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Synopsis: Resistance training in children can result in significant strength gains without excessive risk of injury.
Source: Guy JA, Micheli LJ. Strength training for children and adolescents. J Am Acad Orthop Surg. 2001;9:29-36.
As the intensity of sport participation for young athletes increased in the 1970s and early 1980s, many looked to strength training to enhance performance in this age group. Questions arose over the safety and effectiveness of such an activity in the prepubescent and pubescent child. The senior author of this review article, Micheli, has been active in research in this area for several decades and has been an integral part of many of the intense discussions on the subject.
In the present article, Guy and Micheli define a strength training program as a controlled, individualized activity involving a timely progression in intensity. It uses free weights, individual body weight, hydraulics, elastic bands, or similar equipment to increase one’s ability to exert or resist force. Strength training, in this context, is used synonymously with resistance training but is distinct from power lifting or weight training where high-intensity training is used in an effort to be able to lift maximal weight.
Guy and Micheli critique the available literature on the effectiveness and risks of strength training in children, concluding, "current evidence indicates that resistance training can result in marked strength gains in the pubescent child without a significant risk of injury. However, the duration and intensity of training needed for maximal results has not been clearly defined. Moreover, such strength gains from resistant training appear to be transient with the degree of training regression dependent on the magnitude of strength gains, level of inactivity, and duration of detraining. Surprisingly, there does not appear to be any sex- or age-related differences to training in this age group."
Although the effect of factors such as muscle hypertrophy, increase in muscle cross-sectional area, motor-unit coordination, central nervous system activation, and psychological drive on strength increases in adults have been studied extensively, Guy and Micheli remind us that little is known regarding how and why strength gains occur in children following proper resistant training regimes.
Comment by Letha Y. Griffin, MD, PhD
Children today are under increased pressure to excel in sports. Our society equates success with wining, not merely doing your best. Moreover, athletic excellence brings with it tremendous social and financial rewards. In women’s sports such as dance, skating, and gymnastics, the peak of one’s athletic career is frequently the mid-teenage years. Hence, there is a need to know how, at a very early age, one can best maximize strength and performance without causing injury.
In 1985, members of the National Strength and Conditioning Association met with physicians and educators to review available literature on relative risks and benefits of strength training for the prepubescent athlete and to establish a policy statement on the same. They concluded that resistance training in youth helped to increase fitness and minimize sport injury. Now, almost 20 years later, Guy and Micheli, after reviewing the current literature, arrive at a similar conclusion—that is, that prepubescent and pubescent children, participating in well-designed strength training programs, can increase muscle strength with little risk of injury provided they do so in a well-designed, progressive-resistance training program. Moreover, such strength gains appear to be "the result of increased neuromuscular activation and coordination" rather than a consequence of muscle hypertrophy. This article is an excellent review for those involved in the supervision or medical care of youth sport participants.