Your little gymnast is serious about the sport, which means she's training hard, since competition is fierce. And you probably already know what that means: a risk of injury. In the United States, more than 86,000 gymnastics-related injuries a year require medical treatment, according to Many injuries — broken bones, for example — are the result of a fall or bad landing. But others result from overtraining.

From the outside, it might seem complicated to spot overtraining. After all, gymnasts have to practice moves over and over with a spotter (or on the floor before doing them on a balance beam) to make sure they can do them safely in competition. And with all those workouts, some aches are inevitable.

Related: Girls in Sports: Is Your Daughter at Risk for a Knee Injury?

So how can you recognize overtraining?

Veteran coach Angela Regan describes the telltale sign in two words: persistent pain. “Aches and pains that don’t go away indicate overtraining,” says Regan, who has devoted 35 years to training athletes and works at Classics Gymnastics Center in Charlottesville, Virginia.

Moderation is key, says Donna Koehler, the owner of All American Gymnastics in Ashland, Virginia. Her coaches, she says, are trained to watch girls for signs of pushing too hard.

“A huge problem with the sport is that if a kid wants to work out four or five days a week, the parents are probably going to go along with it,” she says. “But moderation is important. It’s a really safe sport if you condition and treat it with respect and don’t overdo it.”

If children say their hips are sore or their wrists are sore from tumbling too much, that can be a sign of overtraining, she says. Koehler also dislikes pressure to do extended leg splits. “I don’t believe in assisting a child in doing splits or putting pressure on a child to do a split. We don’t do that,” she says.

Related: Keeping Your Young Cheerleader Safe

The toll of overtraining 

Kids can start learning gymnastics from the time they’re 18 months old until they reach 18, Koehler says, although the prime age to start training for competitive gymnastics is between 3 and 4. According to the Sports Injury Bulletin, Pediatrics journal and UPMC Sports Medicine, here are some problems related to overtraining.

Eating disorders. The image of the awarding-winning gymnast — thin and poised — may spur some girls to overdo their training to meet this idealized notion of perfection. Worries about weight may lead to eating disorders, such as anorexia or bulimia.

Low bone density. In children, too-rigorous gymnastics training can result in low levels of certain hormones, including growth hormone and estrogen. Combined with inadequate nutrition, this can lead to weak bones, stress fractures and even stunted growth.

Delayed or absent periods. Overtraining has been shown to lower estrogen levels in a girl’s body. When this happens, young women may experience irregular periods, delayed menstruation or no cycle at all, a phenomenon known as athlete amenorrhoea. 

Self-image problems. Girls who spend countless hours in the gym may sacrifice time with friends and classmates and may lag behind their peers socially. They may also have trouble sleeping or keeping up with school work. If a young gymnast doesn't feel she's living up to the ideal of gymnastics perfection, she may feel stressed or depressed.  

"There's a time to push and a time to pull back"

Watch your child for signs of overtraining, including stress or depression, missed periods and persistent pain. Talk to the coach and see a doctor if necessary. 

Coaches and trainers must also pay close attention to every gymnast under their wing, Regan says, since each athlete develops at a different rate. Parents need to do the same for their little gymnasts, she says.

“There are times to push hard and times to pull back,” Regan adds. “We have training cycles. We work on conditioning and flexibility during the off season. We train them to peak at their culminating competitions.”

Then the cycle starts again with body conditioning.

“You get the body strong and flexible,” Regan says. “Then, during the season, you work routines, but you’re not conditioning nearly as hard. Especially when you’re at the Olympic level. You build and build and build and then plateau for a while. Growth spurts and changes in weight are going to affect that. You have to really know your individual athlete.”

Related: Sports Parents: Are You Poisoning the Game?

Steve Evans, MA, is an award-winning journalist with more than 20 years experience in daily news, investigative, health and business journalism. Among other jobs, he has served as managing editor of the Central Virginia Newspaper Group, as a senior writer for SNL Financial and as a staff writer for The Progress Index and the Richmond Times-Dispatch.