Without periods, the young athletes may never reach peak bone mass, which typically occurs in a woman's late 20s. That leaves women more at risk for a variety of ills, including osteoporosis, stress fractures, arthritis, joint replacement and more.

One of The Orthopedic Specialty Hospital's weapons is its BEST Clinic — Better Eating, Safer Training — a monthly seminar that includes a discussion on what to eat, as well as hands-on time in the kitchen to put it into practice. Spence is especially pleased when parents and coaches join in.

Spence teaches that a training meal is mostly carbohydrates, lean proteins and a variety of colorful fruits and vegetables. For athletes, carbs, proteins and fats are all important.

More intense workouts call for more carbs. Fats, she added, are "not all created equally." You want to avoid saturated fats and eat olive oil and avocados, nuts, seeds, salmon and other fatty fish and mono-unsaturated fats. Trans fats are all to be avoided. Those are found mostly in processed foods.

Walker puts the girls through an acceleration program that includes a series of one-legged drills and exercises, all sport-specific and geared to improve balance, movement and core stability. The need for training, he said, can't be overemphasized.

"I'm hoping that coaches will look at this, sit down and reflect on what's going on and have days when they leave the ball home and run, jump, cut, etc., to simply train," he said. "There's a lot of very, very good skill and tactical training going on, but physical training is lacking."

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E-mail: lois@desnews.com