Lehigh County Health & Medicine Fall/Winter 2020 - 20

FEATURE

Resistance Training in Children

By ELISA GIUSTO D.O., Family Medicine Resident PGY-3

esistance or strength training is designed to enhance muscular
strength, power, and endurance whether for general exercise or
competitive sports. It consists of a variety of modalities from free
weights, weight machines, kettlebells, elastic tubing, or simply
body weight. Given evidence of decreased muscular fitness, inactivity,
and obesity academic in youth, year-round resistance exercise is
essential regardless of sport participation. The American Academy of
Pediatrics (AAP) released a revision on its policy statement from 2008
on the benefits and risks of resistance training for children and adolescents this year. Here is what you need to know:
Among the most obvious benefits of resistance training is building
strength, but advantages of this in youth with proper supervision and
correct techniques include improvements in motor skill performance,
gains in speed and power, developing physical literacy, reducing
risk of injury, and injury rehabilitation. Other health benefits have
been seen as well resulting in enhanced cardiovascular fitness, body
composition, bone mineral density, blood lipid profiles, mental
health, and insulin sensitivity in overweight youth. It is important
to note, though, that resistance training combined with aerobic
training does not appear to impair strength gains and may be more
beneficial than single-mode training.
Risks with resistance training injuries occur with prolonged training
with heavy loads or inadequate rest and recovery between sessions. Youth
with poorly controlled or preexisting hypertension require physician
oversight, given the risk of marked elevation of blood pressure during
resistance training. Youth with hypertrophic cardiomyopathy should also

20 Lehigh County Health & Medicine | FALL / WINTER 2020

be counseled, given the risk of worsening ventricular hypertrophy and
restrictive cardiomyopathy or hemodynamic decompensation from an
acute increase in pulmonary hypertension. Caution should be advised
in youth with a previous history of cancer treated with anthracycline
chemotherapy, given an increased risk for cardiotoxicity and acute
congestive heart failure during resistance training. Although resistance
training has been determined to be safe in children with underlying
seizures that are well controlled on medication, guidance from physicians
should occur for those with uncontrolled seizures.
Starting resistance training at 5 years old is reasonable since strength
gains can be made in ways other than lifting external loads with exercises
such as frog jumps, bear crawls, crab walks, kangaroo hops, and one-leg
hops. Resistance-training programs lasting over 23 weeks for 2-3 times a
week are most effective in attaining maximal benefits. It is recommended
to take 1-2 days off per week and rest 1 minute between sets for beginners
and 2-3 minutes as the training intensity increases. Youth should begin
with 1-2 sets of 8-12 repetitions using a low resistance training intensity
as proper technique is developed. Dynamic warm-up exercises should
be integrated into the training followed by cool-down periods with
appropriate stretching techniques. It is important to note that detraining
effects can occur after 8-12 weeks of no training.

Source:

Stricker, Paul R., et al. " Resistance Training for Children and Adolescents. "
Pediatrics, vol. 145, no. 6, 2020, doi:10.1542/peds.2020-1011.

Lehigh County Health & Medicine Fall/Winter 2020

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