New guidelines for Strength Training of Children and Adolescents from the American Academy of Pediatrics

A summary of the recently revised policy statement, April 2008

The American Academy of Pediatrics (AAP) recently revised its policy
regarding the safety and efficacy of strength training for children and
adolescents involved in sports and for general health improvement. It has been shown that, similar to adults, strength training in children has a beneficial effect on cardiovascular fitness, body composition, bone mineral density, blood lipid profiles, and mental health. Strength training not only gives an advantage to the young athlete, but has shown to be an effective form of exercise for overweight children and can increase overall function in children with disabilities such as cerebral palsy.

In past years, a great deal of concern was expressed over the potential
for injuries in children resulting from strength training. However, the majority of these injuries were the result of improperly supervised exercises carried out in home gyms. Growth plate injuries were extremely rare and were, again, usually the result of a combination of improper technique and inadequate supervision. In fact, the injury rates among children strength training under proper supervision is far less than those that occur during recess play at school or participating in organized team sports. Appropriately supervised
strength training programs seem to have no detrimental effect on linear growth, growth plates, or the cardiovascular system. However, children with pre-existing medical conditions such as hypertension, cardiomyopathy, Marfan syndrome, and seizure disorders should consult with their physician before
beginning any program.

In addition to those listed above, the benefits of strength training
programs for children and adolescents include possible prehabilitative benefits. Prehabilitation refers to the strengthening of common problem areas that are more subject to overuse injuries such as the shoulder and the knee. Studies performed on the use of strength-training programs combined with plyometric exercises have shown to drastically reduce the number of anterior cruciate ligament (ACL) injuries in female adolescent athletes. Female adolescents who
engage in sports are four to six times more likely to suffer an ACL injury than their male counterparts.

Once children attain postural maturity, which occurs by ages seven or
eight, they can participate in a strength-training program with physician approval. Since most weight machines are made for adults and are therefore sized for larger physiques, these are not appropriate for children. Therefore, free weight and bodyweight exercises are optimal as they also develop balance, coordination, and allow joints to achieve a full range of motion.

Appropriate strength training programs for children should include
functional movements that strengthen all of the muscles through a full range of motion. Of particular importance are the core and trunk muscles including the abdominals, low back, and gluteal muscles. Technique should be prioritized over increases in resistance and the program should include 2-3 sessions per week that are at least 20-30 minutes in duration. Strength training sessions should include appropriate warm up and cool down periods and should be supervised by a qualified fitness professional.

Although explosive or rapid lifting of weights is not recommended, the AAP reserves its judgement on the teaching of the explosive movements of the Olympic weightlifting techniques such as the clean and jerk and the snatch to children and adolescents. These exercises are distinct from common weightlifting, as participation in these lifts requires rigorous instruction of technique and strict supervision. The limited studies of children participating in the sport of Olympic weightlifting have reported relatively few injuries provided they are taught by a qualified trainer or coach. The AAP is, however, actively opposed
to childhood involvement in power lifting, body building, or use of 1-repetition maximum lifts until skeletal maturity.

In conclusion, the AAP recommends strength training for children and
adolescents for both sport specific and general health advantages. To prevent injuries, children need medical clearance from their doctors and training programs should be developed and closely supervised by qualified individuals experienced in pediatric strength training.

For free full text article:
http://www.pediatrics.org/cgi/content/full/121/4/835

References:

American Academy of Pediatrics, Council on Sports Medicine and Fitness.
Strength training by children and adolescents. Pediatrics. 2008;121 (4):835–840

Blundell SW, Shepherd RB, Dean CM, Adams RD, Cahill BM. Functional
strength class for children aged 4–8 years. Clin Rehabil. 2003;17 (1):48 –57

Hewett TE, Meyer GD, Ford KR. Anterior cruciate ligament injuries in
female athletes: part 2—a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006;34 (3):490 –498

Recommended Reading:

Sullivan JA, Anderson SJ, eds. Care of the Young Athlete.

Kraemer WJ, Fleck SJ, Strength Training for Young Athletes, 2nd edition