Sports Endocrinology and the Gestalt Approach to Athlete Care
Dr. Sara Forsyth
Endocrinology is the study of the various glands throughout the body that secrete hormones that circulate in the blood stream. These hormones functiond like “chemical messengers” and act on an assortment of structures throughout the body. They act to regulate many body processes and systems.
These hormones work in a complex concert-like manner with intricate feedback loops responding to the concentration of hormones within the loop.
Exercise and training can impact the concentration of various hormones resulting in alteration of the feedback loop. One key example of this is the menstrual cycle. The menstrual cycle functions via a positive feedback loop. The normal functioning of this loop is essential to general health and sport performance. Disruption of these loops is often caused by lack of integration of nutrition, sleep, recovery and training.
Disruption of hormones secreted from the endocrine system can impair sport performance and have potential long-term negative health impacts for males and females. These hormones play important roles in bone strength, cardiovascular health and production of brain chemicals to regulate mood. The effects of low levels of estrogen and progesterone are known to lead poor bone health and ultimately fractures and osteoporosis.
This picture is seen in the relative energy deficiency in sport (RED-S), which has been shown to impact multiple body systems. In RED-S there is a discrepancy between energy intake and energy output. This negative balance results in the body going into “conservation mode”. This is like putting your phone on “energy save”. The overall result is inhibition of overall performance and optimal general health. This can manifest itself in lack of response to training load, poor performance, recurrent soft tissue injuries, bony stress injuries and negative effects on cognitive function.
Prevention and awareness are the key messages for all those involved in Youth Sport. This is the key time to help athletes establish healthy approach to training and life. A team approach is imperative. Coaches, parents and practitioners need to be “on-board” with encouraging young athletes to “fuel” with optimal quantity and quality of food and get adequate rest and recovery, in order to reach their goals. We need to engage in the “whole athlete” approach to care and coaching. This involves engaging the athletes in reporting not just energy intake and output via their data gathering wearables; but reporting subjective data on fatigue, sleep quality and mood. Considering this Gestalt-like approach, those involved can being working on prevention and early detection in concert.
