Welcome back to part two of the off-season series. If you’ve already reflected on the past season (as covered in part one), the next step is getting more clinical specifically, understanding what to ask your doctor for gymnast off-season recovery.
Many families only visit the doctor when something is wrong. But for gymnasts training 20–30 hours per week, a proactive gymnast health check during off season can help catch hidden issues early from under-fueling to delayed development, fatigue, and injury risk.
Are You Tracking Growth and Development Properly?
Regular check-ups are not just for when your gymnast is sick; they are essential for tracking long-term health.
It’s important to monitor a gymnast’s growth regularly to assess their needs and help them adapt to their growing body.
Why annual visits matter
Even if your gymnast seems healthy, skipping yearly appointments can mean missing early signs of:
- Under fueling in gymnasts
- Delayed growth and development
- Hormonal imbalances
- Recovery issues
Without consistent growth data, it becomes difficult to identify trends or red flags later on. At The Gymnast Nutritionist, we look at both height and weight to track growth patterns.
What to ask your doctor
- Are growth charts being reviewed consistently?
- Is development aligned with age and training load?
- Are there signs of slowed or delayed growth?
Tracking gymnast growth and development is one of the most important indicators of overall health.
Why Growth Is a Key Performance Indicator
Growth is not just about height, it’s a reflection of whether the body has enough energy to function.
What proper growth tells us
If your gymnast is growing and developing normally, it usually means:
- She is getting enough nutrition
- The body has energy for recovery and adaptation
- Hormonal systems are functioning properly
What poor growth may indicate
If growth is delayed or stalled, it may signal:
- Chronic under-fueling
- Inadequate recovery
- Increased injury risk
Even when gymnasts appear to be “fine,” years of subtle under-fueling can eventually catch up often through injuries or performance plateaus.
Why Gymnasts Need Athlete-Aware Doctors
Not all doctors understand the demands of high-level gymnastics, so to them, growth patterns can look “normal” but they fail to consider your gymnast’s active lifestyle and their energy availbility needs.
When analyzing growth, doctors are commonly comparing to other kids the same age, but are much less active. Remember, your gymast can be training 20+ hours a week which makes them much different from the average child
The challenge with standard growth charts
Growth charts are based on general populations not athletes training 20–30 hours per week.
This can lead to confusion around:
- Weight changes
- Body composition
- Puberty timing
What to look for in a provider
Ideally, your gymnast’s doctor should:
- Understand athlete physiology
- Be familiar with training demands
- Avoid making weight-focused comments
If your current provider isn’t a good fit, it’s okay to find one who better understands gymnast health and performance. And more importantly, you have to advocate for your gymnast and clearly explain their training levels and the demand on their body.
Is Your Gymnast’s Reproductive Health on Track?
Reproductive development is a critical part of a gymnast’s health check during off season.
Key red flags to discuss
- No period by age 15
- Delayed puberty
- Irregular cycles
In most cases, gymnast period delay causes are linked to:
- Under-fueling
- High training load
- Low energy availability
Why this matters
Delayed reproductive development is associated with:
- Low bone density
- Increased stress fracture risk
- Long-term hormonal issues
This is not something to “wait out”; it should be addressed early.
Could Fatigue Be a Hidden Nutrition Issue?
Fatigue is one of the most common and most overlooked concerns in gymnasts.
Questions to explore
- Is your gymnast constantly tired?
- Are energy levels inconsistent? How do they feel during and after practice?
- Is recovery slower than expected? Do they have injuries that take months to heal?
Labs to consider
You may want to ask about:
- Iron levels (including ferritin)
- Vitamin D
- General bloodwork
These are key for understanding gymnast fatigue and bloodwork connections.
Don’t overlook the basics
Fatigue is often a combination of:
- Poor sleep
- Under-fueling
- High training load
- Lack of recovery
All of these should be assessed together rather than individually as they paint the proper picture of your gymnast’s health.
Why Some Gymnast Injuries Don’t Heal
If injuries are lingering, it’s worth digging deeper. Children are resilient and injuries should take weeks not months to recover.
Possible reasons for slow healing
- Inadequate nutrition
- Poor recovery
- Misdiagnosis
- Incorrect rehab approach
The nutrition connection
Without enough fuel, the body cannot:
- Repair tissue
- Build strength
- Adapt to rehab
This is why gymnast injury recovery questions should always include nutrition.
When to Get a Second Opinion
Parents are your gymnast’s best advocate. Remember, you know your gymnast best and are responsible for communicating your gymnast’s lifestyle to other health practitioners so they have the full picture of your gymnast and what they may need.
When to seek another opinion
- Injury isn’t improving
- Diagnosis doesn’t feel clear
- Treatment plan isn’t working
Not all providers understand gymnastics-specific demands and that’s okay.
Getting another perspective can prevent:
- Prolonged injury
- Missed training time
- Incorrect treatment
The Role of Under-Fueling in Injury Recovery
Under-fueling is one of the biggest reasons injuries don’t heal. Above, we talked about how under-fueling prevents proper tissue repair, makes it tougher to build strength, and adapt to rehab.If energy is insufficient, even the best rehab plan will fall short.
Dizziness, Electrolytes, and Performance Red Flags
Dizziness is another symptom that should not be ignored.
Common causes in gymnasts
- Low iron
- Dehydration
- Low electrolyte intake
- Blood pressure regulation issues
What to ask your doctor
- Could this be related to hydration or electrolytes?
- Should we test iron or other markers?
Many gymnasts are not getting enough sodium due to overly restrictive eating patterns, which can impact gymnast dizziness, electrolytes, and balance.
Sleep Issues: Medical or Lifestyle Problem?
Sleep plays a major role in recovery, but it’s not always a medical issue.
Common causes of poor sleep
- Anxiety
- Poor time management
- Screen use
- Under-fueling
Why under-fueling affects sleep
When the body lacks energy, the brain stays alert,making it harder to fully rest.
Before turning to supplements or medication, it’s important to identify the root cause.
Breaking the Injury Cycle Before Next Season
Many gymnasts get stuck in a cycle:
Injury → Rehab → Return → Re-injury
What’s often missing
- Root cause analysis
- Nutrition assessment
- Workload evaluation
To truly break the cycle, ask:
- Was this injury preventable?
- Was nutrition a factor?
- Are recovery strategies adequate?
Signs of Disordered Eating in Gymnasts
Disordered eating is often subtle especially in athletes, and especially in a sport like gymnastics where it’s been ingrained in people’s minds for years that “gymnasts are just naturally smaller”. This is not true, and nor should it be the norm.
Common signs of disordered eating
- Skipping meals
- Sudden dietary changes
- Excessive exercise outside of training
- Avoiding certain food groups
These may be overlooked or even praised as “discipline.”
What Most Doctors Miss
Many doctors are not trained to identify signs of disordered eating in gymnastst
Why this matters
In adolescents:
- Weight may not drop significantly
- Growth may simply slow or stop
This is why growth charts and behavior patterns matter more than appearance alone.
Subtle Warning Signs Parents Should Watch
Parents often notice changes first.
Trust your instincts if you see:
- Changes in eating behavior
- Increased fatigue
- Mood shifts
- Obsession with food or body
Early intervention can prevent more serious issues later.
Ready to Help Your Gymnast Upgrade This Season?
The off-season is the best time to take a proactive approach to your gymnast’s health.
Instead of waiting for problems to appear, use this time to:
- Ask the right medical questions
- Review growth and development
- Address fatigue, injuries, and recovery
- Support proper fueling
If you want a step-by-step plan to support your gymnast’s nutrition, recovery, and long-term performance, The Balanced Gymnast program walks you through exactly what to focus on during the off-season and beyondAnd if you’re still figuring out where to start, a Gymnast Nutritionist can help you connect everything from medical insights to daily fueling habits so your gymnast is set up for a stronger, healthier next season.
Learn more about Christina’s work as a Gymnast Nutritionist / Dietitian
Explore the Balance Gymnast Program
Apply for Nutrition Coaching
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