Exercise is so important for everyone, and especially kids today.  Being sedentary is considered the new smoking as it is a huge contributing cause of diabetes, heart disease, stroke, and cancer.  Each year the rates of childhood obesity continue to rise along with the rates of obesity related diseases in a younger and younger population of Americans.  The solution is of course to get up and start moving with exercise.  Keeping kids active is so important for their health, fitness, and mental well-being.  It’s something that should be instilled from a young age to make it a consistent habit.  A habit that comes from daily child strength and conditioning.

But, how much exercise and what exercises are best when choosing child strength and conditioning regimens?  How much exercise is too much for children?  What about weight lifting?  Many questions arise from parents about child strength and conditioning and this article has some facts, tips, and recommendations to help kids and adolescents reach their full physical potential.  This also kicks off the new series of posts and YouTube videos for the Kids Strength and Conditioning Workout of the Day.  This article will review important principles for physical activity in children in addition to providing a prescription to start child and adolescent exercises and weight training.

 

Goals and Principles for Child and Adolescent Exercise

• Main goal is to successfully integrate exercise, nutrition, and recreational pursuits
• Remember that kids are NOT adults, they have different needs and will get different injuries
• Find fun activities that children enjoy
• Limit or reduce sedentary time to 30 minutes per day
• American Heart Association recommendations for activity:
  • Participation Age 2+ in 30 min moderate, age-appropriate, and varied physical  activity daily
  • Multiple small periods (2-15 min or 3-10 min) of exercise are acceptable alternatives
• Less than 3 in 10 high school students get at least 60 minutes of physical activity every day.
• Physical activity can improve health.
  • People who are physically active tend to live longer and have lower risk for heart disease, stroke, type 2 diabetes, depression, and some cancers
• Physical activity can also help with weight control, and may improve academic achievement in students.
• Inactive kids have a higher risk for obesity, early death, heart disease, hypertension, stroke, type 2 diabetes, depression, and some cancers
• Exercise helps with weight management to prevent obesity, which is a huge American epidemic
  • >12 million U.S. children are obese — 1 in every 6 children.
  • Increased risk of developing high blood pressure, high cholesterol, heart disease, sleep apnea, bone and joint problems, asthma, and type 2 diabetes.
  • More bullying and suffering from depression
  • Obesity rate has tripled since the 1970s
  • Obese children rates increasing epidemically, especially in economically depressed and minority populations

 

Tips for Getting Kids to Exercise

Encourage physical activity for one hour or more each day, with activities ranging from informal, active play to organized sports. Here are some ways you can do this:

• Set a positive example by leading an active lifestyle yourself.
• Make physical activity part of your family’s daily routine by taking family walks, playing active games together, surfing, or going to the beach.
• Give your children equipment that encourages physical activity (like how my husband buys me exercise equipment on Christmas and my birthday).
• Take kids to places where they can be active, such as parks, community fields, basketball courts, pools, hiking, the beach.
• Be positive about the physical activities in which your child participates and encourage them to be interested in new activities.
• Make physical activity FUN. Fun activities can be anything your child enjoys, either structured or non-structured. Activities can range from team sports or individual sports to recreational activities such as walking, running, skating, bicycling, swimming, playground activities or free-time play.
• Instead of watching television after dinner, encourage your child to find fun activities to do on their own or with friends and family, such as walking, playing chase, wrestling (jiu-jitsu), or riding bikes.
• Be safe! Always provide protective equipment such as helmets, wrist pads or knee pads and ensure that activity is supervised and age-appropriate.

What if my child has a disability?

Physical activity is important for all children. It’s best to talk with a health care provider before your child begins a physical activity routine.  Get advice from a professional with experience in physical activity and disability. They can tell you more about the amounts and types of physical activity that are appropriate for your child’s abilities.

 

Specific Exercise Recommendations by Age

Infancy (0-2 years)

• The infant’s natural curiosity will stimulate motor and proprioceptive skills.
• Help support this by providing tactile toys and playing with children.  
• Examples include brightly colored soft toys and balls that are designed to stimulate kids to move.
• Make sure toys are larger than the inside of a toilet paper roll in diameter to prevent choking hazard
• Motor progression: rolling -> sitting -> crawling -> walking -> running & throwing

Early Childhood (2-5 years)

• Master skills of running, kicking, and throwing
• Unstructured play is important
• Visual skills not yet mature
• Emphasize FUN!
• Competition is not appropriate (many team sports focus on fun and sportsmanship)
• Walking, running, swimming, tumbling – appropriate activities

Childhood (6-9 years)

• Central nervous system integration of psychomotor skills
• Visual skills improve
• Avoid emphasis on winning
• Acquisition of skills for eventual competition
• Swimming, baseball, gymnastics, soccer – appropriate activities
• Not ready for complex skill and rapid decision-making sports (football, volleyball, basketball), though this is debatable and may be child dependent/specific

Preadolescence (10-12 years)

• Better able to master complex motor skills and use memory strategies for rapid decision-making sports (e.g., football, volleyball, basketball)
• Should be able to compete in any sport

Adolescence (>12 years)

• The early adolescent growth spurt may cause a temporary decrease in postural control
  • The “gangly” teenage years
• Physical and emotional maturity are important and child dependant

Children are NOT Adults! Special considerations

• Potential mismatch of body size and development
• Impact of training on normal growth and development (e.g., gymnastics, figure skating, ballet) on delayed periods and short stature:
  • Current evidence suggests these reflect size demands of particular sports rather than outcomes of sports participation if nutrition is adequate
  • Eating disorders may confound these outcomes
• Early sports specialization may lead to psychological burn-out
• Growth plates at risk for injury (unlikely to be a “sprain” in children as their growth plates are so much softer)

 

Predisposition to Heat Illness in Children and Adolescents

• Greater heat production during exercise
• Less sweat production
• Higher threshold for sweat production
• Larger surface-to-mass ratio
• Less peripheral perfusion
• Slower environmental acclimatization
• Prevention: Lots of fluids, slower more gradual increases in activity amounts, more water breaks, use external cooling methods like watering down and forearm ice immersion more frequently

 

 

Concussion

• Concussion and Chronic Traumatic Encephalopathy (CTE) have made recent big headlines in the sporting world
• It is known that repetitive head trauma is bad and leads to chronic brain damage, early Alzheimer’s disease, neurological disease (Amyotrophic Lateral Sclerosis), mental/emotional disorders (depression), dizziness, balance instability, even death (second impact syndrome), and much more.
• Rules are very strict now for children and adolescents in sports:
  • Any concussion means NO same day return to play, at least 6 days before full return to sports
  • Hawaii State public school high school and University of Hawaii athletes take a computerized baseline concussion test and cannot return after a concussion until their testing returns to baseline
  • Complete physical and mental rest for 24+ hours after concussion, until symptoms completely resolve
  • Imaging is usually NOT necessary
• Parents should be aware of risks for concussion in every sport, know the signs, and what to do after head trauma
  • Signs and symptoms include: memory loss, Headache, “Pressure in head”, Neck pain, Nausea or vomiting, Dizziness, Blurred vision, Balance problems, Sensitivity to light, Sensitivity to noise, Feeling slowed down, Feeling like “in a fog“, “Don’t feel right”, Difficulty concentrating, Difficulty remembering, Fatigue or low energy, Confusion, Drowsiness, More emotional, Irritability, Sadness, Nervous or Anxious, Trouble falling asleep
  • Symptoms may get worse with physical or mental activity
  • I once had a parent tell me that many of these symptoms sound like typical teenager, so it would be symptoms above that are abnormal or unusual for your child
• Seek medical attention for any suspected concussion with a specialist with experience in sports concussion like a sports medicine physician

 

 

The positive and negative sides of competition

Psychological factor	Negative	Positive
Competitive stress	Anxiety disorder, identifies self as winner or loser, no fun involved	Develops coping skills for a competitive world
Self-esteem	Failure is a consequence of their own action, feelings of incompetence	Achievement of realistic, personal goals
Motivation	Repeated failure leading to fear of failure and lack of risk-taking	Tremendous challenge that motivates excellence, internal gratification
Competitiveness	Irrationally competitive, win at all costs	Cooperative and competitiveness mixed together
Moral development	Poor sportsmanship – cheating, violence, intimidation	Positive role models, rule organization, used appropriately
Attitudes	Criticism, exercise punishment	Healthy bodies, healthy lifestyle
Responsibility	External control, no independence	Strategy and decision making skills

 

Safe Weight Training for Children and Adolescents

• Previously controversial, studies have shown weight training can be safe and effective if done with proper supervision, lower reps, lower weights, alternating days (max2-3x/week)
• Key differences between adults and children include: lower numbers of repetitions, submaximal weights, exercising through the full range of motion and only doing a resistance program two to three times per week.

Frequency	Intensity	Type	Time
Two to three times per week	Upper body: Choose four to five muscle groups and use eight to 12 repetitions of each group in one to three sets	Submaximal resistance	Start with no weight
At least one rest day between work-outs	Lower body: Choose four to six muscle groups, use nine to 15 repetitions of each group in one to three sets	Integrate with conditioning in flexibility/cardiovascular strength	Add weight gradually to an initial maximum of six repetitions, add one to two repetitions per training session to a maximum of 12 to 15 repetitions
		Use the full range of motion	Increase weight by 0.5 to 1 kg (1 to 3 lbs). Increments every third training session No maximum lifts Each session should be 20 to 30 mins

References

• Alleyne, J.  Safe exercise prescription for children and adolescents.  Paediatr Child Health. 1998 Sep-Oct; 3(5): 337–342.
• Andrew Nichols, MD.  University of Hawaii, John A Burns School of Medicine Sports Medicine Fellowship Director and University of Hawaii Student Health Director.
• AAP, Committee on SM and Fitness and Committee on School Health: Organized sports for children and adolescents.  Pediatrics 107(6):1459-1462, 2001.
• British Medical Journal.  Sport Concussion Assessment Tool 5.  https://bjsm.bmj.com/content/51/11/848
• Centers for Disease control.  Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion.
• Madden, et al.  Netter’s Sports Medicine. Saunders © 2010.
• Reider B. Sports Medicine: The School-Age Athlete. Philadelphia: WB Saunders; 1991.
• Report of the Board of Trustees Group on Science and Technology, American Medical Association. Athletic preparticipation examinations for adolescents. Arch Pediatr Adolesc Med. 1994;148:93–8.
• Blimkie CJR. Resistance training in preadolescence: issues and controversies. Sports Med. 1993;15:389–407.
• Ozmun JC, Mikesky AE, Surburg PR. Neuromuscular adaptations following prepubescent strength training. Med Sci Sports Exerc. 1994;26:510–4.
• Faigenbaum AD, Wescott WL, Micheli LJ, et al. The effects of strength training and detraining on children. J Strength Conditioning Res. 1996;10:109–14.
• Sallis JF, Patrick K. Physical activity guidelines for adolescents: consensus statement. Pediatr Exerc Sci. 1994;6:302–14.
• DeRenne C, Hetzler RK, Buxton BP, Ho KW. Effects of training frequency on strength maintenance in pubescent baseball players. J Strength Conditioning Res. 1996;10:8–14.
• Blimkie CJR. Resistance training during pre- and early puberty: efficacy, trainability, mechanisms, and persistence. Can J Sport Sci. 1992;17:264–79.
• Cahill BR, Pearl AJ. American Orthopaedic Society for Sports Medicine, Intensive Participation in Children’s Sports. Champagne: Human Kinetics Publishers; 1993.
• Rowland T, Goff D, DeLuca P, Popowski B. Cardiac effects of a competitive road race in trained child runners. Pediatrics. 1997;100:e2.
• Kraemer WJ, Fleck SJ. Strength Training in Young Athletes. Champaign: Human Kinetics; 1993.
• Faigenbaum AD. Psychosocial benefits of prepubescent strength training. Strength Conditioning. 1995;17:28–32.
• Committee on Sports Medicine, American Academy of Pediatrics Assessing physical activity and fitness in the office setting. Pediatrics. 1994;93:686–9.
• American Academy of Pediatrics Committee on Sports Medicine: Strength training, weight and power lifting, and body building by children and adolescents. Pediatrics. 1990;86:801–3.
• Bernhardt DT, Landry GL. Sports injuries in young athletes. Adv Pediatr. 1995;42:465–500.
• Smith, Jordan. Overcoming resistance: The case for strength training in children and adolescents [online]. Sport Health, Vol. 35, No. 1, 2017: 15-18. [cited 09 Jul 18].

 

Thank you for reading this article and hopefully this helps to inspire some great physical fitness plans and activities for kids and the whole family keeping safety in mind always.  Child strength and conditioning is so important and a wonderful goal would be to instill its importance on the next generation for their mental and physical health and well-being.  Please feel free to ask any questions in the comments below or through Facebook, Twitter, Google+, linked-in, or Instagram.

 

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