Research Review By Kevin Neeld©

Date Posted:

January 2010

Study Title:

Resistance training among young athletes: safety, efficacy and injury prevention effects

Authors:

Faigenbaum AD & Myer GD

Author's Affiliations:

Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ; Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH; Rocky Mountain University of Health Professions, Provi, UT.

Publication Information:

British Journal of Sports Medicine, 2010, 44: 56-63.

Background Information:

It has long been accepted that resistance training is unsafe for children under a certain age. The thought was that the stresses associated with weight training exceeded the capacity of the child’s bones, ligaments, tendons, and muscles. Recently, more children and adolescents (hereon referred to as “youth”) are participating in some form of strength training through physical education programs and private youth fitness programs.

As a result of this increase in popularity, concerns about the supervision, intensity, volume, and overall safety of these programs for youth participants. The purpose of this study was to review research detailing injuries related to resistance training and provide recommendations appropriate for this cohort.

Pertinent Results:

  • Reported youth resistance training injury rates range from 0.0017-0.176 per 100 participant hours. In comparison, the injury rate for rugby was 0.800 per 100 participant hours.
  • Per person-year, injury rates were 0.11, 0.091, and 0.51 for junior high, high school freshman/junior varsity, and high school varsity athletes, respectively. These seemingly higher injury rates can be explained by the difference in scale (person-year vs. 100 participant hours) and the fact that only 36% of the training sessions in the study describing these results were supervised.
  • Another report noted that over 2/3 of the weight lifting related injuries to 8-13 year olds were to the hand and foot related to dropping and pinching.
  • The overwhelming majority (24/27) of cited studies reported ZERO weight-training related injuries in youth participants. The three studies that did report injuries reported only one injury in all three cases.
  • Several of the examined reports described safely performing 1-RM tests using free weights. The authors point out that many of the stresses youth athletes experience in regular sports participation exceed those experienced through 1-RM resistance training.
  • Of the documented injuries, the trunk was the most common injury site in both men and women (36.9% and 27.4% of all injuries, respectively).
  • While growth plate injuries are a serious concern among youth resistance training participants, ZERO cases have been documented during studies that were designed and directed by a professional. The authors also note that there is currently no evidence to suggest that weight training stunts growth in any way.
  • The major proposed risk factors for injury include: growth spurt, age, biological maturity, body size, poor coaching, fitness and previous injury.
  • Resistance training programs can serve to improve movement mechanics and decrease sport-related injury risk.

Clinical Application & Conclusions:

The recurring theme amongst weightlifting-related injuries in youth was that they occurred under unsupervised conditions. With anyone, but especially with our youth, it’s important that all weight-lifting sessions are supervised. Adequate supervision not only minimizes the risk of injury due to “horseplay”, it also minimizes injury risk due to poorly chosen loads, volumes, and/or training technique.

The authors point out that the participant should have “the emotional maturity to accept and follow coaching instruction.” The presence of this requisite “emotional maturity” may be a better determinant of weightlifting-readiness than chronological age. Indeed there appears to be a lack of evidence suggesting that resistance training is unsafe for children at any age, especially in light of the fact that children at very young ages are participating in running and jumping activities that places relatively high amounts of stress on the body.

Practical Application:
Contrary to current practice, it’s probably best to isolate youth lifters from their peers so they can learn proper technique in a maximally supervised setting without the distractions of peer-interaction. The downside of this approach is that camaraderie built through team training is one of the primary benefits of training. To account for this, coaches could divide their teams into small groups (3-5 people).

One of the groups could learn proper exercise technique during a given day, while the rest perform speed, acceleration, and conditioning and/or sport-skill work in a large group. Groups can be rotated during subsequent training sessions.

Study Methods:

This was a narrative review however the authors were unclear about their search criterion for the cited articles.

Study Strengths / Weaknesses:

The study presented evidence contradicting most of the commonly accepted myths associated with youth-based resistance training. It would be insightful for future research to document differences in resistance training safety between genders, amongst participants of different body compositions and amongst non-athletes and athletes of different sports.

Additional References:

  1. Faigenbaum AD et al. The effects of different resistance training protocols on muscular strength and endurance development in children. Pediatrics 1999; 104: e5.
  2. Sadres E et al. The effect of long term resistance training on anthropometric measures, muscle strength and self-concept in pre-pubertal boys. Pediatr Exerc Sci 2001; 13: 357-372.
  3. Faigenbaum AD et al. Comparison of 1 and 2 days per week of strength training in children. Res Q Exerc Sport 2002; 73: 416-424.
  4. Centers for Disease Control and Prevention. Sports-related injuries among high school athletes-United States, 2005-2006 school year. MMWR Morb Mortal Wkly Rep 2006; 55: 1037-1040.