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STRENGTH TRAINING FOR

CHILDREN AND ADOLESCENTS
Avery D. Faigenbaum, EdD

Strength training has proven to be a safe and effective method of

conditioning for adults, and it now appears that a growing number of
children and adolescents also are training to improve their health, fitness,
and sports performance. Although much of what we understand about
the stimulus of strength exercise has been gained by exploring the
responses of adults to various training protocols, research into the effects
of strength exercise on children and adolescents has increased in recent
years. Despite the contention that strength training was inappropriate
or dangerous for young weight trainers, the safety and effectiveness of
youth strength training are now well documented,39,79 and the qualified
acceptance of youth strength training by medical and fitness organiza-
tions is becoming universal?, 4* 29*30
It is important to encourage young people to be physically active.
Not only does a sedentary lifestyle early in life appear to track into
adulthood,84a physically active lifestyle during childhood and adoles-
cence may help to prevent some chronic diseases later in life. It has been
recommended that children and adolescents be physically active on
all, or most, days of the week, as part of play, games, sports, work,
transportation, recreation, physical education or planned exercise.23Al-
though a variety of physical activities should be recommended, the
purpose of this article is to discuss the trainability of muscular strength
in children and adolescents, to highlight the potential benefits and con-
cerns associated with youth strength training, and to outline strength
training guidelines for young weight trainers. Reviews by Blimkie,"

From the Department of Human Performance and Fitness, University of Massachusetts,

Boston, Massachusetts

CLINICS IN SPORTS MEDICINE

-
VOLUME 19 * NUMBER 4 OCTOBER 2000 593
594 FAIGENBAUM

Sale,goand Kraemer et aP2have reviewed selected issues related to youth

strength training.
In this article, the term children refers to boys and girls who have
not yet developed secondary sex characteristics (approximately up to
the age of 11 in girls and 13 in boys; Tanner stages 1 and 2 of sexual
maturation). This period of development often is referred to as preadoles-
cence. The term adolescence refers to a period of time between childhood
and adulthood and includes girls aged 12 to 18 years and boys aged 14
to 18 years (Tanner stages 3 and 4 of sexual maturation). For ease of
discussion the terms youth and young athletes are defined broadly to
include children and adolescents. By definition, the term strength training
(also known as resistance training) refers to a specialized method of
physical conditioning that is used to increase one's ability to exert or
resist force. The term strength training should be distinguished from the
competitive sports of weightlifting, powerlifting, and bodybuilding.

EFFECTIVENESS OF STRENGTH TRAINING

Although the potential for adolescents to increase their muscular

strength in response to a training program is well established,M the
traditional belief was that training-induced strength gains during pread-
olescence were not possible because of insufficient levels of circulating
androgens.z Results from several studiesz6,Io8 supported this contention,
despite that methodological limitations, such as a short study duration,
a low training volume (sets x repetitions X load), and, in some cases,
a lack of adequate control for growth or learning, may have influenced
the results. In 1978, Vrijens108concluded in a frequently cited report that
strength development was closely related to sexual maturation, and that
strength training could be effective only in the postpubescent age.
Although limited data from the European scientific community
(primarily published in non-English-language journals) challenged Vri-
jen's conclusion during this time," more recent investigations using
higher training intensities and greater training volumes provide compel-
ling evidence that training-induced strength gains are indeed possible
during preadolescen~e.~~? 79 Pfeiffer and Francisso noted significant
strength gains in a group of preadolescent boys who trained for 9 weeks
using weight machines and free weights (barbells and dumbbells), and
in one of the only reports to explore the effects of Olympic lifting (i.e.,
the snatch and clean and jerk) on children, Servedio et a192reported
significant gains in isokinetic shoulder flexion following 8 weeks of
training. Sewall and M i ~ h e l studied
i~~ the effects of strength training on
preadolescents and reported significant gains in shoulder flexion as
compared with the controls. Weltman et allo9 studied the effects of
concentric hydraulic strength training on preadolescent ice hockey play-
ers and reported strength gains of 18% to 36% following 14 weeks of
training.
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 595

In a well-designed study by Ramsay et al:5 20 weeks of strength

training resulted in significant gains in bench-press strength (35%), leg-
press strength (22%), and other strength measures in preadolescent boys.
Faigenbaum et a133,36 evaluated the effects of various strength training
protocols using child-sized weight machines on preadolescent boys and
girls and reported strength gains up to 74% following only 8 weeks of
training. Recent data from Lillegard et aP3who studied preadolescent to
early postpubescent males and females provide additional evidence that
training-induced strength gains are possible in young weight trainers.
In addition to weight machines and free weights, other modes of
training also have been used to provide adequate stimulus for strength
development in children. Clarke et alZ1studied the effects of 3 months
of wrestling training on 7- to 9-year-old boys and reported significant
increases in isometric strength and selected strength-related performance
tests. Similar findings were noted by Seigal et alg4who developed a
creative strength training program for children that consisted of body-
weight exercises, hand-held weights, and stretch tubing.
Reports suggest that a variety of training modalities, including
weight machines (adult and child sized), free weights, body-weight
exercises, sports-conditioning drills, and different combinations of sets
and repetitions, from 1 set of 10 repetitions112to 5 sets of 15 repetition^^^
can provide adequate stimuli for strength enhancement in young weight
trainers. Children as young as 6 years old have benefited from strength
training,33,38* logand there is no clear evidence of any difference in muscle
strength adaptations between preadolescent boys and girls9On average,
strength gains of 30% to 40% have been observed in untrained children
following short-term (8-12 weeks) training programs, although gains of
up to 74% have been
The degree of variability in observed strength gain may be related
to several factors, including the program design, quality of instruction,
specificity of testing and training, whether the researchers accounted for
the learning effect, and the participants’ background level of physical
activity. At the start of any training program, the so-called window of
adaptation (i.e., opportunity for change) is relatively large; therefore,
impressive gains in any performance variable (e.g., 1 repetition maxi-
mum leg press) are probable. Since it is unlikely that children in the
aforementioned training studies had any previous experience with
strength training, the opportunity for change in muscular strength was
large, and it was not surprising to observe significant training adapta-
tions. Following several months of training, however, the window of
adaptation is reduced, and training expectations therefore must be modi-
fied.
Can preadolescents increase their muscular strength above and be-
yond growth and maturation? Collectively, the aforementioned reports
indicate that training-induced gains during the preadolescent period are
possible provided that the training program is of sufficient duration,
intensity, and volume. Although early research provided the foundation
for future work in this area, perhaps a more appropriate conclusion
596 FAIGENBAUM

from the handful of studies that questioned the trainability of children

may be that training-induced gains from low-volume, short-duration
strength-training programs may not be distinguishable from growth
and maturation. Two recent meta-analyses on preadolescent strength
trai1-ting3~.79 and clinical impressions from physicians and therapists
provide additional evidence that well-designed strength training pro-
grams can enhance the strength of preadolescents beyond what is nor-
mally the result of growth and maturation.

Trainability of Children Versus Adolescents and Adults

A follow-up question relates to the effectiveness of the strength-

training stimulus in preadolescents compared with older populations.
Although data are limited, a few studies have compared the training
response in different age groups. Pfeiffer and Francissoreported larger
relative (percentage) increases in selected isokinetic strength measures
in preadolescent boys compared with late pubertal and young adult
men. Other studies by Westcott"' and Neilsen et a175 support these
findings. Conversely, when compared on an absolute basis, data from
Sailors and Bergs9 SaleIgoand Vrijens1OS suggest that adolescents and
adults make greater gains than preadolescents, although some findings
are at variance with this suggestion."'
In general, it appears that relative gains achieved during the preado-
lescent period are quantitatively greater than (or at least similar to) gains
made by older populations. Although the issue of whether training-
induced gains should be compared on an absolute or relative basis is
debatable, it seems unrealistic to expect a preadolescent to make the
same absolute gains in strength as a larger adolescent or adult who
probably has at least twice the absolute strength of a young boy or girl.
Even though preadolescents can develop-during maximal voluntary
contractions-about the same force per unit muscle cross-sectional area
as adultsg0one should not expect a 30-kg child to make the same gains
in absolute strength as a 100-kg adult.

The Effects of Reduced Training on Children

and Adolescents

Because it is likely that children and adolescents will at some point

undergo periods of reduced training or inactivity because of program
design factors, injury rehabilitation, travel plans, or decreased motiva-
tion, it is important to evaluate strength changes following the tempo-
rary or permanent reduction or withdrawal of the training stimulus
(called detraining). This is an interesting topic to address in children
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 597

and adolescents because of the concomitant growth-related increases in

strength during the detraining (or reduced training) period.
Only a few studies have explored the effects of detraining on adults,
and data on children and adolescents are scarce. Sewall and M i ~ h e l i ~ ~
observed small decreases in isometric strength in preadolescent boys
following 9 weeks of detraining, and similar findings were reported by
Blimkie et a1.12Only one other study investigated the effects of detraining
on preadolescents. Faigenbaum et a P observed rapid and significant
decreases in upper- and lower-body strength of preadolescent boys and
girls after discontinuation of an 8 week strength training program.
Training-induced strength gains in this study regressed toward pretrain-
ing values during the course of the detraining period at a rate of 3%
per week. Participation in physical activities (e.g., football, soccer, and
basketball) during the detraining period did not maintain the children’s
training-induced strength gains.=
The suggestion that sport conditioning may not maintain children’s
training-induced gains underscores the importance of some type of
maintenance training program to maintain the strength advantage or at
least slow the loss of strength. Blimkie et all2 reported that a once-per-
week training program was not enough to maintain training-induced
gains in preadolescent boys, with most strength measures regressing
toward control group values during the maintenance training period.
Conversely, DeRenne et alZ4noted that strength training once per week
was as effective as twice per week in maintaining training-induced
strength gains in young baseball players (age 13.2 years). More informa-
tion is needed before specific maintenance training guidelines can be
recommended for children and adolescents. Nevertheless, it seems sensi-
ble for young athletes to participate in some type of maintenance train-
ing program during the sports season. Clinically, it would be prudent to
provide children and adolescents with a home-maintenance training
program after discharge from the hosspital or clinic.
Limited data suggest that training-induced gains in preadolescents
are impermanent and tend to regress toward untrained control group
values during the detraining period. It is likely that similar findings
would be observed in adolescents. Although strength training appears
to have little if any effect on muscle size during preadoles~ence,~~~ 90 it
seems that changes in neuromuscular functioning (and possibly a loss
of motor coordination) would be at least partly responsible for the
detraining response observed in children. Because of the potential for
training-induced gains in muscle size during adolescence, the mecha-
nisms responsible for the detraining response in adolescents may be
more complicated.

Mechanisms of Strength Gains

Although factors related to increased strength in adults following

training have been thoroughly investigated,6only recently have scientists
598 FAIGENBAUM

begun to explore the mechanisms responsible for training-induced gains

in younger populations. Indirect and direct measurements techniques
have been used to assess the effects of youth strength training on
selected anatomic and physiologic adaptations to strength training.
Most of the data suggest that strength training will not result in
training-induced muscle hypertrophy in preadolescents because of inad-
equate levels of circulating androgens.78,85, After 20 weeks of strength
training (3-5 sets of 5-12 repetitions), Ramsay et aP5 failed to show
any increase in selected measures of upper- and lower-extremity cross
sectional areas (measured by CT) in preadolescent boys. Because training
did cause significant gains in muscle strength, it was concluded that
changes in motor unit activation and motor unit coordination, recruit-
ment, and firing were responsible, at least in part, for the observed
strength gains. The authors of this study also suggested that intrinsic
muscle adaptations (i.e., changes in excitation or contraction coupling,
myofibrillar packing density, and muscle fiber composition) and im-
provements in motor skill performance and the coordination of the
involved muscle groups also may have contributed to the observed
strength gains.
In support of these findings, Ozmun et a178noted that training-
induced strength gains in preadolescents were associated with increases
in electromyographic (EMG) amplitude of the trained muscle group.
Other investigators noted significant strength improvements in preado-
lescents without concomitant increases in limb circumference, as com-
pared with age-matched controls.36,89, log In an excellent review of this
topic, Salegosuggests that preadolescents and adults in the untrained
state may have more difficulty activating their muscles and, therefore,
may have more of a potential for an increase in strength owing to neural
factors rather than hypertrophic factors.
Interestingly, two reports have challenged the suggestion that train-
ing-induced strength gains during preadolescence are independent of
changes in muscle size. In one study involving two preadolescent, mono-
zygotic twin boys, Mersch and Stoboy reported that 10 weeks of isomet-
ric strength training (one 10 second contraction, 10 times per day, 6 days
per week) resulted in a 4% to 9% (depending on scan level) increase
in quadricep cross-sectional area, determined by magnetic resonance
tomography.43Similar findings were reported by Fukunga et a1,& who
measured the cross sectional areas of tissues in the upper arm by ultra-
sonic methods following 12 weeks of isometric strength training (three
10 second contractions, twice per day, 3 days per week). At present, it
cannot be stated a priori that strength training will not result in at least
some degree of muscle hypertrophy in preadolescent weight trainers
above and beyond growth and maturation. It is possible that longer
training periods, higher training intensities, and more precise measuring
techniques may be needed to uncover the potential for training-induced
hypertrophy in preadolescent weight trainers.
During and after puberty, training-induced gains in males are asso-
ciated with increases in muscle mass owing to hormonal influences (e.g.,
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 599

testosterone).62In adolescent females, muscular development is limited

by lower levels of male sex hormones.gOIt is likely that other hormone
and growth factors (e.g., growth hormone and insulin-like growth factor)
contribute to muscle development in females.60

POTENTIAL BENEFITS OF YOUTH STRENGTH

TRAlNING

In addition to increasing the muscular strength of children and

adolescents, regular participation in a strength training program has the
potential to influence other health- and fitness-related measures. At
present, limited data suggest that youth strength training programs may
favorably alter selected health parameters; may improve motor skills and
sports performance; and may reduce injuries in sports and recreational
activities.

Health-related Benefits

Children and adolescents should be encouraged to participate in a

variety of sports and recreational activities to enhance their physical and
psychosocial development and establish good health habits at an early
age.46,91 Along with other types of physical activity, youth strength
training has been shown to have a positive influence on several measur-
able indices of health, including cardiorespiratory fitness,'09 body
comp~sition,~~, 94 bone mineral density,74blood lipids,4z,110 and selected
psychological measures.55,11*
One of the commonest misperceptions surrounding youth strength
training is the belief that it could stunt the statural growth of children
and adolescents. This myth seems to have been fueled by an earlier
report that suggested that children who performed heavy labor experi-
enced damage to their epiphyseal plates, which resulted in significant
decreases in Other causative factors, however, such as poor
nutrition, were not accounted for in this study. Current observations
indicate no evidence of a decrease in stature in children and adolescents
who participate in well-designed youth strength training program^.^, 29
In all likelihood, if age-specific training guidelines are followed and if
nutritional recommendations (e.g., adequate calcium) are adhered to,
physical activity (including strength training) will have a favorable in-
fluence on growth at any stage of development but will not affect the
genotypic r n a x i m ~ m . ~
Despite the traditional concerns regarding the potential adverse
consequences of high impact loading on the developing skeleton, some
datalo suggest that strength training actually may be an effective stimu-
lus for bone mineralization in children and adolescents." 64, Io7 The bone
mineral density of junior Olympic weight lifters has been shown to be
greater than reference norms,22,107 and gymnasts as young as age 7 have
600 FAIGENBAUM

been found to have a higher bone mineral density than age-matched

control^.'^ In one of the few reports providing direct evidence that
exercise enhances bone accrual in children, Morris et a174reported that
participation in a high impact exercise program (which included strength
training) resulted in significant improvements in strength and bone
mineral density in preadolescent girls compared with an age-matched
control group. The authors of this study commented that childhood may
be an opportune time for the bone modeling and remodeling process to
respond to the mechanical loading of high impact physical activities.
Although peak bone mass is strongly influenced by genetics,96this
particular health benefit may play a role in the prevention of youth
sports injuries and may be especially important for young women who
are at increased risk for osteopenia or osteoporosis. Although the poten-
tial for youth strength training having a favorable influence on bone
mineral density is encouraging, the training program needs to be care-
fully developed and monitored because too much exercise may result in
bone loss and increased susceptibility to fractures.18
Another potential benefit of youth strength training is its influence
on body composition. In adult populations, strength training has been
shown to increase the resting metabolic rate and aid in desirable body
composition changes,82but data on children and adolescents are limited.
Following 8 weeks of strength training, Faigenbaum et a136reported a
significant loss of body fat (as measured by skinfolds) in preadolescents,
and similar observations were made by Lillegard et al?3 Siegal et al,94
and Sailors and Berga9Other studiesa5,108, Io9 involving children, however,
failed to show favorable changes in body composition following regular
participation in a strength-training program. Further, a 5-month strength
training exercise intervention that consisted of 2 sets of 12 to 15 repeti-
tions on 7 exercises did not significantly improve energy expenditure,
which was measured by 24-hour calorimetry and doubly labeled wa-
ter.'O' The authors of this report, however, did comment that higher
volume, more intense training programs might alter energy expenditure
in young weight trainers.
As the prevalence of childhood obesity in the United States contin-
ues to increase,lo2the influence of physical activity (including strength
training) on body composition should continue to receive attention.
Increasing the physical activity of obese children and adolescents can
decrease their risk for developing cardiovascular disease and noninsulin-
dependent diabetes mellitus. Recent data suggest that obese children
can benefit by participating in a well-designed aerobic physical activity
program,77and unpublished findings from this author's youth training
center suggest that strength training also can provide an opportunity for
overweight children to experience success and feel good about their
performances. Although strength training is sometimes thought of as
anaerobic exercise, in the author's youth strength training programs,
children's heart rates (measured by Polar Vantage XL [Polar Electro,
Woodbury, NY] monitors) typically vary between 130 and 150 beats
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 601

per minute throughout the entire 30-minute strength-training session.

Although speculative, strength training at moderate intensities with a
high number of repetitions may be part of the solution for long-term fat
loss and weight maintenance in overweight children and adolescents.
The potential psychosocial benefits (i.e., psychological and social-
psychological outcomes) of youth strength training should not be over-
looked. If the strength-training program is well designed and compe-
tently supervised by instructors who appreciate the uniqueness of child-
hood and adolescence, strength training may offer psychosocial benefits
that are comparable with other sports and activities. Favorable changes
in selected psychometric measures (e.g., self-concept, self-esteem, and
body cathexis) have been observed in adults who participated in a
strength training program,67,lo3, lo4 and it seems that similar benefits
could occur in children and adolescents.28,55 Holloway et a155reported
significant improvements in self-efficacy and general self-esteem in un-
trained adolescent girls who participated in strength training for 12
weeks, and other investigators have noted that the socialization and
mental discipline exhibited by children who strength trained were simi-
lar to the experiences of children who participated in team sports.86
Anecdotal reports from parents indicate that children were more willing
do to homework and household chores on the days that they trained.lo9
Although limited data suggest that strength training will have a
positive influence on the psychological well-being of children, it seems
that the potential impact of strength exercise on selected psychosocial
measures will depend on the intensity, frequency, and duration of train-
ing, and the initial levels of muscular strength and psychosocial well-
being. In one 8 week training study Faigenbaum et a137reported signifi-
cant gains in upper- and lower-body strength in untrained preadolescent
boys and girls but did not observe significant changes in self-concept or
self-efficacy scores. The authors commented that the short duration of
the training study and the relatively high pretest self-concept scores in
the experimental and control groups may have precluded significant
gains. As previously noted in adult population^,'^^, lo4 strength training
may have its greatest impact on children and adolescents who begin
with relatively low levels of muscular strength and poor body attitudes.
Note that unethical coaching practices and excessive pressure to perform
at a level beyond one's capability can negatively influence the youth
strength training experience and can lead to untoward con~equences.3~~47,loo

Motor Skills and Sports Performance

Whether strength training can enhance the motor skills and sports
performance of children and adolescents is of growing interest to health
professionals, youth coaches, and physical educators. Because muscular
strength and power are required for success in most sports, it is attractive
to assume that stronger and more powerful young athletes will perform
602 FAIGENBAUM

better. Several studies have noted significant improvements in the long

jump and vertical jump following a youth strength training program,38,
53, 63, 75,Io93 and others have noted improvements in sprint speed and
agility run time.63,113 Other studies, however, have reported significant
gains in strength without significant improvements in selected motor
performance skills.36Perhaps these inconsistent findings could be ex-
plained by the design of the strength training program: that is, programs
that include movements that are specific to the test may be more likely
to improve selected motor performance skills, compared with programs
characterized by less specific exercises.
Although not well documented, limited data suggest that strength
training may enhance the sports performance of young athletes. Anec-
dotal reports from children, parents, and youth coaches suggest that
strength training enhances athletic ability, but scientific reports of this
observation are limited because athletic ability is a multivariate gestalt.
At present, two studies have reported favorable changes in swimming
performance in age-grouped swimmers,8,l6 and one study noted im-
provements in gymnasts.83Conversely, other studies have failed to show
any significant improvement in sports performance in young athletes.', 41
Additional studies are needed; however, limited direct and indirect
evidence suggests that properly designed youth strength-training pro-
grams will not have a negative effect on sports performance, and likely
will result in some degree of improvement by enhancing a young ath-
lete's strength, power, endurance, and general well being. Strength train-
ing during childhood and adolescence may provide not only the founda-
tion for dramatic strength gains during adulthood, but, as children and
adolescents gain self-confidence in their physical abilities, they may be
more likely to experience success and less likely to drop out of sports.

Prevention of Injuries

Properly organized and structured youth sport programs can con-

tribute to the physical, emotional, and intellectual development of chil-
dren and adolescents; yet there is the potential for abuse. Unsafe envi-
ronments, poor coaching, and inappropriate changes in the volume,
intensity, or progression of training can be injurious. Owing to the
growing incidence of sports-related injuries, a significant benefit of
strength training may be its ability to better prepare young athletes for
the demands of sports participation.
It appears that the focus of most youth programs is on the develop-
ment of sport-specific skills rather than on the development of funda-
mental fitness abilities. Instead of participating in a variety of sports and
games, children and adolescents are participating in the same activity
for longer periods. Some parents and coaches have argued that early
sports-specializastrion was the key to success, but it now appears that
broadly based participation in a variety of skills and activities is related
more to later sports success than early sports spe~ialization.~~ Further-
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 603

more, emphasizing sports skills over fundamental fitness abilities not

only discriminates against children and adolescents whose motor skills
are not as well developed, but it also may lead to acute (macrotrauma)
and repetitive microtrauma, or overuse injuries (e.g., stress fractures,
tendinitis, and b ~ r s i t i sA
. ~youngster’s
~ participation in sports need not
start with competition but rather evolve out of preparatory conditioning
and instructional practice sessions. It has been suggested that sports
specialization should be avoided until the age of at least 10.”
In the United States, millions of children and adolescents participate
in school-sponsored and non-school-sponsored sports. Along with this
remarkable interest in youth sports there is a concomitant increase in
the number of sports-related injuries. Although factors such as growth,
improper footwear, hard playing surfaces, underlying disease states,
anatomic malalignment of the legs, and training errors (i.e., “too much
too soon”) have been implicated as risk factors for overuse injuries in
children, the young athletes background level of physical activity also
must be ~ o n s i d e r e d .According
~~ to the American College of Sports
Medicine, an estimated 50% of overuse injuries sustained by young
athletes could be prevented if more emphasis were placed on the devel-
opment of fundamental fitness skills, as opposed to sports specific train-
ing.96
The need for young athletes to participate in a general conditioning
program before sports specific training may seem unnecessary to some,
however, reports indicate that only one half of the young people in the
United States regularly participate in vigorous physical and
the upper body strength of children reportedly is decreasing.@Further,
most children and adolescents spend most of their free time watching
television or surfing the net,25and the incidence of childhood obesity is
increasing.lo2By the time most students graduate from high school, they
will spend more time in front of the television than in school.99Owing
to this apparent decline in free-time physical activity, the supporting
structures of aspiring young athletes may be ill prepared to handle
the demands of sports training and competition. This concern may be
particularly important for young female athletes who appear to be
particularly susceptible to knee injuries?
The total elimination of youth sport injuries is an unrealistic goal,
but encouraging children and adolescents to participate in preparatory
conditioning (which includes strength, aerobic, and flexibility exercises)
before sports-specific training seems to be a reasonable recommendation
(Fig. 1). Because young athletes often are forced to train longer and

a
harder to excel in sports, encouragin them to participate in conditioning
programs that prepare them for t e demands of their sport merits
consideration. During this time, correctable risk factors (e.g., muscle
imbalance, poor flexibility, and poor physical condition) can be identified
and treated by trainers and coaches. In support of this suggestion, it
was recently noted that hamstring flexibility training was associated
with a decreased incidence of lower extremity overuse injuries in male
trainees (mean age 20 years).50
604 FAIGENBAUM

Competition

Sport-Specific
Training

/ General Strength, Aerobic

8 Flexibility Conditioning
\
/ Lifestyle Physical
Activities
\
Figure 1. Physical activity recommendationsfor children and adolescents.

Strength training has been recommended as part of a preseason

conditioning program for adults,40and limited data suggest that it could
be beneficial for younger populations. Henja et a152reported that adoles-
cent athletes who underwent strength training had a lower injury rate
and required less time for rehabilitation compared with their teammates
who did not. Cahill and Griffith17 observed that strength training de-
creased the number and severity of knee injuries in high school football
players, and DominguezZ7reported less shoulder pain in adolescent
swimmers who underwent strength training. Recent preliminary obser-
vations from Mediate66suggest that a 6-week preseason functional condi-
tioning program for high school students using medicine balls, balance
boards, and body weight exercises may better prepare young athletes
for sports participation by developing general athleticism and self-con-
fidence. Although these reports involved adolescents, it seems that
strength training could offer a similar protective effect to preadolescents,
by improving the strength and integrity of their muscle tissue and
supporting structures.
Owing to interindividual differences in stress tolerance, the fre-
quency, intensity, volume, and progression of the strength training pro-
gram need to be carefully prescribed. In some cases, young athletes may
need to decrease the time they spend practicing sport-specific skills to
allow time for preparatory muscle conditioning. Unfortunately, the
“more is better” attitude is still common, as evidenced by a published
report” on an 11-year-old swimmer who had been training in the range
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 605

of 5000 to 7000 yards per day and was made to swim 11,000 yards per
day as part of a ”development program.” Clearly, strength training
should not simply be added onto a young athlete’s training program
but rather incorporated into a periodized conditioning program that
varies in volume and intensity throughout the year. Additional clinical
trials are needed to determine the most effective method of reducing the
incidence of sport-related injuries in children and adolescents.

Concerns Associated with Youth Strength Training

For many years strength training often was not recommended for
children and adolescents because of the presumed high risk for injury.
Although many factors may be responsible for this belief, the wide-
spread fear of youth strength training primarily stemmed from data
gathered by the National Electronic Injury Surveillance System (NEISS)
of the US Consumer Product Safety Commission. NEISS makes nation-
wide projections of the total number of injuries related to exercise and
equipment by using data from selected hospital emergency rooms. The
NEISS reports, however, do not distinguish between injuries associated
with properly designed and supervised youth strength training pro-
grams and those characterized by excessive loading, unqualified supervi-
sion, poorly designed equipment, or free access to equipment. Further-
more, because the NEISS data are based on injuries that the parents said
were related to strength-building exercises and equipment, concluding
that the injuries were caused by such activities and devices is incorrect.
A careful review of the reports from the US Consumer Product
Safety Commission reveals that the commonest injuries were sprains
and strains, although more serious injuries have been reported. For
example, one 4-year-old boy died when he fell off a weight-training
bench and struck his head on the floor; other children were injured
when they were playing in the weight room or when they were hit with
weights dropped by others.lo5Rissers7noted several other examples in
which children and adolescents suffered serious musculoskeletal injur-
ies, including ruptured intervertebral discs, spondylolysis, spondyloli-
sthesis, and fractures. Although these reports suggest that unsupervised
and poorly performed strength exercises may be injurious for children
and adolescents, it is misleading to generalize these findings to compe-
tently supervised and properly designed strength training programs.
Instead of judging the safety of youth strength training on the
emotional reaction to case study reports and weight room accidents, it
is preferable to answer the question of whether strength training has an
unacceptable risk for injury for children and adolescents by systemati-
cally reviewing the pertinent scientific literature. Raising the discussion
to this level will reveal that youth strength training is relatively safe
when compared with other sports and activities in which children and
adolescents regularly parti~ipate.~~, 114 Paradoxically, the sport-specific
forces placed on the joints of young athletes may be greater in magnitude
606 FAIGENBAUM

and duration than those resulting from appropriately designed strength

training programs. In one retrospective evaluation49of strength training
injuries incurred by 13 to 16 year olds, it was revealed that strength
training (and competitive weightlifting) were remarkably safer than
other sports, such as soccer, basketball, and football.
A common concern associated with youth strength training ad-
dresses the potential for injury to the epiphyseal plate or growth carti-
lage. In children, the epiphyseal plate has not yet ossified and is prone
to injury, which may result in limb deformity or the cessation of limb
Although epiphyseal plate fractures in adolescent weight train-
ers have been reported,14,48, 57 these injuries typically were caused by
improper lifting techniques and the performance of heavy overhead
lifts in unsupervised settings. Young weight trainers are susceptible to
epiphyseal plate fractures, however, this type of injury has not been
reported in any prospective youth strength training study. If children
are taught how to strength train properly, and if appropriate training
loads are used, it seems that the risk of an epiphyseal plate fracture is
minimal. Interestingly, Micheli70 noted that the risk for an epiphyseal
plate fracture in prepubescents is less than in adolescents because the
epiphyseal plates of younger children are stronger and more resistant to
shearing-type forces.
At present, it appears that the greatest concern for children and
adolescents who strength train is the risk for overuse soft tissue injur-
ies.14,15, 87 Although the incidence of this type of injury is difficult to
determine, because it does not always result in a visit to a physician,
limited data suggest that the risk of developing this kind of injury is
n o t e ~ o r t h y . ' In
~,~ ~ study15of adolescent powerlifters, 50% of the 98
one
reported injuries were to the lower back. Although these competitive
young athletes presumably trained with maximal or nearly maximal
loads, similar injuries could occur in recreational weight trainers. Fur-
ther, it is noteworthy that only two published prospective studies involv-
ing children have reported injuries related to the strength training pro-
gram (minor shoulder strains which resolved within 7 86

The belief that strength training is unsafe for children and adoles-
cents is inconsistent with the needs of children and adolescents and the
documented risks associated with youth strength training. At present,
there are no justifiable safety reasons to preclude children and adoles-
cents from participating in well-designed strength-training programs.
On the other hand, if established training guidelines and safety proce-
dures are not followed, catastrophic accidents are p0ssible.4~

YOUTH STRENGTH-TRAINING GUIDELINES

Guidelines and recommendations from the American College of

Sports Medicine,30the American Academy of pediatric^,^ the American
Orthopaedic Society for Sports Medi~ine,~and the National Strength and
Conditioning Ass~ciation~~suggest that youth strength training can be a
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 607

safe and worthwhile activity for young weight trainers provided that
the program is appropriately designed and competently supervised.
Although a medical examination is recommended for children and ado-
lescents with known or suspected health problems, it is not mandatory
for apparently healthy children.29
Parents frequently ask if their children can ”lift weights” and at
what age they may start. Although some observers have commented
that children should be at least 12 years of age, no data support this
contention nor is there any information that suggests that other sports
or recreational activities are safer than strength training. Although all
participants should have the emotional maturity to accept and follow
directions and should genuinely appreciate the benefits and risks associ-
ated with youth strength training, current public health objectives aim
to increase the number of children age 6 and older who regularly
participate in physical activities that enhance and maintain muscular
fitness.lo6In general, if a child is ready for participation in some type of
sports training, then he or she is ready to strength train.
It is important for children and adolescents to begin strength train-
ing at a level that is commensurate with their physical abilities. Too
often, the volume and intensity of training exceed a young athlete’s
capabilities, and the rest periods are too short for an adequate recovery.
This approach may be particularly hazardous for children and adoles-
cents because it not only increases the risk for injury, but it may under-
mine the enjoyment of the strength training experience. When introduc-
ing beginners to strength training activities, it always is better to
underestimate their physical abilities rather than overestimate their abili-
ties and risk an injury. Although some young weight trainers may want
to see how much weight they can lift on the first day of the program,
their enthusiasm and interest in maximal strength training should be
redirected toward the development of proper form and technique on a
variety of strength-building exercises, using submaximal loads.
Throughout the program, teaching young weight trainers about
proper lifting techniques and safe training procedures (e.g., controlled
movements and proper breathing) is important. Further, coaches and
teachers should not overlook the importance of having fun and devel-
oping a more positive attitude toward strength training and other types
of physical a~tivity.’~ Rather than compete against each other in the
weight room, with appropriate guidance and supervision young weight
trainers can learn to embrace self-improvement and feel good about
their own accomplishments. The use of individualized workout cards
can help each child to focus attention on his or her own performance.
No matter how big or how strong a child is, adult strength training
guidelines and training philosophies (i.e., ”no pain, no gain”) should
not be imposed on young weight trainers. Coaches and teachers need to
listen to concerns and closely monitor each participant’s ability to toler-
ate the exercise stress. This may be particularly important when training
adolescents who may be in a growth spurt. During growth spurts, the
relative weakening of the bone, muscle imbalances, and relative tight-
608 FAIGENBAUM

ening of the muscle-tendon units spanning rapidly growing bones are

risk factors for overuse injuries in children.71Decreasing the volume and
intensity of strength training (and emphasizing flexibility) during peri-
ods of rapid growth may be necessary.
Several areas of concern are important to address when developing
strength-training programs for children and adolescents. Namely, the
quality of instruction, mode of training, choice of exercise, rate of pro-
gression, and method of testing need to be considered.

Quality of Instruction

When children and adolescents strength train, they should do so

under the watchful eye of a qualified adult. The efforts of untrained
supervisors are appreciated, but it is unlikely that they will be able to
provide the quality of care and instruction needed for safe and effective
training. Coaches, teachers, and trainers must have a thorough under-
standing of youth strength-training guidelines and safety procedures.
They should speak at a level that children and adolescents understand
and should keep the program fun and challenging while recognizing
the importance of adhering to safe training procedures. All exercises
must be clearly explained and properly demonstrated to all participants,
who then should receive constructive feedback regarding their perfor-
mance. An instructor-to-participant ratio of 1 to 10 has been recom-
mendedz9;however, additional instruction time may be needed if all the
participants are learning the exercises for the first time.

Mode of Training
Different modes of training, including body weight exercises, rubber
tubing, medicine balls, free weights, and weight machines can be used
in youth strength-training programs. Factors such as cost, quality of
instruction, adjustability, proper fit, and weight stack increments should
be considered when evaluating strength training equipment for young
weight trainers. Most children are too small to use adult-sized weight
machines, but many adolescents can fit into these machines if extra pads
and boards are used. The problem is that the increments on the weight
stack often are too large (e.g., 10 to 20 pounds). Child-sized weight
machines are a viable alternative and have proven to be safe and effec-
tive for children and adolescents, but the cost is relatively expensive
when compared with most other modes of training (Fig. 2). Free weights,
rubber tubing, and medicine balls are relatively inexpensive types of
equipment that can be used with children and adolescents of all ages
and abilities. If equipment is not available, a circuit of body weight
exercises can be developed; however, this type of training may be too
challenging for sedentary boys and girls who may not have the muscular
strength to perform certain exercise (e.g., pull-ups).
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 609

Figure 2. Child-sized strength-training equipment (seated-row machine).

Choice of Exercises

Single-joint (e.g., leg extension) and multijoint (e.g., squat) exercises

can be incorporated into youth strength-training programs. Single-joint
exercises are relatively easy to perform and are appropriate when activa-
tion of a specific muscle group is desired, whereas multijoint exercises
require the coordinated action of many muscle groups. When preparing
young athletes for sports participation, it is important to include
multijoint exercises in the workout program because this type of exercise
requires more balance and stabilization, and promotes the coordinated
use of multijoint movements. Movement in sport does not occur in one
plane, thus, proprioceptively challenging multijoint exercises should be
part of a young athlete’s strength-training program.
Advanced multijoint exercises, such as the snatch, and clean and
jerk (sometimes called Olympic-style lifts), also can be incorporated into
the training program provided that the child or adolescent has success-
fully mastered the performance of introductory exercises and that quali-
fied supervision is available (e.g., a Certified Strength and Conditioning
Specialist or United States Weight Lifting Federation Club Coach). In the
snatch lift, the barbell is lifted from the platform to arms’ length over-
610 FAIGENBAUM

head in a single, continuous movement, whereas in the clean and jerk,

the barbell is lifted from the platform to the shoulders and then to the
overhead position to complete the two part lift. Although the safety and
efficacy of Olympic-style lifting for young weight trainers was ques-
tioned in the current observations suggest that children and
adolescents can perform successfully and benefit from these lifts pro-
vided that the focus remains on form and technique and that appropriate
loads are used.31,81In one study,49it was reported that this style of lifting
was markedly safer than many other sports. Although this level of
training may not be appropriate for all weight trainers, children and
adolescents who want to learn these lifts under the supervision of a
qualified coach may benefit from this type of training (Fig. 3).
There also has been some concern regarding the appropriateness
and effectiveness of plyometric exercises for young athletes.98By defini-
tion, plyometrics (also termed stretchshortening cycle exercise) are jump-
ing, hopping, and throwing exercises that link strength with speed of
movement to produce power.20Although plyometrics often are used by
adult athletes in sports such as volleyball, football, and track and field,
some observers believe that this type of training may be unsafe for
children and adolescents because of the stresses placed on their musculo-
skeletal system. Plyometrics, however, are a natural part of most move-
ments as evidenced by the jumping and hopping movements that can
be seen on most playgrounds. In fact, jumping jacks and hop-scotch
actually can be characterized as types of plyometric exercise because

Figure 3. Practicing the proper technique for the snatch lift using a lightweight bar. A, The
ready position. 19,Top of the first pull position. C, Finishing position in full squat. (Courtesy
of Chris Polakowski, BS, CSCS, Essex, VT.)
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 611

they exploit the muscles’ cycle of lengthening and shortening to increase

power. If the goals of a conditioning program for young athletes are
to enhance sports performance and increase resistance to injury, low-
volume and low-intensity plyometrics should be incorporated into the
training program. Although additional study is warranted, beginning
with one set of 5 to 10 repetitions of low-intensity drills, such as squat
jumps and medicine ball chest passes, performed twice per week, is
reasonable. Depending on individual needs and goals, the program can
progress to multiple jumps, hops, and throws.20
Another issue concerning the choice of exercise is the inclusion of
functional exercises for the ”core” of a young weight trainer’s body (i.e.,
the hips, abdomen, and lower back). It seems young athletes sometimes
spend too much time training their extremities (e.g., arms) and not
enough time (or no time at all) strengthening their core musculature.
Because of the potential for lower back injuries, prehabilitation exercises
for the core musculature should be included in the training program.
That is, exercises that may be prescribed for the rehabilitation of an
injury should be performed beforehand as part of a preventative health
measure. Exercises such as sit-ups and back extensions are useful, but
they train only the muscles that control trunk flexion and extension.
Multidirectional exercises that involve rotational movements and diago-
nal patterns, performed with one’s own body weight or a medicine ball,
can be used effectively to strengthen the core (Fig. 4). Depending on
the needs of the young athlete and the demands of the sport, other
prehabilitation exercises (e.g., internal and external rotation) can be
incorporated into the workout. Guidelines for incorporating medicine
ball training into a youth strength training workout are available else-
where.20

Rate of Progression

A fundamental principle of strength training is that as the muscle

adapts to the strength-training stimulus, the demands placed on it need
to become more challenging to maintain the same relative training
intensity. This does not mean that every strength training session needs
more intensity or volume than the previous session, but over time
the training stimulus needs to be increased. Children and adolescents,
however, should be given the opportunity to develop the proper form
and technique on a variety of exercises before increasing the training
load. For example, when teaching a multijoint exercise, such as the
squat, young weight trainers should start with a long wooden stick
instead of a loaded barbell. Over time, continual gains can be made by
gradually increasing the resistance, the number of repetitions, or the
number of sets. On average, a 5% to 10% increase in training load
(typically 2 to 5 pounds) is appropriate for most exercises. Thus, a child
performing two sets of 10 repetitions with 20 pounds on the leg exten-
sion can probably progress to 22 pounds. Once the desired number of
612 FAIGENBAUM

Figure 4. Partner twist exercise with a medicine ball for strengthening core musculature.

repetitions are performed, the weight can be gradually increased, and

the repetitions can be decreased to allow for continual gains.

Methods of Testing

One method of evaluating a young weight trainer's response to the

strength training program is to use repetition maximum (RM) lifting
(e.g., 1- or 10-RM testing) on the equipment used in training. By defini-
tion, a 1 RM is the maximum amount of weight that can be lifted with
proper form once but not twice, and a 10 RM is the maximum amount
of weight that can be lifted with proper form ten times but not eleven
times. Some clinicians and researchers have used relatively high repeti-
tion maximum values to assess muscular ~trength,~" 112 whereas others
have used maximal load lifting, such as 1-RM tests, maximal isometric
tests, or maximal isokinetic tests.24*
32, 33, 78, 85
Despite previous concerns that 1-RM testing may cause structural
damage to young weight trainers, no injuries have been reported in
any prospective study that used adequate warm-up periods, individual
progression of loads, and close and competent supervision. Because
many of the forces to which children and adolescents are exposed in
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 613

sports and recreational activities are likely to be greater than properly

performed maximal strength tests, it seems that this type of testing can
be safely used to evaluate training-induced changes in muscular
strength, provided that qualified supervision is present. Unsupervised
and poorly performed 1-RM testing, however, should not be performed
under any circumstances because of the potential for a serious injury.

Program Design Considerations

With competent instruction and quality practice time, children and

adolescents can learn the skills needed for successful and enjoyable
participation in a youth strength training program. Although different
combinations of sets and repetitions have proven to be effective, recent
data suggest that high repetition-moderate load strength training (13 to
15 RM load) may be more beneficial than low repetition-heavy load
training (6 to 8 RM load) for children starting a strength training pro-
g1-arn.3~
Beginning a strength training program for children (and perhaps
adolescents) with a resistance that can be performed for 10 to 15 repeti-
tions allows not only for positive changes in muscular performance but
also provides an opportunity for appropriate adjustments to be made.
A summary of youth strength training guidelines is presented.
Youth Strength-Training Guidelines
Qualified adults should provide supervision and instruction at
all times.
Participants should wear appropriate clothing and footwear in the
training area.
The training environment should be safe and free of hazards.
Realistic goals consistent with the needs and abilities of each
participant should be established.
Warm up by performing at least 10 minutes of light aerobic and
stretching exercises.
Begin with one light set of 10 to 15 repetitions on 6 to 8 exercises:
Encourage success by choosing the appropriate exercises and
workloads for each student.
Focus on participation and proper technique instead of the amount
of weight lifted.
Depending on individual needs, goals, and training time, 1 to 3
sets of a variety of single- and multijoint exercises can be per-
formed.
Teach students how to use workout cards and regularly review
each student’s progress.
When necessary, adult spotters should actively assist the partici-
pant, in the event of a failed repetition.
Two to three nonconsecutive training sessions per week are appro-
priate.
614 FAIGENBAUM

Increase the resistance gradually as strength improves (e.g., ap-

proximately 5% to 10%).
The strength-training program should be systematically varied
over time to optimize training adaptations and prevent boredom.
Strength training should be one part of well-balanced youth fitness
program.
Participants should be encouraged to maximize their athletic po-
tential by optimizing their dietary intake (e.g., adequate hydration,
proper food choices).
Only limited data are available regarding the relationship between
repetitions and selected percentages of the 1RM in and informa-
tion on children and adolescents is scarce. In one study,32preadolescent
boys and girls performed a significantly greater number of repetitions
at 50% 1 RM on the leg press exercise compared with the chest press
exercise, yet at 75% of the 1 RM, there were no significant differences in
the number of repetitions that could be performed. These findings sug-
gest that at a given percentage of the 1 RM (at least at intensities below
75% of 1 RM), the number of repetitions that children can perform may
vary between exercises, possibly because of the amount of muscle mass
involved with each exercise. When prescribing a strength-training pro-
gram for children and adolescents, the best approach may be to first
establish the repetition training range (e.g., 10 to 15), and then by trial
and error determine the maximum load that can be handled for the
prescribed range. It is beyond the scope of this review to present sport-
specific training programs, but this information is available else-
where.31a,

SUMMARY

The potential benefits of youth strength training extend beyond an

increase in muscular strength and may include favorable changes in
selected health- and fitness-related measures. If appropriate training
guidelines are followed, regular participation in a youth strength-train-
ing program has the potential to increase bone mineral density, improve
motor performance skills, enhance sports performance, and better pre-
pare our young athletes for the demands of practice and competition.
Despite earlier concerns regarding the safety and efficacy of youth
strength training, current public health objectives now aim to increase
the number of boys and girls age 6 and older who regularly participate
in physical activities that enhance and maintain muscular fitness.
Parents, teachers, coaches, and healthcare providers should realize
that youth strength training is a specialized method of conditioning that
can offer enormous benefit but at the same time can result in serious
injury if established guidelines are not followed. With qualified instruc-
tion, competent supervision, and an appropriate progression of the vol-
ume and intensity of training, children and adolescents cannot only
 STRENGTH TRAINING FOR CHILDREN AND ADOLESCENTS 615

learn advanced strength training exercises but can feel good about their
performances, and have fun. Additional clinical trails involving children
and adolescents are needed to further explore the acute and chronic
effects of strength training on a variety of anatomical, physiological, and
psychological parameters.

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