[#2] Do Youth Athletes Need Strength Training?

In this episode, I go over the benefits of strength training for youth athletes specifically, why it’s still not universally implemented in all youth sports programs, and give a rough idea of what a strength training program for youth athletes should focus on.

Main topics covered:

• The problem with youth sports today
• Sports performance benefits with strength training
• Injury risk reduction with strength training
• Other factors affecting injury risk in youth athletes
• Why more youth sports teams don’t do strength training
• What strength training should look like for youth athletes

Position Statements and Research Articles:

• Faigenbaum, A. D., et al (2009). Youth resistance training: updated position statement paper from the national strength and conditioning association. https://doi.org/10.1519/JSC.0b013e31819df407 
• Stricker, P.R., et al. Resistance Training for Children and Adolescents. https://doi.org/10.1542/peds.2020-1011
• Bergeron MF, et al. International Olympic Committee consensus statement on youth athletic development https://doi.org/10.1136/bjsports-2015-094962 
• Myer GD, et al. Sport Specialization, Part I: Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? Does Early Sports Specialization Increase Negative Outcomes and Reduce the Opportunity for Success in Young Athletes? doi:10.1177/1941738115598747
• Brenner, J.S. & Watson, A. COUNCIL ON SPORTS MEDICINE AND FITNESS; Overuse Injuries, Overtraining, and Burnout in Young Athletes. https://doi.org/10.1542/peds.2023-065129
• Faigenbaum, A. D., & Myer, G. D. (2010). Resistance training among young athletes: safety, efficacy and injury prevention effects.  https://doi.org/10.1136/bjsm.2009.068098 
• Lesinski, M., et al. (2016). Effects and dose-response relationships of resistance training on physical performance in youth athletes: a systematic review and meta-analysis. https://doi.org/10.1136/bjsports-2015-095497 
• Robles-Palazón, F. J., et al. (2024). A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 1: an analysis by classical training components. https://doi.org/10.1080/07853890.2024.2408457
• Ayala, F., et al. (2024). A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns. https://doi.org/10.1080/07853890.2024.2337724 

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Transcript

SPEAKER_00 0:07

Hello and welcome to Candid Conversations with Dr. Kelsey. I'm your host, Dr. Kelsey, and this is the space where I share my honest thoughts, real experiences, and the no BS conversations I wish more people were having about movement, training, injury recovery, and life as an active human. The goal of this podcast is to help you better understand your body, think more critically about rehab and fitness, and feel more confident making decisions so you can stay active long term. Before we start, a quick reminder. I am a physical therapist, but I am not your physical therapist. Nothing here is medical advice. So if you're dealing with something specific, please reach out to your PT or schedule a session to work with me. Alright, now let's get into today's conversation. So I once treated a volleyball athlete who was coming to physical therapy because they kept spraining their ankle. When I asked what their training looked like, they basically told me all they did was, you know, volleyball drills, you know, regular practice like games, scrimmages, and maybe some conditioning like running and shuttle runs. I was a little surprised that in you know in today's age they weren't doing any strength training. But I figured, you know, maybe it was just because this wasn't like an elite program. Like, yes, this volleyball player was doing like special camps and stuff, but you know, maybe an elite, a more elite program uh would have some strength training. But then over Thanksgiving, I had a conversation with my cousin about her son who plays ice hockey and was experiencing some hip pain. Um, so for a little context, like her son attends this fancy hockey boarding school. I admit I don't really know anything about ice hockey, especially like their youth development programs. Um, but like he's legit, basically, is what I'm trying to say. And so when I asked about the training that he did, he basically said kind of the same thing, like they did hockey practice, uh, you know, like normal hockey practice, like um like games and stuff. Um I don't remember if he said anything about conditioning, but like the main thing was that again, he didn't really do any strength training. Like he did remember one of his coaches kind of doing strength training, but I think another one of his coaches didn't really emphasize it at all. And I was really, really surprised about that because like I mentioned, he's going to like this really fancy and elite, like he's doing this fancy hockey program, like this elite program. And so then it became a little bit of my soapbox moment about uh strength training, um, even for youth athletes. Um thirdly, uh I was recently having a conversation with a local speed development coach here, and he told me that strength training culture in youth sports is actually somewhat regional. Um and so, for example, in SoCal it's really developed, but not so much here in Vegas. So seeing this pattern raised a bigger question to me of why youth athletes aren't doing strength training and if they are actually being physically prepared for the demands of their sport, especially with all the information that we know nowadays. Um and the reason why I'm so passionate about this topic is because one of the hills that I'll die on is that everybody needs to be doing some sort of strength training. So every single person, whether they're old or young, would benefit from some sort of strength training. And I know there's historically been some hesitation around strength training for kids, with one of the biggest concerns being around strength training, stunting growth. And that myth was linked to a 1960s report about children doing manual labor having stunted growth, which obviously has nothing to do with strength training itself. And in recent years, there have been several research papers investigating and finding that supervised strength training is safe and even encouraged in kids as young as four. So, in fact, the NSCA, American Academy of Pediatrics, and the IOC all support resistance training in youth athletes when properly supervised and programmed appropriately. It is worth mentioning that while I have worked with youth athletes before, I do not exclusively work with them. So for this episode, I did consult with my brother-in-law, who is an accomplished athletic trainer at an elite high school, so that I can gain a better understanding of youth sports and not just, you know, talk about my personal bias around strength training. And to make sure I wasn't just making stuff up to support my bias, I've also included some links to research articles on this topic in the show notes. So in today's episode, I'm going to go over three of the benefits of strength training for youth athletes specifically, why it's still not universally implemented in all youth sports programs, and give a rough idea of what a strength training program for youth athletes should focus on. So to begin, youth sports today look very, very different than when I was in high school over 15 years ago. Kids today will specialize way earlier than ever before. They also have year-round participation in their sport, or alternatively, they play multiple sports so that when the season for one sport ends, they go directly to their next sport, so there's hardly any rest or recovery time in between. And they also have a higher training volume overall. So all of these are risk factors for overuse injuries, which are when demands on an area exceeds its capacity, and in fact, about half of all youth sports injuries are overuse injuries. So I will say that I thought more people would care about preventing injuries, but according to my brother-in-law, people care more about sports performance than about reducing injuries. So I guess that's the rehab bias in me. So first, let's talk about how strength training can improve sports performance. So besides general strength, resistance training also improves things like vertical jump performance, sprint speed, change of direction, aka like agility performance, and other sports-specific skills. And this is because while you know sport practice, so normal practice will develop their like sports skill tactics and sport-specific movement patterns, practice alone probably is not developing their strength, leaning mechanics, deceleration ability, force production, or most importantly to my rehab brain, tissue tolerance enough. So just going to practice isn't going to develop these things nearly enough compared to adding on strength training as well. And so that brings me to reducing injury risk. While it doesn't seem as important because many families participating in travel sports are quote unquote playing to play or sorry, paying to play, so to speak, it's important to remember that having an injury will reduce sports performance and will decrease the athlete's playing time. So while a lot of injuries will happen by accident, such as you know, kids colliding on the field or what have you, remember that half of all injuries in youth sports are overuse injuries, which are largely preventable. And so structured training programs that include strength work, flexibility, and stability and balance exercises will reduce injury risk by about 30%. Like that's that's pretty huge. And so all of this is to say that if a youth athlete wants to participate in their sport long term, general physical preparation is just as important as the sports practice and you know technique lessons and stuff themselves. So I do want to bring up some nuance here because while strength training is still pretty important, it's not like this magical solution. Injury risk is also influenced by factors like sleep, nutrition, training volume, growth spurts, and that early specialization I talked about. I would say sleep and nutrition are the biggest things, and that like if you were to rank all of the factors, I would put sleep and nutrition at the very top. After that, I would put strength, like general strength, and then the bottom would be like the training volume growth spurts and early specializations. A couple reasons why teams might not do strength training or might not incorporate it into like practice is well, one, they already have limited practice time. So again, going back to my uh swim team days, I think it just really depends on how well the practice is going to be structured. So my first um, I barely remember my freshman year honestly, but in my sophomore and junior years, our practices were about an hour, I believe, but we actually got a lot done. So we still did like our like strength and flexibility stuff, our quote unquote dry land uh stuff, and then um I think for like about half an hour, and then I think we did a half hour of swimming, maybe up to an hour. But we the point is here that we didn't have a lot of time, but everything was focused, and certain things were like for swimming, for example, the actual sports practice. Um the coach focused a little bit more on intensity than on volume. So we were gaining the same amount of benefits without having to swim for hours and hours and hours. Um and then if you contrast that with my senior year, where we had a different coach for this one, he practice was for two hours, and or at least more than half an hour was on the strength training, and the other part was on the swimming. So we were definitely swimming way more yards. Um, and for a while he wanted us to do two a days, but then eventually we we had to stop the mornings because that was when they like checked the pool and stuff. So I was pretty glad for that. But but anyway, he focused a lot more on volume over intensity, and that's when I started getting some overuse injuries myself. So that's a little bit anecdotal, but I feel like that illustrates the point that a lot of sports teams are gonna have limited practice time, and a lot of times they choose to just do the sports practice itself, so like the scrimmages and like the sports specific uh things. But I feel like if the coach is able to um use their time more wisely, they can still fit in the strengthening while still having um while still having a good sports practice and developing that uh in a good way. Um so and this brings me up to the second part. Another reason why teams might not do it is because either the coach doesn't have any strength and conditioning experience or they are not able to hire a strength and conditioning specialist. And this is especially true in less affluent areas. So my brother-in-law did, you know, he did say like he the school he works for is very in a very affluent area, and so even if the school itself doesn't offer like specific strength and conditioning in the different sports programs, a lot of the families hire their own strength and conditioning coach for their child, and that's obviously not true for everywhere else in the country. I mean, like I know like my family wouldn't have been able to like hire a separate strength and conditioning coach just like just for me. So so again, like if even if the coach uh is able to utilize their practice time wisely, if they don't have the experience with strength and conditioning, or if they're not able to hire the experience, um then you know that's another reason why they might not even do strength and conditioning. Um two other lesser uh reasons are again the misconceptions about safety. Um so I feel like less people um less people nowadays believe that strength training is dangerous, but it's it is still out there. Like people still do believe it's dangerous for kids or that it'll stunt their growth or whatever, and also the regional culture. So um, and I think these two go hand in hand where because if the coach or if the parents in a certain area all still believe that strength training is bad, they're not going to want to pursue it, um, even though there are benefits to it. Um and versus other areas where like youth athlete development is a lot stronger, then they're going to do everything they can to improve performance, which includes adding strength training. Um so that brings me to what youth strength training should look like. So I feel like when I say strength training, a lot of times people like the thing that pops into people's heads are gonna be maybe college athletes, maybe regular athletes like maxing out the deadlift in the gym or maxing out our bench press, like like doing these like fantastical things that are posted on social media. But you have to remember, like, people post those things on social media because they look fantastical and like you know, it makes people want to see it. But in reality, like that's not what strength training is. Strength training is just simply you know using resistance training to build your strength. And so, especially with youth athletes, the focus is going to be on proper form first and not necessarily on finding like a one rep max. And the emphasis is going to be on movement quality, so again, proper form, their coordination and balance, and at the end of the day, their basic strength. Um, and another thing to take into consideration is their overall training volume. So uh for example, if the athlete is in season, like they're not going to be doing as much strength training versus off-season where they're not practicing as much, that's when they're going to be building more of their base. So, going back to the volleyball athlete that I was treating, the recurring ankle sprains was a big indicator to me that the muscles around their ankle and possibly the joint itself was not able to keep up with the demands that person was the athlete was putting onto their ankles whenever they jumped or landed from a jump. And so definitely uh landing mechanics were a huge thing here. Um, like, yeah, some balance of coordination, but just general strengthening as well, so that the ankle complex would be able to tolerate the loads that this athlete was putting on their ankles from the constant running and the constant jumping and landing. At the end of the day, the takeaway here is that youth athletes are spending so much time practicing their sport, but it's it's clear that some of them are not preparing their bodies for the demands of that sport. And so, again, I believe incorporating strength training along with the other lifestyle factors such as sleep and nutrition can go a long way with their performance and increasing the longevity of these kids in their sport. So that's it for today. If you like this episode, I'd really appreciate it if you could share it so more people can find my podcast. Thanks for listening, and I'll see you in the next conversation.