Exercise Prescriptions for Children (Excerpted from Chapter 9 - Special Training Considerations for Women, Masters and Young Athletes)

There has been a concern within the medical community for many years regarding the practice of strenuous forms of athletics by young athletes. There is special concern with respect to prepubescent athletes and those in the early stages of pubescence. Most of this concern centers around the possibility of damage to growth centers and of outright traumatic injury. While conclusive evidence has not been developed in Western Europe and the United States, it appears that practice of weight training and weightlifting is relatively safe (more so than other sports, such as basketball and football, about which parents and medical authorities appear to have fewer concerns). In Eastern Europe, where the sport of weightlifting has been practiced by athletes as young as ten or eleven for many years, sports medicine authorities have generally detected no reason to restrict the activities of these athletes (as long as well established principles of employing proper technique and gradually increasing the training load over a period of years are followed).

In order to err on the side of caution, sports authorities such as the American Orthopedic Society for Sports Medicine, the American Academy of Pediatric Medicine and the National Strength and Conditioning Association have taken the position that weight training is acceptably safe if the young athletes follow certain guidelines. Among those guidelines are recommendations that are intended to limit the training stress that is applied to young athletes. For instance, one recommendation is that young athletes should never use weights in excess of what they can handle for at least six repetitions.

Unfortunately, recommendations of this type are rather arbitrary and may be inherently dangerous. The six-rep guideline appears to be based on the assumption that weights which an athlete can lift for at least six reps are well enough within that athlete’s capabilities that an injury is unlikely. However, an athlete is at least as likely to hurt himself or herself on the sixth rep of a maximum set of six as on an attempt with a single rep maximum. This is because by the time the athlete has reached the sixth rep of an all out set, considerable fatigue has set in. Under such conditions, motor control deteriorates and stress is more likely to be transferred from muscle to connective tissue than when the muscles are "fresh." Neither of these conditions is conducive to safe exercise. A more reasonable standard would be that young athletes should never attempt weights that they cannot perform comfortably and that they should avoid high reps altogether on the Olympic lifts. They should never perform more than five reps in any Olympic or related lift, and reps this high should only be performed with weights that permit the last rep to be performed crisply and rather easily.

Research in Eastern Europe suggests that younger athletes can gain strength with far lower intensities than older athletes. In fact, high intensities appear to be counterproductive in terms of generating strength gains in youngsters (not to mention the threat of injury that they pose).

Injuries to athletes (young or old) usually result from pushing too hard and employing improper technique. Pushing too hard can occur either when athletes compete against their peers (particularly when these athletes are not well matched in terms of size, sex, maturity and experience) or when overzealous coaches and/or parents push athletes to their limits and beyond. Therefore, giving children or their supervisors the license to push to the maximum as long as the weight can be handled for six or some other number of repetitions can be at least as dangerous as permitting them to try single rep maximums.

In attempting a single rep maximum, errors and accidents can occur as a result of unrealistic expectations, fear, over-excitement, technical errors (which are more likely to occur with maximum weights) and the sheer stress of a maximum effort. But these same factors can contribute to failure in the later reps of a six-rep maximum attempt as well. And, as noted above, on such a late repetition there is the additional and significant risk factor of muscular and nervous system fatigue. Most bodybuilders use fairly high repetitions (six or more) in most of their training, and injuries among body builders on the later reps of high rep sets are not uncommon.

In training young athletes (and athletes of all ages) it is important to emphasize proper technique and gradual progression. The coach should never push or permit the young athlete to attempt any all out maximum, regardless of the number of repetitions. No attempt should ever be made at a weight that may be beyond the athlete's limit on a given day, irrespective of how much an athlete may have lifted in the past. It should be emphasized to the young athlete that the true measure of his or her success is technique perfection and gradual conditioning to the demands of high level performance, the foundation of all subsequent performance. Moreover, as was indicated in the earlier chapters of this book, research in Eastern Europe suggests than young athletes actually experience faster strength gains when they exercise with moderate loads than when they lift heavy loads.

Great care should be taken never to overtrain the young athlete. Patience should be exercised in eliciting the body's adaptive capabilities. Young athletes require their energy for growth and maturation as well as sports improvement. Exhaustion may divert such energy. In addition, an overtrained athlete is prone to injury and illness, both of which are to be especially avoided in young athletes. Finally, there is evidence (though it is not directly related to weightlifting) that heavy physical exercise over a sustained period can cause damage to growth cartilage, with resulting bone deformation, pain and/or disability. Joint pain should never be ignored in any athlete and this is doubly true in young athletes.

All young athletes should be carefully supervised in order to assure that proper training methods are applied, to teach them proper technique and to prevent their attempting lifts that are beyond their capabilities. Finally, all young athletes should be taught how to handle situations in which misses occur. As was noted in Chapter 2, one of the first things any lifter should learn is how to handle a miss safely. Once that is learned, the chances of any subsequent injury are greatly reduced.

As has been emphasized throughout this book, the coach should pay attention to the physical and mental characteristics of the athlete. While the maturation process takes place in all young lifters, the rate and precise character of the maturation process varies substantially from athlete to athlete. Athletes who are psychologically, emotionally or physically unprepared for weightlifting training should not be permitted to engage in such training regardless of their age. Those who are ready should not be arbitrarily restrained (though they should be rationally managed). That is, they should never be pushed, and their training should always emphasize proper technique and careful conditioning, but if the athlete demonstrates an ability to tolerate a little more (not necessarily heavier) training, there is no reason to discourage or forbid it, as long as the increase in training is gradual, periodic and carefully monitored.

Although it has long been feared that bone growth would be inhibited by weight training, there is a growing body of evidence that weight training has positive effects on bone growth. Little or no evidence developed in the United States suggests any negative effect of resistance training (or other exercise) on the growth of bones, and considerable evidence now suggests that bone density is improved through resistance training. Similarly, long term studies performed in Eastern Europe (at least those that have been widely reported in the West) do not indicate that resistance training adversely affects bone growth.

It is important to note that the "growth cartilage" of children is particularly susceptible to injury from trauma. This growth cartilage is located at three primary sites: the growth plate of long bones, the point of tendon insertion onto a bone and the joint surfaces. Severe damage to the growth plates prior to their ossification (late in puberty) is believed to interfere with further bone growth. Any or all of the growth cartilage sites can be damaged by a single trauma or by repeated smaller traumas (microtraumas), with damage (e.g., fractures) to the growth (epiphyseal) plate being perhaps the most common type of joint injury in children. Low levels of stress stimulate epiphyseal growth, but excess stress may suppress the development of epiphyseal cartilage and consequent endochondral ossification.

Growth plate fractures have been reported as a result of weightlifting by children. However, the majority of these injuries have occurred among unsupervised athletes who were lifting near maximal weights. Recent studies involving closely supervised resistance training among children suggest that the injury incidence among such children is quite low. While no serious research has been done in the United States with respect to weightlifting or powerlifting among children, work done in Eastern Europe suggests that with close supervision and carefully applied training loads, weightlifting is a relatively safe activity for young athletes (as long as the emphasis is on skill development and maximal and near maximal efforts are absent or strictly limited).

As has already been noted in earlier chapters, frequency, duration and intensity of training are the key variables which can be manipulated to manage the stress that is presented by training. However, these are certainly not the only variables with which the coach needs to be concerned, particularly as pertains to injury prevention and management in young athletes. In this area, technique and the selection of exercises require careful attention as well.

Adaptations in the functional performance of pre-pubescent athletes as a result of training appear to parallel those of adults. However, as was noted earlier, the ability of prepubescents to generate muscle hypertrophy appears to be significantly smaller than that of adults. Research on adults suggests that resistance training increases bone density and helps to prevent certain kinds of injury, but no such effects have yet been documented in children. (There has been very little research in this area at all.)

When training with children is being conducted under conditions that are not climate controlled, special care should be taken. Children have less resistance to short term changes in temperature, and they adjust more slowly to changes in climate. Therefore, this fact should be taken into account in all activities in which children participate.

Dietary restrictions are far more problematic in children than in adults. Children require adequate nutrition for growth and development. Dietary restrictions in order to remain in certain weight classes are definitely contraindicated. Some coaches who are anxious to push their athletes to high performance and/or to score team points encourage artificial weight control. This kind of behavior can undermine the athlete's growth and development and, hence, the athlete's long term potential.

It should be noted that the potential for increasing an athlete’s muscle mass is never greater than during the athlete’s late teens and early twenties. Consequently, artificially restraining increases in muscle mass during this period undermine the fulfillment of the lifter’s potential in a way that can never be overcome.

It is important for coaches to realize that increases in the height and weight of young athletes during puberty may outrun increases in strength. Flexibility may also fail to keep pace with rates of bone growth. In addition, it will also take time for many young athletes to adjust their motor skills to changes in body mechanics that occur as a result of growth. Therefore, young athletes may undergo stages of increased awkwardness during the maturation process.

Adults who engage in large training volumes tend to suppress the effectiveness of their immune systems and therefore can be more susceptible to infections. This has not yet been studied extensively among children, but because infectious diseases often affect the young (and the elderly) more profoundly than adults, special care should be taken to avoid training loads that could adversely affect the immune system. Similarly, increases in cortisol (which are associated with stress) can stimulate collagen synthesis in the short term, but prolonged treatment with related compounds (gluccocorticoids) restrains it. This suggests that overstress may negatively impact collagen growth and synthesis.

Some of the keys to safety and effective training for youngsters are:

1. Never permit the very young athlete to attempt a maximum or near maximum weight;

2. Teach proper technique and require that such technique always be employed;

3. Inculcate a desire to learn proper technique at the outset;

4. Convey the message that overall progress will actually occur more rapidly if the athlete trains with lighter loads than if he or she trains with heavier ones;

5. Emphasize that lifting without proper supervision in unacceptable and that weights are not toys;

6. Develop an understanding in the athlete that competition and attempting heavy weights at this stage are unimportant. What is important for the athlete is to lay a foundation of sound general physical preparation and perfect technique, so that championship poundages can eventually be lifted (this is the method used by the champions).

In summary, the following guidelines should be followed when training prepubescent athletes in the sport of weightlifting:

1. The training of young athletes should emphasize the development of general physical qualities and not overemphasize weightlifting.

2. Training should be limited in volume and intensity. (Beginners neither require nor benefit from excessive loading, and in children the risks of such loading make it even more important that moderation be stressed.)

3. The training load should be only gradually increased, and the increase should be cyclical in nature, so that there is an overall increase but high and low loads are interspersed throughout the training process.

Athletes should be carefully evaluated and monitored to identify those at increased risk for injury or those who have any negative reaction to training (e.g., delayed menarche). The biological, psychological and emotional age should be considered along with the chronological age in planning the training. In sports which have a relatively high incidence of certain kinds of injuries, athletes should be monitored and examined frequently to assure that no injury is being incurred. This is particularly important for those who have a physical characteristic which places them at increased risk. Careful instruction in technique and modification for individual needs are required in order to develop skills that are both safe and efficient for that athlete.

When training young athletes, the emphasis should be on the development of a love for the sport and for training. Such a foundation will carry a lifter much further than any physical capabilities that are developed through early training.

Copyright 1998 A is A Communications. All rights reserved.
Revised: February 15, 1998