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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 training without ill effects. Still, there are special issues when a child becomes involved in intensive sport training that are important and bear careful consideration.

MUSCULOSKELETAL INJURIES
Child athletes, like their adult counterparts, suffer from overuse injuries such as muscle strains, "shin splints", and ligament strains. There has been concern, 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 document that this is a serious consideration. Child athletes demonstrate normal increases in height as they train, and injuries to growth areas of bones are exceedingly rare. Still, serious musculoskeletal 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 athletes.

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.

PSYCHOLOGICAL CONCERNS
Most experts recommend that children participate in diverse sports activities prior to puberty, even if a "special talent" is discovered early. Too early specialization 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 competition. The risk of interfering with normal social and psychological development ­ 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.

REPRODUCTIVE FUNCTION
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 menstrual irregularities or even ceasing menstruation altogether. These effects of training do not appear to have any adverse effects on future reproductive function.

There is less research information available 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 athletes, particularly those involved in sports that favor a large muscle mass (football, wrestling).

RISKS FOR HEAT STRESS INJURY
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 climates. Therefore, adequate replenishment with fluids is particularly important for children training in these conditions.

GUIDELINES
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 athlete:

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 training, the child should be supervised by an individual who is knowledgeable about proper training techniques and equipment (usually not a parent).

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 adolescence.

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.