Strength Training For Kids Is OK.
But Bodybuilding Is Dangerous?
The title of this article appears as the first line in a Mayo Clinic online article.
The article goes on to say:
The young athlete in your family is disciplined and devoted, squeezing in practice whenever he or she can. Now your child wants to start strength training. You've heard coaches and other parents talk about strength training, but you wonder - is strength training really good for a child?
The answer is yes. Strength training exercises that are supervised, safe and age-appropriate offer many bonuses to young athletes.
The American Academy of Pediatrics, the American College of Sports Medicine, and the National Strength and Conditioning Association all support strength training for kids - if it's done properly. Today's children are increasingly overweight and out of shape. Strength training can help put them on the lifetime path to better health and fitness.
A few paragraphs down the article states:
Strength training for kids— - not to be confused with weightlifting, bodybuilding or powerlifting—is a carefully designed program of exercises to increase muscle strength and endurance.
Weightlifting, bodybuilding and powerlifting are largely driven by competition, with participants vying to lift heavier weights or build bigger muscles than other athletes. This can put too much strain on young muscles, tendons and growth plates, especially when proper technique is sacrificed in favor of lifting larger amounts of weight.
After reading this article I wondered just what planet the writer was on. Does he/she really think that bodybuilding, Olympic lifting and powerlifting are more dangerous than the other sports that millions of kids are encouraged, even pushed (by parents, coaches and organizations) to play?
And does the author really believe that first of all most bodybuilders, those that do Olympic lifters, and powerlifters are in it strictly to compete? Or that even if they are they can't set up a reasonable and safe program for their kids?
Here's a tip for the Mayo Clinic - Weight training is weight training, regardless if you use if for increasing strength and lean body mass for bodybuilding, Olympic lifting, powerlifting, OR ANY OTHER SPORT.
And as far as the info in this article that says:
Your child can build muscle strength using:
- Free weights
- Weight machines
- Resistance bands
- His or her own body weight
Maybe they've never been in a gym because other than the cardio machines that's all there is. And even more of a revelation for these guys - regardless of the sport, we all use the same equipment.
Unfortunately the attitude in this article is all too common and a result of either a lack of information, bias or both.
Other Sports Are A Lot More Dangerous
I've always found it interesting and a bit perverse when our sports are singled out as being both inappropriate and dangerous for pre-pubertal and peri-pubertal children.
In my four decades of being involved in weight training in general and bodybuilding and powerlifting in particular, I've yet to see any serious injuries in properly supervised kids using weights for these sports or for any other uses.
And those in our sports that do encourage our kids to take up weight training know enough to make sure that the programs we set up are safe for children, making sure they know how to do the lifts correctly, always stay in control, don't overdo it and keep within their limits.
And most of all supervise them while they're lifting, at the same time instilling some family and societal values into our sons and daughters. And that's why there aren't a lot of significant injuries in the kids we encourage.
On the other hand I don't see a lot of naysayers to kids being involved in competitive sports where the chance of injury is so much higher because of the lack of control because of unforeseen interactions when they're involved in those sports.
And it shows in the statistics as reported by the Consumer Products Safety Commission, roughly 4 million kids between ages 6 and 16 end up in hospital emergency rooms for sports-related injuries each year.
Eight million more are treated for various medical problems caused by their participation in their sports such as shin splints, ligament, joint and tendon injuries, and stress fractures. For more information on just how dangerous team sports can be see the citations and abstracts below.
The Facts On Weight Training For Children
But just don't take my word for it that training with weights, if done properly, isn't dangerous.
The authors of a paper published in 1987 (Am J Sports Med. 1987 Sep-Oct;15(5):483-9. Strength training for prepubescent males: is it safe? Rians CB, Weltman A, Cahill BR, Janney CA, Tippett SR, Katch FI.) stated:
This study examined the safety of one type of strength training for prepubescent males. Eighteen males (average age, 8.3 +/- 1.2 years) participated in a 45 min/session, three session/week, 14 week supervised strength training program with an attendance rate of 91.5%.
Concentric work was done almost exclusively. KinCom analysis showed significant strength gain in this group (P less than 0.05), while an age, sex, and activity matched control group did not gain strength.
Safety was evaluated by injury surveillance, blood pressure and heart rate monitoring, scintigraphy, and creatine phosphokinase measurement. Effects on growth and development, flexibility, and motor performance were also investigated, as these are factors with an impact on sports injury occurrence.
Results showed that in the short term, supervised concentric strength training results in a low injury rate and does not adversely effect bone, muscle, or epiphyses; nor does it adversely affect growth, development, flexibility, or motor performance.
A review paper in 1993 (Pediatr Nurs. 1993 Jul-Aug;19(4):325-32. Strength training and the immature athlete: an overview.Metcalf JA, Roberts SO.) stated:
The developing musculoskeletal structures of the immature athlete are uniquely susceptible to injury, particularly at the physes. These growth plates are present in arm and leg bones, and some may not close until the late teen years.
Early literature suggested that weight training might be inappropriate for these athletes. However, recent evidence suggests that, properly done, strength/resistance training may not only be safe, it may also help reduce the risk of injury for the young athletes.
In 2003 a paper (Pediatr Endocrinol Rev. 2003 Dec;1(2):120-7. Resistance training, skeletal muscle and growth.Falk B, Eliakim A.) stated:
Resistance training in youth and its effectiveness, possible effect on growth and safety considerations, has received considerable public and scientific attention in recent years. Although few early studies questioned the usefulness of resistance training in children, numerous recent studies have demonstrated its effectiveness in both children and adolescents.
Nevertheless, the optimal intensity and volume of training for youths of different ages requires further study. The increase in strength following resistance training in youths, especially in prepubertal children, is believed to be due mainly to neural adaptations and only minimally, if at all, to muscle hypertrophy.
Few studies have examined the long-term effect of resistance training on growth. The few which have, found that, contrary to the common misconception that resistance training may retard growth.
Scientific evidence indicates that resistance training results in increased serum IGF-I and that there is no detrimental effect on linear growth. Finally, numerous studies have demonstrated that with appropriate supervision and precautions, resistance training can be safe and effective for children and adolescents.
In November of 2006 an evidence based review paper (Clin J Sport Med. 2006 Nov;16(6):478-87. Weight training in youth-growth, maturation, and safety: an evidence-based review. Malina RM.) concluded:
Experimental training protocols with weights and resistance machines and with supervision and low instructor/participant ratios are relatively safe and do not negatively impact growth and maturation of pre- and early-pubertal youth.
In another study published in 2006 (J Sports Sci. 2006 Sep;24(9):987-97. The effect of a complex training and detraining programme on selected strength and power variables in early pubertal boys.Ingle L, Sleap M, Tolfrey K.) the authors concluded:
In pre- and early pubertal boys, upper and lower body complex training (a combination of resistance training and plyometrics) is a time-effective and safe training modality that confers small improvements in anaerobic power and jumping, throwing and sprinting performance, and marked improvements in dynamic strength.
And for anyone looking for my "rules of engagement" here they are:
- The young bodybuilder, Olympic lifter and powerlifter should be mentally and emotionally mature. There's no room for fooling around while you're lifting. Now after is a different matter.
- The first several weeks should consist of basic physical conditioning and learning techniques.
- Don't let them attempt weights that they can't perform comfortably and with complete control.
- Training intensity and volume should be in line with what the kid can cope with easily and safely.
- Emphasize correct technique and gradual progression. Stress that success should be measured in technique perfection first and performance after.
- Repetitions should only be performed with weights that allow the last rep to be rather easily executed.
- Never overtrain and thus avoid overuse injuries and illness. Training three or four time a week is more than enough.
The bottom line is that with intelligent guidance and supervision so that the movements are done safely, moderately, in proper form and with complete control, training with weights, whether for the purpose of bodybuilding, Olympic lifting, powerlifting or for increasing strength and performance, is safe and healthy for all kids.
Acad Emerg Med. 2006 May;13(5):571-4. Epub 2006 Mar 28. Childhood soccer injuries treated in U.S. emergency departments. Adams AL, Schiff MA. Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland, OR 97239-3098, USA. adamsan@ohsu.edu
Objectives:
Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury-related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer-related injuries and described the nature of these injuries.
Methods:
Data from the 2000 National Electronic Injury Surveillance System All Injury Program were used to estimate the overall number and rate of soccer injuries in children, calculate injury rates per 1,000 children, and describe the body regions affected and types of injuries. Results were stratified by five-year age groups (5-9 years, 10-14 years, and 15-19 years).
Results:
Approximately 144,600 children sustained soccer-related injuries in 2000 for a rate of 2.36 injuries per 1,000 children. Injury rates increased with age (0.8, 5-9 year olds; 3.1, 10-14 year olds; 3.2, 15-19 year olds). Common types of injuries were strains/sprains (36.7%), fractures (23.0%), and contusions (20.9%). Fractures decreased with age; sprains/strains increased with age. Commonly injured body regions varied by age.
Wrist and finger injuries were most common (12.7% and 12.4%, respectively) in the youngest group; in the 10-14-year-old group, ankle and wrist injuries were most common (15.7% and 13.6%, respectively). In the oldest age group, ankle injuries were most common (21.9%), followed by knee injuries (17.6%).
Conclusions:
Substantial numbers of children were treated in EDs for soccer-related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer-related injuries may need to be age specific.
Pediatrics. 2006 Feb;117(2):e143-7. Erratum in: Pediatrics. 2006 Jun;117(6):2334-6. Body-checking rules and childhood injuries in ice hockey. Macpherson A, Rothman L, Howard A. School of Kinesiology and Health Sciences, York University, Toronto, Ontario, Canada. alison3@yorku.ca
Background:
Body checking is the predominant mechanism of youth ice hockey injuries. The Canadian Hockey Association has allowed body checking from ages 12 to 13 (peewee level) and up. One Canadian province (Ontario) introduced body checking at ages 10 to 11 (atom level) in the competitive leagues, whereas in Quebec body checking has only been allowed at ages 14 to 15 (bantam Level).
The purpose of this study was to compare body-checking injuries, fractures, and concussions in boys' minor hockey between jurisdictions in which checking is allowed and jurisdictions in which body checking is not allowed.
Methods:
Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to characterize children's ice hockey injuries from September 1995 to the end of August 2002. Children treated at CHIRPP hospitals in areas in which checking was allowed were compared with children in areas in which checking was not allowed.
Results:
Of the 4736 hockey injuries, 3006 (63%) were in Ontario and 1730 (37%) were in Quebec. Most of the injuries occurred in areas in which checking was allowed (3618 [76.4%]) [corrected] At ages 10 to 13, players had significantly greater odds of suffering a checking injury where checking was allowed (odds ratio [OR]: 2.65 [corrected]; 95% confidence interval [CI]: 2.21[corrected]-3.18 [corrected]).
Players in this age group were also more likely to suffer a concussion (OR: 1.53 [corrected]; 95% CI: 0.93 [corrected]-2.52 [corrected]) or fracture (OR: 1.20 [corrected]; 95% CI: 1.00 [corrected]-1.47) where checking was allowed.
Among older players, when checking was allowed in both provinces, there were higher odds (OR: 1.1 [corrected]; 95% CI: 0.94 [corrected]-1.33 [corrected]) of receiving a checking injury in the province that had introduced checking at a younger age, suggesting that there is no protective effect from learning to check earlier.
Conclusions:
Increased injuries attributable to checking were observed where checking was allowed. This study supports policies that disallow body checking to reduce ice hockey injuries in children.
J Pediatr Orthop. 2003 Sep-Oct;23(5):629-34. Childhood fractures in Bergen, Norway: identifying high-risk groups and activities. Brudvik C, Hove LM. Bergen Accident and Emergency Department and Haukeland University Hospital, Bergen, Norway. christina.brudvik@kir.uib.no
In 1998 the authors conducted a prospective registration of children younger than 16 presenting with a new traumatic fracture in the city of Bergen, Norway. In this epidemiologic study, the authors registered a total of 1.725 fractures in children; the fracture incidence was 245 per 10,000 children below the age of 16.
One fifth needed reduction, and the distal radius was the most common fracture site (27%). Activities associated with fracture were mostly soccer and bicycling, but compared with the total number of injuries associated with each activity, we found a doubled risk of fractures during rollerblading/skating or snowboarding (60%) compared with playing soccer (38%) or bicycling (33%).
Scaphoid fracture, an infrequent fracture in children, was seen in 9% of all fractures due to rollerblading/skating. There was a doubled risk of fracture in boys aged 13 to 15 compared with their female peers. To make fracture prevention more efficient, it should be targeted at this risk group and these high-risk activities. Protection of the wrist region might prevent the most common fractures.
Sports Med. 2005;35(8):671-84. Management of sport-related concussion in young athletes. Patel DR, Shivdasani V, Baker RJ. Primary Care Sports Medicine Program, Michigan State University Kalamazoo Center for Medical Studies, Kalamazoo, MI 49008, USA. patel@kcms.msu.edu
Sport-related head injuries are a common clinical problem. Most head injuries in young athletes are mild traumatic brain injuries or concussions. The highest number of sport-related concussions has been reported in American football.
In addition to the well described physical and psychosocial growth, there is ongoing neurocognitive development of the brain during childhood and through adolescence. This developmental process has direct implications in the assessment and management of head injuries in young athletes.
Research on the management and long-term outcome following brain injuries in young athletes is limited. Traditionally, the assessment of concussion has been based on clinical history and physical and neurological examination.
Increasingly, neuropsychological testing, especially computerized testing, is providing objective measures for the initial assessment and follow-up of young athletes following brain injuries.
Numerous guidelines have been published for grading and return to play criteria following concussion; however, none of these have been prospectively validated by research and none are specifically applicable to children and adolescents.
Inj Prev. 2006 Dec;12(6):390-4. Injury risk from popular childhood physical activities: results from an Australian primary school cohort. Spinks AB, Macpherson AK, Bain C, McClure RJ. School of Population Health, University of Queensland, Brisbane, Queensland, Australia. a.spinks@griffith.edu.au
Background:
Children engage in various physical activities that pose different injury risks. However, the lack of adequate data on exposure has meant that these risks have not been quantified or compared in young children aged 5-12 years.
Objectives:
To measure exposure to popular activities among Australian primary school children and to quantify the associated injury risks.
Method:
The Childhood Injury Prevention Study prospectively followed up a cohort of randomly selected Australian primary and preschool children aged 5-12 years. Time (min) engaged in various physical activities was measured using a parent-completed 7-day diary. All injuries over 12 months were reported to the study.
All data on exposure and injuries were coded using the International classification of external causes of injury. Injury rates per 1000 h of exposure were calculated for the most popular activities.
Results:
Complete diaries and data on injuries were available for 744 children. Over 12 months, 314 injuries relating to physical activity outside of school were reported. The highest injury risks per exposure time occurred for tackle-style football (2.18/1000 h), wheeled activities (1.72/1000 h) and tennis (1.19/1000 h).
Overall, boys were injured more often than girls; however, the differences were non-significant or reversed for some activities including soccer, trampolining and team ball sports.
Conclusion:
Although the overall injury rate was low in this prospective cohort, the safety of some popular childhood activities can be improved so that the benefits may be enjoyed with fewer negative consequences.
Am J Sports Med. 2006 Dec;34(12):1960-9. Epub 2006 Jul 21. Injury rates, risk factors, and mechanisms of injury in minor hockey. Emery CA, Meeuwisse WH. Sport Medicine Centre, Roger Jackson Centre for Health and Wellness Research, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada. caemery@ucalgary.ca
Background:
Hockey is one of the top sports for participation in youth in Canada. There are limited data on the epidemiology of injury in youth hockey.
Purpose:
Through implementation and validation of an injury surveillance system, youth ice hockey injury rates, risk factors, and mechanisms of injury will be examined.
Study Design:
Descriptive epidemiology study.
Methods:
During the 2004-2005 season in minor hockey in Calgary, Alberta, Canada, 71 hockey teams (N = 986) were studied, including teams from each age group (Atom, 9/10 years; Pee Wee, 11/12 years; Bantam, 13/14 years; Midget, 15/16 years) and division of play (7-10 divisions per age group).
A certified athletic therapist or candidate did weekly assessments of any identified hockey injury. Injury definition included any injury occurring during the regular hockey season that required medical attention, removal from a session, or missing a subsequent session.
Results:
Of the 986 participating players, 216 players sustained a total of 296 injuries in the 2004-2005 season. The overall injury rate was 30.02 injuries per 100 players per season (95% confidence interval, 27.17-32.99) or 4.13 injuries per 1000 player hours (95% confidence interval, 3.67-4.62). Forty-five percent of all injuries occurred during body checking. Compared with the youngest age group, Atom, the risk of injury was greater in Pee Wee (relative risk, 2.97; 95% confidence interval, 1.63-5.8), Bantam (relative risk, 3.72; 95% confidence interval, 2.08-7.14), and Midget (relative risk, 5.43; 95% confidence interval, 3.14-10.17) leagues.
The risk of injury in Pee Wee was greatest in the most elite divisions (relative risk, 2.45; 95% confidence interval, 1.15-5.81). Concussion, shoulder sprain/dislocation, and knee sprain were the most common injuries.
Conclusion:
Significant differences in injury rates were found by age and division of play. The public health significance of body checking injury in minor hockey is great. Future research will include expansion of surveillance to further examine body checking injuries and prevention strategies in minor hockey.