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Muhammad Nazrul Hakim Sports Academy Universiti Putra Malaysia

Young athletes are physically developing, from early childhood to late adolescence. This means they have different capabilities for, and adaptations to, exercise and for this reason, young athlete training programs should not be just scaled down versions of adult training programs.

In the first two years children grow about 5 inches (13 cm). Growth then continues at a steady rate of 2.5 inches (6 cm) per year until about the age of 11 in girls and 13 in boys, when the pubertal growth spurt begins.

The pubertal growth spurt lasts about 2 years and is accompanied by sexual development (growth of pubic hair, development of sex organs, deepening of the voice in boys, and beginning of menstruation in girls). Normal growth stops when the growing ends of the bones fuse.

This usually occurs between the ages of 13 and 15 for girls, and 14 and 17 for boys. The typical pattern of rate of growth for boys and girls from birth through adolescence is shown in the figure "Growth Rates for Boys & Girls" This growth rate is an important factor in the Long Term Athlete Development (LTAD) of a child.

Sports scientists have reported that there are critical periods in the life of a young person in which the effects of training can be maximised. They have also concluded that it can take anything from eight to twelve years of training for a talented athlete to achieve elite status. This has led to the development of athletic models, which identify appropriate training aims at each stage of the athlete's physical development.

Research has shown that that chronological age is not a good indicator on which to base athletic development models for athletes between the ages of 10 to 16 as within this age group there is a wide variation in the physical, cognitive and emotional development. One practical solution is to use the onset of Peak Height Velocity (PHV), which is influenced by genetics and environmental factors (climate, cultural & social), as a reference point for the design of training programs.

PVH is the point in a child's development when they reach their maximum growth rate. The average age for reaching PVH is 12 for girls and 14 for boys. Peak weight velocity normally follows shortly after PVH. Following PVH Vo2max and strength increase significantly as a result of growth. Most girls experience their first menstrual cycle approximately one year after PVH. Using simple measurements (standing height & sitting height) PHV can be monitored and appropriate training can be set to match the athlete's development.

Sports can be classified as early specialization (e.g. gymnastics) or late specialization (e.g. Track and Field, Team sports). Early specialization sports require a four phase model while a late specialization model requires six phases.

Bones develop from a cartilage growth plate, called epiphysial plates, at each end of the bone shaft. These growth plates divide the calcified head of the bone (epiphysis) and the calcified shaft (diaphysis). The bone lengthens as cartilage is calcified into bone. Growth ends when the plate eventually calcifies.

Muscle mass increases steadily until puberty, at which point boys show faster muscle growth.

The hormonal changes at puberty also affect body composition in terms of fat. At birth, both boys and girls have around 10 to 12% body fat Pre-puberty, both girls and boys still have a similar 1618% body fat Post-puberty, girls have around 25% body fat due to high serum oestrogen, which causes the hips to widen and extra fat to be stored in the same area. Post-puberty, boys have 12 to 14% body fat

Most athletic females, post-puberty, tend to keep body fat at around 18% , Any lower than 12% body fat for females can be considered unhealthy in terms of maintaining bone density and disrupting hormone levels, which may increase the risk of stress fractures.

Coaches need to ensure female athletes are aware that until they are 19, they will steadily gain in muscle and so will naturally be gaining weight and that by eating the right kinds of foods is the way to avoid unwanted weight gain.

The change in female body shape during the growth spurt has its particular injury risks. The hips widen, placing the femur at a greater inward angle. During running or walking, this increased femur angle leads to greater inward rotation at the knee and foot. This rotation can result in an injury called chrondomalacia patella, which occurs when the knee-cap does not run smoothly over the knee joint and pain is caused at the front of the knee.

Appropriate preventive training to avoid chrondomalacia patella would be to strengthen the vastus medialis muscle, the lower abdominals, obliques (side of stomach), hip abductor and hip external rotator muscles.

Traction injuries are another type of injury associated with bone growth. They are caused by repetitive loading while the tendon is sensitive to stress as the bones and tendons are fusing. Traction injuries occur at different sites at different stages of growth.

tibial tubercle apophyseal traction injury

10 to 13 years of age at the heel (Sever's disease) 12 to 16 years of age at the knee (Osgood Schlatter's disease) late adolescence lower back and iliac pain The only cure for these traction injuries is rest.

plantarflexion inversion injuries

Exercise will neither stunt nor promote growth in terms of height but it does thicken the bones by increasing mineral deposits [Wilmore & Costill, 1994]. Growing bones are sensitive to stress so repetitive loading should be avoided. The epiphysial plate is susceptible to injury and therefore a fracture to the epiphysial plate prior to full growth could be a serious injury as it could disrupt bone growth.

Anabolic steroid use in young athletes can stunt growth by causing premature calcification of the epiphysial plate [Sharp, 1995].

From research [Weltman et al (1986)] carried out on the effects of resistance training on young athletes, it would appear that, in general, strength improvements are possible.

If coaches are to place young athletes on strength training programs then they must ensure:
 young athletes are properly

taught (skill development)  young athletes undertake a well controlled progressive program (planning)  young athlete's joints are not subject to repetitive stresses (injury prevention)  Strength can be developed with circuit training programs where the young athlete's body weight is used as the load.

Types of skill There are a number of different types of skills:


 Cognitive - or intellectual skills that require

thought processes  Perceptual - interpretation of presented information  Motor - movement and muscle control  Perceptual motor - involve the thought, interpretation and movement skills

The teaching of a new skill can be achieved by various methods:


 Verbal instructions  Demonstration  Video  Diagrams  Photo sequences

The aerobic ability of young athletes can be developed so it makes aerobic training worthwhile, since it will improve their performance. Anaerobic training is of limited use to young athletes as they possess little anaerobic capacity. Training for aerobic and anaerobic endurance is best left until the young athlete reaches adolescence.

The development of sport specific skills along with agility, balance and co-ordination are important areas to focus on when coaching young athletes.

Each year, more than 3.5 million sports-related injuries in children under age 15 are treated in hospitals, doctors' offices, clinics, ambulatory surgery centers and hospital emergency rooms in the United States, according to the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission.

The number of sports-related injuries involving children ages 5 through 16 years includes: Football: 448,200 Basketball: 574,000 Baseball: 252,665 Soccer: 227,100 Hockey: 80,700 Gymnastics: 75,000 Volleyball: 50,100

Children are Still Growing Young athletes are not merely small adults. Their bones, muscles, tendons, and ligaments are still growing. This makes them more susceptible to injury.

Growth Plate Injuries Growth plates are the areas of developing cartilage where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. What is often a bruise or sprain in an adult can be a potentially serious growth plate injury in a young athlete.

Children Vary in Size and Maturity Young athletes of the same age can differ greatly in size and physical maturity. Some youngsters may be physically less mature than their peers and try to perform at levels for which they are not ready. Parents and athletic coaches should try to group youngsters according to skill level and size, not chronological age, particularly during contact sports. If this is not practical, they should modify the sport to accommodate the needs of children with varying skill levels.

Injuries among young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones. Acute Injuries
 Acute injuries are caused by a sudden trauma. Common acute injuries among

Overuse Injuries

young athletes include contusions (bruises), sprains (a partial or complete tear of a ligament), strains (a partial or complete tear of a muscle or tendon), and fractures.

 Not all injuries are caused by a single, sudden twist, fall, or collision. A series of

Contact Sports Injuries

small injuries to an immature body can cause minor fractures, minimal muscle tears, or progressive bone deformities, known as overuse injuries.  As an example of an overuse injury is "Little League Elbow." This is the term used to describe a group of common overuse injuries in young throwers involved in many sports, not just baseball. Other common overuse injuries can tear the tendons in heels and knees.
 Contact sports have inherent dangers that put young athletes at special risk

for severe injuries. Even with rigorous training and proper safety equipment, children are at risk for severe injuries to the neck, spinal cord, and growth plates. Following the rules of the game and using proper equipment can decrease these risks.

Prompt treatment can often prevent a minor injury from becoming worse or causing permanent damage. During the evaluation, the orthopedic surgeon will inquire as to how the injury occurred and will examine the child. If necessary, the doctor may perform X-rays or other tests, to evaluate the bones and soft tissues. The basic treatment for many simple injuries is often "R.I.C.E.," or Rest, Ice, Compression, and Elevation.

Treatment for a child with any significant injury will usually involve specific recommendations for temporary or permanent adjustment in athletic activity. Depending on the injury's severity, treatment may range from simple observation with minor changes in athletic level to a recommendation that the athletic activity be discontinued. Some combination of physical therapy, strengthening exercises, and bracing may also be prescribed. A basic component of any treatment plan is the orthopedic surgeon's ongoing assessment of the child's physical condition until signs of healing and reduction of symptoms occur. Successful treatment requires cooperation and open communication among the patient, parents, coaches, and doctors.

Coaches, athletes and parents often ask about the appropriateness of weight training for young athletes. Is it safe and effective? This is one area of youth sports where there seems to be a number of myths and considerable misinformation. The old story holds that weight lifting will stunt a child s growth. This myth seems to have been arisen from a 1964 study showing that Japanese children who performed heavy labor tended to be shorter in stature than those who did not. However, the study did not examine other factors such as nutrition which may have affected growth. Also heavy labor is much different than a supervised weight training session.

Today there is little reason to suspect that weight lifting as part of comprehensive training program would adversely affect a child s growth. As it turns out, the overwhelming majority of evidence indicates that weight lifting in young athletes can be very safe and is very effective in promoting strength, enhancing performance and reducing the risk of injury.

The first question surrounding youth weight training is, is it safe for the young athlete? The answer to that question is a resounding yes, with one caveat. Research studies that examined the effects of weight training on children and adolescents report only the rare occurrence of injuries. The most common cause is poor technique Reported injury rates for youth strength training are small, on the order of less than 1 per 1000 participant hours. Particularly important is that there is no evidence to suggest any adverse effects of weight training on musculoskeletal growth, development, flexibility or performance of young athletes.

The important caveat to consider is proper supervision and adequate instruction. The majority of injuries that occur do so as a result of poor technique. Either proper technique was never learned or lack of supervision lead to incorrect lifting form. It is also critically important to consider the emotional maturity of the athlete when initiating a weight training program.

The second question asked is, is weight training effective? Research indicates that in children as young as age 6 to adolescents as old as age 18, weight training improves both muscular strength and physical performance. Training programs of 8-12 weeks typically elicit strength gains of 30-50%.

In a recent study on young soccer players (12-15 years), weight lifting added to a soccer training program resulted in significant increases in both upper and lower body strength by more than 50%, sprint and shuttle run speed by 3-5% and vertical jump height by 23%. These results indicate that weight training incorporated as a part of a comprehensive soccer training program can improve strength, agility and speed.

For young athletes, strength gains are mostly the result of neuromuscular adaptations with little or no muscle growth. Following weight training, athletes show increased ability of activate muscle fibers and enhanced reflex responses. In older adolescent boys, the strength gains occur along with increases in muscle mass and neuromuscular adaptations. At these ages, increased levels of androgens (e.g. testosterone) allow for muscle growth and adaptation. In adolescent girls, some hypertrophy occurs but much of the strength gains are due to neuromuscular changes. Despite the specific mechanisms, it is cleat that weight training in young athletes increases strength and improves athletic performance.

Aside from increasing strength and enhancing performance, there are a multitude of additional benefits to weight training. Bone health is improved through increased bone mineral density. Weight bearing activities such as strength training, mechanically stress the bone which, in turn, stimulates osteogenic activity (bone production). This stimulus likely enhances the normal growth-related increased in bone mass and increases the strength of the developing bone. As noted above, this occurs without detrimental effects on growth plates. Resistance exercises also seem to lessen the risk of injury during competition. Several studies show reduced injury rates in adolescent athletes who participate in conditioning programs that include weight training. It appears that increased muscular strength, increased strength of connective tissues (tendon and ligament) as well as enhanced neuromuscular reflexes all act to stabilize various joints that are at risk (e.g. ankle and knee). This may be particularly important for females where the risk of anterior cruciate ligament injury may be reduced through resistance exercises.

Athletes can use a combination of body weight exercises, machines and free weights. Inexperienced lifters should focus on using body weight exercises and machines.

 These exercises are very safe and can help the athlete

develop proper technique along with building strength and balance needed to perform the more complex free weight lifts. These exercises also allow the athlete to get comfortable with the facility and learn proper etiquette.

While it is clear that weight training in young athletes can be both safe and effective, there are some broad general guidelines to be followed. These guidelines serve to guard against injury while maximizing the benefits of the training program. The athlete must be emotionally mature He/She must be able to follow instructions and take supervision

Train 2-3 days per week Use 7-10 exercises focused on the major muscle groups For each exercise, perform 1-3 sets of 10-15 repetitions Use moderate weight and emphasize proper technique

Exercises may incorporate a combination of body weight, machine and free weight exercises Use body weight and machine exercises to build strength and technique Overhead lifts using free weights should be avoided

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