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AOSSM 2022 Annual Meeting Recordings - no CME
Strength Training for Adolescents
Strength Training for Adolescents
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Video Transcription
First, can I see how many people are certified in strength and conditioning? Great. Okay. I feel much happier. So this is strength training in the 5 to 15-year-old. My disclosure is I have no disclosure except after doing all this work, I want to be a strength coach, okay? When we look back through these things, Dr. Vojtas back in 2009 said, you know, I'd like to know more about strength training. What should be our thought process? And in this article, a lot of maybes were written. So in 2020, the American Pediatrics Academy came out and said that everything I'm going to tell you right now is true. So it doesn't necessarily sound like it should be true, but they've had at least no reason to say it's false. So let's start out. That's an 8-year-old doing a snatch in Olympic lifting, and you'd think that, oh, my heavens, that should be horrible, yet there's no known injuries associated with it. What are the benefits? Well, you've seen our grandchildren. That's their best crab. It improves strength and begins with lifelong exercises. What did we find? We found that most problems were accidents, and they were avoidable, and the growth plates do not seem to be at risk. Now, it may be certain times, and I'll talk about the pitcher who, when they're going through all these physiological changes that we just talked about, maybe that is the reason why we get little leaks of shoulder when we do. So the injuries happen if the equipment is misused, too much weight, bad technique. My 8-year-old grandson shouldn't be supervising my 6-year-old granddaughter and overuse. The focus has to be on having fun and appropriate technique, and if you work on technique early, it really carries them the rest of their lives. To become a knowledgeable adult, you don't need to be a pediatric personal trainer or a strength coach, and usually your parents or grandparents, and why this is important to many grandparents, particularly if they were orthopedic surgeons, particularly if they were sports orthopedists, if they were taking care of their kids on the sidelines and really didn't have time to coach them. So they may have had an interest, as I did, in the weight room and may get in the weight room a little bit more often, but it really is something that you're going to be able to do that. You're going to be able to learn these things. There are many online children-specific programs. There are hundreds of videos with training tips. The gentleman who introduced me to a lot of this is Jim Roney. He's at EDGE Sports Therapy, and almost all the children's hospitals, including Boston Children's, have recommendations for these things on their websites so that you can actually go in and see what the thoughts are of the people in your communities. All successful programs are functional, practical, and progressive, and I want to draw attention to two things. Sports specificity, again, gets us in trouble, and if you go longer than 45 minutes, it gets us in trouble. So those are two things that whatever your program is, you need to keep at 45 minutes or less. If there was a reason why teachers make their classes 45 minutes, it's because you can't maintain their focus. Warm-up can be anything from running to plyometrics to jumping rope, and this is something I learned that most ropes that you buy for the gyms are for someone six feet. So what you're supposed to do is take the height of the athlete and add three feet and set the rope to that length. So that's tip number one, that if you're above six feet, you have to get special ropes. So if you want to have a rope that's appropriate length, what I would do is divide your athletes into six-inch increments and have a number of ropes in that area. Dynamic stretching usually needs to be less than five minutes. The frog hops, the kids have the most fun with. So what you can usually do is jump out five frog hops and jump back five frog hops. If you want to go a little longer, 25 feet, but I wouldn't go more than 50 feet. If you're going to do resistance training, regardless of what it is, you need to think about is it part of my regular practice or is this a strength training day? If it's a strength training day, you're much more likely to do two to three sets as opposed to if it's combined with the rest of your practice, probably only get one. So let's talk about body weight exercises. Supermans, planks, crunches, bridges, mountain climbers, and lunges, these are all things that you'll see on almost any athletic field, almost any sport. The superman with or without the cape is usually held three to five seconds and we do 10 reps of those. The plank is a really interesting exercise. If you do it on your elbows, it's more core. If you do it in the high position, the start of a pushup, it's usually the shoulders are more active and usually the total shouldn't be more than 60 seconds, but they're not going to be able to hold 60 seconds. So you're going to do 15 seconds or 10 seconds and then you can regulate how many you do and progress that over the course of your year. The crunch, this lemon underneath his chin is to give them an idea of not doing too much cervical flexion. It's usually a three second hold, one to three sets of 10. The bridge is a great sister exercise. You can go from the crunch to the bridge without them changing positions. And that again is a three count, one to three sets. Mountain climbers are a pretty good workout for the kids. The biggest workout is the crab walk. If you're involved with soccer, by doing crab walk and playing with the soccer ball at the same time is quite a workout at the end of practice. That will be all you need to do that day. Five minutes of that will be enough. The lunge is the lunch. Now for the pushups, this is another takeaway. I wasn't aware until I did this talk that if you do pushups on your knee, you're only doing 50% body weight. I guessed it was about 60%, but it's 50%. And that if you're doing a true pushup, you're only at 65%. If you want to do less, you can do it against an incline. If you want to do more, you can build your feet up, prop them up two feet on a box and that'll get you up to 74%. The thing about pushups is that the kids are notorious for doing the worm. And what the worm is, is when they bring their shoulders up but their body stays down because they have a weak core. So if you find that you have a lot more worming action, I would go back to a plank as a recommended start perhaps at the beginning of the season and then go to a pushup. So again, that the knee pushup is only 50%. Elastic bands, there's all types of elastic band programs right now. As theraband, you can cut to the size that you want. If you use it on the side, you can use it either for the upper extremity or for the hips. So it can be chest and shoulders or it can be hips. You can hook those up. They tend to be cumbersome. That's the bad news. They tend to have a learning curve. That's the bad news. The good news is they're lightweight and they're not expensive. That's the good news. So you can incorporate those into your practices. Medicine balls. Medicine balls are expensive, but you can use it as a group. And the chest pass, the overhead pass, the overhead squat, again, on a strength day, two to three sets of 10 to 15 reps. There's a repetitive thing about this 10 to 15 reps, and it's going to become more important in some other slides. Let's get to the free weights, the barbells, and the dumbbells. I want to come back to the fact even these are safe. So what we thought to be true has not been proven by the literature. They do have two concepts that they'd like to bring out in almost everything I read. One is the training age, which is how much formal training and how much time they've been actually working out. So this is a learned activity. So the young person who has had more formal training with someone, an experienced adult, and one who has done more time doing it, is going to be at a higher level. But the skill competency level is equally important. And that's where we get into the quality of the lifting movement. And that's so important. This is an example of Sam tried to do an overhead squat, but he didn't have the strength to be able to do that. So this is not a good exercise for him, because he lacks the quality of the lifting movement. So we either have to go back to a smaller medicine ball, or more importantly, probably start without one. Dr. McKaley did mention the fact that training progression less than 10% increase. That 10% could be any of three things, and it's not 10% in each of the three things. It's a combined 10%. So if you're going to increase the training time 10%, you should not be increasing the distance or the weight amount. So you can do one or the other as you work forward. Let's get into the training progression. And this is probably my biggest takeaway, other than how to set the rope and the push ups on your knees are only 50%. You have two sets of 10 reps when you're establishing any exercise that you're doing, particularly with any type of resistance situation. The 10th rep on that second set should be some form of fatigue, or you probably didn't start it high enough. When they're able to get to the 10th rep, you're going to go ahead and add another set to that until they get up to three sets of 10. Then you're going to increase the reps to 15, but you're going to increase it on the third set and work backwards so that they aren't fatigued after the first set and you aren't able to complete it. So you do the third set for 15, then you'd work the next week to the second and third set of 15, and then finally you work all three sets to 15. Now when you get to that level, you're going to ask them on the third set of 15 to see if they can do 17. And if they can do 17, then you increase the weight 10% and you do two sets of 10 and you go back to where you started. Now this two times two rule is two consecutive workouts of two or more reps on the final set. Why that's important, they may have had a great day on that one workout. So they have to prove to you that indeed that's easier for them to do and time for you to move up. Back in 1998, we developed the soreness rules as a means to progress in weightlifting. We've then used it in everything from our interval throwing programs and everything that we do, we use this set of rules to allow us to progress. So if they're sore during warmup, and the warmup set, and that soreness continues, then you need to take two days off and drop down one set because you know why? Or one unit of whatever you did, because you did too much. If the soreness during warmup goes away, probably okay, but don't increase it that day. If the soreness during warmup comes back, you need to drop back down again, and if you have no soreness. So no matter what you do, if you get into the soreness situation, you have to ask yourself, did I increase too many variables at the same time? Did I do too many reps? Maybe I need to back off. These soreness rules have been very helpful, I said, in all interval throwing programs and all other progressions. Rest. What the recommendation currently is, if you're doing something between 10 and 15 reps, you should have 30 to 90 seconds rest. When you start to get into heavier weights, particularly in adolescence, and you're dropping it down to five to six, then the recommended rest period is two to two and a half minutes. You should do three workouts per week and have one day off between each workout. That's a mandatory time off. In order to get this thing going, you need to do the program for at least eight weeks and up to 24 weeks. You should take a rest for a period of time as you progress. If you want to maintain, two times per week to maintain. And at eight weeks, if you stop for eight weeks, you're going to have a 3% loss per week. And the recommendation is increased sleep to 10 hours a day. So the most important takeaway is how much time between sets. And that's usually 30 to 90 seconds. And you can do something else in that interval. The equipment. They have a lot of stuff on the internet. So I bought this set of dumbbells just to see how bad it was. And that's $100 worth of equipment to have that bench and those foam weights that also have, you can put some water in, and the total is about 45 pounds. In the center at the bottom is something that I made back in 1985 that my kids started lifting with. And the reason why I had wooden weights was twofold. We got it up off the floor and it also wasn't going to be intimidating when they got under the bench. When they looked to their sides and saw the big weights, I didn't want them to be fearful just because they had the weights. This has worked out pretty well with this particular technique. This set won't go very long in use though. The OneRepMac is safe. This is the strength coach for the Arizona Cardinals, Buddy Morris, who was the strength coach at the University of Pittsburgh when I was a resident. We became very close. And he introduced me to most of my understanding of barbell weightlifting. He felt that OneRepMacs weren't necessary unless you were testing and it was for something within the team. And he developed this concept of a 3% rule. This is the chart of the 3% rule. This is good for bench press, squat, deadlift, and also military press. This chart alone will predict within 5 pounds based upon the number of reps that you did your maximum. So if you can do 225, which is what the NFL standard is for repping, and you can do 10 reps, you will be either 295 or 305 in your maximum rep. And this chart has stood the test of 40 years in my practice. It's in every weight room of every high school in Delaware, and I encourage it in the other gyms as well. The 3% comes from the formulaic thing on the bottom left column. But this single piece of paper has been a godsend for me not seeing the one rep maximum problems that you see, which is usually the reps from pec or associated injuries. Now, you can still have it with multiple reps. I'm a testimony to the fact that I was bench pressing. I had 360 for five. I wanted to bench press 400 pounds before I turned 40. I got almost up at the six. I appreciated two pops, and I tore both my subscaps off. I didn't tear my pec. So it was a lesson that you can't exceed sanity when you get into this whole deal. Nutrition, we briefly talked about protein needs, but .5 grams per pound is what's currently recommended for growing athletes. Chocolate milk has become the mainstay of replenishment fluids. It's recommended as the number one way to, after your workout, for things that you don't need to have all these expensive things. Chocolate milk got wind of that. They are very commonly seen in every high school website as a sponsor of the scores because of that particular thing. If you happen to be a parent on the run, you can feel comfortable giving an eight ounces of chocolate milk, an ounce of cheese, and a hard-boiled egg and get 23 grams into them as snacking foods. I draw attention to supplements as we get into the older age group, just like the chart was for the older age group. The supplements, there are branched-chain amino acids. They do work. They are very help. The concerns are if you go more than 10% of your protein needs. I do not recommend it in younger folks, just the older ones. Let's talk about the overuse of sports-specific problem. In baseball, they love bodyweight exercises. They like elastic bands. Again, easy travel. I have a lot of experience with the weighted glove and weighted balls in the course of my clinical research. They are not for the growing athlete. My last slide is the card. This is something I developed in 1996. The reason why it was developed was to help to anticipate these athletes that were going to have problems because they were so gifted. We identified these athletes and the purpose was then to protect them. I can share with you that the four standard deviation orange and the five standard deviation red, all the kids that have pitched in the Little League World Series are in those two categories. I can also say to you that there have been less than 10 kids in the Little League World Series that ever pitched in the major leagues. So it just says you were good. It doesn't say how long you stayed good. You know what a 100 mile an hour fastball is down the middle of the plate? It's a 100 mile an hour home run that's knocked out of the park. Now what we know about this is that if you have these gifts, you have to throw in order for the humoral head to remain retroverted. So you cannot put them in a box. You have to let them throw. It's just a question of how much. If indeed the person for two consecutive years, you notice the age group here is 8 to 14. This data was collected all over the world. It was collected in all the countries where the major league players come from as well as the U.S. And we calculated this formula and it has held true that indeed this is reproducible. And with that, if you're in that same category two years in a row, that tells you that you weren't maturing one year and not the other. So if you remain in that category, you own it. And if you are in the red zone, then we recommend until you're 10 or 4 that you only throw four times your age in any one outing. So if you're a 10 year old and you throw in the red, you would only throw 40 pitches, four times your age. I have some cards in the back for any of you that would like them. They're easy to put in your wallet. The best thing in the world for a parent that tells you that they have a budding superstar, you can pretty much calculate how fast they throw and whether they need to be protected or not. Thank you.
Video Summary
The video transcript discusses strength training for children ages 5 to 15 and includes recommendations for exercises, training progression, rest periods, and nutrition. The speaker states that strength training for children is generally safe and beneficial, with no known injuries associated with activities like Olympic weightlifting. The focus should be on having fun and using appropriate technique. Bodyweight exercises, resistance bands, medicine balls, and free weights can all be used in strength training workouts. The speaker emphasizes the importance of proper training progression and rest periods to avoid overexertion and injury. The video also mentions the importance of nutrition, with a recommended protein intake of 0.5 grams per pound for growing athletes and the use of chocolate milk as a post-workout recovery drink. The speaker cautions against overusing sports-specific training methods and highlights the potential risks of weighted gloves and balls for young athletes. The video ends with the speaker discussing a card he developed to help identify and protect gifted young athletes who may be at higher risk for injury. The card helps determine appropriate pitch counts based on age and performance level.
Asset Caption
Michael Axe, MD
Keywords
strength training
children
exercises
nutrition
injury prevention
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