Weightlifting for Children and Adolescents: A Narrative Review

A National 20-year Analysis of Weight Lifting-related Injuries and Fractures Among Adolescents

BACKGROUND

Increasing strength through weightlifting has become a core component of competitive sports training, recreational exercise programs, and school physical education classes. Although many health benefits exist, there is concern for injury, especially with improper supervision and accelerated progression of training loads. Though organizations have advocated safe training practices, trends in the national health burden of injuries, specifically fractures, associated with weightlifting in the adolescent population have not been investigated.

METHODS

The National Electronic Injury Surveillance System database was queried between 2002 and 2021 for patients aged 11 to 21 years presenting to US Emergency Departments with weight lifting-related injuries. The narrative component of each case identified was analyzed to include only patients noted to be using weightlifting equipment or free weights at the time of injury. Estimates and analyses were performed with 95% CIs.

RESULTS

Although there has been some variability in weight lifting-related injuries, the incidence remained roughly constant over the 20 years ( R2 =0.0364). 14,497 cases were identified, reflecting a national estimate of 540,986 total injuries and an annual estimate of 27,049 injuries. Most injuries occurred among 15-to-18-year olds (44.1%±1.6%) and 19-to-21-year olds (38.3%±2.0%). The most common injuries were sprain/strain (36.7%±1.3%), contusion/abrasion (15.7%±0.7%), and fracture (9.9%±0.3%). There were 53,813 estimated fractures, giving an annual incidence of 2,691 fractures. As a portion of all injuries, the number of fractures decreased significantly as patients got older, accounting for 26.8%±3.3% at age 11 and only 8.3%±0.9% at age 21 ( R2 =0.6626). Fingers (37.1%±1.8%) and toes (27.9%±1.4%) were the most fractured body parts. Overall, fractures mainly occurred either at school (25.3%±2.0%) or places of recreation (24.7%±2.2%).

CONCLUSIONS

Despite the guidelines to improve safety, the national health burden of weight lifting-related injuries among adolescents has remained constant over the past 20 years. Given that most of the fractures occur in the distal extremities, such as toes and fingers, at school and places of recreation, there may be an opportunity to promote safer weightlifting practices and the development of weightlifting equipment with in-built safety mechanisms, especially at gyms and schools.

LEVEL OF EVIDENCE

Level III-prognostic.

Trauma informed weight lifting: considerations for coaches, trainers and gym environments

A growing body of research supports weight lifting as an effective adjunct intervention in the treatment of psychological trauma and trauma-related disorders. However, studies indicate that numerous barriers exist to participation in weight lifting, especially among populations disproportionately impacted by trauma. Trauma-informed care offers a paradigm for service delivery that aims to empower clients to access healing resources by attending to six domains of experience: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and cultural, historical, and gender issues. This mixed-methods study utilizes semi-structured, one-on-one interviews and surveys to inform the design of an evidence-based trauma-informed weight lifting program for trauma survivors. The contributions of this paper are twofold. First, the salient experiential categories for conceptualizing psychological healing in the gym environment are presented, informed by the lived experiences and recommendations of a national sample of trauma-impacted weight lifters. Second, based on the findings of this study, guidelines are proposed for the development of trauma-informed weight lifting programming that may be incorporated into the practice habits of personal trainers. The results of this study aid in the reduction in barriers that currently limit the adoption of weight lifting as an adjunct intervention for trauma and contribute to the professionalization of personal trainers in trauma-related competencies.

Association between sugar-sweetened beverage consumption frequency and muscle strength: results from a sample of Chinese adolescents

BACKGROUND

Although sugar-sweetened beverage consumption has become an important and widespread concern, there are few studies on the association between sugar-sweetened beverage consumption frequency and muscle strength in Chinese adolescents. The objective of this study was to analyze the association between sugar-sweetened beverage consumption frequency and muscle strength in Chinese adolescents.

METHODS

A stratified whole-group sampling method was used to survey 25,893 adolescents aged 13-15 years old in China for sugar-sweetened beverage consumption frequency and muscle strength for grip strength and standing long jump. The subjects' basic information, body mass index (BMI), and covariates were investigated. The association between sugar-sweetened beverage consumption frequency and muscle strength was analyzed by multivariate logisitc regression analysis.

RESULTS

The proportions of Chinese adolescents who consumed sugar-sweetened beverage ≥ 3 times/week, 1-2 times/week, and < 1 time/week were 12.23%, 52.79%, and 34.98%, respectively. The differences in sugar-sweetened beverage consumption frequency were statistically significant when compared across gender, parental education, duration of physical activity, snacks, and mode of commuting to school (χ² values = 228.570, 51.422, 275.552, 3165.656, 10.988, P < 0.01). Logistic regression analysis showed that overall Chinese adolescents with sugary drinks 1-2 times/week (OR = 1.207, 95% CI:1.132-1.287) and sugary drinks ≥ 3 times/week (OR = 1.771, 95% CI:1.611-1.947) were associated with lower muscle strength compared to sugary drinks < 1 time/week showed a positive association (P < 0.01). The same trend was found for boys and girls.

CONCLUSION

Chinese adolescents' sugar-sweetened beverage consumption is common, and high-frequency sugar-sweetened beverage consumption is associated with lower muscle strength. In the future, we should control the use of sugar-sweetened beverages and increase muscular strength training in Chinese adolescents to promote healthy growth.

National Strength and Conditioning Association Position Statement on Weightlifting for Sports Performance

ABSTRACT

Comfort, P, Haff, GG, Suchomel, TJ, Soriano, MA, Pierce, KC, Hornsby, WG, Haff, EE, Sommerfield, LM, Chavda, S, Morris, SJ, Fry, AC, and Stone, MH. National Strength and Conditioning Association position statement on weightlifting for sports performance. J Strength Cond Res XX(X): 000-000, 2022-The origins of weightlifting and feats of strength span back to ancient Egypt, China, and Greece, with the introduction of weightlifting into the Olympic Games in 1896. However, it was not until the 1950s that training based on weightlifting was adopted by strength coaches working with team sports and athletics, with weightlifting research in peer-reviewed journals becoming prominent since the 1970s. Over the past few decades, researchers have focused on the use of weightlifting-based training to enhance performance in nonweightlifters because of the biomechanical similarities (e.g., rapid forceful extension of the hips, knees, and ankles) associated with the second pull phase of the clean and snatch, the drive/thrust phase of the jerk and athletic tasks such as jumping and sprinting. The highest force, rate of force development, and power outputs have been reported during such movements, highlighting the potential for such tasks to enhance these key physical qualities in athletes. In addition, the ability to manipulate barbell load across the extensive range of weightlifting exercises and their derivatives permits the strength and conditioning coach the opportunity to emphasize the development of strength-speed and speed-strength, as required for the individual athlete. As such, the results of numerous longitudinal studies and subsequent meta-analyses demonstrate the inclusion of weightlifting exercises into strength and conditioning programs results in greater improvements in force-production characteristics and performance in athletic tasks than general resistance training or plyometric training alone. However, it is essential that such exercises are appropriately programmed adopting a sequential approach across training blocks (including exercise variation, loads, and volumes) to ensure the desired adaptations, whereas strength and conditioning coaches emphasize appropriate technique and skill development of athletes performing such exercises.

ENHANCEMENT BY DIET AND AEROBIC EXERCISE IN PROFESSIONAL ATHLETES

ABSTRACT Introduction: Body weight regulation in sports competitions is an essential factor affecting the physical capacity of athletes. Especially in high-level events, the role of weight loss is significant in improving the competitive status. Weightlifters have high anaerobic capacity, high aerobic capacity, high flexibility, and less body fat. In all regular competitions, weightlifters compete against competitors of the same weight class. Objective: This paper investigates the effect of moderate aerobic exercise on weight loss in athletes and the effects of related biochemical parameters. Methods: Twenty weightlifters were randomly selected to conduct a questionnaire survey. The athletes performed aerobic exercises for eight weeks. The collection method and mathematical statistics were used to study body shape and constitution, blood indices, and other relevant data about weightlifters in China. Results: The effect of aerobic exercise on improving the athletes' physical fitness is discussed. The results showed that body weight, waist circumference, hip circumference, and body mass index decreased the most (P<0.05). Waist-to-hip ratio, waist-to-height ratio, hip-to-height ratio, and BMI significantly decreased (P<0.05). There was no significant change in height and fat index (P>0.05). Conclusion: 8 weeks of aerobic exercise and an appropriate diet can significantly improve the body shape index, physical index, and biochemical index of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

TRAINING FOR PHYSICAL CONDITIONING OF YOUNG BODYBUILDING ATHLETES

ABSTRACT Introduction Biochemical indicators such as blood urea nitrogen and creatine kinase in young athletes are ways to test their fitness. These data provide the basis for assessing young athletes’ physical and functional fitness during training. Objective Investigate serum urea nitrogen levels and creatine kinase levels in weightlifters. Methods 12 biomarkers of athletes were tracked and observed in this article. After this study, it was found that changes were observed in their physiological parameters. These changes are usually found every three weeks. The method of mathematical statistics was used to analyze the data obtained. Results The average creatine kinase levels were significantly elevated in the first cycle. These data differ from the basal level (P<0.01). The increased serum urea nitrogen and creatine kinase levels indicate that the athlete has entered a state of fatigue. Conclusion Blood urea nitrogen and creatine kinase levels are essential in determining the degree of fatigue and sports injuries in athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Incidence and temporal changes in lumbar degeneration and low back pain in child and adolescent weightlifters: A prospective 5-year cohort study

This study was conducted to investigate the incidence of lumbar degeneration findings and low back pain (LBP) in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires over a 5-year period. Moreover, we aimed to reveal the temporal changes in the lumbar vertebrae caused by long-term weightlifting training during the growth period. Twelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys, including data on practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up. Lumbar disc degeneration was detected in all the participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting. This 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. High frequency weightlifting training over a long period during the growth period may increase the risk of developing current and future LBP.