TRAINING

Pédiatrie Resistanee Training: Benefits, Coneerns,

and Program Design Considerations i
Ayery D. Faigenbaum^ and Gregory D.
'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, Provo, UT i

FAIGENBAUM, A.D. anJ G.D. MYER. Pédiatrie resistance training: benefits, concerns, and program design considerations.
C.iirr. $¡xrrLs Mt'd, Rep., Vol. 9, No. .3, pp. 161-168, 2Ü10. A growing number of chiíÁren and adolescenis are mvalved m resistance
training in schiiols, fitness centers, and sports trcúning facüities. ín addition to increasing muscular strength and power, regular participation
in a ¡'^ediatric resistance trüiníng ¡no^am may have a favorable influence on body compo.'iition, hone health, and réduction of spmls-related
mjunes. Resistance training targeted w improve IUVJ fitness levels, pow trunk strcngt/i, and defieivi in movement mechanics can offer
observable health and fitness benefits to young athletes. However, pediatnc resisMiice training programs Tieed to be well-desi^xed and
supervised by qiuilified professionals whn understand the physical and psychosocial uniqueness of children and cuíole.scents. The sensible
iTiit'gration of dißereni craming methods aUmg with the periodic manipulation of progrartvi design variables over time will keep the iraining
stimulus effective, cMienging, and enjoyable for the participants. I

INTRODUCTION In this article, the term resistance training refers to a method

of conditioning that involves the progressive use of a wide
A growing number of young athletes are involved in resis- range of resistive loads, different movement veltKities, and a
tance rrainin^j in scbools, fitness centers, and sports-training variety of training nii.xlaltties including weight machines, free
facilities (13,61). Over tbe past decade, evidence-based reports weights (dumbbells and barbells), elastic bands, medicine balls,
have emer}jed refjardinji botb tbe safety and efficacy of resis- and btxiy weight. The term resistance training is distinguished
tance training in children and adolescents and the acceptance from the sports of weightlifting and powcrlifting in which
oí pédiatrie resistance training by medical, fitness, and sport athletes periodically train with heavy loads and attempt to lifr
organizations has become widespread (2,3,13). Nowadays, maximal amounts of weight in competition. For ease oí dis-
physical education curricula include activities that improve cussion, the terms pédiatrie, youth, and young refer to children
muscular strength, and training programs specifically designed and adolescents.
CO enhance sports pertoniiance (especially among ytiung ath-
letes) have become a top 10 fitness trend for 2010 (58,72).
Tiius, as more children and adolescents get involved in POTENTIAL BENEFITS OF PEDIATRIC RESISTANCE
resistance training in SCIKKIIS, health clubs, and sport training TRAINING
centers, it is important to establish safe and effective guide-
tines by which resistance exercise can improve the health, While a majority of the pédiatrie research has focused on
titness, and sports performance of younger populations. activities that enhance cardiorespiratory fitness, recent find-
ings indicate that resistance training can offer unique benefits
for children and adolescents when appropriately prescribed
and supervised (13,48). in addition to enhanced muscular
Adàresi /iir íimL-spfiniknce: Avcry D. FaigcnKiuiii. Ed.H., FAC^M, tVpnrrmcni ul strength and motor skill performance, regular participation
Health and Exercise Science, The Oïlluge of New Jtisc'y, 2000 Pennington Ruad. in a pédiatrie resistance training can facilitate weight control,
FwinK, N) 08628 (E-niail; [email protected]).
strengthen bone, and increase a young athlete's resistance
to sports-related injuries (11,55). Further, since gixx] health
IS17-890X/090.Ï/I61-I68
Cturrenr SfxffU Medicine Repiim
habits established during chiidhoc)d may carry over into adult-
C jipyrichi P 2010 hy the Amcriain nf-Sjnins Medicine hood (71 ), the positive influence of these habits on the adult

161
 T A B L E 1. Potential benefits of pédiatrie resisrance training. increase in insulin sensitivity after 16 wk of resistance train-
ing in overweight adolescent males (65). Ek'cause overweight
Increase muscle strength
children and adolescents with low muscle fitness are reported
Increase muMrle power to have the poorest metabolic risk profile (68), the protective
Increa.se local muscle endurance effects of muscular fitness on metabolic health in youth
should not be ovcrkniked by health care providers who con-
Enhance motor skill perfonnance
tinue to embrace the challenge of dealing with overweight
Increase bone mineral density and ohese youth.
Improve body comptwition
hnprtwc insulin sensitivity' ' Bone Health
Improve blood Iipid profile The traditional fears and misinformed concems that re-
sistance training is harmful to the immature skeleton of
Reduce risk of sport-reinted injuries
young lifters have been replaced by scientific evidence that
Enhance sports performance indicates thar childhood and adolescence may be the oppor-
Stimulate a more po.'iitive attitude toward lifetime physical activity tune time for the bone-modeling and remodeling process to
respond to the tensile and compressive forces associated with
weight-bearing activities (3,73). If age-specific resistance
lifestyle should be rccofinized by teachers, coaches, and health training guidelines are followed with consumption of proper
care providers. The potential benefits of pédiatrie resistance nutrients {e.g., adequate calcium and vitamin D) (4), regular
participation in specialized fitness programs that include
training are outlined in Table 1.
I resistance exercise can play a critical role in hone mass ac-
quisition during the pédiatrie years (73). Because low levels
Body Composition of peak bone mass are a significant risk factor of osteoporosis
The influence of resistance training on body composi- and associated fractures, regular participation in programs
tion has become an important topic of investigation, given that maximize peak bone mass during childhood and ado-
that the prevalence of obesity among children and adoles- lescence may be an effective strategy for reducing the risk oí
cents continues to increase (14)- Although obese youth tra- osteoporosis later in life (25). While weight-bearing activities
ditionally have heen encouraged to participate in aerobic (particularly resistance exercise) can he an osteogenic stim-
activities, excess body weight hinders the performance of ulus during adu]thot)d (22), resistance training may be most
weight-bearing physical activities such as jogging and in- beneficial during childhood and adolescence because the
creases the risk of musculoskeletal ovenise injuries. Further, mechanical stress from this type of training may act syner-
obese youth often lack the motor skills and confidence to be gistically with growth-related increases in bone mass (3,73).
physically active, and they actually may perceive prolonged
In support of these results, previous reports of adolescent
periods of aerohic exercise to be boring or discomforting.
weightlifters who regularly performed multijoint liits with rel-
As noted by Stodden and colleagues, there is a "negative
atively heavy loads have been found to have levels of bone
spiral of disengagement," whereby youth with low levels of
mineral density and bone mineral content significantly greater
motor skill competence engage in less physical activity,
than age-matched control subjects (8,74)- While additional
which in tum leads to increased weight gain (69). In support
clinical trials are needed to define more precisely the exercise
oí these observations, others observed that total bixly fat was
prescription for optimizing bone development in youth, the
inversely related to minutes of physical activity per day in
importance of participating in sports and weight-bearing
children (10).
physical activities as a lifetime activity should not he over-
Although the treatment of pédiatrie obesity is com- looked, as training-induced gains in bone health may be lost
plex, exposure to resistance exercise (along with behavioral over time if the program is not continued (23). ,
counseling and nutrition education) may provide a gateway
for overweight and ohese youth to initiate exercise activities.
From regular participation in resistance exercise, they may S ports-Re lated Injuries
gain confidence in their ability to he physically active, which Although tbe total elimination of sports-related injuries is
in tum may lead to a noticeable improvement in muscle an unrealistic goal, appropriately designed and sensibly pro-
strength, favorable changes in b(xJy composition, and an in- gressed conditioning programs that include resistance train-
crease in regular physical activity (including recreational ing may help reduce the likelihood of sports-related injuries
sports). Our observations suggest that overweight and obese in young athletes. Owing to the apparent decline in free time
youth enjoy resistance training because it is not aerobically physical activity among children and adolescents (57,59),
taxing and it provides an opportunity tor participants to it seems that the musculoskeletal system of some aspiring
enhance fitness performance while gaining confidence in young athletes may not be prepared tor the demands of sports
their abilities to be physically active. practice and competition. In tme study, it was reported that
Several studies have reported favorable changes in body children engaged in approximately 3 hd of moderate to
composition in children and adolescents who were ohese or vigorous physical activity (MVPA), hut adolescents were
at risk for obesity following participation in a progressive only engaging in MVPA for 49 min d on weekdays and
resistance training program (44,65,67). Sbaibi and colleagues 35 mind ' on the weekend (57). Qmsequently, the sup-
observed a significant decrease in hody fat and a significant porting structures of some young athletes may he ill-prepared

162 Current Sports Medicine Reports www.acsm-csmr.org

ro handle the demands of weekly sports practice sessions and of whole-body power) increases steadily in boys during puberty
weekend competitions. but not in girls (62). T~his puberty'-related divergence in neu-
By addressing the risk factors associated with youth sport romuscular development between boys and girls may explain,
injuries (e.g., low fitness level, muscle imhalances, and errors at least in part, gender-related differences in injury risk ob-
in training), Micheli suggested that both acute and overuse served in post-pubertal female athletes (1,33,35).
injuries could be reduced by lS'íb-SO'ííi (46). Heidt and col- Multitaceted training programs that combine resistance
leagues were able to significantly reduce injury rates with the training, plyometric training {with education on jumping
;iddition of a preseason conditioninj^ regimen in adolescent and landing techniques), postural balance, and body position
female soccer players (26). Cahill and CSrittith incorpt>rated control (proprioception) have been found to enhance move-
resistance training; into their preseason program for adoles- ment biomechanics and lower extremity strength in adoles-
cent football teams und reported a reduction in nonsurgical cent girls (49-55). Observed relative gains in girls may be
;ind surgical knee injuries over iour competitive seasons (5). greater than in boys because baseline neuromuscular per-
Hejna et al. reported that young athletes {13-19 yr) who formance levels are lower on average in girls versus Kiys
incorporated resistance training in their exercise regimen (20,35,40,54,62). Girls have been shown to improve strength
surtcred fewer injuries and recovered from itijuries with measures up to 92% with just 6 wk of training (54). In
less time spent in rehabilitation compared with teammates addition to reduced knee injuries in adolescent (30) and
who did not resistance train (28). Protocols incorporating mature female athletes (56), regular participation in a multi-
resistance training into preseason and inseason conditioning faceted resistance training prijgram also may induce measures
programs are predictive of future injury risk as well as anterior of the "neuromuscLilar spurt," which t>pically are not seen
cruciate ligament injuries in adolescent female athletes in females (54). Of potential interest to sports medicine
(29,32). While there is not one combination of exercises, professionals, resistance training timed with growth and
sets, and repetitions that has proven to optimize training development may induce the desired neuromuscular spurt,
adaptations, these data indicate that multifaceted programs which may improve sports performance and improve bio-
that increase muscle strength, enhance movement mechan- mechanics related to injury risk in young girls (34,54). Cumu-
ics, and improve functional abilities appear to he the most latively, these findings indicate that young female athletes
cflective strategy for reducing sports-related injuries in young should participate regularly In multifdceted resistance training
athletes. programs.
Clearly, participation in physical activity should not hegin
with competitive sport hut should evolve out of preparatory
fitness conditioning that is sensibly progressed over time. RISKS AND CONCERNS
Although there are many mechanisms to potentially reduce
sports-related injuries (e.g., coaching education, safe equip- Current findings from pédiatrie resistance training studies
ment, proper nutrition), enhancing physical fitness as a Indicate a low risk ot injury' in children and adolescents who
prevcntative health measure is considered a cornerstone of follow age-appropriate training guidelines (18,24,42). A tra-
multicomponent programs for school-aged youth. This is an ditional concem associated with youth resistance training
important consideration for health care providers who often is the potential for injury to the physis or growth plate in a
pcrtomi preparticipatiofi physical examinations to assess a young lifter's btxiy. The growth plate can be three to five
young athlete's readiness for sport (35). ln addition to rhe times weaker than surrounding connective tissue, and it may
medical examination (including a mu.sculoskeletal assess- be less resistant to shear and tension forces (66). Injury to
ment), health care providers should inquire about a patient's this section of hone could result in time lost from training,
participation in physical activities over the past few months. significant discomfort, and growth disturbances {6). Al-
Because training errors (e.g., "too much, too soon.") are a though a few retrospective case reports noted injury to the
growth cartilage in youth (18), most of these injuries were
common theme in many sports-related injuries In youth (46),
caused by improper lifting techniques, poorly chosen training
there is an ongoing need to ensure that aspiring young ath-
loads, or tack of qualified adult supervision. For example, in
letes participate in multicomponent conditioning programs
one case report, a 13-yr-old boy suffered bilateral fracture
hefore the start ofthe sport season and continue training in
separations ofthe distal radial epiphyses when he lost control
H
; mixiified program throughout the competitive season. ofa barbell as he attempted to press a 30-kg weight overhead
while exercising alone in a "makeshift gymnasium" at home
(38). It is unclear from this report whether this teenager
SPECIAL CONSIDERATIONS FOR TRAINING FOR GIRLS received instruction on proper resistance training procedures
or if he was involved in an activity without qualified super-
While nuisculoskeletal growth and development show vision. Future reports should provide details of predisposing
very similar trends between genders, male and female strength factors to better understand the true risk of injury to the
and cixirdination (ncuromuscuhir) pattems diverge signifi- physis in young lifters.
cantly during and after pubert>' (31). Bt^ys naturally demon-
strate that power, strength, and btxJy coordination increase Injury to the growth cartilage has not been reported in any
with chronological age, which correlates to maturational prospective youth resistance training research study, and
stage, whereas untntined girls on average show lirrlc improve- there is no evidence to suggest that resistance training will
ment in strength, balance, and power throughout puberty negatively impact growth and maturation during cliildhood
(31,35,43,62). For example, vertical jump height (a measure and adolescence (18,42). To date, only three puhlished

Volume 9 • Number 3 • May/June 2010 Pédiatrie Resistance Training 163

training studies have reported resistance training-related in- If pédiatrie resistance training guidelines are not followed,
juries in young lifteri, namely, anterior shoulder pain that there is the potential for serious injury. For example, it has
resolved within 1 wk oí rest (63), a strain of a shoulder muscle been reported that unsafe behavior, equipment malfunction,
that resulted in one missed training session (41), and non- and lack of qualified supervision increase the risk of injury in
specific anterior thigh pain that restilved with 5 min of rest young children who exercise at home (39). Myer and col-
(64). A review of these findings revealed estimated injury leagues recently reported that two-thirds of resistance training-
rates of 0.176, 0.053, and 0.055 per 100 participant hours, related injuries sustained by 8- to 13-yr-old patients who re-
respectively, which suggests that supervised resistance training ported to emergency departments in the United States were
protocols are relatively safe for youth ( 18). Significant gains in to the hand and foot, and most were related to "dropping"
strength without any report of injury also have been reported and "pinchir^" (47) (Fig. 1). These findings underscore the
in prospective studies in which weightlifting movements (in- importance of qualified supervision, safe exercise equipment,
cluding mtxiified cleans, pulls, and presses) were incorporated and strict adherence to pédiatrie resistance training guidelines
into youth resistance training programs (7,16,21). ' at home, school, and sports-training centers.
While the avaitahle data indicate that the injury occur-
rence in pédiatrie resistance training studies is either very low
or nil (18,24,42), professionals who prescribe resistance ex- PEDIATRIC RESISTANCE TRAINING GUIDELINES
ercise should be mindful ofthe inherent risk associated with
this type of training, cognizant of safety precautions, and A prerequisite for the development and administration oí
aware of the potential risk for repetitive use soft-tissue in- safe, effective, and enjoyable youth resistance training pro-
juries. For example, Quatman and colleagues reported that grams is an understanding of established training principles
the trunk was the most frequently injured body part for both and an appreciation for the physical and psychosiKia! unique-
men and women between the ages of 14 and 30 yr who ness of children and adolescents. Qualified and enthusiastic
presented to U.S. emergency departments from weightlifting instruction not only enhances participant safety and enjoy-
injuries (61). Since lower back pain has become a significant ment, but direct supervision of youth resistance training pro-
health concern among adolescents (37), there appears to be a grams can improve program adherence and optimize strength
role for preventative interventions that enhance the gains (9). Although there is no minimum age requirement at
strength, local muscular endurance, and stability of the lower which children can begin resistance training, all participants
hack to redtice the prevalence or severity of lower hack in- must be mentally and physically ready to comply with coach-
juries in young lifters. From our experience, some young ing instructions and undergo the stress oí a training program.
lifters spend too much time training their "mirror muscles" In general, if a child is ready for participation in sport activ-
{e.g., chest: bench press; arms: biceps curl) and not enough ities (generally age 7 or 8), then he or she is ready for some
time (or no time at all) strengthening their trunk or posterior type oí resistance training.
chain musculature. Thus, observed injuries to the lower back There does not appear to be one optimal combination of
in young lifters may be due, at least in part, to poor program sets, repetitions, and exercises that will promote favorable
design. Other factors such as improper exercise technique adaptations in young athletes. Rather, the sensible integra-
and inappropriate progression of training loads also may in- tion of different training methods and the periodic manip-
crease the risk of soft-tissue injury. ulation of pR)gram variables over time will keep the training

&-13 years 23-30 years

77 2% Accidental 27.5% Accidental
Figure 1. Percentage of injuries of the oldest and youngest age categories. Note that the small prevalence of leg in|unes in the 8-13 yr age categories
provides invalidated results and should be interpreted with caution, (Reprinted from Myer GD, Quatman CE, Khoury J, Wall EJ, Hewett TE. Youth vs. adult
"weightlifting" injuries presenting to United States emergency rooms: accidental vs. non-accidental injury mechanisms, J. Strength Cond. Res. 2009;
23.2054-60. Copyright © 2009 National Strength and Conditioning Association. Used wiîh permission,)

164 Current Sports Medicine Reports I www.acsm-csmr.org

srimuliis effective, challenging, and pleasurable for the partic- procedures that involve tbe performance of dynamic move-
ipnnts. We refer to this concept as fitness integraáon because ments (e.g,, bops, skips, jumps, and movement-hased exer-
ir inct)[p<.)rates a combination of perfonnance-enhancing and cises for the upper and lower Kxiy) designed to elevate core
injiiry-reduciny components {e.g., stren^jrh, power, and bal- body temperature, enhance motor unit excitability, improve
Lince) into one fitness pro^Tam. This type of traininj,; does not kinesthetic awareness, and maximize active ranges of motion.
necessitate expensive equipment, hut it dcx'S require qualifiée! Warm-up protocols that include mtxierate- to high-in tensity
instruction, a systematic progression of training variables, and dynamic movements have been found to enhance power per-
;in understanding of pédiatrie resistance exercise guidelines fonnance in young athletes (12,17). A reasonable suggestion
( i.l Í), In short, the act of resistance training in and oí itself is to perfomi 5-10 min of dynamic activities (e.g., jumping,
d(K's not ciisun- that favorable changes in fitness and per- skipping, and lunging) during the warm-up period and less
tomiancL' will be reiilizetl. Rather, individual effort combined intense calisthenics and static stretching at the end of the
with a well-designed training program ultimately will deter- workout.
mine rhe adaptations that take place.
When designing resistance training programs for young Selection and Order of Exercise
athletes, it Is important to consider the total exercise diise, Weight machines {hoth child-sized and adult-sized) as well
which includes sports practice and competition as well as free as free weights, elastic bands, medicine halls, and body
play, physical education, and possibly private training ses- weight exercises have heen used by children and adolescents
sions. Some young athletes with relatively immature mus- in clinical- and school-hased exercise programs (.3,15,55).
culoskeletal systems may not be ahle to tolerate the same While each mode of training has advantages and disadvan-
exercise dose us their teammates. Because oí the interindi- tages, it is important to select exercises that are appropriate
vidual variahility of stress tolerance, each young athlete for a participant's body size, fitness level, exercise technique
should he treated as an individual, and coaches must he experience, and training goals. It is desirable to start with
aware of incipient signs of overtraining, which would require relatively simple exercises and gradually progress to more
a modification oí the training program. A reduction in sports advanced multijoint movements as confidence and compe-
perfonnance and an increased risk of injury can result if tence improve.
resistance exercises are simply added t)nto a young athlete's From our experience, resistance training with free weights,
training schedule. medicine balls, and one's own h<idy weight may be partic-
The acute program design variahle.s that should he consid- ularly beneficial for young athletes who need to enhance
ered when designing pédiatrie resistance training programs motor skill perfonnance, halance, core strength, and muscle
include 1) warm-up and cool-down, 2) selection and order of power as part of an integrated training program. Increased
exercise, 3) training intensity and volume, 4) rest intervals dynamic halance may help to provide young athletes witb a
between sets and exercises, and 5) repetition velocity. Table 2 stable core (i.e., pelvis, abdomen, trunk, and hip) that will
summarizes pédiatrie resistance training guidelines. Detailed he better prepared to respond to the high forces generated at
descriptions of pédiatrie resistance training programs using the distal body parts during athletic competition (50).
different types of equipment are beyond the scope of this During peak height velocity in pubertal athletes, the tibia
article hut are available elsewhere (]5,4'>,')O). and femur grow at relatively rapid rates in hoth sexes (31,70).
Rapid gr(.>wth of tbe two longest levers (tihia and femur)
Warm-Up and Cool-Down initiate height increases that concurrently increase height of
Over the past tew years, long-held beliefs regarding the the center of mass, making muscular control of the trunk
routine practice of warm-up static stretching have heen more difficult (31,35,50).
questioned. Lately, there has heen rising interest in warm-up Although tbe isolated effects of core training and balance
training on measures of performance have not heen demon-
T A B L E 2. General fieJiatric rtsistiince triiininy ^UÍLIClints. strated clearly, the potential benefits of this type of training
likely are suhstantial and comhinatory to other modes oí
• Providi' qu;i]ified iimructinn und clo.se supervision conditioning (27). For example, core strengthening and bal-
• finsurt' the exercise envirunmcnt i.s siitt- ;inJ tret' of hazards ance training can improve dynamic balance, which may help
• Pieam fach session with a dynamic wann-up provide an athlete with a dynamically stähle core that can be
better prepared to respond to the high forces generated at
• Fotu;- on ilfvelopirn; proper exercise techniquf nnJ Icaminy fiinLÍa
the distal body parts during athletic competition (36,60).
printlpit's
While further study is warranted, the glohal effects of core
Pertonn 1-Ï sers of 6-15 reperirions on strength exercises strength gains may be best attained with the integration of
Pt'rtorm 1-Î sets ot 6 or fewer repetition.s on power exercises core strengthening and halance training into a multifaceted
Pertonn exercises tor the upper hiKly, lower btxly, and midsection resistance training program. Overhead training exercises such
as the unilateral loaded walking lunge press are designed to
Include exercise;, that require balance and coordination
simultaneously improve core strength and dynamic stability
CiKil down with less intense activities and stretchin(i during a multiplanar movement progression (Fig. 2).
Resistance train 2-3 times each week on nonconsecutive days Tiiere are many ways to arrange the sequence of exercises
in a resistance training session. Most youth will perform total
Ket'p ihe program fresh una challengin); hy sv.';temaiic;tlly varying the
body workouts several times per week, which involve multiple
trainmti
exercises stressing all major muscle groups each session. In

Volume 9 • Number 3 ' May/June 2010 Pédiatrie Resistance Training 165

Figure 2. Demonstration of the unilateral loaded walking lunge press exercise that is designed to simultaneously improve core strength and dynamic
stability during a multiplanar movement progression. To perform this exercise, the athlete performs a lunge, and instead of returning to the start position,
he or she steps through with the back limb and proceeds forward with a lunge on the opposite limb while pressing a dumbbell above his or her head. The
weight should move up and down with the same tempo and direction as the lunge. Encourage the athlete to lunge his or her front limb far enough out so
that the knee does not advance beyond the ankle during the exercise.

this type of workout, large tnuscle group exercises should be likelihood of boredom will he reduced, and risk of overuse
performed before smaller muscle group exercises, and multiple- injuries may decrease.
joint exercises should be performed before single-joint exer-
Rest Intervals Between Sets and Exercises
cises. Of note, it is desirable to perform more challenging
exercises earlier in the workout when the neuromuscular system The length oí the rest interval between sets and exercises
is less fatigued. Thus, if a child is learning how to perfonn a is an important but often overlooked program variable.
weightlifting mtivement or a plyometric exercise, this type of While rest intervals oí 2-3 min typically are recommended
exercise should he performed early in the training session so for adult lifters, this guideline may not be consistent with the
that the child can practice the exercise without undue fatigue. needs and abilities of younger populations due to growth-
and maturation-related differences in response to physical
Training intensity and Volume exertion. The available data suggest that children and adoles-
cents can resist fatigue to a greater extent than adults during
Training intensity typically refers to the amount of re-
several repeated sets of resistance exercise (19). Thus, a
sistance used for a specific exercise, whereas training volume
shorter rest interval (about 1 min) may suffice in children
generally refers to the total amount uf work performed in a
and adolescents when perfonning a nnxietate-intensity resis-
training session. While both of these program variables are
tance exercise prott:)col, although the likelihood that youth
significant, training intensity is tme of the more important
with lower levels of strength may recover faster than youth
factors in the design of a resistance training program because
with higher levels of strength should be considered.
it is the major stimulus related to changes in muscular fitness.
However, to maximize gains in muscular fitness and reduce Repetition Velocity
the risk of injury, youth must first learn how to perform each
The velocity or cadence at which a resistance exercise is
exercise correctly with a light load (e.g., unloaded barbell)
performed can affect the adaptations to a training program.
and then gradually progress the training intensity and/or
While it generally is recommended that youth resistance-
volume without compromising exercise technique.
train in a controlled manner at a mixJerate velocity, different
A simple approach may be to first establish the repetition training velocities may be used depending on the choice of
range, and then by trial and error determine the maximum exercise. For example, plynmetric exercises and wcigbtlifting
load that can be handled for the prescribed range. For ex- movements are explosive but highly controlled movements
ample, a young lifter may begin resistance training with one that are performed at a high velocity. As part of an integrated
or rwo sets of 10-15 repetitions with a light or moderate load resistance training program, we believe that the performance
in order to develop proper exercise technique. Depending of different training velocities within a training putgram may
on individual needs, goals, and abilities, over time the rep- provide the most effective training stimulus for young ath-
etition range can be progressed to include additional sets letes. However, as youth increase movement veltKity during
with heavier loads {e.g., 6-10 repetition maximum) on large training, it is critical that technical performance of each ex-
muscle group exercises to maximize gains in muscle strength. ercise is mastered befi>re progressing to more advanced move-
Because of the relative complexity of power exercises {e.g., ments. Instructors should monitor every training session and
plyometric or weightlifting movements), note that youth provide constructive feedback to ensure that athletes tnaintain
typically perform fewer quality repetitions (<6) in order to proper technical performance of all exercise movements.
maintain movement speed and efficiency for all repetitions
within a set. As training programs become more advanced
(and potentially more intense), the importance of reinforcing CONCLUSION
proper exercise technique and training habits should not be
overlooked. Moreover, by periodically varying program var- Scientific evidence and clinical impressions indicate that
iables, long-term performance gains will be optimized, the resistance training has the potential to offer observable

166 Current Sports Medicine Reports www,acsm-csmr org

health and fitness value lo children and adolescents, pro- 17. Falf¡enhaum AD, McFarland JE, Schweulnnan JA. e! d. D>Tiamic warm-
up protocols, widi and without a weighted vest, and fitness performance
vided that appropriate training guidelines are followed and in high schtKil female athletes. J. AtW. Train. 2006; 41:357 61.
qualified instruction is available. Comprehensive resistance 18. Faigenbaum AD, Myer GD. Resi.stancc training among youn^ atbletes:
training programs that integrate different elements of physical safety, efficacy and injury prevention effects. Br. J. Sports Med. 2010;
fitness are most likely to enhance sports performance and
reduce the risk of injury. These benefits can be obtained 19. Faigenbaum AD. Ratamess NA, McFarland J, ei d. Effect of rest interval
lengtb on bench press performance in hoys, teens, and men. Pcihacr.
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