Should youth athletes, adolescents, and children complete resistance training? This is a well discussed questions, and a sometimes-controversial topic. In my role as a physiotherapist in a sports medicine private practice, discussions are regularly had regarding the risk and efficacy of such training in these populations. The questions are usually posed to me via children and adolescents parents.
Youth athletes completing resistance-based weights training is often thought of as dangerous, inappropriate, unnecessary, likely to stunt growth, has potential to injure growth plates, not as important as field-based training… I could go on. These beliefs is often fostered by parents of young athletes/children, along with coaches, general public, and even medical professionals. Thankfully, recent evidence has shown that these view-points need to change.
A search of the recent literature shows that the belief of potential injury is unfounded, with low injury risk and injury rates when athletes follow age-appropriate strength training guidelines (1, 2). Evidence (1) has shown that injury rates across a multitude of studies have been reported at <1 injury per 100 hours (reported as low as 0.0017 per 100 hours in some studies). The risk of injury from weight training has also been shown to be less than the risk of injury in a multitude of sports. Overall, the risk of injury for resistance training and plyometrics does not appear to be any greater than the injury rates from most other sports youth athletes will commonly compete in (1). Positively, the National Strength and Conditioning Association (NSCA), one of the global leaders in resistance training guidelines and recommendations, advised that this form of training is safe when appropriately supervised and prescribed (3).
The key risks of injury in this population are related to a lack of education, poor supervision and instruction, inadequate technique, along with inappropriate training loads (1, 2). It is however important to consider growth spurts, anthropometric factors (e.g. height, weight), athlete age, fitness/strength and previous injuries (1). These factors can all impact upon the potential outcomes and risks when training a youth athlete and warrant consideration when prescribing exercise for these individuals. Notably, there is no evidence or reported injuries to youth or adolescent growth plates when the athletes have been provided with professional guidance and instruction (1, 2). Moreover, there is no research to suggest that, when undertaken correctly, this form of training will have negative impacts on future growth and maturation (2). This is an important point to consider, as this is one of the key myths around this form of training in the youth population.
Positively, evidence suggests the number of young athletes completing resistance-based training is growing (1). The benefits of structured, supervised, age-appropriate resistance training are numerous, with some displayed visually in the figure below (figure-1). Resistance training and injury prevention programs have been shown to substantially reduce the risk of injury in sport and can improve exercise performance, muscular strength and motor skills (1, 2, 3, 4, 6). This form of training has been recommended as an essential component of preparatory programs for youth athletes (6). Increasing strength and movement control through resistance-based exercise can assist in lower limb injury prevention such as ACL and patellofemoral pain. Improving lower limb strength will aid in increasing speed, acceleration, jump height, sport-specific skills, and much more. Along with improving strength, power, endurance and sports performance; resistance training can assist with improving insulin sensitivity, blood lipid profile, increasing metabolism, and helping to maintain healthy body composition (2, 3). This form of training can also improve the psychological well-beong of youth (3). These benefits advocate for the inclusion of resistance training in not only athletic youth populations, but all children and adolescents.
Figure-1. As sourced from Faigenbaum & Myer (2).
Furthermore, the final point of the figure above I think is extremely important. The statistics show that less than 15% of adults (aged 18-64 years old) complete the resistance training physical activity requirements. The figure below highlights these statistics visually (see figure-2). The benefits of strength training throughout the entire lifespan are well known and researched, thus starting resistance training in adolescents and having a greater participation rate later in life is a big positive. The inclusion of resistance training to promote healthy adult lifestyle habits is recommended by the NSCA and a 2014 international consensus statement (2, 6).
Figure-2. See the original Instagram post >>> click here.
An international consensus supports the use of resistance training in the youth and adolescent populations, providing it fits with certain parameters (6). The training should be supervised, with programs should be designed by qualified professionals (2, 6). There are a number of factors to consider when designing programs, with these including:
The training age, along with motor skill & technical competency of the athlete (2).
The existing strength levels of the athlete will help dictate intensity and loads (6).
The programs should be enjoyable, effective and safe (2).
Focus on developing technical skill and competency. Only increase intensity and load once these have been mastered and the athlete’s confidence in the task improves (2, 6).
Biological age & psychological maturity: there is no minimum age, however children must be at a mental and physical maturity to comply with coaches’ instructions. Generally, if the child is ready for sport participation, they are likely ready for resistance training. This is around the age of 7-8 years old (2, 6).
Consider total load of external sports/activities along with the resistance training (2). One of the biggest injury risks in the youth athletic population is load and load spikes.
Include appropriate warm ups and cool downs. Warm ups should generally include more dynamic activities, whilst cool downs more slower/static type activities, however this is not always the case (2).
Education on the potential benefits should be provided to parents, teachers, coaches and healthcare providers (6). This may help to reduce mis-informed beliefs and increase participation.
For exercise selection, generally complete higher mental demand tasks before lower mental demand tasks. Furthermore, include larger muscle groups before smaller muscle groups (2).
Plyometrics are safe and appropriate for youth athletes providing they are well designed and supervised (5). Parameters to consider include: 2 days per week, minimum 72 hour rest period, 50-60 foot contacts per session initially (progress up to 80-120), generally avoid use of loaded plyometrics (5).
The figure below (figure-3), provides further information on program design. The references in the bibliography contain greater depth on the parameters for those interested.
Figure-3. As sourced from Faigenbaum & Myer (2).
My Evidence-Based Recommendations:
Resistance training in youth athletes is safe and effective. Don’t avoid this method of training because of fear of injury.
Youth bodies are NOT adult bodies. What works for a 35 year old will not be the appropriate treatment for a 12 year old.
Appropriate guidance and supervision is a MUST in this population group. Settings such as supervised, group-based strength & conditioning classes work well.
Master technique BEFORE load. If an athlete can’t complete a good technique body weight squat, why load them in this movement pattern?
Complete periodized, well structured, goal focused programs that are at an appropriate level of interest for the youth athlete. If the athlete is 10 years old, make it fun!
Coach key movement and skill patterns. Why include fancy movements or exercises just for the sake of it?
Whilst plyometrics are safe, and a very useful performance enhancement/injury prevention exercise type, I would recommend against high-load plyometrics in this population. Bodyweight plyometrics will likely have the desired effects in this athletic group.
Health professionals (and others) should educate parents, athletes, and other health professionals on the benefits of these training methods in this population group.
My favourite exercises for youth athletes include: squats (technique before load), jump/land technique, hip bridge/glute bridge, crab walks, hurdle drills/exercises, calf raises, balance, and more.
This form of exercise can significantly assist with injury prevention, and should hold significant priority in the developing athlete’s busy training/sport schedules.
Figure-4. Originally posted on Instagram >>> click here.
Working with youth athletes to treat pain, reduce injury risk, and improve performance are big areas of interest for me. I currently run a number of supervised, strength and conditioning classes at Physiosports Brighton (see more here http://physiosports.com.au/team-member/ky-wynne/, or get in contact with me via the contact page)
Bibliography:
1. Faigenbaum, A. D., & Myer, G. D. (2010). Resistance training among young athletes: safety, efficacy and injury prevention effects. BJSM, 44(1), 56-63.
2. Faigenbaum, A. D., & Myer, G. D. (2010). Pediatric resistance training: benefits, concerns, and program design considerations. Current sports medicine reports, 9(3), 161-168.
3. Faigenbaum, A. D., Kraemer, W. J., Blimkie, C. J., Jeffreys, I., Micheli, L. J., Nitka, M., & Rowland, T. W. (2009). Youth resistance training: updated position statement paper from the national strength and conditioning association. The Journal of Strength & Conditioning Research, 23, S60-S79.
4. Rössler, R., Junge, A., Bizzini, M., Verhagen, E., Chomiak, J., aus der Fünten, K., ... & Faude, O. (2017). A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of ‘11+ Kids’: A Warm-Up Programme to Prevent Injuries in Children’s Football. Sports Medicine, 1-12.
5. Bedoya, A. A., Miltenberger, M. R., & Lopez, R. M. (2015). Plyometric training effects on athletic performance in youth soccer athletes: a systematic review. The Journal of Strength & Conditioning Research, 29(8), 2351-2360.
6. Lloyd, R. S., Faigenbaum, A. D., Stone, M. H., Oliver, J. L., Jeffreys, I., Moody, J. A., ... & Herrington, L. (2014). Position statement on youth resistance training: the 2014 International Consensus. Br J Sports Med, 48(7), 498-505.