more consistent performers, have fewer injuries, and adhere to sports play longer than those who specialize early. They sweat less, create more heat per body mass, and acclimatize slower to warm environments. As a result, child athletes may be more at risk for heat-related injuries in hot, humid conditions. It is particularly critical that coaches, parents, and young athletes are aware of signs of heat injury. They also should be aware that limiting sports play and training in hot, humid conditions and ensuring adequate fluid intake can prevent heat injury.