Friday, February 17, 2006

Pediatricians and Resistance Training

After the recent discussions regarding the BFS program (Bigger, Faster, Stronger) and some of the less desirable practices in youth resistance training, I thought it was time to discuss the other end of the spectrum: MD's and their opinions on resistance training. These people are the bane of my existence and they set back good, appropriate use of resistance training techniques with young people 100 years or more. They also hurt the Olympic sport of weightlifting in this country, but that discussion is for another post.

I would encourage anyone who deals with strength and conditioning to check out the American Academy of Pediatrics Position Statement on "Strength Training by Children and Adolescents" which appeared in the Pediatrics in June of 2001. It is a real eye-opener as to how much these people DON'T know. The review of literature is pathetic, with the most recent reference being 1996. I found it interesting that they do not even acknowledge the NSCA's (National Strength and Conditioning Association) position paper on the same subject (1996) even though they site articles written by some of the same academic professionals that contributed to the NSCA's paper.

These particular excerpts bother me the most:

Strength training (also known as resistance training) is a common component of sports and physical fitness programs for young people.

Strength training can improve an adolescent athlete's performance in weight lifting and power lifting. Strength training is a common practice in sports like football in which size and strength are desirable. Despite theoretical benefits, scientific studies have failed to consistently show that improved strength enhances running speed, jumping ability, or overall sports performance.6,10

Evidence that strength training programs help prevent sports-related musculoskeletal injuries in preadolescents and adolescents is inconclusive.11 Furthermore, there is no evidence that strength training will reduce the incidence of catastrophic sports-related injuries.

Young people who want to improve sports performance will generally benefit more from practicing and perfecting skills of the sport than from resistance training.

First, there IS a distinction between strength training, resistance training and weight training, but the AAofP doesn't appear to understand that. Second, age-appropriate resistance training is not just about BIGGER, FASTER, STRONGER or maximal efforts or bodybuilding--as this paragraph suggests. Third, too much sport-specific practice and competition are the things that are HURTING young athletes. Young men experience overuse and fatigue-mediated injuries and young females experience non-contact injuries because they are not strong enough to control their own bodies for the level of sport they play. These kids need more recovery and general physical preparation; not more sport practice and play.

When used appropriately and effectively, strength/resistance/weight training is about the following:
  • controlled overload to create stability around a joint
  • "grooving" good sport-related movement patterns
  • increasing functional neuromuscular control of acceleration / deceleration forces
  • proper body mechanics for optimal power production and prevention of injury

There is very good evidence to support the use of resistance training for increasing sport-specific performance and reducing injury. Tim Hewett PhD in Cincinnati has done some of the best. Look here for some references.

Resistance training isn't just about meat-head muscles and gut-busting max lifts. It's about body awareness, alignment, movement AND strength. It's about making the scaffolding of the human body sturdy, stable and coordinated so you perform better and you handle the physical demands of your sport tasks.

I wish physicians would stick to what they really know. I thought the Hippocratic oath was to do no harm. Statements like this hurt.

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