The motto of the Olympic Games is Citius, Altius, Fortius which is Latin for 'Faster, Higher, Stronger'. It is a clarion call to all competitors, including the youngest, to engage in training strategies that prepare athletes to be the best in the world. Existing research indicates that various forms of resistance training can elicit performance improvements in young athletes. Stronger young athletes will be better prepared to learn complex movements, master sport tactics, and sustain the demands of training and competition. An integrative training programme grounded in resistance training and motor skill development can optimise a young athlete's potential to maximise their athletic and sporting performance, while reducing the risk of a sports-related injury. Resistance training may be especially important for modern-day young athletes who are more likely to specialise in one sport at an early age at the expense of enhancing general physical fitness and learning diversified sport skills. Structured interventions that include qualified instruction; targeted movement practice; and strength and conditioning activities that are developmentally appropriate, progressive and technique driven are needed to attain a level of athleticism that is consistent with the Olympic motto.

ow back pain (LBP) in school-aged children is a common occurrence; nevertheless, it is often underappreciated. 1 The prevalence of LBP rises with age: 1% at age 7 years, 6% at age 10 years, and 18% at ages 14 to 16 years. 2 By age 18 years, the lifetime prevalence rates of LBP approach those documented in adults, with an estimated yearly prevalence of 20% and a lifetime prevalence of 75%. 3 More than 7% of adolescents experiencing LBP will seek medical attention. 1 The effect of LBP on this population can be considerable and may significantly restrict instrumental activities of daily living for this population, such as attendance at school and gym or sports participation. 4 Low back pain in this age group is a significant risk factor for developing LBP as an adult. 5 Several potential risk factors for developing LBP in schoolaged children have been investigated. The prevalence of LBP correlates with participation in sports and level of competition. 4,6,7 There is a U-shaped association between physical activity and the incidence of LBP in school-aged children, with both low and high levels of physical activity associated with a higher risk. 8,9 Female sex, growth acceleration, adverse psychosocial factors, increasing age, previous back injury, and family history of LBP are all potential risk factors for school-aged children to develop LBP. 9-12 Although there has been concern about a potential association of LBP and backpacks, the evidence pointing to use of backpacks as a risk factor is weak. 9 No single risk factor for a first episode of LBP in school-aged children has been definitively validated (level of evidence, 1). 13 Historically, it has been taught that most LBP in school-aged children has an identifiable diagnosis. More recent research has challenged this thinking. A high-quality prospective study of 73 pediatric patients with LBP (level of evidence, 2) followed up for 2 years found that nearly 80% had no definitive diagnosis. 14 Most cases of LBP in school-aged children are nonspecific and self-limiting. 15,16 Discussion and Observations Relevant AnatomyPediatricians need a basic but solid understanding of the anatomy of the lumbosacral spine to provide effective care to school-aged children with LBP. The lumbar spine is composed of 5 vertebrae IMPORTANCE Low back pain (LBP) in children and adolescents is a common problem. The differential diagnosis of LBP in this population is broad and different from that seen in the adult population. Most causes of LBP are musculoskeletal and benign in their clinical course. Clinicians should have an understanding of the relevant anatomy and the most commonly encountered etiologic factors of LBP in children and adolescents to provide effective care.OBSERVATIONS Low back pain is rarely seen in youth before they reach school age. Subsequently, rates of LBP rise until age 18 years, at which age the prevalence of LBP is similar to that in adults. The differential diagnosis of LBP in this population is broad, and individual etiologic factors are most often associated wit...

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