Faigenbaum, AD, Kraemer, WJ, Blimkie, CJR, Jeffreys, I, Micheli, LJ, Nitka, M, and Rowland, TW. Youth resistance training: Updated position statement paper from the National Strength and Conditioning Association. J Strength Cond Res 23(5): S60-S79, 2009-Current recommendations suggest that school-aged youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that is developmentally appropriate and enjoyable and involves a variety of activities (). Not only is regular physical activity essential for normal growth and development, but also a physically active lifestyle during the pediatric years may help to reduce the risk of developing some chronic diseases later in life (). In addition to aerobic activities such as swimming and bicycling, research increasingly indicates that resistance training can offer unique benefits for children and adolescents when appropriately prescribed and supervised (). The qualified acceptance of youth resistance training by medical, fitness, and sport organizations is becoming universal ().Nowadays, comprehensive school-based programs are specifically designed to enhance health-related components of physical fitness, which include muscular strength (). In addition, the health club and sport conditioning industry is getting more involved in the youth fitness market. In the U.S.A., the number of health club members between the ages of 6 and 17 years continues to increase () and a growing number of private sport conditioning centers now cater to young athletes. Thus, as more children and adolescents resistance train in schools, health clubs, and sport training centers, it is imperative to determine safe, effective, and enjoyable practices by which resistance training can improve the health, fitness, and sports performance of younger populations.The National Strength and Conditioning Association (NSCA) recognizes and supports the premise that many of the benefits associated with adult resistance training programs are attainable by children and adolescents who follow age-specific resistance training guidelines. The NSCA published the first position statement paper on youth resistance training in 1985 () and revised this statement in 1996 (). The purpose of the present report is to update and clarify the 1996 recommendations on 4 major areas of importance. These topics include (a) the potential risks and concerns associated with youth resistance training, (b) the potential health and fitness benefits of youth resistance training, (c) the types and amount of resistance training needed by healthy children and adolescents, and (d) program design considerations for optimizing long-term training adaptations. The NSCA based this position statement paper on a comprehensive analysis of the pertinent scientific evidence regarding the anatomical, physiological, and psychosocial effects of youth resistance training. An expert panel of exercise scientists, physicians, and health/physical education teachers with clinical, practical, and research expertise regarding i...

The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate highquality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the ''knee over toe position'' when cutting.The incidence of anterior cruciate ligament (ACL) injury remains high, especially in young athletes aged 14-19 years. In spite of the fact that some successful prevention programmes have been introduced, ACL injury continues to be the largest single problem in orthopaedic sports medicine, with the incidence of non-contact ACL tears being much higher in female athletes in sports such as basketball and team handball than in male athletes.As ACL injury remains a significant problem, especially in young female athletes, procedures for improved prevention and management are needed. The mechanism of ACL injury is an important focus of discussion, as an ACL tear is more often a non-contact event with a deceleration or a change of direction manoeuvre than a contact or direct blow injury. A prophylactic neuromuscular and proprioceptive training programme may reduce the number of ACL injuries in female athletes.The President of the International Olympic Committee (IOC) Jacques Rogge stated in 2001 that ''the most important goal of the IOC Medical Commission is to protect the health of the athlete''. The IOC Medical Commission therefore invited a group of physicians, physical therapists, biomechanists and scientists active in ACL research to review current evidence relating to risk factors, prevention programmes and the need for further research concerning non-contact ACL injury in young female athletes. EPIDEMIOLOGY OF ANTERIOR CRUCIATE LIGAMENT INJURIESThe incidence of ACL ...

The current manuscript has been adapted from the official position statement of the UK Strength and Conditioning Association on youth resistance training. It has subsequently been reviewed and endorsed by leading professional organisations within the fields of sports medicine, exercise science and paediatrics. The authorship team for this article was selected from the fields of paediatric exercise science, paediatric medicine, physical education, strength and conditioning and sports medicine.

There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize the key recommendations detailed within the position statement. With these pillars in place, it is believed that the NSCA can (a) help foster a more unified and holistic approach to long-term athletic development, (b) promote the benefits of a lifetime of healthy physical activity, and

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Imbalance of the internal and external rotator musculature of the shoulder, excess capsular laxity, and loss of capsular flexibility, have all been implicated as etiologic factors in glenohumeral instability and impingement syndrome; however, these assertions are based largely on qualitative clinical observations. In order to quantitatively define the requirements of adequate protective synergy of the internal and external rotator musculature, as well as the primary capsulolabral restraints, we prospectively evaluated 53 subjects: 15 asymptomatic volunteers, 28 patients with glenohumeral instability, and 10 patients with impingement syndrome. Range of motion was evaluated by goniometric technique in all patients with glenohumeral instability and impingement. Laxity assessment was performed and anterior, posterior, and inferior humeral head translation was graded on a scale of 0 to 3+. Isokinetic strength assessment was performed in a modified abducted position using the Biodex Clinical Data Station with test speeds of 90 and 180 deg/sec. Internal and external rotator ratios and internal and external rotator strength deficits were calculated for both peak torque and total work. Patients with impingement demonstrated marked limitation of shoulder motion and minimal laxity on drawer testing. Both anterior and multidirectional instability patients had excessive external rotation as well as increased capsular laxity in all directions. Sixty-eight percent of the patients with instability had significant impingement signs in addition to apprehension and capsular laxity. Isokinetic testing of asymptomatic subjects demonstrated a 30% greater internal rotator strength in the dominant shoulder. Comparison of all three experimental groups demonstrated a significant difference between internal and external rotator ratios for both peak torque and total work. Conclusions are that there appears to be a dominance tendency with regard to internal rotator strength in asymptomatic individuals. Impingement syndrome and anterior instability have significant differences in both strength patterns of the rotator muscles and flexibility and laxity of the shoulder. Isokinetic testing potentially may be helpful in diagnostically differentiating between these two groups in cases where there is clinical overlap of signs and symptoms.

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