AAP addresses resistance training

June 2, 2020

Many young athletes are interested in resistance training, and a policy statement update from the American Academy of Pediatrics (AAP) addresses how they can safely participate.

For many young athletes and children who are interested in physical fitness, resistance training has become increasingly popular over the years, and many parents want to ensure that their child is engaging in a safe program. The American Academy of Pediatrics has updated its 2008 policy statement on resistance training for children and adolescents.1

The revised policy statement highlights that some children may require additional consultation before starting resistance training, such as children with poorly controlled hypertension or seizure disorders. Children who had cancer treated by anthracycline chemotherapy should be cautious when starting training because they are at increased risk of cardiotoxicity and acute congestive heart failure during resistance training. Children with pulmonary hypertension, Marfan syndrome, and hypertrophic cardiomyopathy should be counseled against resistance training.

The policy statement also offers the following recommendations:

1. When children with complex congenital cardiac diseases come in for consultation, a pediatric cardiologist should be consulted to give guidance on safety and any possible modifications.

2. Resistance training should be added to aerobic training and other skill-related fitness components in order to form a comprehensive fitness program.

3. Recommend basic resistance exercises over a more aerobic fitness program for children and adolescents who are overweight or obese.

4. Make sure that children and adolescents are using dynamic warm-up exercises and less intense stretching in the cool down.

5. Discuss and encourage adequate fluid intake and proper nutrition.

6. Assess the resistance training regimen and give feedback to minimize the risks from resistance training.

7. Ensure that all major muscle groups are used in the resistance training. For children and adolescents who have sport-specific goals, additional exercises can be added to complement the initial training regimen.

8. Count resistance training as part of the total training program and monitor the amount of time spent to reduce the risk of overuse injuries.

9. Evaluate any sign of injury or overuse before allowing the child or adolescent to resume the exercise program.

10. Weightlifting exercises can be incorporated under the direction of a qualified professional.

11. Discuss the risks of performance-enhancing substances as well as anabolic steroids.

12. Make sure the resistance training is overseen by professionals who are qualified, trained, and aware of the unique aspects of children and adolescents.

References:

1.    Stricker PR, Faigenbaum AD, McCambridge TM; Council on Sports Medicine and Fitness. Resistance training for children and adolescents. Pediatrics. 2020;145(5):e20201011. doi:10.1542/peds.2020-1011