Strength Training For Children & Adolescents – Part 1

While parents, carers and schools positively promote children engaging in team sports like netball, football, AFL and individual sports and activity like running, riding, tennis and cycling, there seems to be unfounded negative connotations when it comes to children and resistance training ⁽¹⁾. The evidence does not support this view in anyway.

Children & adolescents MUST be engaged in muscle and bone strengthening activities of a minimum dosage of two times per week for 30-45min of moderate to high intensity.

The Problem

“The least fit 10-year old in a class of 30 in 1998 would be one of the five fittest kids in that same class today” ^(2-3)

World-wide rates of obesity, chronic disease, mental health problems, low fitness, low strength and sedentary lifestyles are at an all-time high. This is despite having greater access than ever to high quality services and educated practitioners in this space, and the kids have not escaped this downward spiral. So, let’s briefly summarise just some of the current challenges facing our younger generation:

Decline of 10 year old children fitness 1998 to 2014 – Image source: Sandercock et. Al 2015

• Physical activity levels decline by ~7% per year during adolescent years ⁽⁴⁾
• Young peoples’ cardio-respiratory fitness levels declined by 3.6% per decade between 1958 and 2003 ^{(5, 6)}
• People 18 years and under with low aerobic fitness are almost twice as likely to develop serious depression in adulthood, as well as cardiovascular disease ⁽⁷⁾
• Type 2 Diabetes used to be termed adult onset diabetes, but that name had to be dropped due to the rise in the prevalence of type 2 diabetes in children and adolescents in the two decades leading up to 2012 ^(8,9,10)
• One in seven children between the age of 4 and 17 years old has a diagnosed mental disorder, with ADHD, anxiety, depression, and conduct disorders (in that order) being the most common ⁽¹¹⁾
• Unlike almost every other chronic illness (which typically affect just adults), 50% of mental disorders present by age 14 (75% by age 24) and usually go untreated until adulthood. Primary School is key time to prevent these risks! ⁽¹¹⁾
• One in 15 adolescents (7.5%) reports suicidal ideation in the prior 12 months (i.e., have seriously thought about taking their own life) ⁽¹¹⁾. Physical activity is linked with reduced odds of this happening ⁽¹²⁾
• Children as young as 8 are reporting poor body image ⁽¹³⁾

Here is a powerful quote from one of the most recently published review on physical activity, sedentary behaviour and mental health in children and adolescents ⁽¹⁴⁾.

“Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behaviour and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents.”

So why don’t more children participate in regular supervised resistance training to turn the tides on these issues? Perhaps its due to some common myths around resistance training for children.

The Myths

While parents may understand and support their child engaging in team sports, running, riding, tennis and cycling as examples, there is hesitation, and perhaps fear of children engaging in resistance training. So, let’s discuss the 2 big myths and dispel them once and for all:

Myth 1: Strength Training Is Dangerous For Children

For some strange reason, the thought that strength training is dangerous for children has been around for a long time, despite there be very little evidence that this is the case. There have been limited examples that people have grabbed on to, where children were injured during strength training, through misuse of equipment unsupervised in the gym ⁽¹⁵⁾, but to be clear this was from MISUSE! The American Academy of Paediatrics (AAP) even got on the bandwagon in 1990 recommending strength training be avoided until physical maturity. What people didn’t realise was this was specific to high level maximal loaded power lifting and highly technical weightlifting, it was NOT referring to supervised and appropriately dosed strength training.

Strength training planned and supervised by professionals is safer and has lower injury rates than sports many children happily participate in, such as soccer, netball, football and basketball ⁽¹⁶⁾. Yet we don’t hear the same dogma for these activities.

So, to be crystal clear, strength training is extremely safe for children and adolescents, and it is detrimental for them to not be doing it regularly. So much so that the 2014 international consensus position statement ⁽¹⁷⁾ in the British Journal of Sports Medicine on youth resistance training went so far as to state:

“misinformed concerns that resistance training would be harmful to the developing skeleton have been replaced by reports indicating childhood may be the opportune time to build bone mass and enhance bone structure by participating in weight-bearing physical activities.”

And of course, the American Academy of Paediatrics got up to date and have since changed their tone, addressing 3 key aspects in their 2008 position statement ⁽¹⁸⁾:

1. Resistance training should be an essential component of preparatory training for aspiring athletes.
2. Participation in resistance training earlier in life correlates with participation later in life.
3. Individuals who do not participate in resistance training are likely at increased risk of negative consequences.

Myth 2: Strength Training Will Stunt My Childs Growth

This misguided belief has basis in thinking that loading growing children’s bones risks damaging their growth plates (or epiphyseal plates). Growth plates are cartilaginous areas of growing tissue at the ends of long bones, and it is true that until they fully harden in adulthood do have greater risks of damage. This damage, in extreme cases, would then mean that the bone lengthening effect’s that occur through childhood and adolescents until skeletal maturity may be stunted.

But weightlifters and strength athletes are short you say? It must be because they lifted weights while they were growing right? This is a reverse causation error. It is not that strength training stunted growth, they are successful, and therefore more likely to pursue the sport, BECAUSE they are short.

Growth plate injuries do occur in sport, and I mean all sport, not just strength training. In fact, these injuries are more common in traditional sports like long distance running, basketball, football, soccer, gymnastics, rugby, tennis, and cricket ⁽¹⁹⁾. The likelihood of this damage affecting growth is incredibly rare.

Long story short (pun intended), strength training for children and adolescents is extremely safe and has no adverse effects on growth or final adult height, especially when supervised by expert coaches, and this is supported by extensive research ⁽²⁰⁾.

In part 2 of this article I will discuss the benefits of strength training for children and adolescents while providing a high-level overview of what that training should look like. Stay tuned and click this link HERE for part 2.

To find out more about Absolutes Junior Program to get your child on the right path in their health, performance and injury prevention, get in touch with the expert team at Absolute HERE.

Written by Co-founder, Head Performance Coach & Exercise Scientist David Smith

 

References

1. Ten Hoor, G.A., Sleddens, E.F.C., Kremers, S.P.J. et al.Aerobic and strength exercises for youngsters aged 12 to 15: what do parents think? BMC Public Health 15, 994 (2015). https://doi.org/10.1186/s12889-015-2328-7
2. Dumith, S., Gigante, D., Domingues, M., & Kohl, H. (2011). Physical activity change during adolescence: a systematic review and a pooled analysis. International Journal Of Epidemiology, 40(3), 685-698. doi: 10.1093/ije/dyq272
3. Tomkinson, G. R., Olds, T.S. Pediatric Fitness: Secular trends and geographic variability. & Sports Sci. Vol 50 (2007).
4. Hardy, L., Merom, D., Thomas, M., & Peralta, L. (2018). 30-year changes in Australian children’s standing broad jump: 1985–2015. Journal Of Science And Medicine In Sport, 21(10), 1057-1061. doi: 10.1016/j.jsams.2018.04.005
5. Henriksson, H., Henriksson, P., Tynelius, P., Ekstedt, M., Berglind, D., & Labayen, I. et al. (2019). Cardiorespiratory fitness, muscular strength, and obesity in adolescence and later chronic disability due to cardiovascular disease: a cohort study of 1 million men. European Heart Journal. doi: 10.1093/eurheartj/ehz774
6. Poor fitness is a bigger threat to child health than obesity. (2020). Retrieved 24 February 2020, from https://theconversation.com/poor-fitness-is-a-bigger-threat-to-child-health-than-obesity-4365.
7. Sandercock, G., Ogunleye, A. & Voss, C. Six-year changes in body mass index and cardiorespiratory fitness of English schoolchildren from an affluent area. Int J Obes39, 1504–1507 (2015). https://doi.org/10.1038/ijo.2015.105
8. Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F & Silink M 2004. Type 2 diabetes in the young: The evolving epidemic: The International Diabetes Federation Consensus Workshop. Diabetes Care 27:14.
9. Craig M & Huang C 2009. Type-2 diabetes in childhood: incidence and prognosis. Paediatrics and Child Health 19:321‒6.
10. Pinhas-Hamiel O & Zeitler P 2005. The global spread of Type 2 Diabetes Mellitus in children and adolescents. The Journal of Pediatrics 146:8
11. Lawrence, D., Hafekost, J., Johnson, S., Saw, S., Buckingham, W., & Sawyer, M. et al. (2016). Key findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian & New Zealand Journal Of Psychiatry, 50(9), 876-886. doi: 10.1177/0004867415617836
12. Vancampfort, D., Hallgren, M., Firth, J., Rosenbaum, S., Schuch, F., & Mugisha, J. et al. (2018). Physical activity and suicidal ideation: A systematic review and meta-analysis. Journal Of Affective Disorders, 225, 438-448. doi: 10.1016/j.jad.2017.08.070
13. Elizabeth K. Hughes, Lisa K. Mundy, Helena Romaniuk, Susan M. Sawyer, Melissa Wake, Joanne Williams, Timothy Olds, Nicholas B. Allen, George C. Patton. Body Image Dissatisfaction and the Adrenarchal Transition. Journal of Adolescent Health, 2018; DOI: 1016/j.jadohealth.2018.05.025
14. Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, et al. Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.). 2019 Sep;49(9):1383-1410. DOI: 10.1007/s40279-019-01099-5.
15. Jenkins, N. H., & Mintowt-Czyz, W. J. (1986). Bilateral fracture-separations of the distal radial epiphyses during weight-lifting. British journal of sports medicine, 20(2), 72–73. https://doi.org/10.1136/bjsm.20.2.72
16. Faigenbaum, A., & Myer, G. (2009). Resistance training among young athletes: safety, efficacy and injury prevention effects. British Journal Of Sports Medicine, 44(1), 56-63. doi: 10.1136/bjsm.2009.068098
17. Lloyd RS, Faigenbaum AD, Stone MH, et al. Position statement on youth resistance training: the 2014 International Consensus. British Journal of Sports Medicine 2014; 48:498-505.
18. Strength Training by Children and Adolescents. Council on Sports Medicine and Fitness. Apr 2008, 121 (4) 835-840; DOI: 10.1542/peds.2007-3790
19. Caine D, DiFiori J, Maffulli N. Physeal injuries in children’s and youth sports: reasons for concern. British Journal of Sports Medicine 2006; 40:749-760.
20. Malina, R. (2006). Weight Training in Youth-Growth, Maturation, and Safety: An Evidence-Based Review. Clinical Journal Of Sport Medicine, 16(6), 478-487. doi: 10.1097/01.jsm.0000248843.31874.be
21. Faigenbaum A, Lloyd R, Myer G. Youth resistance training: past practices, new perspectives and future directions. Pediatr Exerc Sci 2013; 25:591–604.
22. Myer G, Faigenbaum A, Chu D, et al. Integrative training for children and adolescents: techniques and practices for reducing sports-related injuries and enhancing athletic performance. Phys Sportsmed 2011; 39:74–84
23. Lloyd RS, Oliver JL, Faigenbaum AD, et al. Long-term athletic development-part 1: a pathway for all youth. J Strength Cond Res 2015; 29:1439–50.
24. Emery C, Meeuwisse W. The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. British Journal of Sports Medicine. 2010;44(8):555-562.
25. Andersen, K., Rasmussen, F., Held, C., Neovius, M., Tynelius, P., & Sundström, J. (2015). Exercise capacity and muscle strength and risk of vascular disease and arrhythmia in 1.1 million young Swedish men: cohort study. BMJ, h4543. doi: 10.1136/bmj.h4543
26. Ortega F, Silventoinen K, Tynelius P, Rasmussen F. Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ. 2012;345(nov20 3)
27. Sgro M, McGuigan MR, Pettigrew S, Newton RU. The effect of duration of resistance training interventions in children who are overweight or obese. J Strength Cond Res. 2009;23(4):1263-70.
28. Benson A, Torode M, Singh M. The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial. Int J Obes. 2008;32(6):1016-27.
29. Schranz N, Tomkinson G, Olds T. What is the effect of resistance training on the strength, body composition and psychosocial status of overweight and obese.
30. Ginty F, Rennie KL, Mills L, Stear S, Jones S, Prentice A. Positive, site-specific associations between bone mineral status, fitness, and time spent at high-impact activities in 16- to 18-year-old boys. 2005 Jan;36(1):101-10.
31. Morgan PJ, Saunders KL, Lubans DR. Improving physical self-perception in adolescent boys from disadvantaged schools: psychological outcomes from the Physical Activity Leaders randomized controlled trial. Pediatr Obes. 2012;7(3):27-32.
32. Velez A, Golem DL, Arent SM. The impact of a 12-week resistance training program on strength, body composition, and self-concept of Hispanic adolescents. J Strength Cond Res. 2010;24(4):1065-73.
33. Schranz N, Tomkinson G, Olds T. What is the effect of resistance training on the strength, body composition and psychosocial status of overweight and obese children and adolescents? A systematic review and meta-analysis. Sports Med. 2013;43(9):893-907.
34. Gray JJ, Ginsberg RL. Muscle dissatisfaction: an overview of psychological and cultural research and theory. Washington DC: APA; 2007.
35. Huberty JL, Rosenkranz RR, Balluff MA, High R. Describing weight status and fitness in a community sample of children attending after-school programming. J Sports Med Phys 2010;50(2):217-28.
36. De Rezende LFM, Lopes MR, Rey-López JP, Matsudo VKR, do Carmo Luiz O. Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews. PLoS ONE. 2014;9(8): e105620.
37. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101(Suppl 2):518-25.
38. Coe DP, Pivarnik JM, Womack CJ, Reeves MJ, Malina RM. Health-related fitness and academic achievement in middle school students. J Sports Med Phys Fitness. 2012;52(6):654-60.
39. Du Toit D, Pienaar AE, Truter L. Relationship between physical fitness and academic performance in South African children. South African Journal for Research in Sport, Physical Education and Recreation. 2011;33(3).
40. Dwyer T, Sallis JF, Blizzard L, Lazarus R, Dean K. Relation of academic performance to physical activity and fitness in children. Pediatr Exerc Sci. 2001;13(3):225-37.
41. Lloyd RS, Faigenbaum AD, Stone MH, Oliver JL, Jeffreys I, Moody JA, et al. Position statement on youth resistance training: the 2014 International Consensus. Br J Sports Med. 2013; In press.
42. Palmer-Green D, Stokes KA, Fuller CW, et al. Training activities and injuries in English youth academy and schools rugby union. J Sports Med 2015;43: 475–81.
43. Klusemann M, Pyne D, Fay T, et al. Online video-based resistance training improves the physical capacity of junior basketball athletes. J Strength Cond Res 2012; 26:2677–84.
44. Coutts A, Murphy A, Dascombe B. Effect of direct supervision of a strength coach on measures of muscular strength and power in young rugby league players.
    J Strength Cond Res 2004;18:316–23.
45. Annesi JJ, Westcott WL, Faigenbaum AD, et al. Effects of a 12-week physical activity protocol delivered by YMCA after-school counselors (Youth Fit for Life) on fitness and self-efficacy changes in 5–12-year-old boys and girls. Res Q Exerc Sport 2005; 76:468–76.
46. Faigenbaum AD, Westcott WL, Loud RL, et al. The effects of different resistance training protocols on muscular strength and endurance development in children. Pediatrics 1999;104: e5.
47. Van Praagh E. Pediatric anaerobic performance. Champaign, IL: Human Kinetics, 1998.
48. Myer G, Faigenbaum A, Ford K, Best T, Bergeron M, Hewett T. When to Initiate Integrative Neuromuscular Training to Reduce Sports-Related Injuries and Enhance Health in Youth? Current Sports Medicine Reports. 2011;10(3):155-166.
49. Rössler R, Donath L, Verhagen E, et al. Exercise-based injury prevention in child and adolescent sport: a systematic review and meta-analysis. Sports Med 2014; 44:1733–48. Med Rep 2011;1 0:155–66.
50. Visek AJ, Achrati SM, Mannix H, et al. The fun integration theory: towards sustaining children and adolescents sport participation. J Phys Act Health 2015; 12:424–33.

Faigenbaum A, Lloyd R, MacDonald J, Myer G. Citius, Altius, Fortius: beneficial effects of resistance training for young athletes: Narrative review. British Journal of Sports Medicine. 2015;50(1):3-7.