We have a little bit of time before our break for questions for all of our speakers. We'll just pass the microphone along to everybody around. Any questions from the audience, please step up to the microphone. It's being recorded and then we'll try to repeat the question. Just real quick, you touched just a second ago on max and stuff, and I feel okay with that with some of the older athletes, but I have a lot of patients come in young, you know, junior high, you know, 6th, 7th, 8th grade, and talking about they're maxed out, you know, they maxed the deadlift, whatever, in their school, and I counsel them, stuff like that. What are you guys' sort of general feelings on that in sort of that junior high age group? I think that's when you go to the chart, to be honest with you, because you can convince them that they don't have to do a single rep max. I only come back to you to say that the single rep max was checked and was not found to have an increased injury rate. I don't agree with that. I like no less than three. That's always been my, the 3% rule doesn't say that, but that's how I use the 3% rule. Question. I was at a baseball meeting at Cooperstown, it's been over 20 years ago, Jimmy Andrews and some of the guys that were really leading it came up with something that I have used to tell my parents for the last 20 years, and they said you should not, if you're a kid, you're an adolescent kid, you should not throw a curveball, breaking ball, slide, whatever you want to call it, anything that's not a fastball or a changeup until you are shaving. In other words, if you're not shaving, you should not throw an off-speed, curve, breaking, whatever you want to call it. No, you may be misquoting him a little bit. Changeup, yes. Changeup and fastball is fine. He gets into great arguments with the other people in the research lab with regards to curveball. The curveball probably is just, the reason why people start throwing a curveball is because their fastball can't get players out, and they develop the other pitch. But we won't take argument with the fact that you don't need to throw a curveball early to have the appropriate orientation in your growth plates. You do not. So it's probably a risk, it has no benefit, therefore I would continue to teach the way you do, which is fastball, changeup, and not throw the curveball. So a question for Mark. Mark, you raised the question a couple times about the relationship of fat mass with the onset of puberty, and if you look at the gymnasts and the figure skaters and the cross-country runners who are very lean, they often have a delayed puberal onset, and yet we know obesity definitely can hurry or hasten the onset. So clearly it has something to do with fat mass, and you mentioned leptin. Can you go over that relationship again? Because with the amount of obesity that we have in our country today, I think it's an important one to understand. Yeah, thank you, Dr. Vojtis, about that. So there is some literature out there that looks at leptin, and leptin is a modulator through the metabolic pathways. One of the slides that I had shown, its relationship with the hypothalamus, the gonads, the adrenals, it is a regulator to start puberty a little bit sooner than normally it would not. So there is an association, again, with obesity and higher leptin levels that we see predominantly in the literature for African-American girls that we don't see in leaner athletes, too, as well. So there is a clear association with leptin and the triggering and onset of puberty. But how about the fat mass? I mean, we know that fat does sequester estrogen, and yet estrogen is very important to the onset. So if you're sequestering estrogen with increased fat, why does puberty happen earlier? That's a good question. I don't know that specifically. Puzzling. Yeah. More questions from the audience? Can you come up to the microphone so we can get it recorded? Just a follow-up. Can you influence that release to try to manipulate what happens? Influencing the release of leptin? Yeah, that's a good question. I don't know the answer to that either, and I would not take a stab. Sure, please. Mark, a question that I get asked sometimes by concerned parents. When is it indicated, or is it indicated to refer to an endocrinologist for supplemental hormonal treatment? Yeah. No, that's a great question. I think, again, in today's competitive youth athletes, have parents coming in, they want their kids to be early matures, tall, strong. And that's why it's shown that one slide on constitutional growth delay, which I think is the most common reason why boys especially are late maturing, and that reassurance is all that's needed. Not having done or worked with an endocrinologist on the topic, I think they get pressured a lot in the use of exogenous testosterone in boys who have not gone through puberty. So I don't know the answers to all of that. They probably go through a detailed metabolic workup, hormonal workup. But I'm sure that the endocrinologists have a lot of pressures from parents wanting their kids to be superstars, boys especially, and use of supplemental testosterone. So in terms of weight training, Lyle, Greg, in our runners, frequently they don't like to go to the weight room. They just want to run. But to really prevent those stress fractures, increasing bone strength, increasing muscle strength, what would be a good resistance training program for those athletes, the running athletes? The ones, they don't want to get bigger, they don't want increased bulk, but they definitely need to be stronger. Yeah, and Greg, I'm sure, will amplify this, but we use the technique that was taught to us by Dr. Tom DeLorme, which was that you train at 70 percent of your 1RM for that type of running athlete. And then generally, if you take, if you do the 1RM, say a bench press, 1RM, and then you train at 70 percent of that, that'll generally be your 10 to 15 RM. And that's generally what our strength trainers are, the goal for the endurance athlete is 10 to 15 reps of their 1RM. Yeah, I agree with that, you just increase, you do higher volume, and then they don't have the hypertrophy because they're all, they're very worried about hypertrophy and more load that they would carry. But I think that there's huge benefits for runners, for resistance training, to do it to make them better runners. They can also be doing plyometrics and things and building their power and creating some of that muscle confusion, so they're tapping into untapped resources, because our distance runners are some of the least powerful human beings we've ever seen, so they can tap into that and have that capacity for other, you know, the end of the race, or even have better muscle performance. Would you use that same program for the sprinters? Sprinters will get more lower volume and more power exercises, so no, I would change it some for them, but it would be, definitely have some components of high and low volume, we want to have a periodization of having that muscle confusion as they transfer. Tim might have some other opinions too. Oh, he's right there. Yeah, I've got a question for Lynn. Thanks very much for your presentation, and it's so good to see you present in person after following you for so long. So you mentioned the sex, sex, gender issues, and that the training environment hasn't really been conducive for women, and maybe that explains part of it, why we're seeing the higher injury rates in some injuries. Now it's a little bit more acceptable, it's a lot more acceptable to see women in the weight room training, and they train really well. Can you speculate what might be the result of that in 20 years' time? I think if there is more, sort of the recommendations that Sherry had up there, if that's really happening across the board, not just in special circumstances, where the weight room is more accepting and we see more, I think, seeing more women as strength coaches as well, then I think you're going to see less of that. I think probably, I mean, I hope that will help injury rates go down. It seems like it should, because that's the stuff we end up training in prevention programs down the road, right? Because they're not doing that. I think you guys studied, Greg, a long time ago, that when boys go through puberty and their knees, and actually Lyle showed a picture of that, I think, you know, they don't generally fall into that valgus, dynamic valgus. Girls, as they go through puberty, they don't have that neuromuscular spurt that came up before that boys have, and I think part of it is not doing things like whole body play when they're little, and then getting into an environment where, you know, girls don't do that. Go do this, right? And that still happens, I mean, honestly. But if you could level the playing field, I think it would, and again, change the expectations that people have of what girls can do and should do, it's a big ask, but at least we're talking about it, right? Yeah, absolutely. Well, look, we have this philosophy of never mention prevention, and only from the point of view that prevention isn't as sexy as performance. Yeah, there you go. Wins and losses, too. But when I look at what Greg does, what you're prescribing, the qualities that you develop through climbing and lifting and pushing and pulling and jumping and running, they're injury prevention qualities, but they're the exact same qualities that lead to better performance. Absolutely. The cell becomes, if you want to perform at the best level you can, this is going to help you do that. Yeah, I also think when you learn those things when you're young, you don't unlearn them as you go through puberty, I mean, that is the, you know, your techniques stay the same or get better, even. So I don't know. But I think it's a fun concept, and again, these guys have just started to, they wrote about it in 2020, but they just started to really go out and talk about it. You can pass on to your six-year-old granddaughter that I've never seen a six-year-old plank so well, so she's very, very strong, you can pass that on to her. Keep going at it. Okay, so we're going to take about a 15-minute break, we're a little ahead of schedule, and we have four excellent talks after the break. Thank you.

weightlifting for young athletes

curveballs and growth plates

fat mass and puberty

leptin as a regulator

endocrinologists and hormonal treatment