Thursday, December 2, 2010

Strength Training Beneficial for Children and Adolescents

In the last decade (2000-2010) there has been a shift in the recommendations regarding strength training for children and adolescents. "Strength training, as part of a well-balanced youth fitness program can be beneficial for children as young as 6 years old", according to a statement by the AAP (American Academy of Pediatrics, 2003). As long as the child is adequately supervised and training follows specific and careful guidelines, the benefits of strength training are many.

Whether your child is struggling with obesity or overweight, or is young athlete looking to gain a competitive edge, the benefits of incorporating resistance training exercises can improve your child's overall health. The benefits of strength training may include: increased lean body mass and body composition (less fat/more muscle), improved base metabolic rate (calories burned/hour), increased muscle strength, efficiency and power, improved flexibility and resistance to injuries sustained during other sports activities, better posture and improved cardiovascular health. New evidence has been published that strength training may also have benefits for diabetes prevention. As one acquires more muscle mass, blood sugar levels become more normalized. But perhaps the most often overlooked benefit is improved self-esteem and self-confidence. Resistance training can have an overall positive effect on a child's ability to jump higher, run up and down a gym faster, hit a volleyball farther, make more baskets in basketball and swing a baseball more effectively. New found improvement in skills and energy level may enhance a child's self-perception.

Our Pediatric Nurse Practitioners at PHA provide Nutrition Consults that incorporate fitness and exercise goals as a part of the overall process toward healthier lifestyles. Your child should have a completed sports/school physical by one of our pediatricians or nurse practitioners prior to embarking on strength training program This is critical to minimize the chances of your child being injured or re-injured. Our providers can answer questions you may have at this time as well.

Guidelines for strength training have been developed by the American Academy of Pediatrics in collaboration with other medical professional organizations and are provided in a table at the end of this article.

It is important that everyone understands what strength training is and is not. Injuries from overuse, rapid or jerking movements can result if the perception of the training is that it involves pushing oneself to the limits or using an excessive amount of weight. Children and teens need their parents' guidance in order to avoid the misconception that they must lift their "max" or maximum amount of weight during workouts. Perhaps the most classic representation of lifting weights is that of Olympic power lifting competitions. This is NOT at all what is recommended. In an article written by physicians, HJ Benjamin and KM Glow for "The Physician and Sports Medicine Journal", a clear distinction between this type of training and "weight lifting , power lifting or bodybuilding" was made. Many potentially serious injuries are associated with the sports of weight lifting and power lifting. In contrast, strength training results in less injuries while still increasing strength and flexibility.

Specifically, strength training, "uses resistance methods to increase one's ability to exert or resist force. The equipment uses free weights, the individual's own body weight, machines, or other devices like elastic bands and medicine balls to provide resistance - Low weight, more repetitions." For example, one pound arm or ankle weights to lift the arm or leg in a slow sustained movement, ten times in a row. Ten repetitions is equal to one set. It is typical that one would do three sets of ten repetitions. Another example of a strengthening exercise using resistance is for the ankle, a very important, but often overlooked joint. Strengthening the ankle for all kinds of running sports may prevent injury. Using a resistance rubber band tied to a leg of a chair, the other end of the resistance band is wrapped around the foot, the foot is flexed and counter flexed in all four directions while supporting the ankle just under the heel. This movement is slow and steady and with care, so as to avoid any rapid rebounding movements.

In contrast, weight lifting and power lifting, "are competitive sports that contest maximum lifting ability. The sport of weight lifting is composed of two competitive lifts: the clean-and-jerk and the snatch. Power lifting involves three competitive lifts: the squat, the bench press, and dead lift. This type of workout is not appropriate for children.

Similarly, children's strength training should not be linked to bodybuilding. Bodybuilding "is an esthetic sport that does not involve competitive lifts but depends on weight training." This is a sport of competitive body sculpting for the art of creating a certain physique or body shape. Today, we have a better understanding of the physiology of neuromuscular strength development of children and adolescents. There are differences in the way a pre-pubertal child gains strength compared to an adolescent who has reached pubertal maturity. Researchers conclude that strength gains seen in resistance-trained children before puberty are due to various neural adaptations and muscle size is not increased. Increases in neural activation, muscular adaptations and improvements in motor coordination (muscle memory) seem to play a role in strength development in childhood." (Benjamin, HJ; Glow, KM, 2003) The American Academy of Pediatrics (AAP) and the American Orthopedic Society for Sports Medicine(AOSSM) recommend that children and adolescents should avoid weight lifting, power lifting, and bodybuilding until they have reached a stage of physical maturity called "Tanner stage 5." Your pediatric medical provider will identify for you if your child has reached this stage of physical development.

Here are the AAP's tips for any kind of strength training:

  •  Take it easy. At first, there should be ''no load," or no resistance, while learning the exercise. Add weight in increments of 10% only after 8 to 15 repetitions can be done.
  • Focus on technique. It's better to do the exercise correctly than to do more repetitions or to take on more resistance.
  • Ensure proper supervision and safety. The AAP says instructors or personal trainers should be certified and should have specific qualifications in pediatric strength training.
  • Don't lift weights rapidly or do "explosive" lifting. The AAP discourages power lifting and body building until someone reaches physical and skeletal maturity.
  • Strengthen all major muscle groups, including the core muscles.
  • Warm up and cool down with gentle stretching without weights. Devote 10-15 minutes to your warm up and another 10-15 minutes to cool down after strength training.
  • Be sure to stay properly hydrated and eat a nutritious diet to help muscles recover.
Remember, strength training is just one part of fitness. Don't overlook aerobic conditioning or replace your child's active play time or sports programs with strength training if he or she is already enjoying those activities. Strength training is only one aspect in helping your child grow physically strong.


American Academy of Pediatrics Grand Rounds

Benjamin, HJ; Glow, KM. Strength Training for Children and Adolescents: What Can Physicians Recommend? Phys Sports Med. 2003; 31:19-28.

By Romina Gieseman, PHA Nurse Practitioner

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