Youth Resistance Training Protocols Discussion.
Youth Resistance Training Protocols Discussion.
Discuss the NSCA position on youth resistance training protocols and compare that to the ACSM guide for youth strength training (you will need to search for the ACSM guideline).
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POSITION STATEMENT YOUTH RESISTANCE TRAINING: UPDATED POSITION STATEMENT PAPER FROM THE NATIONAL STRENGTH AND CONDITIONING ASSOCIATION AVERY D. FAIGENBAUM,1 WILLIAM J. KRAEMER,2 CAMERON J. R. BLIMKIE,3 IAN JEFFREYS,4 LYLE J. MICHELI,5 MIKE NITKA,6 AND THOMAS W. ROWLAND7 1 Downloaded from https://journals.lww.com/nsca-jscr by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD35y8U/jUqeExdtzOmtBaRmijgj72SCmKUszPxzjKu+Ak= on 12/12/2019 Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey 08628; 2Department of Kinesiology, University of Connecticut, Storrs, Connecticut; 3Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada; 4 Department of Science and Sport, University of Glamorgan, Pontypridd, Wales, United Kingdom; 5Division of Sports Medicine, Children’s Hospital, Boston, Massachusetts; 6Health and Physical Education Department, Muskego High School, Muskego, Wisconsin; and 7Department of Pediatrics, Baystate Medical Center, Springfield, Massachusetts ABSTRACT Faigenbaum, AD, Kraemer, WJ, Blimkie, CJR, Jeffreys, I, Micheli, LJ, Nitka, M, and Rowland, TW. Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association. J Strength Cond Res 23(5): S60–S79, 2009—Current recommendations suggest that school-aged youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate and enjoyable and involves a variety of activities (219). Not only is regular physical activity essential for normal growth and development, but also a physically active lifestyle during the pediatric years may help to reduce the risk of developing some chronic diseases later in life (196). In addition to aerobic activities such as swimming and bicycling, research increasingly indicates that resistance training can offer unique benefits for children and adolescents when appropriately prescribed and supervised (28,66,111,139,147,234). The qualified acceptance of youth resistance training by medical, fitness, and sport organizations is becoming universal (5,6,8,12,18,33,104,167,192,215). Nowadays, comprehensive school-based programs are specifically designed to enhance health-related components of physical fitness, which include muscular strength (169). In addition, the health club and sport conditioning industry is getting more involved in the youth fitness market. In the U.S.A., the number of health club members between the ages of 6 and 17 years continues to increase (127,252) and a growing number of private sport conditioning centers now cater to young athletes. Thus, as more children and adolescents resistance train in Address correspondence to Avery Faigenbaum, faigenba@tcnj.edu. 23(Supplement 5)/S60–S79 Journal of Strength and Conditioning Research Ó 2009 National Strength and Conditioning Association S60 the TM Journal of Strength and Conditioning Research schools, health clubs, and sport training centers, it is imperative to determine safe, effective, and enjoyable practices by which resistance training can improve the health, fitness, and sports performance of younger populations. The National Strength and Conditioning Association (NSCA) recognizes and supports the premise that many of the benefits associated with adult resistance training programs are attainable by children and adolescents who follow age-specific resistance training guidelines. The NSCA published the first position statement paper on youth resistance training in 1985 (170) and revised this statement in 1996 (72). The purpose of the present report is to update and clarify the 1996 recommendations on 4 major areas of importance. These topics include (a) the potential risks and concerns associated with youth resistance training, (b) the potential health and fitness benefits of youth resistance training, (c) the types and amount of resistance training needed by healthy children and adolescents, and (d) program design considerations for optimizing long-term training adaptations. The NSCA based this position statement paper on a comprehensive analysis of the pertinent scientific evidence regarding the anatomical, physiological, and psychosocial effects of youth resistance training. An expert panel of exercise scientists, physicians, and health/physical education teachers with clinical, practical, and research expertise regarding issues related to pediatric exercise science, sports medicine, and resistance training contributed to this statement. The NSCA Research Committee reviewed this report before the formal endorsement by the NSCA. For the purpose of this article, the term children refers to boys and girls who have not yet developed secondary sex characteristics (approximately up to the age of 11 years in girls and 13 years in boys; Tanner stages 1 and 2 of sexual maturation). This period of development is referred to as preadolescence. The term adolescence refers to a period between childhood and the TM Journal of Strength and Conditioning Research adulthood and includes girls aged 12–18 years and boys aged 14–18 years (Tanner stages 3 and 4 of sexual maturation). The terms youth and young athletes are broadly defined in this report to include both children and adolescents. By definition, the term resistance training refers to a specialized method of conditioning, which involves the progressive use of a wide range of resistive loads and a variety of training modalities designed to enhance health, fitness, and sports performance. Although the term resistance training, strength training, and weight training are sometimes used synonymously, the term resistance training encompasses a broader range of training modalities and a wider variety of training goals. The term weightlifting refers to a competitive sport that involves the performance of the snatch and clean and jerk lifts. This article builds on previous recommendations from the NSCA and should serve as the prevailing statement regarding youth resistance training. It is the current position of the NSCA that: 1. A properly designed and supervised resistance training program is relatively safe for youth. 2. A properly designed and supervised resistance training program can enhance the muscular strength and power of youth. 3. A properly designed and supervised resistance training program can improve the cardiovascular risk profile of youth. 4. A properly designed and supervised resistance training program can improve motor skill performance and may contribute to enhanced sports performance of youth. 5. A properly designed and supervised resistance training program can increase a young athlete’s resistance to sportsrelated injuries. 6. A properly designed and supervised resistance training program can help improve the psychosocial well-being of youth. 7. A properly designed and supervised resistance training program can help promote and develop exercise habits during childhood and adolescence. KEY WORDS strength training, weight training, weightlifting, children, adolescents LITERATURE REVIEW Risks and Concerns Related to Youth Resistance Training D uring the 1970s and 1980s, one of the reasons that resistance training was not often recommended for children and adolescents was the presumed high risk of injury associated with this type of exercise. In part, the widespread fear of injury associated with youth resistance training during this era stemmed from data gathered by the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission. NEISS uses data from various emergency room | www.nsca-jscr.org departments to make nationwide projections of the total number of injuries related to exercises and equipment (231,232).
However, NEISS data are based on injuries that patients state are related to resistance exercise and equipment, and therefore, it is incorrect to conclude that the injuries were caused by such activities and devices. In fact, many of the reported injuries were actually caused by inappropriate training techniques, excessive loading, poorly designed equipment, ready access to the equipment, or lack of qualified adult supervision. Although these findings indicate that the unsupervised and improper use of resistance training equipment may be injurious, it is misleading to generalize these findings to properly designed and supervised youth resistance training programs. Youth Resistance Training Protocols Discussion.
Current findings from prospective resistance training studies indicate a low risk of injury in children and adolescents who follow age-appropriate training guidelines. In the vast majority of published reports, no overt clinical injuries have been reported during resistance training. Although various resistance training modalities and a variety of training regimens have been used, all the training programs were supervised and appropriately prescribed to ensure that the training program was matched to the initial capacity of the participant. Only 3 published studies have reported resistance training– related injuries in children (a shoulder strain that resolved within 1 week of rest (187), a shoulder strain that resulted in 1 missed training session (144), and a nonspecific anterior thigh pain that resolved with 5 minutes of rest (198)). In a report (187), there was no evidence of either musculoskeletal injury (measured by biphasic scintigraphy) or muscle necrosis (determined by serum creatine phosphokinase levels) after 14 weeks of progressive resistance training. Youth resistance training, as with most physical activities, does carry with it some degree of inherent risk of musculoskeletal injury, yet this risk is no greater than many other sports and recreational activities in which children and adolescents regularly participate. In a prospective study that evaluated the incidence of sports-related injuries in schoolaged youth over a 1-year period (258), resistance training resulted in 0.7% of 1576 injuries whereas football, basketball, and soccer resulted in approximately 19, 15, and 2%, respectively, of all injuries. When the data were evaluated in terms of injury to participant ratio in school team sports, football (28%), wrestling (16.4%), and gymnastics (13%) were at the top of the list. In general, injuries related to resistance training in high school athletes appear to involve the aggressive progression of training loads or improper exercise technique (31,35,108,197). Youth Resistance Training Protocols Discussion.
Findings from the 2005–2006 High School Sports-Related Injury Surveillance Study revealed that participation in team sports resulted in an estimated 1.4 million injuries at a rate of 2.4 injuries per 1,000 athlete exposures (i.e., practices and competition) (45). Of the 9 sports studied, football had the highest injury rate (4.36 injuries per 1,000 athlete exposures), whereas boys’ baseball (1.19) and girls’ softball (1.13) had the VOLUME 23 | SUPPLEMENT 5 | AUGUST 2009 | S61 Updated Position Statement Paper From the NSCA lowest injury rates (45). Although data comparing the relative safety of resistance training, weightlifting, and other sports are limited, in a retrospective evaluation of injury rates in adolescents it was revealed that resistance training and weightlifting were markedly safer than many other sports and activities (114). In the aforementioned report (114), the overall injury rate per 100 participant hours was 0.8000 for rugby and 0.0120 and 0.0013 for resistance training and weightlifting, respectively. Youth Resistance Training Protocols Discussion.
This later finding may be explained, at least in part, by the fact that the sport of weightlifting is typically characterized by well-informed coaches and a gradual progression of training loads, which are required to effectively learn the technique of advanced multi-joint lifts. With qualified instruction and a stepwise progression of the training program, researchers have reported significant gains in muscular strength without any report of injury when weightlifting movements (snatch; clean and jerk; and modified cleans, pulls, and presses) were incorporated into a youth resistance training program (74,105,198,204). In support of these observations, others have evaluated the incidence of injury in young weightlifters and concluded that competitive weightlifting can be a relatively safe sport for children and adolescents provid ed that age-appropriate training guidelines are followed and qualified coaching is available (38,182). Youth Resistance Training Protocols Discussion.
ecause weightlifting movements involve more complex neural activation patterns than other resistance exercises, childhood may be the ideal time to develop the coordination and skill technique to perform these lifts correctly (57). To date, no scientific evidence indicates that properly performed and sensibly progressed weightlifting movements performed during practice or competition are riskier than other sports and activities in which youth regularly participate. Nevertheless, due to the potential for injury during the performance of multi-joint free weight exercises (190), youth coaches should be aware of the considerable amount of time it takes to teach these lifts and should be knowledgeable of the progression from basic exercises (e.g., front squat) to skill transfer exercises (e.g., overhead squat) and finally to the competitive lifts (snatch and clean and jerk). Another concern related to youth resistance training regards the safety and suitability of plyometric training (also called stretch-shortening cycle exercise) for children and adolescents. Unlike traditional strength-building exercises, plyometric training conditions the body through dynamic movements, which involve a rapid eccentric muscle action that is immediately followed by a rapid concentric muscle action (47,97). When the stretching and shortening of a muscle are performed quickly, the force generated during the muscle action is greater than the force that would be generated if the muscle were not stretched immediately before the muscle action (97). Youth Resistance Training Protocols Discussion.
The contention that ageappropriate plyometric training is unsafe for youth or that a predetermined baseline level of strength (e.g., 1 repetition maximum [1RM] squat should be 1.5 times body weight) S62 the TM Journal of Strength and Conditioning Research should be a prerequisite for lower-body plyometric training is not supported by current research and clinical observations. Indeed, comprehensive resistance training programs that include plyometric exercises have been found to enhance movement biomechanics, improve functional abilities, and decrease the number of sports-related injuries in young athletes (115,120,143,149,168). Research studies indicate that plyometric training can be a safe and worthwhile method of conditioning for youth if appropriately prescribed and implemented (56,69,75,125,134,143,150,151,202). Although plyometric exercises typically include hops and jumps that exploit the muscles’ cycle of lengthening and shortening to increase muscle power, watching children on a playground supports the premise that the movement pattern of boys and girls as they skip and jump can be considered plyometric. For example, when a child plays hopscotch and jumps from square to square, the quadriceps stretch eccentrically when the child lands and then they shorten concentrically when the child jumps. This type of exercise, although game like in nature, actually conditions the body to increase speed of movement and improve power production (47). Nonetheless, there is the potential for injury or illness to occur if the intensity, volume, or frequency of plyometric training exceed the abilities of the participants. In a case report, a 12-year-old boy developed exertional rhabdomyolysis after he was instructed to perform excessive (.250) repetitive squat jumps in a physical education class (48). A traditional area of concern related to youth resistance training is the potential for training-induced damage to the growth cartilage, which is found at 3 main sites in a growing child’s body: the growth plates near the ends of the long bones, the cartilage lining the joint surfaces (articular cartilage), and the points at which the major tendons attach to the bones (apophysis) (161). Because growth cartilage is ‘‘pre-bone,’’ it is weaker than adjacent connective tissue and therefore more easily damaged by repetitive microtrauma (161). In some cases, damage to this area of the bone could result in time lost from training, significant discomfort, and growth disturbances (41). Youth Resistance Training Protocols Discussion.
A few retrospective case reports published in the 1970s and 1980s noted injury to the growth cartilage during preadolescence (108) and adolescence (25,31,108,128,194,197). However, most of these injuries were due to improper lifting techniques, maximal lifts, or lack of qualified adult supervision. Although children and adolescents are susceptible to injury to the growth cartilage, the potential for this type of injury may be less in a preadolescent child than in an adolescent because the growth cartilage may actually be stronger and more resistant to sheering type forces in younger children (160). To date, injury to the growth cartilage has not been reported in any prospective youth resistance training research study. Furthermore, there is no evidence to suggest that resistance training will negatively impact growth and maturation during childhood and adolescence (91,147). the TM Journal of Strength and Conditioning Research The potential for repetitive-use soft-tissue injuries is another concern related to youth resistance training. This type of injury often does not always cause children or adolescents to go to the emergency room or even to see a physician, so the incidence of these injuries is more difficult to determine. Nevertheless, lower back pain among youth has become a significant public health issue with prevalence rates in adolescents approaching those in adults (9,131). In several reports, lower back pain was the most frequent injury in high school athletes who participated in resistance training programs (31,35,190). In a study that involved adolescent powerlifters who presumably trained with maximal or nearmaximal resistances, it was revealed that 50% of reported injuries were to the lower back (35). Although many factors need to be considered when evaluating these data (e.g., exercise technique and progression of training loads), the importance of general physical fitness and lower back health should not be overlooked. Because insufficient strength, muscular endurance, and stability in the lower back have been associated with current and future lower back pain in adolescents (9,211), there is a role for preventive interventions that include resistance exercise to possibly reduce the prevalence or severity of lower back pain in youth. Of note, ther e is an increased risk of injury to children and adolescents who use exercise equipment at home (107,132). Youth Resistance Training Protocols Discussion.
It has been reported that young children are more likely to be injured from home exercise equipment than older age groups due, in part, to unsafe behavior, equipment malfunction, and lack of supervision (132). There is also the potential for a catastrophic injury if safety standards for youth resistance training are not followed. In a case study report, a 9-year-old boy died when a barbell rolled off a bench press support and fell on his chest (102). These findings underscore the importance of providing close supervision and safe training equipment for all youth resistance training programs. Any exercise or activity recommendation for children and adolescents has risks as well as benefits. The risk of injury while resistance training or weightlifting can be minimized by qualified supervision, appropriate program design, sensible progression, and careful selection of training equipment. Youth Resistance Training Protocols Discussion.
In addition, the risk of injury can be minimized by limiting the number of heavy lifts during a workout, allowing for adequate recovery between training sessions, and listening to each child’s questions and concerns. In general, the risk of injury associated with resistance training is similar for youth and adults. There are no justifiable safety reasons that preclude children or adolescents from participating in such a resistance training program. Effectiveness of Youth Resistance Training During childhood and adolescence, physiologic factors related to growth and development are in a constant state of evolution. Due to the progression of growth, it can be expected that healthy children will show noticeable gains in height, weight, maximal oxygen uptake, anaerobic capacity, | www.nsca-jscr.org and muscle strength during the developmental years (195). Although different children do not follow the same rates of change, performance variables such as grip strength normally increase from childhood through the early teenage years (148)