SHEREE DIBIASE, PT: Let's hear it for the girls!

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Physical literacy is a real need for our young athletes, whether female or male, in a highly competitive sport or playing with other friends in your neighborhood. It is important for parents to know that a woman's body develops differently than a man's body, and because of its unique cycles, it can develop other complex issues that need to be talked about and addressed in order for our girls to become healthy women.

Our young female athletes need to understand their bodies. From the age of eight until 25, they experience many unique changes. Bone growth happens early and they will often have their growth spurt before their male friends.

A girls feet usually grows first from the age of 8 to 10 years old. Their pelvis develops, their hips widen and their spine lengthens. Their legs and arms grow quickly between the ages of nine and 13, and sometimes they have a gangly stage where they are all arms and legs. Their peak height velocity is usually reached by 11 or 12 years old, but their peak bone mass is not reached till approximately 19 years old. During this time your women's health physical therapist can be particularly valuable at helping your young athlete learn how to move in their ever changing body. They can train them to know how to move for their sport and to prevent long-term injury.

Their cognitive brain growth is high from the ages of nine to 13. It is often called the “magic window” in time, due to the brain and the nervous system being so active in hard wiring themselves. The psychological stress due to so many bodily changes is evidenced. As the body is growing in all avenues, their hormones are changing which affect their sexuality. Around this time they often get their menses. This affects them psychologically and they can go from being emotionally stable young girls in their daily life, to highly moody young women. They tend to internalize everything and blame themselves and others. They don't feel like themselves, but have no idea it is due to so many physical changes their body is going through. These physical changes affect the nervous system and they can become especially agitated and short with their parents and friends. They may retreat to be alone or become overly involved in social cliques or groups, with bullying being especially high during this time frame. Many girls feel left out and have no tribe. Other girls lead the tribe and are inclusive, but some become “mean” girls. This is a time of great vulnerability and decision making for young women. Their physical body is affecting their bodies perception of itself and their social network. Girls who have been friends since kindergarten suddenly are no longer friends.

The family health climate also directly affects these young woman. Positive self image reflection from their parents is necessary to help them adjust to the new physical bodily changes and the changes in their cognitive awareness. This can be a scary time for young women and their family, extended family and good family friends can assist in stabilizing their view of themselves. It is a time where a parent's consistent presence is needed, but not often wanted. Find things that bridge the gap, that you can do together to have common ground, but that gives them choices and freedom. Many of our parents are a steady presence at team functions and haul around carloads of girls, quietly listening and directing the next generation of women.

Many of our young women athletes are at high risk, especially in competitive sports, for the “women's athlete triad.” This triad consists of low energy levels, low bone mass and no menarche. Often young competitive athletes do not get their period due to their high level of training. This is not optimal and needs to be addressed with their health care provider.

This appears to be the time frame where nutritional information needs to be discussed with our young women and intervention needs to occur in order to deter the obsessive compulsive patterns that can elicit a propensity towards eating disorders. There is a lot of pressure for the young athlete to stay fit and to have a certain type of body that they see and read about in social media. They need to understand that nutrition is fuel and you can use it to enhance performance. Good eating habits facilitate bone and muscle mass production. Instead, when they don't fit the “right body type,” they feel insecure and afraid and stop eating foods that provide the fuel they need. They begin habits that can hurt them throughout their lifespan, physically and cognitively. They can develop iron deficiencies, mood disorders and body image issues to name a few.

Research indicates that young women are not learning about these things in school and their parents and medical providers need to become actively involved in this process. Please don't wait. Have conversations with your daughters and the parents of your daughter's friends to ensure you are caring for your active, young women athletes correctly. There are many free online medical resources and your health care providers can help to make a long-term difference in the health of our athletes.

• • •

Sheree DiBiase, PT, is the owner of Lake City Physical Therapy. She and her staff can help our young athletes have a fun, exciting athletic career. Please call us in Coeur d'Alene, 208-668-1988; Hayden, 208-762-2100 or Spokane Valley, 509-891-2623.

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