With response to early specialisation, the bones during adolescence are more susceptible to issues such as breaks and fractures. This increased risk may be related to a number of factors, but are mainly due to the diminished size-adjusted bone, weakness of the growth cartilage, and decreased physeal tolerance . Furthermore, bones experiencing rapid growth as a result of maturation are less resistant to tensile, shear, and compressive forces than their adult or prepubescent counterparts, resulting in an increased risk of potential fractures or breaks . The long-term impact of this can result in early onset osteoporosis, joint instability, and decreased function .
During adolescence, psychological challenge is essential to provide both positive responses and the capacity to generate appropriate coping strategies for the stresses of daily life and sport. In competitive situations, excessive travel, academic stress, and pressure to succeed may lead to psychological overload. Unrealistic expectations placed on oneself, by a parent, or coach, may lead to low self-esteem, depression, anxiety, and potential burnout . Over time, these individuals’ can withdraw from sport and feel isolated by a routine that has so far limited their opportunity to develop an identity with their peers or social norms. As a result of this, daily life can prove challenging and children can perceive a lack of control over their lives, believe they have fewer chances for autonomy, and possess low-levels of motivation to train .
In physically active girls and women, early sport specialisation has been identified as a major contributor to a medical condition known as the female athlete triad (See Figure 1). The female athlete triad describes three interrelated components of health, where it is shown that highly voluminous sports training and inadequate energy intake can lead to alterations in energy availability, menstrual cycle function, and bone mineral density (BMD) . Female athletes who specialise in disciplines which require body leanness or endurance such as; endurance running, gymnastics, dancing, and figure skating are particularly vulnerable . The long-term effects of this can be devastating, placing an individual at an early risk of osteoporosis, disordered eating, and amenorrhea described as an abnormal menstrual cycle .