Among Runners, Elite Girls Face Burnout and Injury

By MARC BLOOM

ulia Stamps was a running star from her first strides in seventh grade. She showed immense promise as a distance runner in her early years in high school, but then endured years of injury and illness before fracturing her left leg in two places in an accident two years ago. Doctors told her she would be lucky to run again, much less race.

Stamps, who is now 24, became a symbol for a generation of high-achieving girls who withered in adolescence before having the chance to fulfill their promise as runners. At a time of tender growth, many of them trained at a high level, and that often led to injury, impaired health or physical and emotional scars.

Doctors and medical researchers say there are several reasons for this. While adolescent boys generally grow stronger year by year, girls usually experience more erratic growth.

Doctors say that before the onset of menstruation, girls tend to have brittle bones and relatively weak muscles, making them prone to injury if they are training intensely. In addition, doctors say, such training has been shown to delay menstruation, and this, too, can increase the risk of injury.

Girls' development can affect their athletic performance in a third way, researchers say. Once menstruation begins, the body often undergoes a series of changes that inhibit at least temporarily the ability of blood to carry oxygen, producing a decline in physical fitness.

The grim trajectory of Stamps's career is not uncommon, many coaches say. Growing up in Northern California, she made headlines as a 14-year-old freshman at Santa Rosa High School, winning state championships and setting records in track and cross-country. With her speed and her lithe physique, Stamps was heralded as the next Mary Decker, the high school phenomenon who went on to compete in three Olympics.

Training 45 to 50 miles a week, Stamps lived up to her billing for a time. Beginning with her freshman season in 1994, she won the first of three consecutive national 3,000-meter titles for those age 19 and under, defeating college women. As a sophomore, she won the national high school cross-country title in the 5,000 meters.

But by her junior and senior years, Stamps was no longer dominant. She collapsed twice in national meets. She was frustrated and confused and often became sick. She received a track scholarship to Stanford but never realized her extraordinary potential as a runner. She was injured, lost her passion for competing, took up other sports and at one point nearly gave up running for good.

Doctors say that running moderately is healthy for young girls. But intense training at a young age can carry serious physical risks, said Dr. Angela Smith, an orthopedic surgeon specializing in pediatric sports medicine at Children's Hospital in Philadelphia.

"At age 13 or 14 when girls experience rapid growth — what we call peak height velocity — their bones grow long, but have not yet solidly mineralized into good, strong structures," Smith said. "During this period, girls in running also don't have the muscle for shock absorption. Girls are at maximum risk for injury and should back off hard training."

Smith said she had recently cared for a girl who was so fast as a high school freshman that she made the varsity cross-country team. She became the team's best runner, and the coach gave her extra workouts. But she also grew very quickly, Smith said, and developed three stress fractures in her legs. The girl was unable to finish the season.

Many Risk Factors
The risk of injury for girls can be increased by delayed menstruation, a condition associated with heavy training.

"A number of studies indicate that if a girl burns a lot more energy than she takes in, she will not start a new function like reproduction," Smith said. Delayed menstruation results in low estrogen levels and thin bones.

"When girls finally get their periods, we see quantum improvements in their healing from injury," Smith said. "Whether that's from eating more or the Among Runners, Elite Girls Face Burnout and Injury

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Many girls who confront these natural changes after early success, like Erin Davis, a former star at Saratoga Springs High School in New York, ultimately drop out of competitive running. In 1993, Davis became the first and only freshman to capture the national high school cross-country title.

Her freshman season was her best in high school, however. Davis received a track scholarship to Penn State and graduated last year without living up to her early promise.

"Erin had significant injuries that prevented her from training at a high level," said Beth Alford-Sullivan, the women's track and cross-country coach at Penn State, who coached Davis's last two years. "Her motivation was down. By the time I inherited her, she did not have the drive or passion to compete or train."

Training intensely at a young age carries psychological as well as physical burdens that can affect a girl's development. Stamps, who graduated from Stanford last year without winning any major titles, said she felt "tremendous pressure" as a young runner in high school.

"I tried to compete against myself," Stamps said. "But you can't do that every day. I needed a break. I had other interests outside of running that I wanted to pursue but was not able to. I was cursed.

"I wore myself thin. I had no time to rest."

Stamps moved to New York after graduation and is working for a financial services company. She is healthy for the first time in years and is running again. As a test, she ran the New York City Marathon last November, her first marathon. It was probably the easiest long run of her life. She is training as much as 10 miles a day and hopes to contend for a spot on the United States Olympic team next year in the marathon.

Choosing an Alternate Path
Concerns over burnout and injuries among young runners led Dick Brown, a coach from Oregon who has worked with professionals including Mary Slaney (the former Mary Decker) to start a radical program this year aimed at improving American success in running. Brown plans to recruit high school girls to attend a college in Oregon and train with him. But they will not compete for the college; instead they will compete less frequently for a club. Brown has begun raising money to pay for the runners' education and training.

And in a surprising backlash to the major-college system, two young women who were high school stars last season, Amber Trotter and Natasha Roetter, decided not to run for Division I programs this season.

Trotter, who won the national high school cross-country title in 2001 by 40 seconds, attends Middlebury College in Vermont, which competes in Division III. "I don't want to be a piece of meat in the corporate sports world," Trotter said defiantly in an interview after winning the high school title. "I run for the joy it brings me."

Roetter is a freshman at Duke. She placed third in the high school cross-country nationals in 2001 despite a succession of injuries. In August, as her first semester was about to begin, Roetter told the Duke coaches that she had decided to give up her athletic scholarship.

"I underestimated the intensity of Division I running," Roetter said. "I'm enjoying my classes and like having some time for myself. I still run, but at my own pace. If I ran on the team, I would probably end up running myself into the ground."

Some experts believe that burnout among young runners is made more likely by rules in about a dozen states, including New York, that permit middle school students to compete on high school varsity teams.

Dr. William Roberts, a pediatric sports medicine specialist in the Minneapolis area who is a vice president of the American College of Sports Medicine, views that practice with concern.

"When I look at a couple of these eighth grade girls in cross-country, they're too skinny and look awful," Roberts said. "They are potentially malnourished."

Aware of the burnout pattern, Coach Patrick Shane of Brigham Young, the reigning N.C.A.A. women's cross-country champion, said: "In recruiting, I don't look at stars in 8th, 9th or even 10th grade. Their success means nothing. They haven't grown up yet and matured into young women."

But a number of coaches and parents contend that it is appropriate to enable some exceptionally talented young runners to take advantage of their skills by training hard and competing at an early age.

Briana Jackucewicz, a 12-year-old from Farmingdale, N.J., competes weekly while training up to 50 miles a week. Briana, who has been racing since she was 6, set a national record for 11-year-old girls last fall, 17 minutes 42 seconds for a 5,000-meter road race. Her older sister, Leisha, now a high school junior, had followed a similar program. Last summer, Leisha had surgery on both legs as a result of running injuries.

additional impetus of estrogen, nobody knows."

Paradoxically, the beginning of the menstrual cycle can bring with it a different burden for young runners: it often affects their fitness levels, slowing their performance, at least for a while.

"Girls gain fat, and in some cases there is a decrease in iron stores and hemoglobin level of the blood," said Dr. Oded Bar-Or, who is director of the Children's Exercise and Nutrition Center at McMaster University in Hamilton, Ontario, and a leading researcher in the field. "Less hemoglobin reduces the capacity of the blood to carry oxygen. Fitness level in girls, their maximal oxygen uptake, decreases after age 12 or 13."

Among Runners, Elite Girls Face Burnout and Injury

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Roger Jackucewicz, the girls' father, said he was preparing Briana for high- school competition. Jackucewicz, who rides his bike pacing Briana in predawn training on school days, said he was careful to have her train primarily on soft park trails and not concrete roads. He also said Briana took breaks every few miles and ran at a comfortable pace.

"I like to expose them to things at an early age," Jackucewicz said. "Both girls are expert skiers and do extreme skiing in Canada. Running is just one thing. They're avid readers and at the top of their class in school."

Renewing Careers
In resurrecting her running career, Julia Stamps may exemplify a development in which female runners rise from turbulent adolescence to regain their zest for running. Stamps ran the New York City Marathon in 2:54:47, outstanding for a first-timer. She placed 30th among women.

"It felt easy," Stamps said. "I ran even pace all the way, about 6:30 per mile, and it took me only a week to recover."

Stamps plans to run her next marathon in June at the Rock 'n' Roll Marathon in San Diego. She hopes to achieve the qualifying standard for the American women's Olympic marathon trials, 2:48.

Two other former youth stars who have resurrected their careers after severe setbacks are Deena Drossin and Milena Glusac, both contenders in distance events for the 2004 Olympic team. Drossin, 31, who said she lost her love for running in the mid-1990's, set an American women's record for the marathon (2:21:16), her latest in a string of records, last Sunday in London. Glusac, 27, who had five stress fractures and various illnesses that left her bedridden, has won several national road-racing titles and is entered in tomorrow's Boston Marathon.

Enduring repeated injuries, Stamps began to think that she had given up too much for her running career. At Stanford, a torn hamstring muscle and a stress fracture in her lower back sidelined her for two years. Then in March 2001, when she was finally healthy and in her junior season, Stamps blacked out while riding a skateboard.

"I totally shattered my left leg with two complete fractures from top to bottom," she recalled. "Doctors told me I'd never run again."

Stamps underwent two operations and was on crutches for seven months. In March 2002, while on vacation in Costa Rica, Stamps tried running again. For the first time in years, she felt no pain. By late June, Stamps was running as much as 20 miles and planning for the New York City Marathon. Her recent training pace has increased to six minutes a mile, encouraging her to think she has a chance to make the Olympic team next year.

"I feel fabulous," she said. "Running the marathon didn't hurt a bit. It's a miracle, like I'm running with a halo."