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Monthly Archives: March 2017

Strength Training

Strength training (or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which requires the use of ballistic movements and maximum lifts and is not recommended for children.

What are the risks of strength training?

The risks of participating in an unsupervised strength training program include injury to the discs and growth plates of the spine and even occasionally death from weights landing on the chest wall. A well-supervised program has a coach-to-student ratio of 1:10 or less and proper certification of the instructor. Significant injuries are rare in well-supervised programs, but can include stress fractures of the shoulder (osteolysis) or spine (spondylolysis), muscle strains, disc herniation, and tendinitis. Misuse of anabolic steroids to improve physique is another possible risk.

What are the benefits of strength training?

Strength training improves muscle strength and stamina. Regular participation in strength training improves cardiac (heart) health, body composition, and bone mineral density, and decreases cholesterol levels. It is particularly helpful foroverweight (obese) youth because it increases lean body mass and metabolic rate without the extra stress on the body. In some sports (like swimming or tennis), strength training may prevent common rotator cuff problems. Research also shows a possible reduction in knee injuries in girls when strength training is combined with a plyometric (jumping) program.

Who should not participate in strength training?

Strength training is not recommended for people with the following:

  • Uncontrolled high blood pressure
  • Seizure disorders
  • Prior history of childhood cancers treated with chemotherapy

Children with complex congenital heart disease should get an OK by a pediatric cardiologist before starting a strength training program.

When can my child start strength training?

The proper age is based on the following:

  • Maturity (if the child has reached certain developmental milestones)
  • The type of sport the child wants to play
  • A desire to participate
  • The discipline to train several times a week
  • The ability to listen and follow directions

Most young athletes have these characteristics and can maintain proper balance and postural control around 7 or 8 years of age.

What are the key components in a strength training program?

To get the most out of strength training, athletes should

  • Include aerobic training along with strength training.
  • Train 2 to 3 times a week for 20 to 30 minutes.
  • Warm up and cool down for at least 10 minutes.
  • Practice all lifts without weights to make sure form and technique are correct. As techniques are mastered, weights can be slowly added.
  • Work all major muscle groups including the core. Joints should be moved through a full range of motion.
  • Do 2 to 3 sets of 8 to 15 repetitions.
  • Train for a minimum of 8 weeks.
  • Gradually increase weights by no more than 10% per week.

How can injuries be prevented?

To prevent injuries, keep the following in mind:

  • Use proper techniques when lifting.
  • Adjust machines for height.
  • Always wear proper clothing and closed-toe shoes with good traction.
  • Always weight train with proper supervision and spotting.
  • Start each session with a 10- to 15-minute warm-up. Avoid rapid breathing (hyperventilation), bearing down, or holding your breath while lifting.
  • No 1-repetition maximums, maximum weights, or ballistic maneuvers should be performed before reaching skeletal maturity.
  • Stop lifting at once if pain is felt.

Where can I learn about qualified strength trainers?

There are many different strength training certification programs in the United States. Some require only an open-book test to become certified, while others require a college degree, CPR training, written and practical examinations, and continuing education to maintain certification. We recommend that, at a minimum, the program be certified through the National Committee for Certifying Agencies.

Sports Physiology

Refining and perfecting motor skills, developing visual precision, and improving mental sharpness are just a few of the many achievements happening in the young, growing body that contribute significantly to your youngster’s enjoyable and successful reality sports experience. Think about shaking up a soft drink can and not opening the top—there is so much rapid change just waiting to happen in these kids.

Sometimes they can sense that they are close to gaining a new skill and they just about burst trying. Suddenly it happens, and they cheer not only with excitement, but relief. Hopefully you can see that each stage of development varies in the length of time it takes to gain accomplishment with a certain skill and also in the completeness of skills actually developed. Some youth will acquire a skill fairly quickly, while others take longer.

Some youth will develop a certain skill very well, while others struggle. That’s why certain kids gravitate toward certain activities—the beauty of the variability of human beings.

Think back to your childhood for a moment. Did you excel at catching and hitting baseballs, or were you hand-eye challenged and avoided that type of activity altogether? Did you throw well, or did you hate dodgeball in PE class when you had to display your lack of ability in front of the whole class? Ah, now you remember. You may see that mirror image in your child, or you may be wondering how on earth he inherited abilities you do not have.

Even with this variability among children of skills for exercise and sports, it is important to allow each child to individually maximize each skill level in his own time before moving on to the next. Each child is unique and should not be pushed faster than the time required to refine a skill needed to acquire a future skill.

Remember not to become impatient and rob your young one of the chance to gain a particular skill that he has been working on so diligently. Sure, your child can occasionally be trying more advanced parts of a sport, but he should not be rushed to get there before the current skills are mastered.When we were kids in school, next year’s classes were usually built on knowledge from the previous year.

Taking calculus before algebra and geometry would not have made as much sense (although for a non–math wizard like me, I am not sure if calculus would have made sense at any time). It is the same with acquiring the different advancing levels of sports techniques, movements, strategies, and training. One step at a time. One throw at a time. One serve at a time. One jump at a time. One kick at a time.

Motor, visual, and mental skills, along with physical growth, only make up part of the overall picture. They are each contributing parts that all fit together. Have you ever searched for that missing piece that allows you to start to assemble the next large chunk of a complicated puzzle? Advancing maturation of the body and brain allow your child to benefit from advancing physical growth. Sure, these physical changes of growth are obvious.

No one is blind to the fact that when friends get your holiday picture this year, Johnny is 6 inches taller than last year’s picture (which is still on their refrigerator). They usually double-check to make sure you did not skip a year. Girls change shape and start looking at boys; boys start to shave, get more muscles, and look at girls. These physical changes certainly have an effect on their abilities to perform against their opponents as they become stronger, faster, and more skilled. Just growing, however, is not the only answer in the game of sports Jeopardy.

Parenting an Athlete

What Parents Can Do to Create a Positive Youth Sports Experience

  • Support for your child must be unconditional.
  • Be patient for the process, and enjoy it.
  • Understand how the developmental progression works for sports skills.
  • Be knowledgeable that many of the developmental milestones for sports skills cannot be accelerated beyond their natural limit.
  • Realize that physical, chemical, and mental development all affect ability and all progress along different timetables.
  • Support achievements as they occur. This will reduce pressure to achieve skills that are not quite ready.
  • Remember, your child has his or her own likes and dislikes and should be able to participate without pressure to choose a certain activity.
  • Remember that there are developmental patterns for chemical changes that allow your child to be able to progress in training intensity when it is time.
  • Understand the extra changes that occur in the puberty transition from child to teenager.
  • Don’t overreact to normal developmental processes and changes that occur during puberty and may temporarily affect ability.
  • Understand the profound developmental effect of a firm positive foundation of self-esteem on future performance and ability to handle competitive pressure.
  • Redefine success and make sure performance disappointments are not seen as failures that the child might take personally.
  • Teach your child that winning means a lot more than a gold medal (you first have to believe that yourself).
  • Encourage your child any way you can.
  • Find more things your child is doing right than things to criticize.
  • Support by being visible at their events.
  • Keep your comments positive without a lot of addenda or stipulations.
  • Help your children take some responsibilities for their sport without making them feel overwhelmed with duties.
  • Watch for warning signs of burnout or avoidance.
  • Remember your child is a child, not a child-sized adult.
  • Help your child set realistic goals (not your goals).
  • Allow changes in sports, and encourage exposure to different sports.
  • Instill a sense of value in exercise and fitness regardless of structured competition.
  • Communicate sincerely and often with your child about his or her desires.
  • Help your child build a strong sense of self-worth and identity that is not dependent on the sport itself or level of achievement.
  • Provide positive momentum by celebrating reality successes as often as possible.


While not all injuries can be prevented, the risk of injuries can be reduced. The following is information from the American Academy of Pediatrics about how to prevent gymnastics injuries. Also included is an overview of common gymnastics injuries.

Injury Prevention and Safety Tips


It is important for coaches to be experienced and familiar with the rules. Coaches should also be certified in CPR and first aid.


Proper supervision and spotting should be available at all times.


“Clowning around” should not be tolerated in the gym, especially around the foam safety pit or trampolines.


Safety gear should fit properly and be well maintained.

  • Clothing that allows for easy movement. (Body piercing should not be allowed around the face or mouth.)
  • Wrist pads/braces like “Tiger Paws” to protect the wrist and decrease wrist pain.
  • Heel supports like Tuli’s heel cups placed in an ankle brace or Cheetahs (which have a heel cup built into a wrap around the ankle brace) cushion the heel for the barefoot athlete.
  • Grips to protect the palms. Basic palm protectors are used by beginners. Dowel grips are used by the advanced gymnast.
  • Apparatus should be well maintained and checked on a regular basis.

Emergency Plan

Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common Injuries

Wrist Injuries

Because gymnasts walk and jump on their hands, significant force (sometimes 2 to 4 times their body weight) is put on the wrists. As a result, most gymnasts complain of wrist pain at some point. Gymnasts are particularly at risk for injuries to the growth plate of the wrist as well as stress fractures of the forearm, tears in the wrist cartilage, and scaphoid fractures.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor if their wrists are swollen or painful the next day. X-rays may be needed.

The risk of these injuries can be reduced by a gradual increase in activity intensity, proper skill progression, proper warm-up and conditioning, and the use of wrist braces.

Elbow Injuries

Elbow sprains, fractures, or dislocations can occur when a gymnast lands on an overextended elbow. Loss of blood supply to an area of bone and cartilage, a condition called osteochondritis dissecans, can cause an inability to straighten the elbow and locking, catching, or swelling of the elbow.

Gymnasts are at risk of these injuries from the repetitive forces placed on the elbow joints.

Treatment begins with RICE. Athletes should see a doctor if their wrists are swollen or painful the next day. X-rays may be needed.

Ankle and Foot Injuries

Ankle sprains are common, and a strength training program that includes balance and theraband exercises is recommended for both treatment and prevention. Sever’s disease (heel pain from inflammation of the growth plate of the heel bone) can happen when an athlete’s bare foot impacts the ground. Use of a Cheetah ankle brace (or a Tuli’s heel cup in an ankle brace) cushions the ankle while performing gymnastics events.

Knee Injuries

Both acute and chronic knee injuries are seen in gymnastics. Anterior cruciate ligament (ACL) tears commonly occur with dismounts and floor exercises. ACL prevention programs, which teach proper landing and stopping techniques and include hamstring strengthening exercises, should be part of the conditioning of all gymnasts. The athletes’ young ages and hours of practice make pain in the front of the knee common (Osgood-Schlatter disease, patellar tendinosis, and patellofemoral pain syndrome).
Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Athletes who return to play with a torn ACL risk further joint damage. Athletes with an ACL tear are usually unable to return to their sport.

Low Back Pain

Spondylolysis, stress fractures in bones of the lower spine, is a common injury in athletes who do a lot of jumping, tumbling, and back-bending activities. Symptoms include low back pain that feels worse with back extension activities like back walkovers or back handsprings. Gymnasts with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis.


Training on the bars, horse, or rings often causes calluses or blisters (also called rips by many gymnasts). These can be prevented by using chalk (to decrease friction), leather grips, and regular shaving of calluses that do develop.

Common Medical Issues

Female Athlete Triad

Female athlete triad is a term used to describe the unhealthy combination of eating problems (not getting enough calories), menstrual problems (absent or infrequent periods), and low bone density (weak bones). Many female gymnasts try to stay thin for appearances, or to be a lighter weight for mastery of difficult moves. Parents and trainers should be on the lookout for rapid weight loss or abnormal eating behaviors to prevent an eating disorder.


Burnout can occur to gymnasts with long hours of training, year-round participation, and pressures to advance. This is common among athletes who began training at very young ages or those forced to “retire” or miss a season after an injury. Athletes should be watched carefully and counseled if burnout is suspected.

For answers to additional questions about injuries, injury prevention, and safe training practices, talk with your doctor or a physical therapist.