Is it Safe for Children to Do Strength Training?

There is substantial interest and lingering concern from parents, coaches, and the medical community about the safety and appropriateness of strength training for children.   Are these concerns based on solid research or are they misconceptions which need to be put to rest?

What is Resistance Training?

Before discussing the evidence, clear definitions of the terms children and resistance (or strength) training are helpful. Resistance training is a specialized form of conditioning whereby an individual is working against a wide range of resistive loads to enhance health, fitness, and performance. Forms of resistance training include the use of body weight, weight machines, free weights (barbells and dumbbells), elastic bands and medicine balls. Resistance training should be distinguished from terms such as weightlifting and bodybuilding. The term children refers to girls and boys (generally up to the age of 11 and 13 years, respectively) prior to puberty and have not developed secondary sex characteristics.

Injury Rates in Children

With qualified supervision, the risk of injury from resistance training for children is very low. Faigenbaum and Myer (2010) summarized over 30 studies conducted on youth resistance training and found reports of only three injuries when properly supervised. The three injuries reported were short-term non-serious injuries such as muscle strains and low back pain. In fact, the estimated risk for injury from youth resistance training has been estimated to be 0.05 to 0.17 for every 100 hours of training. These injuries rates are far lower than those for children engaging in sports such as soccer, football, baseball, gymnastics, lacrosse, and running. Youth injury rates from resistance training are also believed to be no different than those of adults.

Growth Plate Injuries


The most often cited concern associated with youth resistance training is the potential for injury to the growth plate and “stunted growth”. There have been a few retrospective case reports describing injuries to the growth plates in children.  However, most of these injuries were caused by improper lifting technique, poorly chosen loads, or a lack of qualified adult supervision. For example, in one case report a 13-year-old boy sustained elbow growth plate fractures when he lost control of a 65-pound barbell he attempted to press overhead exercising alone at home.

Injury to growth plates has not been reported in any prospective youth resistance training study that provided professional supervision and instruction. There is also no evidence that resistance training can negatively impact growth in height during childhood. The risk of growth plate injury is likely greater when children perform jumping and landing activities during competitive sports or even free play.

Conclusion

Many of the forces that youth are exposed to in sports and recreation (e.g., soccer, basketball, football, and running) are greater both in duration and magnitude than properly performed resistance training. However, problems can, and often do arise, when children are introduced to resistance training with inappropriate instruction or supervision. With the increasing volume and intensity of youth sports, it is more important than ever that children are properly instructed, supervised, and progressed by qualified personnel. Therefore, parents and coaches should seek out qualified professionals who are knowledgeable and up to date with the most current evidence about youth resistance training. When appropriately performed, youth resistance training is safe and extremely beneficial for improving health, fitness, and performance.

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References

  1. Faigenbaum, A., Kraemer, W., Blimkie, C., Jeffreys, I., Micheli, L., Nitka, M., & Rowland, T. (2009). Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association. Journal of Strength and Conditioning Research, 23(5), S60–S79.
  2. Faigenbaum, A. D., & Myer, G. D. (2010). Resistance training among young athletes: safety, efficacy and injury prevention effects. British Journal of Sports Medicine, 44, 56–63. http://doi.org/10.1136/bjsm.2009.068098
  3. Lloyd, R. S., Faigenbaum, A. D., Stone, M. H., Oliver, J. L., Jeffreys, I., Moody, J. A., … Myer, G. D. (2014). Position statement on youth resistance training: The 2014 international consensus. British Journal of Sports Medicine, 48, 498–505. http://doi.org/10.1136/bjsports-2013-092952

Dangers of Athletic Practices in the Heat

Pre-season sport practices will be kicking off over the next few weeks. With the excitement of another season fueling summer practices, comes the dangers of playing in hot and humid conditions. There are three forms of exertional heat illness which players, parents, and coaches should be familiar with. These are heat cramps, heat exhaustion, and heatstroke. For more about what exertional heat illness is and is not, read here.

Three Forms of Exertional Heat Illness

Heat cramps are the least serious and typically involve painful cramping of large muscles (commonly the calf muscles). Heat cramps are caused by sodium loss and dehydration which accompany high rates of sweating. Treatment of heat cramps involves moving the athlete to a cooler environment and administering fluids such as sodium containing sports drinks. Prevention strategies include remaining hydrated during practices and liberal use of sodium containing foods or beverages.

Heat exhaustion is a more serious disorder characterized by fatigue, dizziness, nausea, vomiting, fainting, and a weak, rapid pulse. In such cases, the body’s cardiovascular system is unable to meet the needs of the body as it becomes dehydrated. The underlying cause is dehydration caused by fluid loss from sweating. Athletes who are unfit or not acclimated to the heat are more susceptible. Treatment involves resting in a cool environment with the feet elevated to facilitate blood return to the heart. Administration of fluids (water or a sodium containing beverage) is also recommended.

Heatstroke is a life-threatening disorder requiring immediate medical attention. It is caused by an inability to control core body temperature. A core body temperature exceeding 104 degrees, confusion, disorientation, and unconsciousness are hallmark signs. If left untreated, body temperature will continue to rise progressing to coma and even death. Rapid cooling of the body in an ice bath is the best form of treatment. If cold-water immersion is unavailable the athlete should be wrapped in cold wet sheets while others fan the body.

Impact of Humidity

High humidity means the air contains many water molecules. In these instances, the air cannot accept much more water. During exercise in the heat, excessive body heat is lost through evaporation of sweat at the surface of the skin. If humidity is high, sweating will be much less effective in releasing body heat because evaporation is inhibited. Even though sweat secretion will continue during the exercise bout, without evaporation the rate of core body temperature may continue to rise. Therefore, high humidity increases the likelihood of experiencing any of the three forms of exertional heat illness.

Preventative Steps

Athletes can take preventative steps to minimize the detrimental effects of playing in hot environments. Strategies which promote heat adaptation have been shown to assist with an athlete’s ability to tolerate and perform in hot and humid environments. Adaptation requires a series of gradual progressively increasing temperatures in order to produce sufficient adaptations. Longer and more frequent heat exposures produce heat adaptation benefits resulting in the greatest capacity and performance benefits. Regimens lasting more than 14 days show the greatest benefits.

Coaches and parents should take preventative steps when threatening conditions are present. Practices in the early morning or evening can avoid the severe heat stress of midday. Fluids should be available and athletes should be given drink breaks every 15 to 30 minutes. Weighing athletes before and after exercise can help estimate individual sweat rate and fluid needs. Fluids containing electrolytes and carbohydrate can provide benefits over water alone. Light colored, lightweight, loose-fitting clothing should be worn whenever possible. And finally, heavy use of equipment (i.e., football pads and helmets) should be minimized or avoided early in the practice season when athletes are not yet fit or acclimated to the heat.

References

  1. Bergeron, M. F., Bahr, R., Bärtsch, P., Bourdon, L., Calbet, J. A. L., Carlsen, K. H., … Millet, G. (2012). International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes. British Journal of Sports Medicine, 46, 770–779. http://doi.org/10.1136/bjsports-2012-091296
  2. Kenney, W. L., Wilmore, J., & Costill, D. (2015). Physiology of sport and exercise (6th ed.). Champaign, IL: Human Kinetics.
  3. Tyler, C. J., Reeve, T., Hodges, G. J., & Cheung, S. S., (2016). The effects of heat adaptation on physiology, perception and exercise performance in the heat: A meta-analysis. Sports Medicine, 46(11), 1699–1724. http://doi.org/10.1007/s40279-016-0538-5