Introduction
Strength training before adolescence is becoming more common in sports and physical fitness. [1] Children and adolescents experience similar health benefits from strength training as adults if they follow age-specific training. [2] Strength training A controlled and supervised approach can help children and teens achieve better health strength and overall well-being. [3]
Potential risks of Strength Training
Like any other form of physical activity, strength training has some risks associated with it. However, the risk was no greater than for any other sport or physical activity that children and adolescents regularly participate in. [4] Most reported injuries were due to improper training Technology is under-supervised or under-supervised or overburdened. [5] The risk of strength training injuries can be minimized by ensuring adequate supervision, designing an appropriate training program, careful selection of training equipment and allowing adequate recovery time during training Training sessions and addressing each child’s questions and concerns
Benefits of Strength Training
Strength training programs have many benefits beyond muscle strength, including improved athletic performance injury prevention enhanced overall health and well-being[1] increased bone mineral density and cardiorespiratory fitness weight management and improvement Sports performance skills. [5] Free weight training is better than training with machines, which are often built to adult specifications and may not be suitable for young adults. Moderate-load high-repetition training has been found to be more beneficial than heavy-load low-repetition training repeat [6]
Guidelines for Training
Developing a training program should follow similar principles as developing a program for adults. It’s important to remember that prepubescents are still anatomically, physically and psychologically immature. The following guidelines should be followed when developing a training program For children or adolescents [2]:
- Provide qualified supervision and instructions is important
- The exercise environment must be safe and free from hazards/factors that could cause injury
- Each session should begin with a 5-10 minute active warm-up session
- A lighter load should be included in training with special attention to technique and efficiency
- 1-3 sets of 6-15 repetitions should be performed on various upper and lower body strength exercises
- The program should include specific exercises that strengthen the abdomen and pelvis
- The program should focus on achieving perfect muscle tone and proper muscle balance around joints
- The training program should be improved rationally based on need objectives and capabilities
- The resistance should gradually increase by 5-10% as the intensity increases
- Relaxation should be less intense and should include static stretches
- Every meeting should address individual needs and concerns
- Resistance training should be started 2-3 times a week on non-consecutive days
- Training plan and progress should be documented in the individual plan
- Systematically changes the show to keep it interesting and appropriate for the age group
- Healthy nutrition, adequate hydration and proper sleep should be advised to optimize performance and recovery
- Ongoing support from trainers and parents
- Process – Basic principles of youth resistance training [7].
- P – Progression gradually increases the demands on the human body
- R – Regular ongoing participation in exercise (2-3 days per week)
- O – Overload puts more stress on the body than it is used to
- C – Creativity Introduce novel exercises and training equipment to maintain motivation (youth may be involved in the development of training procedures in a safe environment)
- E – ENJOY Promotes long workout engagement by balancing skill and challenge
- S – Socialization facilitates the acquisition of competence and confidence, as well as the optimization of training progress due to interaction with others
- S – Supervision Safety exercise environment including reasonable information
- General Considerations
- Quality instruction with close supervision and a safe exercise environment
- Systematic changes in exercise selection and training intensity to keep the program fresh and challenging
- Consideration of individual needs and concerns (e.g. training age normal body size maturity) .
- Focus on proper exercise technique
- Train 2-3 weekly on non-consecutive days
- Exercise Session
- Start with 5-10 minute dynamic warm-up
- Incorporating exercises involving all major muscle groups and emphasizing consistent movement around joints
- Multi-muscle exercises performed before single-joint exercises
- Training large muscle groups before small muscle groups
- Includes balance and coordination exercises
- Relax at the end of your workout, including stretching
- Intensity and Volume
- Start with 1-2 sets at ≤ 60% 1RM
- After familiarization, 1-3 sets of 6-15 repetitions of strength exercises approximately 80% of 1RM
- Once familiarized, perform 1-3 sets of 6-8 repetitions of strength exercises
[8]
Practical Assessment and Treatment of Cervicogenic Headaches Ari Kaplan’s online course Learn more on this topic
RELATED ARTICLE Raising Physically Active and Active Kids – Overuse Injury and Burnout – Physiopedia Introduction While there is a general decline in physical activity among young people [1], large numbers of children participate in organized sports each year. Only in the United States of America (USA) More than 46.5 million children play sports. [2] While the benefits of physical activity are clear [3], participation in formal sport can also lead to overtraining, overuse injuries, and burnout. Each year, more than 10 percent of American children under the age of 14 are treated for a sports injury. 2015 to There were 1.2 million injuries among U.S. high school athletes in 2016. [4] Furthermore, half of all sports injuries in children over the age of 10 are overuse injuries. [5][6] Overtraining associated with overuse injuries can also lead to burnout in young athletes, which can affect children’s Participated in sports for a long time. [7] [8] Defining overuse injury and burnout [edit | edit source] Overuse [edit | edit source] Repetitive submaximal loading of the musculoskeletal system can lead to overuse injuries when rest is insufficient for structural adaptation. Injury may involve the musculotendinous unit, the neurovascular structure of the bone capsule, and the epiphysis. Overuse injuries specific to young athletes include condyle injuries and epiphyseal stress injuries. [9] DiFiori and colleagues [9] state that there is a specific “high risk” of overuse injury It will cause the child to be inactive for a long time. These injuries may also affect the child’s future participation in sports. Common injuries in children are discussed here, but examples of high-risk overuse injuries include: Specific stress fractures Pelvic stress injuries Osteochondritis Anatomy of some condyle injuries Burnout [edit | edit source] Burnout is considered part of a range of conditions, including overtraining and overtraining. [9] DiFiori and colleagues state that it occurred when a young athlete stopped competing due to chronic stress in previously pleasant activities. [9] Growing need for intervention [edit | edit source] There are many factors that increase a child’s risk of injury. Specific anatomical features are discussed in more detail here, but the following should be considered:[6] Immature Skeletal[10][11] Insufficient rest training or conditioning/muscle strength after injury[11] Focus on only one sport Young athletes focus on movement (and position) at an earlier age, which is known to increase injury risk[ 9][10][12] Specialization may also be relevant There is burnout, but as noted by DiFiori and colleagues [9], not all children who withdraw from sports have burnout delayed until late adolescence [6] (The video below discusses early and delayed specialization in many fields, including sports) Year-round participation[13] Training programs are often regular and repetitive, which increases the number of overuse injuries in children[13] Society Change [6] Backyard Shrink Perceived Hazardous techniques less play time more training time [14] Overuse Injury and Burnout Prevention [edit | edit source] A child’s injury history is:[6] a risk factor for future injury (during adolescence and adulthood) leading to long-term Degenerative diseases, such as osteoarthritis As As shown in Table 1, which is based on the work of DiFiori and colleagues [9], risk factors can be divided into intrinsic and extrinsic risk factors. Table 1. Intrinsic and extrinsic risk factors. [9] Critical: +++ = strong predictor of future injury/burnout; ++ = moderate predictor; + = mild predictor; 0 = Insufficient evidence Not considered a predictor of injury Intrinsic risk factors Extrinsic risk factors Previous injury +++ Higher training volume++ Growth spurts +++ Overscheduling + (recovery time++) History of amenorrhea +++ Improper equipment + joint hypermobility + (especially during puberty) Motor expertise + readiness + (physiological and psychosocial rather than age) anatomical alignment functional control of mobility 0 sufficient strength to sustain strength and range of motion + Jayanthi and colleagues [15] found that the following factors increased severe probability Overuse Injuries: Young athletes participate in more hours of exercise per week than their peers for their age (i.e. > <60% 1RM 15 to 20 repetitions. [6] Strengthening programs should be generic – i.e. aim for “overall performance”. Exercise Special skills can be added later if required. Balance coordination and plyometrics exercises should also be included. [6] It is important that the program is challenging and does not bore the child. This can be achieved by systematically reviewing/changing training programs. [6] Children and adolescents should not Doing weightlifting bodybuilding or extreme weightlifting (due to physical and skeletal immaturity) – ie they should avoid explosive fast lifting. [17] Another important consideration is the structure of the intensive class. Children should have access to fluids and proper nutrition. Additionally, illness or injury must be considered:[6] Aim for a 10- to 15-minute dynamic warm-up (see above) to focus on proper exercise technique and learning basic training principles Relaxation should include lower-intensity activities and stretching or yoga Note: American Academy of Sciences Pediatrics [17] recommends that instructors or teachers be certified to provide specific pediatric strength training. It’s also important to get medical and parental consent before starting any program. Core training for children[edit | edit source] How important is core training for children? The core muscles are preanticipated, which means they activate prior to activity. [6] As a result, children naturally engage their core while playing (e.g. playing tag, climbing trees, etc.): [6] Therefore, more emphasis should be placed on general strength training rather than just core strengthening. Strength training exercises will also train the core base movements/exercises provide stimulation to accommodate the endurance of the core, as in other systems In order to train for true overall strength and overall development, core training should also address strength and power, not just endurance with Benefits of strength training for speed endurance in children [edit | edit source] Potential benefits of pediatric resistance training include:[29] Greater muscle strength and endurance Improved motor skill performance Increased bone mineral density Enhanced body composition Improved insulin Sensitivity and lipid profile Reduces risk of sports injuries Improves athletic performance It also contributes to a more positive attitude towards physical activity throughout the lifespan. [29] [30] Monitoring effectiveness[edit | edit source] It is beneficial to consider children’s goals When monitoring the effectiveness of interventions. [6] To assess whether physical activity, physical literacy, and physical fitness are improving, consider using: PANIC Physical Activity Questionnaire [31] PACER Shuttle Running CAPL Canadian Assessment of Physical Literacy [32] Motor Coordination Skills (i.e. for Developmental Coordination Disorder) activity can be measured using mABC[33] and BOT2[34]. Standing on one leg (on seconds) walk from heel to toe in one line (up to 6 steps) trunk strength plank assessment (ages 8 to 12) kneeling press (BOT2 for ages 4 to 7) daily step count using pedometer normal here The scope of these tests is provided. Motivate a child [edit | edit source] a child A sense of self-efficacy is needed to engage in challenging tasks. [6] Intrinsic motivation is an important part of strength training. It can be reinforced by:[6] setting a SMART goal for the child “Like” Children Who Can Lead the Way Acknowledge and Explain Discomfort Strength Training – An Introduction to Physiology Strength training (also known as resistance training) increases muscle strength by working the muscles against weight or force. Resistance exercise is a Anaerobic exercise. [1] Different forms of strength training include using free weights, resistance bands, and your own body weight. Beginners will need to train 2 to 3 times a week for maximum benefit. Clients should complete a pre-participation health check and Before starting a new fitness program, consult a professional, such as an exercise physiologist, physical therapist, or registered exercise specialist. Participants should rest each muscle group for at least 48 hours to maximize strength and size gains. Varying Exercise Styles to Help Clients Overcome Difficulties Training Plateaus [2] Examples of Strength Training [edit | edit source] Different types of strength training include: Free Weights – Classic strength training tools such as dumbbells, barbells, and kettlebells. Medicine Ball or Sandbag – A weighted ball or sandbag. weightlifting machine – Equipment with an adjustable seat, the handle of which can be attached to a weight or hydraulic device. Resistance Bands – These provide resistance while stretching. They are portable and can fit most workouts. The band provides continuous resistance throughout the movement. hanging equipment – A training tool that uses gravity and the user’s body weight to perform various exercises. Bodyweight – can be used for squat push-ups and pull-ups (especially handy when traveling or working)[2]. Maximum Repetitions for Weight Training [edit | edit source] Repetitions Maximum (RM) is the maximum weight a person can lift for a specified number of reps. For example, a 10RM is the heaviest weight a person can lift for 10 consecutive repetitions of an exercise. RM is a great way to gauge a person’s current strength level. One repetition maximum (1RM) is defined as A person can only lift a maximum weight for one repetition with proper technique. The 1RM test is most commonly used by strength and conditioning coaches to assess strength capability, strength imbalances, and to assess the effectiveness of training programs [1] by establishing the 1RM and Tracking it, you can observe a person’s progress. This is a precise measure, so it can help judge the program’s effectiveness. [3] It can be computed directly using a max test, or indirectly using a submax estimation method. There are many different formulas to estimate your 1RM All calculations are slightly different. The most popular (and proven accurate1) is Matt Brzycki’s Brzycki formula: Weight / ( 1.0278 – 0.0278 × number of repetitions) If you just managed to lift 100 kg five times, you can calculate your 1RM like [ 4]: 100 / (1.0278 – 0.0278 × 5 ) = 112.5 kg How to Safely Test Your 1RM While the 1RM is a very useful tool, it has limitations. Measuring your 1RM isn’t just a matter of grabbing the max weight you can and having one do reps. By definition, you will be maximally emphasizing this muscle and placing the person in the Risk of injury if not handled correctly. You need to be prepared to do it right. For example, choose the movement you want to test (squat bench press, etc.). A person warms up with at least 15 to 30 minutes of light aerobic exercise and dynamic stretching. person performs selected 6 to 10 repetitions Move with a weight that is about half of what you think is your maximum weight. Then rest for at least a minute or two. Increase the weight to 80% of your considered maximum. The person performs three reps and then rests for at least one minute. Increase weight in approximately 10% increments And people did one repetition per attempt, resting at least one to two minutes between each attempt. The maximum weight that can be successfully lifted with good form and technique is 1RM [3]. Design Strength Program[edit | edit source] It is important to pay attention to safety and form so that Reduce the risk of injury. A typical beginner’s strength training program includes: A warm-up before resistance training, such as walking, cycling or rowing for 5 minutes, starting with 8 to 10 exercises that target the body’s major muscle groups, 2 to 3 times per week. Start with a set of each exercise with a minimum of 8 repetitions of each exercise, no more than twice a week. Gradually build up to two to three sets of each exercise — eight to twelve repetitions every two or three days. Once people can comfortably complete 12 exercises further progress. The principles of strength training include controlling the number of repetitions (reps) setting the tempo of the exercise and strength to overload a set of muscles and produce the desired change in strength endurance size or shape. Specific Combination Exercise Resistance for Repetition Sets Strength will determine the type of muscle development. General guidelines for using the RM range include: Muscle Strength: 1 – 6 RM per set. Muscle Strength/Power: 3 – 12 RM per set fast or controlled. Muscle Strength/Size: Control 6 – 20 RM per set. Muscular Endurance: Control 15 – 20 or more RM per set[2]. Effects of strength training [edit | edit source] Strength training stimulates a variety of positive neuromuscular adaptations that enhance physical and mental health. Physical and Mental Health Benefits That Can Be Realized Through resistance training including: Improves muscle strength and tone. Maintain flexibility and balance, which can help maintain independence in aging. Weight management and increasing your muscle-to-fat ratio—maybe more beneficial for fat loss than aerobic exercise. [1] possible Help reduce or prevent cognitive decline in older adults. Greater Stamina – As you get stronger, you’ll tire less easily. Prevent or manage chronic diseases such as diabetes, coronary artery disease, arthritis, back pain, depression and obesity. pain management. Improve posture. Reduce the risk of injury. Increases bone density and strength and reduces the risk of osteoporosis. Improves well-being – Resistance training can boost self-confidence and improve body image and mood. Improve sleep and avoid insomnia [2]. Increase blood sugar utilization Reduces resting blood pressure Improves lipid profile Increases gastrointestinal transit velocity [5] Strength training and chronic disease[edit | edit source] People with chronic diseases can benefit from exercise, such as diabetes asthma metabolic syndrome cardiovascular disease low back pain Arthritis Joint Pain Depression (COPD). Strength training improves muscle strength and endurance, makes daily activities easier, slows disease-related declines in muscle strength, and provides stability to joints. Obesity A sedentary life can lead to muscle loss, a slowed metabolism and fat gain. Currently, almost 70 percent of American adults are obese, putting them at increased risk for chronic disease and other health problems. Less than 5% of adults engage in regular endurance exercise (US). Strength training offers a practical approach to fighting obesity and triggers Physical and mental improvements that positively impact quality of life. Basic and brief strength training sessions have been proven effective in rebuilding muscle, replenishing metabolism, reducing fat, and enhancing various health and fitness factors[6] Cardiovascular Disease (CVD) Reductions in SBP (5-6 mmHg) and DBP (3-4 mmHg) induced by resistance exercise were associated with an 18% reduction in major cardiovascular events (Antihypertensive Therapy Trials Collaborative, 2014) Mcleod et al 2019 Recommendation Low-Moderate strength Resistance exercise training (RET) (30–69% of 1RM) is safe and effective even in individuals with or at risk of developing CVD. [7] A comprehensive resistance training program consisting of 8 to 10 exercises lasting 20 to 30 minutes at an intensity of approximately ≈50±10% of 1RM with a minimum of 2 Several days per week, it is recommended to progress to 3 days per week if time permits. Exercise needs to be done at a comfortable intensity (RPE [Rate of Perceived Exertion] of 13 to 15) and without Valsalva. If participants can exercise by gaining 5% of their body weight Can comfortably lift weights for 12 to 15 reps. If the participant is unable to complete the minimum number of repetitions (8 or 10) using good technique, the weight should be reduced. [8] (According to AHA) Type 2 Diabetes American Diabetes Association 2014 Report Lifestyle Modifications (i.e., diet and exercise) were associated with lower glycemic control compared with drugs that emphasized more aerobic exercise training. However, there are other studies showing the benefits of resistance exercise for blood sugar control. There is a contradictory result showing Intensity levels of resistance exercise for glycemic control. But the research done by McLeod et al. The 2019 recommendation is to incorporate twice-weekly whole-body resistance training into your routine without worrying about the intensity of the exercise. [7] Cancer resistance exercise in Reduction of cancer risk cancer recurrence cancer mortality and improved prognosis during adjuvant therapy. Resistance movement has been evident in breast cancer [9] and prostate cancer. Further work is needed to address optimal dose strength and resistance-specific mechanisms Exercise-induced cancer benefits. [7] Strength and the Aging Population [Edit | Edit source] As we age, various comorbidities and frailty develop. Debilitating sarcopenia and osteoporosis are the most common disorders leading to reduced physical activity and increased disease fall. [1] Resistance exercises can play an important role in improving functional mobility. Resistance exercise is a potent stimulus for muscle hypertrophy and increases bone density, which is affected by sarcopenia and osteoporosis. Combining resistance training with joint training Exercise (balance exercises, aerobic exercise) has been shown to be the best strategy for improving functional mobility in older adults. [10] Recent evidence suggests that recommended protein intake may be too low for older adults and improving protein intake with strength exercise is very helpful. [11]. See Muscle function and protein in: Age and Exercise; Physical Activity in Aging and Falls; Muscle Function: Impact of Aging Resources [edit | edit source] (2014) ACSM Guidelines for Exercise Testing and Prescribing. suffering from and Cardiovascular disease free – American Heart Association’s effect of weightlifting or resistance exercise on breast cancer-associated lymphedema: a systematic review [Edit source] DeLorme and Oxford strength training principles comparing strength training with Power Training Strength and Conditioning Preadolescent Strength Training Assessment and Exercise Intervention Early and Middle Child Development – PhysiopediaIntroduction The number of children diagnosed with developmental disabilities has increased in recent years. [1] This is Therefore, it is important that therapists and teachers are able to screen children for any difficulties that may affect the child’s readiness for school or sports. This page discusses some of the rapid assessments that can be used to screen children and also explores Children participate in sports activities. PhysiFun Checklist [Edit | Edit Source] The PhysiFun Checklist has been developed to highlight to teachers/therapists whether a particular student needs help with a particular activity. It is also a useful parent feedback tool:[2] Class List Check To be completed by teacher, takes about 10 minutes Grades 0 – 1 Checkup To be done by parent or teacher, takes about 5 minutes Quick test (listed in Table 1) checks each term Specific assessment for tardy children Always refer to one receiving a physical therapy session If child is severely delayed Table 1. Quick test skills 4 years 5 years 6 years Stand on one leg (seconds) 7 10 15 Walk in a straight line from heel to toe (steps) 4 5 6 Lift knee in 30 seconds (repeats) 3 to 5 6 to 10 11 to 15 specific tests [edit | edit source] following balance strength and activity The test can also be used to quickly identify any deficits in the child: Standing on one leg:[2] 4 year olds tend to hold the position for 7 seconds 5 year olds 10 seconds 6 year olds 15 seconds Walking in a line from heel to toe:[2 ] 4-year-old children Tend to be able to walk 4 steps 5-year-olds 5 steps 6-year-olds 6 steps Knee push-ups in 30 seconds:[2] 4-year-olds tend to be able to do 3 to 5 repetitions 5-year-olds 6 to 10 repetitions6 11 to 15 repetitions plank test for children aged 11 to 15 Also used to assess trunk strength in children ages 8 to 12:[3] Children ages 8 to 10 can typically hold this position for 69 to 108 seconds Children ages 11 to 12 can typically hold this position for 86 to 127 seconds Daily steps can also be used as Physical Activity Measures: [2] Children aged 6 to 19 average 12,000 steps per day: [4] Girls average 11,000 to 12,000 steps per day Boys average 13,000 to 15,000 steps (chest and head up): [5] Children aged 3 should be able to Hold this position for about 15 seconds A 4-year-old holds it for about 17 seconds A 5-year-old holds it for about 27 seconds A 6-year-old holds it for about 53 seconds Prone Stretch Test (i.e. lift arms head and legs off the floor):[5 ][6 ] A 4-year-old child should be able to Hold this position for about 18 seconds A 6-year-old should be able to hold for about 29 seconds A 8-year-old should be able to hold for over 30 seconds Push-ups:[5] A 5- and 6-year-old should be able to do 3 repetitions were able Complete 4 reps An 8-year-old should be able to perform 5 reps of curling up (i.e. sitting with legs straight):[5] 5- and 6-year-olds should be able to do 2 reps 7-year-olds should be able to do 4 reps 8-year-olds should be able to do 4 reps Do 6 repeat monitoring Effectiveness [edit | edit source] It is important to consider your goals when monitoring the effectiveness of an intervention (see below). The above tests can be repeated every few months to measure changes following the intervention. There is also a range of outcome measures that can be assessed specific area. [2] To improve physical activity literacy and fitness, the following tools are available as assessments and outcome measures: Canadian Physical Literacy Assessment[7] Progressive Aerobic Cardiovascular Endurance (PACER) Running (similar to the beeper test) PANIC Physical Activity Questionnaire[8] To assess motor coordination skills (i.e. developmental coordination disorder), the following are used as assessment and outcome measures: Motor ABC and Motor ABC Checklist[9] Bruininks Oseretsky Test (BOT) and BOT2[10] for improve focus Self-Regulation and Social Engagement: The Strengths and Difficulties Questionnaire is a freely available self-report assessment tool[11][12] In order to improve children’s experiences in all areas of life (i.e. ecological interventions), it is important to use intervention outcome measures Look at environment tasks and children. Examples include: Assessment of School Functioning[13] Goal Achievement Scale (GAS)[14] Interventions[edit | Edit source] For children who require more investment in physical development, it may be useful to introduce ecological interventions[15] – ie Intervene as part of your child’s daily life, preferably during the school day. [2] The main benefits of classroom integration [edit | edit source] require the following interventions:[2] Cost-effective Easy to implement during school hours Addresses gross motor difficulties Postural problems Poor levels of physical activity participation and inability to concentrate during school hours “Little but regular” physical activity guidelines can be implemented [edit | edit source] The following guidelines are based on World Health Organization recommendations: [16][17] Children ages 5 to 18 should: 60 minutes per day of moderate-intensity (5-6/10) to vigorous activity (8/10) Children ages 3 to 5 should spend less than 2 hours of screen time Goals for 2019 should be: 3 hours of physical activity per day Screen time less than 1 hour Children’s physical health Activity should include a variety of aerobic activities, including some vigorous exercise At least 3 days a week, children should participate in activities that strengthen muscles and bones For additional health benefits, children should be more active – up to several hours per day [18] Components of a physical activity intervention[edit | edit source] Exercise interventions should target all key areas of a child’s development, and exercise should include a variety of skills. [2] Should include the following: A warm-up based on: [2] Injuries Prevention strategies[19][20] targeting health benefits[21] targeting cognitive benefits of short bouts of vigorous activity[22][23] general core and body strengthening exercises to:[2] prevent injury[24][25 ] Prevents pain associated with hypermobility/ligament laxity Prevents restlessness and Improved learning postural control Increased upper body strength to aid in handwriting Increased lower body strength for playground and physical activity Basic motor/motor skills to help achieve: Lifelong enjoyment of movement[26][27][28] These skills include jumping Standing on one leg Jumping, jumping, galloping, catching, throwing and rolling a ball, etc. Self-regulation and executive attention skills through: Yoga and mindfulness training during active movement and postures [29][30][31] Difficulties some children face in the education and empowerment process with teachers and coaches[32] Coaches and teachers should be taught to choose appropriate activities that suit a child’s specific abilities and needs Respect their physical abilities – coaches should also be taught how to develop these skills[2] The video below contains a demonstration of a PhysiFun training session. [33] Warm up [edit | edit source] A warm up should include:[2] half or three-quarter speed jog and reverse Jogging Light jogging with high knees Skip hip kicks and toe extensions Crawling calf stretches Lunge twists Walking quadriceps stretches Active dynamic flexibility exercises [34] are essential in the warm-up. Children should be encouraged to complete the range of motion required for specific sports. If a child does not have the required range of motion/flexibility for an exercise, they should be encouraged to stretch during a downtime or at home. [2] The warm-up should also include three-quarter speed movement-specific coordination exercises (i.e., any challenging balance/stability and agility, such as boundary jumping and diagonal cutting). [2] Some strengthening exercises should be included. It’s especially important to include exercises that target muscles that are prone to strain during your child’s favorite/routine sports, such as hamstrings or groin muscles. [2] Cooling down [edit | edit source] Cooling down should include static stretching and the child should be given time to drink water. Note: Dynamic stretches are helpful for movement similar to those in competition. They raise the temperature of muscle tissue in the body, increase blood flow, and activate nerves The system thus prepares the body for in-game actions. [2] Strength training edit source] Strength training should be included in children’s programs. Both general and core strength training should be included. Note: Any basic strength training will also work the core. Strength Training Should be introduced before strength training so that young athletes develop sufficient strength to perform strength training activities [35] Strength training can help children develop basic motor skills [36] Basic running or chasing activities can promote endurance adaptations in the core (and other systems) three bouts of high-intensity activity (one minute, 60% to 95% of maximum effort) should be included in a program to realize the potential cognitive and metabolic benefits of exercise [2] High-intensity exercise has been found to be beneficial for both inhibition and Work Children’s memory[37] Summary [edit | edit source] Children should be evaluated for any developmental difficulties Teachers or parents can complete a rapid assessment Children can be referred for physical therapy if needed activityPhysical Activity and Injury Prevention in Adolescents – PhysiopediaIntroduction The regular health benefits of participating in physical activity are well researched [1]; however, insufficient physical activity remains one of the greatest health threats globally and the leading preventable cause Morbidity and mortality [2]. From 1975 to [3], the prevalence of obesity worldwide nearly tripled. In 2016, more than 340 million children and adolescents aged 5-19 were overweight or obese [3]. More than 80% of the world’s adolescent population is not physically active [4]. Physiotherapists face increasing challenges in their efforts to promote physical activity so that people can lead healthy lives. Physical activity has its own risks, such as participant injury and accidents. Children and adolescents are the largest participants in physical activity They are particularly vulnerable to these injuries because of high exposure, improper technique, poor proprioception, muscle weakness, equipment not adapted to their size, and lack of fear and understanding of risk [1][5]. Physical activity is leading cause of injuries and hospitalizations Adolescent visits [6]. Most injuries or accidents resulting from physical activity are not life-threatening, but they often result in pain disability, school absence, absence from physical activity, and sometimes short- and long-term functional impairment [1]. Joint injuries will accelerate Osteoarthritis develops, so preventing injuries associated with physical activity is essential. In a review, Emery showed that injury prevention strategies in children can reduce the risk of physical activity-related injuries [7]. Physical activity and health[edit | edit source] The World Health Organization (WHO) defines physical activity as “any movement of the body produced by skeletal muscles that requires energy expenditure” [4]. This broad definition means that there are many ways to exercise, such as playing sports, walking, cycling, doing housework and gardening. Regular physical activity is known to have many health benefits, including: Reduced risk of cardiovascular disease Reduced risk of type 2 diabetes Reduced risk of certain types of cancer Improved heart, lung and muscle fitness Lower blood pressure Improved mental health and Wellbeing Improved social and moral development Ability to improve academic achievement – such as the ability to concentrate and better classroom discipline Helps maintain a healthy body weight [4]. The World Health Organization recommends that children and adolescents accumulate at least 60 minutes of moderate to Daily vigorous-intensity physical activity, which should include intensive activity 3 times per week [4]. All children and adolescents should minimize prolonged sedentary time. The role of the physiotherapist [edit | edit source] British Chartered Institute Physiotherapy (CSP) defines physical therapy as “a health care profession that works with people to identify and maximize their motor and functional abilities” [8]. Physical therapy helps people of all ages prevent and recover from injury, disease or disability. This can be done by Education suggests exercise and manual therapy. It is important to have the skills required to work in these on-demand services. The National Health Service (NHS) knowledge and skills framework focuses on six core areas: communication personal and people development health safety and Security services improve quality equality and diversity [9]. The CSP emphasizes the need for physical therapists to include these core dimensions in their work [10], and they can be applied to the expanding role of physical therapists in the prevention of injuries and accidents. Physiotherapists must Be open to personal and people development Consider health safety and security when developing new methods of open communication to implement ways to improve safety Is critical and important to equity and diversity. Physiotherapists can develop an injury prevention plan by using the Intervention Mapping (IM) protocol. This involves a systematic process that lays out a series of six steps to develop a theoretical and evidence-based health promotion program [1]. these six steps The process can help physical therapists develop various prevention programs, such as preventing injuries and accidents in teens due to physical activity. Risk factors are often the main guide for preventive measures of physical activity [1]. These risk factors can Increased risk of injury or accidents from physical activity in adolescents may include both extrinsic and intrinsic factors. A combination of these factors can also lead to injuries and accidents. It is important for physical therapists to identify these risk factors so that to help prevent. Demand for health care services [edit | edit source] The health benefits of physical activity are extremely important, but physical activity can also put participants at risk of injury or accident. Physical activities such as sports and recreational cycling skateboarding and Playground use was the most common reason for Australian adolescents aged 0-16 years to seek medical attention, with 14% of injuries requiring hospital treatment [11]. Similar results were found in countries such as Norway, France, New Zealand, and the United States [1]. not only do Injuries and accidents related to physical activity affect health care delivery, but also school and work time. A study in the Netherlands showed that 7% of children and adolescents with sports injuries were absent from school, with an average absence of These children are 8 days old [1]. This means that 0.02% of the total population attending school and participating in physical activity is absent for one or more days. If the average duration is 8 days, the total number of days missed due to sports injuries per year can be calculated to be 794,000 days. also 22% of those injured were also not involved in physical activity. The economic consequences of physical activity-related injuries in young people are unknown, but direct medical costs are estimated to be around £145 million, indirect costs (such as school or work) absent) is estimated at around £360 million[1]. These preventable injuries increase the wait time for people to see a physical therapist. The average waiting time to see a physiotherapist in a musculoskeletal clinic in the NHS is around 6 minutes to eight weeks. As a result, fewer people would need rehabilitation from a physical therapist if programs were in place to prevent these injuries. At many of these events, general safety can be improved so that participants can continue to enjoy the activities without compromising their health. Current legislation [edit | edit source] Sports-specific laws [edit | edit source] All sports have their own legislation when it comes to protective equipment, but there are no specific laws for the type of sporting activity. Below is a curated list of popular sports and events with links to: Their laws include laws on protective equipment: Football Rugby Union Rugby League Horse-riding Hockey Ice Hockey Boxing: Technical rules Open boxing competition rules World Series competition rules. There’s more debate around cycling and boxing about helmet use, so these are discussed in more detail. Cycling [edit | edit source] Classified as a sport and a physical activity, cycling is gaining popularity in the UK both as a form of exercise and as a form of transport. 40% of pediatric hospitalizations and deaths are due to head injuries following traumatic brain injury Bicycle-related trauma [12]. Nonetheless, helmet wearing is currently not required by law in most parts of the UK [13], despite repeated calls by various agencies to make it mandatory. However, the Highway Code (Rule 59) states that cyclists should wear A helmet that complies with current regulations is the correct size and is securely fastened. Cycling advocates have opposed the introduction of mandatory bicycle helmet laws because the number of cyclists would plummet. Therefore, this will lead to an increase in preterm births death, and the impact on the health of the population is greater than the risk of head injury from not wearing a helmet. Cycling UK reports that 7-8% of head injuries among children admitted to UK hospitals are due to cycling, with a small proportion of these being the area of the head injury A helmet can protect [14]. Macpherson and Spinks[15] highlighted the following reasons why people choose not to wear helmets, and therefore could lead to fewer cyclists if the law were introduced: The cost of purchasing a helmet The discomfort Wearing helmets Lack of necessary beliefs Helmet image is unpopular, eg children don’t look “cool” in front of friends. In 1999, the British Medical Association (BMA) believed that cycling was likely to decline and recommended against legislation Bike Helmets However, helmets are recommended. In 2004, the BMA changed its position and started supporting mandatory cycling helmets. This change in stance stems from their belief in the protective role of bicycle helmets in reducing the number and severity of the head Injuried. While wearing a helmet is not legally required in most of the UK, in Jersey children under 13 must wear a bicycle helmet. You can read about it here. Bicycle helmets are now mandatory in more than 20 countries around the world, including Finland Sweden Australia and some states of the United States and provinces of Canada [12][13]. A Canadian study [16] focused on cycling-related injuries among children admitted between 1994 and 1998. Incidence of head injuries among children while riding bicycles drops significantly across provinces Passed legislation on mandatory cycling helmets compared to provinces that did not pass such legislation. This trend was also found in New South Wales, Australia by Walter et al. [17] Cyclists had a significantly lower incidence of head injuries Implementation of legislation. McPherson et al. [18] found a decrease in the incidence of other types of injuries as well, but this finding was not statistically significant. Macpherson and Spinks found that cyclists had an 88% lower risk of head or facial injury, and 65% respectively if they were wearing a helmet [12]. A systematic review of injuries and helmet use found a reduced risk of head injury (51%), serious head injury (69%), fatal head injury (65%) and facial injury (33%) [19 ] Profile of . Ontario’s 1995 mandatory bicycle helmets appear to have had no effect on children’s participation in cycling in the East York, Ontario region. Changes in cycling patterns have been noted, but these changes are related to where children ride their bikes and factors including weather. This study shows that legislation introducing mandatory bicycle helmets will not have a negative impact on the number of children riding bicycles. [20] In a Cochrane Review, Macpherson and Spinks emphasize that there is not enough evidence to prove or refute the argument for introducing cycles Helmet legislation leads to fewer cyclists [12]. However, they did find that the introduction of the legislation increased helmet use and reduced the number of head injuries associated with cycling. Physiotherapists with the BMA play a role in educating the population while Helmets are not mandatory, they do provide protection against head and face injuries. While there are currently no laws advocating mandatory use of helmets, physical therapists can address why people choose not to wear helmets; this can be done during one-on-one time with patients Working with patients to overcome these barriers could lead to increased helmet use. For the age group we focus on, it may be beneficial to encourage helmet use from an early age so it becomes a lifelong habit. [21] Before boxing [edit | edit source] By the time of the Summer Olympics (2016), the laws allowing amateur boxers to wear protective helmets in competition changed. Male boxers are no longer allowed to wear protective clothing, but female boxers must still wear protective clothing. Head guards are not permitted during Elite Male (19+) However, in all other categories they remain mandatory. The International Boxing Association (AIBA) can eliminate the use of headgear in non-elite competition; this is in preparation for the removal of headgear from all competitions from January 2018[22]. type Prevention and Protective Equipment [edit | edit source] Injury is a common factor in athletes and physical activity, which means that protective/preventive equipment may be necessary to reduce the risk of injury. The variety and breadth of physical activity today has resulted in Various protective equipment are developed for each sport according to the risk of injury associated with it. Teenagers aged 12 to 18 are at higher risk of accidents or injuries while playing sports because their brains and bodies are still developing. more about caring Safety for physically active teens who often play more than one sport and may play on teams in multiple age groups. This means they are likely to engage in regular vigorous physical activity, increasing the need for them to wear protective equipment at all times to fully from serious injury [23]. [24] Types of sports equipment commonly used in the UK[edit | edit source] Table 2: Common types of sports protective equipment ***red items are must-have items for young people *** Helmets and Face Shields for Adults [edit | edit source] Helmets are often mandatory or strongly recommended in many sports to reduce the risk of injury from a blow to the head (eg American football ice hockey cycling). Masks are often used in many ball sports, such as throwing or baseball to prevent facial injuries. Especially when cycling, it has been shown that wearing a helmet reduces the risk of serious injury from head impact by approximately 63-88%. There is less research on the use and impact of helmets in other sports, but there is a lot Benefits of wearing a helmet in sports like ice hockey and football. Furthermore, in other sports such as cricket in Australia, the incidence of facial neck and head injuries was reduced from 35% to 4% when helmets were mandatory for young players [25][26]. knee Braces [edit | edit source] Knee braces made of resilient foam or plastic that are specifically designed to support the knee joint during movement and also provide protection from direct impact. They are used worldwide, but their ability to prevent injury is Not sure. However, there is evidence that its protective properties may reduce the risk of ligament sprains and provide greater resistance to knee impact [27]. Ankle braces and straps [edit | edit source] Ankle braces essentially provide a copy of knee braces with an emphasis on knee braces On the ankle, helps reduce the ankle’s range of motion. Traditional taping can also be used for sports that help limit ankle motion to prevent injury. Ankle ligament sprains are a major area of prevention and these braces/taps are especially helpful for those with History or predisposition to ankle sprains. There is evidence that a brace or strap reduces the likelihood of an ankle sprain by 69%-71% in athletes with prior ankle injuries [28][29]. Braces[edit source]edit source] A mouthguard, also known as a gum guard, is used primarily in contact sports, where They act as shock absorbers, separating the upper and lower teeth, as well as the teeth from their surrounding tissues. The specific shock-absorbing properties of this sports protection device reduce the force transmitted to the teeth, thus helping to prevent orofacial or dental injuries Can be caused by head impacts in sports such as boxing, football and ice hockey[30] Epidemiology/Injury Statistics[edit | edit source] Table 3: Incidence of injuries in schoolchildren’s physical education class Adapted from Sreekaarini (2014)[31] Table 4: Characteristics of student sports injuries (n=192) Adapted from Carmeli (2003)[32] Potential mechanisms of sports injuries [Edit | Edit source] Lack of protection: Lack of protection especially in contact/high speed sports can lead to injury, so protective equipment is needed to reduce the impact of the force levels exerted on the individual, thereby reducing the risk of injury. Site/Facilities: Terrain/ground that may result in reduced grip, e.g. in puck. A smooth/uneven surface will cause a harder fall during contact. Improperly fitting footwear: Improperly fitting footwear may reduce protection and control of the ankle and foot. Physical Play: Contact such as direct blows may result in serious injury, or due to dropped on the floor. Lack of knowledge/facilities regarding proper equipment use: If specific sports protective equipment (e.g. helmets) are not properly/fitted snugly in place, this may lead to a reduction in their effectiveness in reducing serious injuries. Rules/Regulators: Sports In ice hockey, for example, there is player contact and one player blocks another player out of play, which can cause serious injury to those involved. Age: If an individual is much younger than other players, it can have a major impact on injury development in contact sports special. People who play young are also more vulnerable because their bones continue to grow into adulthood. Issues in specific sports[edit | edit source] Hurling[edit | edit source] Hockey (or Camogie) is a national sport in Ireland played by two teams of 15 players each using a 1 meter A long ash stick (hurley) is used to strike a hard ball (sliotar). It is one of the fastest backcountry sports. Due to the nature and rules of the game such as the swing of hockey and the weight of the slashes, the potential for injury is very high. In previous years, helmets were not often worn or mandatory. This rule has recently changed and wearing a helmet has greatly reduced common head injuries. When full head protection was provided by wearing both a helmet and a face shield, the rate of throwing-related head injuries was reduced by a factor of 10 in athletes treated with A&E. evidence of Similar iatrogenic consequences were found in hand injuries when full head protective equipment was used [33][34]. [35] American Football [edit | edit source] American Football is arguably one of In the most dangerous of sports, athletes of different weights, sizes, speeds and strengths face off against opponents according to their position. Because this protection is especially important for smaller players or players who play at the quarterback position Oversized dimensions require skill and precision. Children aged 12-18 can vary widely in weight and size when competing with their peers, so this means that a great deal of protection must be worn to prevent serious injury [36]. Helmet/Visor [edit | edit source] due to The relentless aggressiveness of American football makes it necessary to wear a helmet to prevent serious head injuries. Beyond that, players may decide to wear other gear to further protect themselves, such as: Mouthguard: Provides shock absorption and separates the upper and lower teeth and teeth in the surrounding tissue Chin Strap: Allows the helmet to be properly secured for a snug fit. Inflatable Internal Pocket: The inflatable pocket is designed as a preventive measure against the severe concussions that often occur during gaming. Mask: yes Consists of a crossbar that goes down the nose area and connects 2 or 3 crossbars from the sides. This “cage” prevents the opponent from reaching into the facial area with his hands. Pads[edit | edit source] There are many different pads that can be used to absorb blows from other players During contact, such as shoulder pads, thigh pads, elbow pads, hip pads, tail pads and knee pads. Shoulder pads protect an individual’s shoulders, but also the sternum area, others also protect the rotator cuff muscles and the top of the arm. Boots/cleats [edit | edit source] Football boots/cleats can be fitted with studs of different sizes from ½ inch to 1 inch. The surface of the court may vary from hard courts to soft courts. Proper selection of cleats provides traction on the ground, preventing injuries from falls to the ground [37]. Variations in the design of different sports equipment, especially the design of helmets, have helped to further enhance the protection capabilities of American football players. Helmets have changed dramatically over the years, with added protection such as visors to provide greater support. size and Weights have also been modified with heavier helmets and air pockets to provide preventive capabilities, especially against concussions [38]. &nbsForbes Ice Hockey[edit |Edit source] Ice hockey is a sport played in many parts of the world and is a A high-contact, high-speed team sport in which two teams use their sticks to drive the puck into the opponent’s net. Injuries in this contact sport are common, so protective equipment is important to prevent serious injuries. The game focuses on physicality between the player and others Impacts such as pucks, skate blades, and hockey sticks can cause serious injury to an individual. Commonly occurring injuries include concussions, muscle strains, fractures, contusions, hyperextension, and ligament tears [39]. Please refer to the IIHF Official Rulebook for relevant information IIHF Inline Official Rulebook 2018-2022 Mandatory and Recommended Hockey Equipment. The following two videos explain how to put on protective hockey gear and how hockey equipment can protect you. [40] [41] Importance of Equipment Adolescents [edit | edit source] Overall, protective equipment is on the rise as it is essential for individuals involved in sports. This is even more important for young people who are still developing, as injuries such as falls can lead to more A 12-year-old is hurt more than a 20-year-old. The reasons why youth need to wear more gear than their adult counterparts are mentioned below. It is important to remember that they are still growing and their bones are still developing, so they are more susceptible to Injury [23]. Types of Injury[edit source] Overuse Injury Sprain Dislocation (Shoulder) Bone Plate Injury Commonly Affected Areas[edit | Edit Source] Increased stress on the Achilles tendon muscles during running jumping and squatting results in knee extensor mechanisms: Primarily the lower extremity shoulder (labrum-ligament complex) Physis Long-term effects on adolescents [Edit | Edit source] Can affect normal growth and maturation of the body Osgood-Schlatter disease: Tractional osteoarthritis of the tibial tuberosity Johansson: Occurs in the distal tibia Patellar myositis Ossification Shoulder instability: Bankart injury Bone plate: deformity by interfering with normal growth[23] Causes[edit | edit source] Excessive stress Forced muscle contraction Improper warm-up before exercise Fatigue Prior injury Physical contact Falls Acute mechanical overload Possible role/treatment for physiotherapists [edit | edit source] General management [edit | edit source] Injury management and education to prevent overtraining and exposure to excessive physical activity. rest ice hamstring stretch quadriceps Strengthen the patellar tendon taping. Achilles tendon and plantar fascia stretches or casts in extreme cases. Educate teams and individuals on the importance of warming up and stretching before physical activity. Early initial immobilization of the muscle under considerable stretch to reduce Edema and buildup of scar tissue and early return of strength. Wear protective/protective equipment such as helmet pads, etc. Examples of specific management[23][edit | edit source] Overuse injury[edit | edit source] Repeated application of submaximal stress to otherwise normal organize. This is more common in organized sports like American football compared to recreational/backyard games. Overtraining and exposure to excessive physical activity can increase the risk of injury. If not managed properly and effectively, overuse injuries can affect normal Physical growth and maturation. Prevention is key Gradual rather than sudden increases in intensity can often prevent physical breakdown. Strain [edit | edit source] Occurs on muscles due to strong contractions of specific areas. Strains are usually ranked by severity 3 The degree of strain, the third is a complete tear at the tendon junction. Contusions [edit | edit source] are most common in contact sports such as ice hockey or lacrosse. Dislocations[edit | edit source] are uncommon in young athletes; however when the shoulder is dislocated Occurring they can be some of the most disabling injuries. Approximately 90% of patients with shoulder dislocations later experience a Bankart injury, resulting in long-term disability and instability of the labrum ligament complex. Physeal plate injuries[edit | edit source] Most vulnerable Bone plate injury in young immature athletes can have devastating effects on growth. Physeal plate injuries/fractures are usually caused by acute mechanical overload, often associated with impact/contact sports such as American football or rugby. Precautions for preventive equipment [edit | edit source] There are some criticisms of the use of certain protective equipment in sports. Here are some arguments against the use of protective gear in sports. Players: Not getting used to it may slow them down or affect vision/performance. Supervision The body may be forgiving and not want to change the sport, which may have been played successfully for many years. In skiing, it has been shown that while helmets provide protection, wearing them may also increase the risk of concussion from impact. children’s Participating in dangerous contact sports [edit | edit source] A letter published in The Guardian on 2 March 2016 said research had shown that people under the age of 18 were at high risk of injury from rugby, a high-impact collision sport, And the injuries are often serious. Now Many secondary schools in the UK insist on contact rugby as a compulsory part of the Physical Education (PE) curriculum from the age of 11. The letter said: “Most injuries occur during contact or impact, such as tackles and scrums. These injuries include fractures Ligament tears, shoulder dislocations, spinal injuries, and head injuries can have short-term, lifelong, and end-of-life consequences in children [42]. Pre-rehabilitation[edit | edit source] Physiotherapists are often involved in the aftermath of an injury or accident. Then patients usually A rehabilitation program begins, which may vary from case to case. Alternatively, “prehabilitation” (or prehab) is a current and emerging strategy used in sporting and clinical settings to help reduce injury, help maintain physical condition or Improve recovery time after surgery. While there are many studies discussing postoperative outcomes for postoperative patients undergoing total knee arthroplasty [43], spinal surgery [44], cardiac surgery [45], and colectomy [46], this section will focus primarily on the following Aspects of impact: Pre-rehabilitation to reduce the incidence of injuries in sport and physical activity, especially in adolescents (12-18 years). While there is no actual definition of “pre-rehabilitation,” it is generally considered an injury prevention program for the individual and individual Selected sport or activity. Essentially, it’s specialized training to prevent injuries from happening. Meir et al. Advice “Pre-rehabilitation describes a systematic approach to identifying common injuries in a specific sport and then designing a series of appropriate exercises minimize their incidence” [47]. This is supported by Brukner [48] who explains that the first step in injury prevention is to understand the incidence and severity of injuries, for example when working with a team, the physiotherapist should Keep a record of all injuries within the team. It could be easy It is done when working with a specific sports team or club, but it creates barriers for individuals who participate in sports and physical activity but do not have a club affiliation or access to a physical therapist. Maybe if physiotherapists had more partnerships with schools and other agencies Organizations have the potential to reach teens who do not have access to pre-rehabilitation/injury prevention programs elsewhere. This could have a positive impact on injury prevention in this population. In fact, a study by Roach et al. [49] showed that as many as half of all injuries are caused by Children’s adherence to physical activity is preventable, highlighting the potential role that physiotherapists can play. Furthermore, Meir et al. [50] suggested that common injuries suffered in rugby are preventable or less severe if the affected areas of the body undergo specific preventive measures Regulator. Pre-rehabilitation programs typically include strength and conditioning training, proprioceptive exercises, and sport-specific training. Mental skills training may sometimes be incorporated. How these aspects of prehab help reduce morbidity and Severity of teen injuries. Youth Strength and Conditioning [edit | edit source] Strength and conditioning are the most common types of pre-rehabilitation used when working with young athletes. Research findings, including strength-flexibility balance and Sports-specific fitness and technique training can prevent lower extremity injuries [51]. It is also believed that the benefits continue when pre-training is done throughout the racing season. This provides important information about the practice of physical therapy, as strength and conditioning should be Ongoing “rehabilitation” strategies for young athletes that physiotherapists should recommend. This is consistent with studies in adults where the use of a prevention program in volleyball resulted in a significant reduction in ankle sprains [52][53][54]. Likewise, training programs in soccer show that 50-75% reduction in general damage, with a significant reduction in ACL damage [55]. Given the evidence that strength and conditioning training helps prevent injuries, it may have important implications for the role of physiotherapists. Physiotherapists who work directly with clubs or teams have Opportunity to implement specific strength and training programs. For adolescents who participate in sports and physical activity but do not have access to a physical therapist through a club or organization, it should be the physical therapist’s responsibility to work closely with the school to Emphasize the potential use of strength and conditioning training in injury prevention. Resistance training in adolescents [edit | edit source] Over the past 20 years, the literature on resistance training in adolescents has been conflicting. Research shows that resistance training Adolescents can be detrimental [56]; however, these programs can benefit children and preadolescents by improving their strength, bone density, balance, lipid profile, fat-free mass, and personal self-esteem [57][58][59][ 60] [61]. Additionally, strength training can help reduce injuries by improving joint integrity The risk of subluxation dislocations and strain injuries is thus reduced. It is the physical therapist’s responsibility to ensure that resistance training is done safely and consistent with personal growth. The benefits that young people can gain from engaging in appropriate activities A resistance training program is outlined below. Current Guidelines[edit |Edit source] The current resistance training guidelines presented by the National Strength and Conditioning Association (NSCA) are [62]: An appropriately designed and supervised resistance training program is relatively Safe for teens. A properly designed and supervised resistance training program can enhance muscle strength and power in adolescents. An appropriately designed and supervised resistance training program can improve cardiovascular risk profiles in adolescents. Properly designed and supervised resistance Training programs can improve motor skill performance and may help improve athletic performance in adolescents. Properly designed and supervised resistance training programs can increase resistance to sport-related injuries in young athletes. Properly designed and supervised resistance Training programs can help improve the psychosocial health of adolescents. Properly designed and supervised resistance training programs can help promote and develop exercise habits in children and adolescents. Stretching [edit | edit source] has long been thought to increase flexibility Muscle gained through stretching reduces the incidence of injury [63]. However, a recent study by Magnusson et al. [64] has shown that “isolated pre-exercise stretching (with or without warm-up) does not reduce overall injury rates” [65]. Furthermore, a systematic review by Thacker et al. al.[66] concluded that although stretching increased flexibility, the increased flexibility did not significantly reduce injury (p=9.3). In the evidence that does show stretching before exercise is beneficial, it was found to be combined with a pre-stretch warm-up. Internally Conflicting Evidence This area shows that stretching is not the most important aspect of injury prevention. Instead, it appears that focusing time on strength training proprioception and proper warm-up is more effective in reducing the incidence of injury in adolescents. This information is useful for Physiotherapists when constructing pre-rehabilitation programs for adolescents. In fact, physical therapists should recognize that while it is important for an individual to have a good range of motion around joints, stretching is not an essential part of injury prevention. On the contrary some studies It has even been suggested that stretching can actually increase the incidence of injury. Shrier [67] proposed five reasons why stretching is not an effective means of preventing injury: In animals, increased muscle compliance induced by immobilization or heat can lead to greater susceptibility to tissue rupture. Stretching before exercise should not interfere with activities where excessive muscle length is not an issue (such as jogging). Stretching did not affect muscle compliance during eccentric activity when most strains were thought to occur. Stretching creates damage at the cytoskeletal level. Stretching appears to mask muscle pain in humans. It is important for physical therapists to understand the evidence about stretching, including the potential risk of injury. Their role should be to know when stretching is recommended and to educate young athletes matter. Proprioception training [edit | edit source] Proprioception is the term used to describe the sensory information that contributes to the sense of body position and movement. A common example of proprioception training is using a wobble board to improve ankle or knee. The theory behind proprioception is that human muscles contain specific nerve endings called “mechanoreceptors” that detect painful pressure on joint motion and position [68]. These mechanoreceptors send signals to the central nervous system and provide information about what is happening around the body. Visual feedback and the vestibular system (inner ear) also play an important role in proprioception. Visual cues help provide reference points for the central nervous system to orient the body in space, and the vestibular system helps maintain overall body posture and balance [69]. use these Considering the important aspect of proprioception is sometimes referred to as the “ensemble of sensations about joint motion and joint position” [70]. Proprioception training is thought to help joint movement and position information be sent to the central nervous system more quickly, thus leading to Accelerate joint and muscle stabilization and injury prevention actions. A randomized controlled trial by Sheth et al. [71] examined the muscular reaction times of the tibialis anterior, tibialis posterior, peroneus longus, and flexor digitorum longus muscles in response to sudden potential injury Changes in ankle position (trapdoor). Twenty healthy adults were recruited and divided into control (n=10) and experimental (n=10) groups. The experimental group used ankle discs for proprioceptive training for 8 weeks, and found that the speed was significantly improved The muscles respond to sudden changes in the ankle’s position. Additionally, it alters the rate at which the tibialis posterior produces force. Research in this area has been motivated by two main factors [72]: if muscles could respond more quickly to posture or joint Perturbations should allow better control of movement and reduce the risk of uncontrolled movement that could increase injury. If the muscles respond faster, the athlete can exert more force (generate more force per unit of time), thereby improving athletic performance. due to growing Evidence in this field suggests that it is becoming more common to incorporate proprioception training into pre-rehabilitation programs to reduce the incidence of injuries. There is indeed good evidence to support its use. A systematic review by Aberneth and Bleakley [73] examined three studies that examined Effectiveness of various proprioceptive exercises. A study investigating a home proprioceptive training program using a wobble board showed that healthy adolescents had improved static and dynamic balance and a reduced incidence of injury over a 6-month period [74]. same study Wedderkopp et al. [75] found that female handball players who used ankle discs in their training program were less prone to injury than a control group. [76] Sport-specific training[edit | edit source] to help prepare the body Specific skills performed in this sport. Helping athletes prepare mentally can help reduce injuries. Common Injuries in Children Ages 12-18 [Edit | Editorial Source] Osgood-Schlatters Disease – Prevention Strategies Stretching Controlled Loading Minimizing Plyometrics Sever’s Disorders – Prevention Strategies Stretching Recognition of podiatric imbalances [77] [78] Education[edit | edit source] Physiotherapists may use a variety of methods within their remit to treat individuals. Some of these methods include manual therapy exercises, physical activity advice and education. Recommendation [79]. CSP states that physical therapists see people as a whole, including patients in their own care, through educational awareness-raising and participation in their own treatment [80]. One of the main responsibilities of a physical therapist is to educate patients during treatment process. Patient education is so important because it: Develops credibility: By educating patients, you demonstrate your knowledge and show that you are the best resource for information and treatment. Build trust: By providing patients with information specific to their problems, you Will help build trust and make them feel better. Increased understanding: If education is provided, patients will better understand their problems and how your treatment will help them. Improves adherence: When a patient is discharged, it is common practice to provide Informative and specific educational material. This will allow patients to respond positively to the overall treatment, making them more likely to follow through. Hydration [edit | edit source] Staying hydrated is critical as your body is made up of an average of 60% water [81]. this Water is distributed between extracellular (intercellular and blood) and intercellular (intracellular), and is the main component of body fluids such as blood and synovial fluid [81]. The decomposition of the fluid is shown on the right. control body fluid concentration By stimulating thirst or regulating urine output; however, if water losses are not replaced, dehydration can set in. Dehydration occurs when you lose 2% of your body weight. Individuals may experience impaired cognitive function, headaches, decreased physical function and symptoms Fatigue [81][82][83]. The risk of injury increases when a person becomes fatigued or unable to perform at their best, whether it is an adult or a child. In rare cases, excessive alcohol consumption can lead to hyponatremia and low sodium levels [81]. amount of water The amount needed depends on the individual and a number of factors: intensity of physical activity age weather body composition A minimum of 1.9 liters per day is recommended for male adolescents and 1.6 liters per day for females [84]; however, this recommendation may change if the individual is Participate in sports activities. During physical activity, you consume fluids to replace fluids lost through sweating. Water is a good source of fluid for moderate physical activity, but for high-intensity activity lasting more than 40 minutes, drinking small amounts of water is recommended Sugar and salt are better [81]. The figure on the right illustrates some of the benefits of staying well hydrated [85]. In conclusion, physical therapists must educate patients to stay well hydrated. It can help prevent dehydration, which can reduce the chance of injury. Nutrition [edit | edit source] Good nutrition is important for anyone who engages in physical activity. This might not be the first common effect you think of, but your diet can help your muscles recover. A good diet helps build a strong body structure. A guide to eating well shows how Maintain a balanced diet that focuses on the five major foods [86][87]. The guidelines recommend: Eat at least 5 servings of fruits and vegetables a day. It’s best to focus on whole grain foods that contain starchy carbohydrates. Eat small amounts of dairy products. Consume Protein: Aim for Fish II times per week. Use unsaturated oils and spreads sparingly. Keep foods high in fatty salt and sugar to a minimum. Drink plenty of water: six to eight glasses a day. To view the Eating Well Guide in more detail, use the images linked below. To prevent injuries while exercising Health professionals should provide adolescents with information about diet. Among adolescents, a healthy diet and physical activity have been shown to provide many short- and long-term health benefits [88][89]. Although the benefits of eating a balanced diet regularly are well known, adolescents are more More likely to skip breakfast than any other meal [90][89]. According to the Health Behavior data for school-age children, nearly three-fifths of young people do not meet the required fruit intake and only ⅓ eat vegetables [89] which is lower than the recommended intake, if these Adolescents’ participation in physical activity may increase their chances of injury because the body is not prepared to meet the demands adequately. Three dietary habits have been suggested to help prevent injuries while participating in physical activity in adults [91] However, these habits may also be relevant to teens: Eat enough: If you are physically active, it is important to make sure you are eating enough calories. Otherwise, your body’s ability to repair tissue damage and muscle recovery will be reduced. Keeping Fat in Your Diet: Fats Necessary for keeping cells healthy, some fats are essential for the inflammatory process. Calcium Intake: Calcium is needed to keep bones healthy and strong. Especially in adolescents, calcium requirements are important to reduce the risk of bone strain or stress fractures. Skill acquisition[edit] |Editorial source] Gaining skills can help prevent youth injuries. This method of learning involves three learning stages. [92] Research finds that including skill acquisition in training programs reduces harm Ratio of children and adolescents. A study by Scase et al. [93] examined the effect of teaching landing and falling skills on improving landing skills and preventing injuries in young soccer players. They used two groups, one with specific landing training and one with specific landing training. group was a control group with no additional landing training. Between the two groups, the intervention group had a lower injury rate and the injuries occurred later in the season. Research by Powers and Fisher [94] and Myer et al. [95] also concluded that the involvement of skills Getting in motion helps prevent injury. Powers and Fisher [96] went on to explain that changes in brain neuroplasticity underlie injury prevention-related behaviors. They say that a decrease in cortical motor excitability may be due to this change, since control is reassignment to subcortical motor areas following skill-specific training [97]. Although these studies focus on specific sports, this may be relevant to all physical activities. Therefore, physical therapists need to teach adolescents basic skills, such as balance running on the ground or Capture is important. Many of these skills are used in many physical activities, and if young people fail to master them, their chances of injury increase. Posture [edit | edit source] Posture has a strong influence on the incidence of injuries physical activities. Adolescents grow at different rates, and these changes can stress the body through changes in posture [98]. Most teens are still in school, where they are required to sit in a chair for a period of time, resulting in listlessness in the chair. although it’s not The same rules directly related to physical activity apply, and what someone does when they are not participating in physical activity can affect their behavior when they are. Good posture involves being able to train your body to lie, sit, walk and stand in the position of least stress Ligaments and muscles [99]. The Mayfield Clinic has created a document that outlines in detail good posture for sitting and even driving. You can access the documentation here. They suggest that in order to maintain good posture you need to meet certain requirements and benefits The benefits of having good posture include: Different postures are illustrated below. Arrows on the picture show where the pose changes occur. Poor posture can lead to altered muscle balance and loss of length Altered athletic performance Altered biomechanics Reduced flexibility and increased risk of injury [100]. Therefore, it would be beneficial if a physical therapist could teach patients how to maintain good posture. When students are studying to be a physiotherapist, they are taught how to identify key points to note and provide for good posture Advice and patient education on how to maintain posture should be routinely incorporated into treatment when appropriate. Rest [edit | edit source] Many children and teens engage in daily play, training and sports, so their bodies don’t get enough It’s time for a complete break[101]. They are known to require rest between physical activities, as lack of rest and muscle fatigue increase an individual’s risk of injury [102]. The NHS [103] recommends that adolescents need 8 to 9 hours of good sleep to Rest well. To achieve this goal, they need to reduce their caffeine intake, eat late at night, limit the time spent on electronic devices, and develop a routine [104]. If a teen is not getting the required rest periods, they are not ready for any physical activity they plan to do A study by Brenner [105] described a lack of rest leading to overtraining overuse injuries and burnout (overtraining syndrome). It has been suggested that while physical activity is important, too much can cause harm, not least because adolescents grow at different rates, meaning there are risks Damage increased [106]. Training programs that include variety rather than constant repetition can help reduce physical stress [107]. Teenagers may be at risk of developing overtraining syndrome if the body does not have time to recover. Watch the video below to get Gain a better understanding of Overtraining Syndrome. [108] Overtraining syndrome is a condition in which reduced rest after excessive exercise leads to physiological maladaptations [109][110]. Some common signs of overtraining are: Kreher and Schwatz [111] suggest Overtraining can cause systemic inflammation and consequent changes in the central nervous system, neurohormonal changes and decreased mood. For more in-depth information on the changes that have occurred, read the following article by Kreher [112]. Brenner [113] provides some guidelines to follow Preventing Overtraining/Burnout: As a healthcare practitioner, it is important to provide education about rest. Individuals should be made aware of the risks of overtraining and advised to look for common signs during the education process, as this can hold them accountable for their responsibilities Wellbeing [114]. During sessions, it is a good idea to ask adolescents how their training is going and whether they have had an increased workload recently, as this can give you an idea of how they are performing and how they are feeling [115]. Therefore, as a physical therapist, it is important to provide Educate about the importance of rest as it can help prevent injuries from happening. Conclusions [edit | edit source] As the NHS demands on maintaining a future healthy population increase, physiotherapists will have to expand their practice to include helping Prevent injuries and accidents, especially among teens. This would be in addition to the current job description, which involves healing injuries from other characters. With this in mind, physical therapists can help prevent injuries and accidents by: Encouraging and enforcing existing legislation. Educate patients on the importance of protective equipment and pre-rehabilitation in preventing injuries and accidents. Because of the workload that physical therapists take on due to injuries and accidents, there are issues with the legal system. Looking ahead, physical therapists are more Other allied health personnel due to the time spent with the patient during evaluation and treatment. They can use this time to educate patients and use some of the research presented in this resource to highlight the importance of protective equipment in preventing disease injuries and accidents. This opportunity to educate the public will hopefully reduce the number of injuries. Strength Training vs Strength Training – Introduction to Physiology The main difference between strength training and strength training is that strength refers to The ability to overcome resistance, while strength refers to the ability to overcome resistance in the shortest possible time. What is intensity? Strength is defined as the ability to apply force (measured in Newtons) to overcome resistance. The formula for force says that force is equal to Mass (m) times acceleration (a). Force is measured in newtons (N), mass is measured in kilograms (kg), and acceleration is measured in meters per second squared (m/s2) What is power? Power (measured in watts) is defined as the ability to apply force for the shortest possible time. physical formula Power is power = force times speed or power = work/time [1] Strength Training[edit | edit source] What is Strength Training? [edit | edit source] Strength training trains the ability to overcome resistance, where you focus on moving as much weight as possible for a given number of reps repeat. The point is to move the weight from point A to point B. [1] Strength training isn’t just for those looking to build muscle. It also builds the strength needed for everyday tasks. Almost any activity will be easier with stronger muscles. The same goes for any sport you enjoy. [2] Strength Training [edit | edit source] Power Training focuses on overcoming resistance, but also on the ability to overcome resistance in the shortest amount of time. Simply put, Power = Force x Velocity, which means that it can be achieved by adding force or velocity or using Mixed methods approach. To maximize power development, use a combination of unloaded (e.g., 0% of 1 RM) and loaded (e.g., up to 90% of 1 RM) exercises and add variety to your program. This enables customers to operate across the entire power continuum (0 to 90% 1RM) to maximize power output. However When trying to build strength, encourage the client to move as fast as possible, but always with control. [3] Typically, the resistance is lower and the velocity of motion is higher during strength training (progressive resistance training is a form of strength training). [1] Examples of strength exercises you can do Adaptive strength exercises (fast and powerful with concentric contractions—the part of you lifting the weight against gravity—but slow and steady pace during eccentric contractions, for example, when lowering the weight back to the starting position) include: deep squat, lunge Overhead presses, biceps curls, overhead triceps extensions, pushups, bench presses, and more. Optimal power reflects how quickly you can exert force to produce the desired motion. E.g. Facing a four-lane intersection, you probably have enough strength to cross the road on foot. but It’s power, not just power, that gets you through all four lanes before the lights change. Likewise, strength helps prevent falls by helping you react quickly when you start to stumble or lose your balance. [2] What are the adaptive changes between strength training and strength training? [edit | edit Source] Power is the ability to overcome resistance in the shortest possible time, thereby being able to produce a higher speed for a given load. Neural adaptations are higher firing rates and stronger high-threshold motor unit activation. strength training can May result in a shift in the muscle fiber type spectrum towards a higher percentage of fast-twitch fibers. Strength training is the ability to exert force against resistance, so your strength training efforts will result in more muscle fiber recruitment and greater strength. Synchronization of muscle fibers. [1] Clinical applications edit source] With age, muscle strength declines faster than strength. Exercises that build strength become especially important later in life. Physiotherapists now combine quick or high-speed movements Strength training with more deliberate and slower strength training exercises to benefit from both activities[2] Research shows that older adults who do progressive resistance training (strength training) combined with rapid strength-building movements have improved physical performance improved. exist In healthy older adults it can significantly improve muscle strength and physical performance. This improvement can prolong functional independence and improve quality of life [4]. Strength training is recommended over traditional strength/resistance training Gait Biomechanics. A progressive model of resistance training in healthy adults to stimulate further adaptation to specific training goals. The American Institute of Physical Education concluded that the progression of strength training requires two general loading strategies: 1) strength training and 2) Use light loads (0-60% of 1 RM for lower body exercises; 30-60% of 1 RM for upper body exercises) at a fast-twitch pace, rest 3-5 minutes between sets, and perform multiple sets of each exercise (three to five sets ). It is also recommended to emphasize polyarticular Exercise, especially one that involves the whole body. For local muscular endurance training, light to moderate loads (40-60% of 1 RM) with high repetitions (<90 s) are recommended. In interpreting this position, as with previous recommendations, it should apply to [5] A 2017 study on the effects of low-load, high-speed exercise (strength training) in patients with type 2 diabetes found that as little as 6 weeks of low-load, high-speed resistance exercise Improves muscle strength output and functional capacity. Furthermore, a physical activity intervention consisting of low-intensity walking dance classes and stretching did not induce any changes in strength and functional capacity. [6] 2016 Strength Training Study Helps with muscle strength in stroke patients. Stroke results in loss of strength, which has a negative impact on functional capacity and ability to work. For paralyzed legs strength training showed higher muscle activity values and alterations in neuromuscular activity leading to functional gain. [7] Sporty Training [edit | edit source] It is clear from research that high-velocity low-load training (i.e., strength training) is associated with the ability to generate force rapidly and has an impact on both activities of daily living and athletic effort. High-speed motion results in specific high Speed adaptation, should be used when trying to increase high speed movement. Sports that require athletes to run faster or jump higher may benefit from secondary training that mimics sport-specific movement speeds. Since maximizing speed is one of the most desired goals FITNESS AND PERFORMANCE Implementing innovative overdrive methods into your training program can help maximize performance. In addition, short-term training is effective for acute adaptations of neurological factors, which lead to dramatic increases in performance in the absence of muscle. Hypertrophy. [8]
References
- ↑ Jump up to:1.0 1.1 American Academy of Pediatrics. Strength Training by Children and Adolescents. Available from www.pediatrics.org/cgi/doi/10.1542/peds.2007-3790. [Accessed 25th Nov 2016]
- ↑ Jump up to:2.0 2.1 Faigenbaum A, Kraemer W, Cahill B, Chandler J, Dziados J, Elfrink L, et al. Youth resistance training: Position Statement and Literature Review. Strength Condition J 1996;18:62-75
- ↑ Dahab KS, McCambridge TM. Strength Training in Children and Adolescents: Raising the bar for young athletes? Sports Health 2009;1:223-226
- ↑ Ignjatovic A, Stankovic R, Radovanovic D, Markovic Z, Cvecka J. Resistance training for youths. Physical Education and Sport 2009;7:189-196
- ↑ Jump up to:5.0 5.1 Faigenbaum AD, Kraemer WJ, Blimkie CJR, Jeffreys I, Micheli LJ, Nitka M, et al. Youth Resistance Training: Updated position statement paper from the National Strength and Conditioning Association. The Journal of Strength and Conditioning Research 2009;23:S60-S79
- ↑ Faigenbaum AD, Westcott WL, Loud RR, Long C. The effects of different resistance training protocols on muscular strength and endurance development in children. Pediatrics 1999;104
- ↑ Drenowatz C, Greier K. Resistance training in youth—benefits and characteristics. Journal of Biomedicine. 2018;3:32-9.
- ↑ Zach Even – Esh Youth Athlete Strength & Conditioning Tips. Available from https://www.youtube.com/watch?v=rtjEWmL0Vig