Tired, injured, going backwards: the hidden fuelling problem in youth team sport that parents should know about

Guest post by Senior lecturer and researcher, Charlotte Gowers.

Picture a 15-year-old basketball player. She trains twice a week with her club, has a school fixture on Wednesday, drives to a regional squad session on Sunday, and does PE on top of all of it. She has always been the most dedicated and capable player on the team.

Lately, though, something is off. She picks up every cold going round. She has had two “niggles”. Her legs are heavy and her shot keeps falling short, despite training more than ever. She is flat, snappy, and sleeping badly. Her periods, which started two years ago, have become irregular or stopped altogether.

Her parents put it down to hormones, GCSEs, a growth spurt, bad luck with injuries. Her coach says she needs to work harder.

There is a reasonable chance she simply isn’t eating enough for the amount she is doing.

A syndrome, not a slip-up

The condition is called Relative Energy Deficiency in Sport, or REDs. It was named by an International Olympic Committee expert panel in 2014, updated in 2018, and updated again in a 2023 consensus statement that remains the reference point for clinicians today.

The underlying idea is simple. Your body needs energy to train and it also needs energy to run everything else: bones, hormones, immune system, brain, and, in a teenager, growth and puberty. When exercise takes too large a share of what has come in, there isn’t enough left for the rest. Sports scientists call the shortfall low energy availability. Sustained over weeks and months, it produces the cluster of health and performance problems known as REDs.

The 2023 statement describes effects across many body systems: bone health, hormonal and menstrual function, immunity, metabolism, cardiovascular health and mental health among them and also stresses that any athlete can be affected regardless of sex, sport or level. It also flags something parents of team-sport children should note: REDs looks very much like overtraining, and the two are easy to confuse.

It isn’t only a problem for runners and gymnasts

Ask most people which young athletes are at risk and they will name distance runners, gymnasts, dancers, jockeys, and athletes in weight-category sports such as judo or lightweight rowing. Those sports do carry known risk, and awareness there has improved.

Team sports are the blind spot, for a structural reason: nobody is adding up the load.

A committed 14-year-old basketball player, footballer, netballer or swimmer can easily be attached to three or four different teams: school, club, region or county, an academy, plus a strength and conditioning session someone has told them to do. Each coach sees their own slice. The school coach doesn’t know about Sunday. The club coach doesn’t know about Wednesday’s fixture. Nobody sees the week as a whole.

Except you. Parents are often the only people with the full picture, and frequently the only ones in a position to notice that the picture has quietly become unsustainable.

Why adolescence raises the stakes

Two things make the teenage years the worst possible time for a prolonged energy shortfall.

The first is growth. A child in a growth spurt has substantial energy demands before they have touched a ball. Sport sits on top of that, not instead of it. Requirements can rise sharply over a matter of months, and eating habits often don’t move with them.

The second is bone. Adolescence is when the skeleton is laid down; the great majority of adult bone mass is banked by the late teens and early twenties. Bone built then has to last a lifetime. Energy shortfall during those years and particularly when combined with disrupted hormones can compromise that process, and the window does not reopen later. This is why repeated bone stress injuries in a young athlete deserve a proper look rather than a fortnight of rest and a shrug.

This is for boys just as much as girls

Boys are not exempt, and the syndrome was renamed precisely because the older “female athlete triad” framing left them out. The difficulty is that boys have no equivalent of a missed period unless you want a VERY awkward conversation with your teenage son so under-fuelling in male athletes tends to be caught later and after more damage has been done. What it looks like instead is a boy whose growth or puberty seems to have stalled next to his mates, who is always the one carrying a knock or a cold, who is putting in more gym work than ever and getting no stronger, and who has become flat, irritable and hard to rouse. The driver in boys’ team sport is also often different: rather than eating less, they are simply doing far more while the pressure to “get bigger” leads them to focus on protein and supplements at the expense of eating enough overall.

Usually, nobody chose this

It is tempting to assume an under-fuelled teenager must be dieting. Often they aren’t.

Hard training blunts appetite, sometimes for hours. A 6pm session followed by a 9pm arrival home is not conducive to a decent meal. A child who leaves at 7.30am and doesn’t get home until after 8pm has a genuinely tight window in which to eat. Add fussiness, a fashionable decision to cut out a food group, or an eight-hour gap between lunch and a late training session, and the shortfall builds without any intention behind it.

That said, intentional restriction is a real driver too. Disordered eating, body-image pressure, comparison on social media, and offhand remarks from coaches or teammates about being “leaner” or “carrying a bit” all feature. 

Signs worth taking seriously

Individually these are unremarkable. Clustered, and persisting for more than a few weeks, they warrant a conversation:

• Frequent illness — always the one with a cold or a sore throat

• Injuries that keep coming, especially bone stress injuries, or niggles that take unusually long to settle

• Performance plateauing or declining despite training more

• Fatigue out of proportion to the load, and poor sleep

• Periods that are late, irregular, or have stopped — in a young athlete this is a signal, not an inconvenient side effect to be tolerated

• Mood changes — irritability, low mood, anxiety, withdrawing from friends

• Growth or development that seems to have stalledrelative to peers

• Rigid rules around eating — skipping meals, cutting out whole food groups, anxiety about eating with others, “clean eating” that keeps narrowing

• Guilt about rest — training on top of training, distress at a day off, exercising while injured

What parents can actually do

Add up the week. Write down every session across every setting. Parents are regularly surprised. If the total looks like a lot, it probably is and you may be the only person able to say so to the various coaches involved.

Close the gaps. The practical fix is usually not a diet plan but timing: something substantial before training, something soon after, and no eight-hour holes in the day. A packed extra meal for the car home is unglamorous and effective.

Keep carbohydrate on the plate. Inadequate carbohydrate intake was singled out as an emerging concern in the 2023 statement. Bread, pasta, rice, potatoes and cereal are not the enemy of a growing athlete.

Watch the language at home. Comments about bodies, “good” and “bad” foods, or earning dinner through exercise land differently in a teenager already immersed in sporting body talk.

Protect rest and off-season. Recovery is when adaptation happens. A child who never has a break isn’t more committed; they’re more likely to be injured.

Go to the GP early. Say the words “I’m concerned about relative energy deficiency in sport.” Ask about bone health, hormones and blood tests where appropriate, and ask for referral to sports medicine or a registered dietitian with sports experience if the picture warrants it. Don’t wait for a stress fracture to make the case for you.

Clearing up the term Athletic in Youth Athletic Development

The word athletic is an adjective used to describe someone that is healthy, strong, and able to perform energetic movements. While this has connotations of organised sports participation, it does not necessarily exclusively represent those involved in Sports. For example, someone could be described as athletic without participating in any particular sport. In addition, there might be instances where individuals involved in sports are potentially not who we might typically describe as “athletic”, meaning they do not appear to possess characteristics associated with being healthy, strong, and able to perform energetic movements! Therefore, no one should be put off by the term athletic. if we are to park the aspect of the definition of athletic that relates to “energetic movement”, and indeed “strong”, what we are left with is being healthy. This is a far more encouraging place to start with our definition for the term athletic development.

For any number of reasons, Sports, in the traditional sense, are not for every child. Many will not find enjoyment from organised sports such as football, netball, rugby, tennis and so on. Instead, it might be that alternative activities, or “lifestyle sports”, such as skateboarding, bike riding, or parkour – those that are not formally organised, capture one’s interest to a far greater degree.

At the initial stage, therefore, athletic development should be considered the early foundations for physical activity. Importantly, the foundations formed can then be layered upon with other forms of physical activity, serving to further increase levels of athletic development. For example, improved competence in a range of basic movement skills, such as throwing and catching, skipping and running, jumping and tumbling. As competency in such skills grows, as does the the level of athletic development of young individuals. This forms a habit of physical activity and better physical health and, as we have come to believe, associated improvement to mental well-being.

From childhood through adolescence, and into young adulthood and beyond, early positive experiences of physical activity as well as the addition of more challenging and advanced skills, equips individuals with the necessary tools to engage with lifelong physical activity.

This is athletic development.

When can children lift weights?

This post is based another question posed recently by a parent. To begin, any concerns around risk of injury (e.g., damage to growth plates) has now been put to bed. Instead, there is a substantial body of evidence supporting the benefits of strength training, including improved bone-mineral density, improved biomechanics (associated with a reduction in risk factors for injury), better motor skill performance, and improved psychological well-being. Another worthwhile consideration is that during jumping and landing actions (activity that is typical in many sports, as well as general physical activities) landing forces can equate to levels 5-7 times that of body weight. These are forces far in advance of those that would be experienced during appropriately structured strength-based training.

With concerns around the safety of youth strength training now out the way, the bigger question related to when children can lift weights is whether following a structured resistance training programme is a priority? If we are using a strict definition of children then we are referring to children that are pre-adolescence, who are capable of improved strength through changes to their nervous system. For these children, there is much room to get these positive changes through movement skills, using movement patterns requiring bodyweight-only. Moving in different planes of motion, and at different speeds, as well as holding different positions and postures, will stimulate improvements in strength. In addition, including speed, agility, and jumping and landing activities, will all contribute to improved athleticism. These activities should be made fun, while at the same time not losing sight of the purpose. At this stage, lifting weights is not a priority, movement is.

In adolescent populations, due to hormonal changes, there is more potential for muscular growth that occurs alongside changes to the nervous system in response to strength training. At this stage, therefore, strength training in the form of weight training, may receive greater attention through more focused training. However, the development of movement skills still remains important for the adolescent. Without the movement skills in place first, the teaching of effective strength training is a harder task.

The key takeaway then, is develop movement skills, and keep on developing them through both childhood and adolescence. Strength training is important and safe, but utilise weight training forms of strength training when there is a requirement to do so.

Why do young footballers require strength and conditioning training?

By Lew Coldham, UKSCA Accredited Strength and Conditioning Coach

Football, like all field-based invasion sports requires a diverse library of movement skills and underpinning athletic qualities perform the required sport skills and tolerate the physical demands of the game.

Consistent and progressive strength and conditioning (S&C) training provides multiple benefits to a young players health and performance. These include the following:

Improving acceleration & maximum sprint speed

Acceleration and maximal velocity sprinting require large amounts of force to be produced and tolerated. Through S&C training we can improve the ability to produce the large amount of force propel the body forwards at the greatest speeds possible.

Improving change of direction

Due to the nature of multidirectional football, the ability to manoeuvre in multiple directions to manipulate the ball, and opposing players are vital skills, and require substantial athletic qualities to perform these actions optimally. Appropriate S&C training can serve to develop the efficiency of movement to improve technical execution.

Improved ball striking

Ball striking requires both the standing leg to provide stability and a braking action to allow the striking leg to swing explosively. Only 15% of the total force produced within the strike is absorbed by the ball itself so the body must act to develop the power for the strike and the braking action after the ball is hit. Strengthening of key muscle groups can improving kicking power and increase tolerance to the large forces from the kicking action.

Improved recoverability from training and games

The sport itself requires the capacity to perform these forceful actions repeatedly to maintain performance. S&C training enhances the body’s ability to tolerate the demands of the game and recover in less time.