The Pediatric Endurance Athlete.

Youth sports participation numbers continue to grow in the United States. A shift toward sport specialization has caused an increase in sport training frequency and intensity that places the growing athlete at risk for overtraining, nutritional deficits, and injuries. Individuals who participate in endurance sports are at especially high risk.

Approach to the Underperforming Athlete.

Children and adolescents who participate in intense sports training may face physical and psychologic stresses. The pediatric health care provider can play an important role in monitoring an athlete's preparation by obtaining a proper sports history, assessing sleep hygiene, discussing nutrition and hydration guidelines, and evaluating physiologic causes of fatigue. Educating parents and athletes on the potential risks of high-intensity training, inadequate rest and sleep, and a poor diet may improve the athlete's performance and prevent symptoms of overtraining syndrome.