By William Vranos, MD

Dr. William Vranos
Dr. William Vranos
William Vranos, MD

As an orthopedic surgeon, I’m often asked about the risks and benefits of strength and weight training for young people.  Unfortunately, there is a lot of misinformation passed along in gyms and weight rooms. I hope this article will give some guidelines to young people who wish to start a strength training program as well instruct the parents and coaches who will also be involved.  Whether a strength training program is intended solely as a fitness program or as an adjunct to other athletic endeavors, if done properly, it can be safe and effective.  Before discussing details of a strength program for young people, however, certain myths need to be dispelled and obtaining a basic understanding of youth physiology is necessary.  Children and adolescents are not small adults.  They have different bone and hormonal physiologies which need to be considered.

Because these young athletes have open epiphysis (growth plates) there is concern that strength training will “stunt their growth.”  This myth is based on some poorly done studies on children who were forced to carry heavy loads while at hard labor.  Nutritional and other health factors were not considered.  Recent studies have shown no effect on growth and many positive health benefits.  The American Academy of Pediatrics (AAP), the American College of Sports Medicine (ACSM), and the American Orthopaedic Society for Sports Medicine (AOSSM) all endorse strength and weight training as part of an overall fitness program for young people, as long as the program is properly supervised and performed in an appropriate manner.

The intent of the program needs to be focused on increasing strength and not bulk or “body sculpting.”  The classic training pyramid of multiple sets of increasing weight building to a “max” is to be discouraged as it has been implicated in overuse strains and, more seriously, low back injuries.  Studies have shown that a proper training program can consistently build strength, but children and adolescents have little ability to increase muscle bulk because they have yet to produce the levels of hormonal support necessary.  Strength increases are achieved through increased muscle fiber recruitment and efficiency as well as improved muscle coordination.  Programs with as little as two training sessions a week have been shown to be useful and four day per week programs have demonstrated an increase in strength of 9-12% over a two month period.

The sports of power lifting and Olympic style weight lifting are not considered appropriate in this age group.  Serious injuries have been reported and there is little additional benefit compared to a “whole body” approach to strength training.

Given this, reasonable guidelines have been proposed by the AAP.

  • Strength training is only a part of a balanced fitness program which should include daily aerobic exercise.
  • All major muscle groups should be trained with a day of rest between sessions.
  • Exercises should be done through a full range of motion.
  • Abdominal and Para spinal (trunk) muscles should be included.
  • Three sets of 10-15 repetitions with proper technique should be achieved before weight is added.
  • Proper spotting or assistance should be available for all lifts.

Finally, there is absolutely no role for steroid or hormonal supplementation.  Recent studies have shown that abuse of these products in adolescents is growing.  These products are dangerous to both the short- and long-term health of the young athlete, and have been linked to problems ranging from acne to suicide. Remember, increased physical fitness and strength, improved self esteem, and better sports performance is possible in this age group.  These benefits are easily identifiable for the young athlete.   Increased muscle bulk and body sculpting are not realistic goals and stressing these characteristics will lead to frustration or the temptation to abuse supplements or steroids.  These are children and any athletic program should be fun and stress a healthy lifestyle.

Dr. Vranos is a board-certified orthopedic surgeon at Brattleboro Memorial Hospital.