Young bodies under pressure

Let's take a break from counting Michael Phelps' medals at the Summer Olympics, shall we? Instead, let's count teenagers.

Of the 596 athletes representing the U.S. this month in Beijing, 30 were teenagers. The youngest Americans are synchronized diving partners Haley Ishimatsu and Mary Beth Dunnichay, both 15, and swimmer Elizabeth Beisel, who turns 16 tomorrow. Four of the six women's gymnasts are teens, as are five members of the women's swim team, including Baltimore native Katie Hoff, who is 19. The youngest male U.S. athletes are a diver, a cyclist, a boxer, a wrestler and a canoe paddler, all 18. The youngest Olympian of all those gathered in Beijing? A 14-year-old British diver, Tom Daley.


Most of these teen phenoms started in their sports early, before they were old enough even to cross the street alone. (Nastia Liukin, the fabulous American gymnast from Parker, Texas, tells visitors to her Web site that she began her tumbling career "when I started walking!") They quickly stood out as prodigies. (Gerek Meinhardt, an 18-year-old U.S. fencer, picked up his epee at age 9 and was competing in national tournaments a year later.) Before long, they had cast aside all other sports to become specialists.

Many passed up school dances, family vacations and the other markers of adolescence. A few even moved from their hometowns to be near highly regarded coaches or sports clubs. After years of endless practice, practice and more practice, they made it to the world's biggest sports stage: the Olympic Games.


To us sofa slouchers, these teen Olympians are heroes. But they have the nation's pediatricians on edge.

It's not only the young Olympians. It's the millions of kid athletes starting earlier and training harder, hoping to be transformed into a sports champion who can muscle her way onto the local elite team or hook an athletic scholarship to college. Some young stars love their sports so much that their moms and dads can hardly hold them back. Others would be happier playing video games or hanging with friends at the mall, but their parents are pushing hard to advance their sports prospects. Some have a real chance to become standouts. Others have lots more ambition than talent.

Pediatricians are concerned about all of them. These aren't idle conversations overheard in examining rooms; they're the official worries of the American Academy of Pediatrics. Twice in the past eight years, the AAP, a national organization of 60,000 children's doctors, has issued policy statements warning that sports training that is too intense and comes too soon in a child's development is a growing health problem. The AAP cites a sobering array of physical and emotional problems linked to overindulgence in sports: eating disorders, burnout, repetitive stress injuries ranging from tendonitis to stress fractures and, in girls, delayed sexual maturation.

The authors of the statements - renowned specialists in treating youth sports injuries - point the finger at several factors, including kids narrowing their focus on one sport earlier than ever before and training year-round in that sport in ways that overwhelm a young body's physical limits, as well as the exploding number of elite games and tournaments set up for younger and younger players.

"To be competitive at a high level requires training regimens for children that could be considered extreme even for adults," the sports doctors wrote. "The necessary commitment and intensity of training raises concerns about the sensibility and safety of high-level athletics for any young person."

These issues are not brand new. For years, there have been reports of Olympic hopefuls training obsessively, to the point where their young bodies break. The most disturbing stories often have come from gymnastics and figure skating, high-pressure sports in which a child's career begins almost in toddler-hood.

In her 1995 book, Little Girls in Pretty Boxes, author Joan Ryan writes about the culture of excessive, even abusive, training methods that once dominated the elite levels of the gymnastics. Ms. Ryan tells of 14-year-old Kristie Phillips, destined to be the next Mary Lou Retton, practicing with a broken wrist while gulping 12 Advils and six prescription anti-inflammatory pills each day. Betty Okino, then 17, competed for the U.S. women's gymnastics team in the 1992 Olympics with stress fractures in her back and elbow, and a tendon in her shin held in place with a screw.

Things were better for this year's U.S. team, but it hardly was a healthy bunch. Samantha Peszek, 18, turned her ankle badly during warm-ups before the first day of competition, knocking her out of all her events except uneven bar. (What's a swollen ankle when there's a medal to be won?) When the competition was over, teammate Chellsie Memmel, 20, revealed that she had competed on a broken ankle.


The International Olympic Committee, which moves at its own glacial pace, has made some modest moves to protect young athletes. About 10 years ago, the IOC adopted a rule barring girls under 16 from competing in gymnastics. It would be working better if it were enforced. (The Chinese team has brushed off charges that some of its tiniest gymnasts were underage.) In 2005, the IOC formed a blue-ribbon committee to study how to make training safer for elite child athletes. Despite naming some impressive experts to the panel, including former U.S. Olympic swimmer Janet Evans, a Swiss psychologist and a cardiologist from Argentina, it didn't amount to much. The committee's big conclusion: "The entire sports process for the elite child athlete should be pleasureable and fulfilling."

Just try telling that to a teenager with a stress fracture.

Mark Hyman, a Baltimore resident, is contributing editor for sports at BusinessWeek. His book on the impact of parents, coaches and other adults on youth sports, "Until It Hurts," will be published in April. He blogs at