Youth Athlete Burnout with Gina Pongetti Angeletti, MPT, MA, CSCS, ART-Cert

I caught up with a colleague, friend, and mentor Gina Pongetti Angeletti. Gina is an amazing physical therapist. She is Co-Owner and Medical Director at Achieve Sports Medicine in the Chicago area. She is also Co-Owner of NeuroSport Chicago! She has spent over 15 years working with U.S.A. Women’s Gymnastics Olympians and World Champions, as well as other international gymnasts and Junior Olympic athletes. Gina has also worked on the US Medical Team of US Figure Skating. From treating at competitive meets to private consulting, traveling with athletes to speaking at USAG Congress, she is very knowledgeable about the health of athletes.

We discussed some signs a youth athlete could be suffering from burnout also some tips for athletes, coaches, healthcare providers, and parents to help recognize the symptoms and help with recovery. These tips can be applied to various types of sports; youth, adult and professional.

1. Lack of motivation: The athlete may appear to have “checked out” and lack of overall effort in practice, at school, competitions and games. Being injured can result with athletes wanting to leave practice or rehab early. Other signs are a drop in academic grades, no self-motivation, and disappointment after an injury. This can lead to an injured athlete that is not interested in substituting work out routines or conditioning to stay in shape in anticipation of return to sport. They may also frequently cancel physical therapy appointments and lack progress in rehab.

2. Mood changes: Be aware of mood changes especially closer to practice time or competition day. Mood changes or mood swings can range from irritability, indifference, sadness, boredom, depression, and/or withdrawal from activities. They may exhibit constant frustration and lack of communication with parents and coaches. Mood changes can result from 1) the mental frustration battle on whether to stay in the sport or retire or 2) the physical manifestation of mental stress effects.

3. Fatigue decreased overall energy, and exhaustion: He or she may be consistently tired and having trouble sleeping and getting sick more often. Lack of sleep contributes to fatigue and does not provide the athlete with adequate physical or mental energy for the next day. Exhaustion is a manifestation of burnout, and vice versa. When he or she is continuously fatigued, they “try” harder seemingly giving more effort for the same result. In turn, this adds to mental and physical stress to sustain the increased energy output.

4. Performance Anxiety: Burnout contributes to increased performance anxiety due to altered mental state, overthinking and lack of recovery leading to anticipating poor performance anxiety. Performance anxiety can manifest as poor or inconsistent performance and lack of progress made in the sport. Perfectionism, attempting to please parents and/or coaches may cause low self-esteem, and lack of confidence can begin to occur.

5. Multiple Injuries: Multiple injuries can lead to fatigue, frustration, and decreased self-confidence. Medical team, be aware of slow recovery from injuries that generally respond to treatment more quickly. Altered physical changes in an individual’s adrenal system (adrenal fatigue), thyroid function, immune system, and hormones can affect the quality of recovery and healing leading to multiple injuries.

6. Lack of concentration: They are talking more, wasting time in practice and not getting much accomplished during practice.

7. Weight gain or Weight loss: Weight gains could reflect the athlete is not trying at all in all areas including nutrition or trying too hard to lose weight and not eating enough (starvation mode, the body is holding calories). Weight loss can be attributed to a loss of appetite due to stress or feeling pressure from parents, coaches or themselves to control their weight. In some sports, this is due to pressure to make a weight class. The physical stress of yo-yo weight wreaks havoc on the body.

8. Overtraining and increasing physical demands too quickly: Coaches, gradually increase strength, endurance, and flexibility over time. Also, increasing too rapidly leads to a lack of recovery time, physically not allowing the body to heal within workouts or between them. Overtraining causes an increase in fatigue and a decline in performance regardless of how hard the athlete is working. Overtraining also leads to overuse injuries (stress fractures, chronic tendinopathy, etc). Be careful not to push athletes past their limits.

RECOVERY FOCUS POINTS!

• Physical REST and recovery: Modify workout frequency, length, and intensity. The goal with modification is to preserve the athlete’s optimal performance level. Massage with a therapist or chiropractor using tools or myofascial release techniques and cryotherapy are good options for muscle fatigue recovery.

• Enough sleep: Between school, practice, conditioning, games, and for some being a student-athlete, the stress/pressure can cause difficulty sleeping. Even if the athlete is sleeping, their REM sleep cycles could be off and the sleep is non-restorative. Consult with a healthcare provider about improving sleep hygiene and other sleep aide options.

• Address Psychological Concerns: Ensure the athlete has a trusted and safe path for emotional honesty if needed. Dormant athlete concerns can manifest negatively mentally and physically. Consult with a primary care physician, sports psychologist or psychiatrist to treat any depression, anxiety, eating disorders or other psych symptoms/disorders that may have arisen.

• Nutrition and Recovery Diet: Eliminate gluten and processed foods. Incorporate lean meats and omega three rich foods. Significantly decrease dairy products and increase green leafy vegetable intake. Adding a good probiotic will help make sure there are enough good bacteria in the gut, to absorb the proper nutrients consumed. Also, it is essential to stay hydrated with water. Consult with a healthcare provider and nutritionist.

• Add vitamins and supplements: Blood work can be done to recognize specific vitamin deficiencies. One of the most common depleted vitamins is a group named the Vitamin B complex. The athlete may also be deficient in magnesium, vitamin D and iron. Vitamins and minerals are essential for tissue health, sleep, recovery and performance. Side effects of low levels of many of these often mimic burnout and fatigue. Consult with a healthcare provider to address the individual’s needs, before adding them to the athlete’s diet.

Athletes: Communicate what you are feeling physically, mentally and emotionally to a parent or your doctor. Coaches: Research and educate yourself on the symptoms and be able to identify them. Know your sport, be mindful of individual athlete limits, avoid overtraining and incorporate workout modifications to prevent burnout. Healthy athletes are more motivated than unhealthy athletes. Parents: Often a tired athlete has sub-optimal performance, leading to extra pressure from coaches to work even harder, or increase self-imposed stress. Be aware of any changes to your child’s behavior. Ensure he or she is getting the proper amount of sleep (at least 7-8 hours), help enforce healthy food options and remember that your child should be having fun in youth sports not stressing! Listen to your kids if they are telling you they are tired and avoid pushing too hard or placing too much pressure on their performance. Healthcare Providers: If you see these symptoms, communicate your findings and recommendations with the parents. Order blood work if it’s within your scope of practice and you feel it necessary. When an athlete is working with different types of healthcare providers simultaneously, they should communicate with each other and work together for the benefit of the athlete’s health and best interest.

Burnout is real, can be easily missed, and can be a vicious cycle of physical and mental stress. The common goal is to keep youth athletes healthy and safe. Most athletes that quit due to burnout do not return to the sport. Youth sports can help develop and nurture discipline, teamwork, good work ethic, time management skills, exercise, and a healthy lifestyle. It can also lead to goal-oriented adults. Let’s be sure to stick to these goals, avoid burnout and have fun!!