From the American Medical Society for Sports Medicine
While geared to sports medicine professionals, a new position statement from the American Medical Society for Sports Medicine (DiFiori JP, et al. 2014) provides helpful guidance to sports parents on the causes, risk factors, diagnosis, and treatment of burnout in youth athletes.
Response to chronic stress
Burnout is considered a response by a young athlete to chronic stress in which he or she ceases to participate in a previously enjoyable activity, withdrawing from the sport because they perceive it is not possible to meet the physical and psychological demands of the sport.
Burnout is considered by experts to be part of a spectrum of conditions that includes overreaching and overtraining syndrome.
Overreaching may either be functional or nonfunctional:
- Functional overreaching is defined as intense training that leads to a period of decreased performance which results in full recovery after a rest period.
- Non-functional overreaching results in a longer period of decreased performance, and is further accompanied by increased psychological and/or neuroendocrinological symptoms, but, like functional overreaching, results in full recovery after a period of rest.
Overtraining syndrome is a series of psychological, physiologic, and hormonal changes that result in decreased sports performance. It is characterized by:
- extreme non-functional overreaching, with a longer period of decreased performance lasting 2 months or more
- more severe symptomatology
- maladaptive physiology, and
- an additonal stressor not explained by other disease.
Although it is difficult to determine the extent of overtraining/burnout in children and adolescents, due in part to the lack of standard terminology used in different studies, it is believed to occur in about 30% to 35% of adolescent athletes.
Burnout occurs in stages
Four stages of burnout have been proposed:
1. the young athlete is placed in a situation that involves varying demands
2. the demands are viewed as excessive
3. the young athlete experiences varying physiological responses; and
4. varying burnout consequences develop, including
- low self-esteem
- low personal performance expectation
- worrying more about failure and adult expectations
- increased anxiety as a result of increased parental pressure to participate
- excessive athletic stress leading to a loss of sleep, physical injury, lower performance, and
- ultimately withdrawal from sport.
Dropping out: burnout not always cause
Not all youth athletes who drop out are burned out. Youth sports attrition is a complex phenomenon influenced by a variety of personal and situational variables. The most common variables are:
Remember, also, that a young athlete who discontinues participation may reenter the same sport or participate in a different sport in the future.
- time conflicts and interest with other activities (most common reason for dropping out of sport, either permanently or temporarily)
- lack of playing time
- lack of success
- lack of skill improvement
- lack of fun
- boredom; and
There are multiple risk factors for young athletes developing overtraining/burnout:
- Extremely high training volumes
- Extremely high time demands
- Demanding performance expectations (imposed by self or significant others)
- Frequent intense competition
- Inconsistent coaching practices
- Personal characteristics
- Need to pleases others
- Uni-dimensional self-conceptualization (focusing only on one's athletic involvement)
- Low self-esteem
- High perception of stress (high anxiety)
- Early specialization:
- several studies have suggested that athletes who had early specialized training withdrew from their sport either due to injury or burnout.
- A study of swimmers found that those who specialized early spent less time on the national team and retired earlier than those who specialized later
- Early specialization also seems to be correlated with reports of decreased general health and psychological well-being.
|| Loss of appetite
|| Weight loss
|Slow or fast heart beat (bradycardia or tachycardia)
|| Lack of mental concentration
|Loss of motivation or interest
|| Decreased self-confidence
|| Heavy, sore, stiff muscles
|Hypertension (e.g. high blood pressure)
|| Frequent illness
The diagnosis of overtraining syndrome/burnout should only be made by a qualified health care professional and only after the taking a thorough history and recognition of nonspecific and varied symptomatology:
- Decreased performance persisting despite weeks to months of recovery
- Mood disturbances
- Lack of signs/symptoms or diagnosis of other possible causes of underperformance
- Lack of enjoyment participating in sport
- Inadequate nutrional and hydration intake
Presence of potential triggers, including
- increased training load with adequate recovery
- monotony of training
- excessive number of competitions
- sleep disturbance
- stressors in family life (parental pressure)
- stressors in sporting life (coaching pressure and travel demands)
- previous illness.
Testing (if indicated by history)
- consider laboratory studies (i.e. complete blood count (CBC), comprehensive metabolic panel, etc.)
- Profile of Mood States (POMS)(a psychometric tool for a global measure of mood, tension, depression, anger, vigor, fatique, and confusion).
Treatment depends on the causes (e.g. etiology) of the burnout in the individual athlete:
- treat any diagnosed organic disease appropriately
- rest or relative rest an important component
- consider whether prevention of dropout is possible by changing adult-controlled factors
- efforts should be made to develop realistic but positive perceptions of competence
- consider consultation with sports pyschologist because more of a psychological component to burnout in children than in adults
- initial treatment of depression, anxiety, and sleep disturbances without drugs, and implementation of drug therapy only with appropriate professional guidance.
DiFiori JP, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. Clin J Sports Med. 2014;24(1):3-20.
Burnout In Youth Athletes: Risk Factors, Symptoms, Diagnosis, and Treatment
While geared to sports medicine professionals, a new position statement from the American Medical Society for Sports Medicine provides helpful guidance to sports parents on the causes, risk factors, diagnosis, and treatment of burnout in youth athletes.