exercise benefits in children - sap€¦ · the prevention of sports injuries in children &...
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Exercise Benefits in Children:Exercise Benefits in Children:Preventing Osteoporosis Since YouthPreventing Osteoporosis Since Youth
Lyle J. Micheli, MDLyle J. Micheli, MDChildren’s Hospital BostonChildren’s Hospital Boston
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Why Train Kids?Why Train Kids?
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Organized Children’s Sports:Organized Children’s Sports:North AmericaNorth America
Team SportsTeam Sports•• BaseballBaseball•• Gridiron FootballGridiron Football•• Soccer Soccer •• Ice HockeyIce Hockey•• BasketballBasketball•• Other: Field hockey,Other: Field hockey,
lacrosse, rugby, etc.lacrosse, rugby, etc.
Individual SportsIndividual Sports•• GymnasticsGymnastics•• SwimmingSwimming•• Tennis SkatingTennis Skating•• Distance runningDistance running•• TriathlonTriathlon•• Other: Dance, cycling, Other: Dance, cycling,
riding, rodeo, etc.riding, rodeo, etc.
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Benefits of Training: Benefits of Training: The Child AthleteThe Child Athlete
•Enhance Performance•Prevent Injury•Health & Fitness•Bone Health
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Benefits of Training: Benefits of Training: The Child AthleteThe Child Athlete
•Enhance Performance••Prevent InjuryPrevent Injury•Health & Fitness•Bone Health
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Injury PreventionInjury Prevention
1. ACSM: Smith, A, Andrish, J, Micheli, L, The Prevention of Sports Injuries in Children & Adolescents. Med. Sci Sports Exercise. 25:1-7, 1993
2. Hejna, Rosenberg, A. et al. The Prevention of Sports Injuries in High School Students Through Strength Training. Nat’l. Strength & Conditioning Assoc. J. 4=28-31, 1982
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Benefits of Training: Benefits of Training: The Child AthleteThe Child Athlete
•Enhance Performance•Prevent Injury••Health & FitnessHealth & Fitness•Bone Health
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Childhood HealthChildhood Exercise
Adult Exercise Adult Health
?
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Benefits of Training: Benefits of Training: The Child AthleteThe Child Athlete
•Enhance Performance•Prevent Injury•Health & Fitness••Bone HealthBone Health
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Bone HealthBone Health
Morris, F, Morris, F, NaughtonNaughton, G, et al., G, et al.
Prospective Ten Month Exercise Intervention in Prospective Ten Month Exercise Intervention in PrePre--MenarchalMenarchal Girls: Positive Effects on Bone Girls: Positive Effects on Bone
and Lean Massand Lean Mass
J. Bone Miner Res. 12=1453J. Bone Miner Res. 12=1453--1462, 19971462, 1997
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Childhood Exericise Adult Bone Health?
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GymnasticsGymnastics
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Skeletal Benefits of Pre-MenarchealGymnastics Are Retained After
Activity Cessation
Scerpella, T et al.
Ped. Ex. Sci. 22: 21-23. 2010
3 year long study
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The Female Athlete TriadThe Female Athlete Triad
•• AmenorrheaAmenorrhea•• OsteopeniaOsteopenia•• Disordered EatingDisordered Eating
Overuse Injury: Stress Fracture
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Sports Training: Sports Training: The Child AthleteThe Child Athlete
•• Cardiovascular Cardiovascular •• MusculoskeletalMusculoskeletal
–– StrengthStrength–– FlexibilityFlexibility
•• NutritionNutrition•• SkillsSkills•• PsychologicalPsychological
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Rowland, TW (ed)Rowland, TW (ed)
Developmental ExerciseDevelopmental ExercisePhysiology, Human KineticsPhysiology, Human Kinetics
Champagne, Illinois 1996Champagne, Illinois 1996
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Pediatric RunnersPediatric Runners
VO2 MaxVO2 Max
Pulse RatePulse Rate
But adaptation less than adultsBut adaptation less than adults
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Sports Training: Sports Training: The Child AthleteThe Child Athlete
•• Cardiovascular Cardiovascular
•• MusculoskeletalMusculoskeletal––StrengthStrength–– FlexibilityFlexibility
•• NutritionNutrition•• SkillsSkills•• PsychologicalPsychological
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Strength Training Strength Training For ChildrenFor Children
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StrengthStrength
The ability to exert force against The ability to exert force against an external resistancean external resistance
•• Joint Joint –– Muscle specificMuscle specific•• Technique specificTechnique specific
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Strength Training: ChildrenStrength Training: Children
•• Safe?Safe?•• Increase ? (Mechanism)Increase ? (Mechanism)•• Benefits? Benefits?
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Strength Training: ChildrenStrength Training: Children
•• Safe?Safe?
•• Increase ? (Mechanism)Increase ? (Mechanism)•• Benefits? Benefits?
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Special Considerations: Special Considerations: Child Strength TrainingChild Strength Training
•• Close, qualified supervisionClose, qualified supervision•• VarietyVariety•• Resistance: PreResistance: Pre--OverloadOverload•• Repetitions: 10Repetitions: 10--15 (5015 (50--70% 1RM)70% 1RM)•• Rest (2Rest (2--3 x/week3 x/week
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PrePre--Season Conditioning for the Season Conditioning for the PrePre--Adolescent AthleteAdolescent Athlete
Faigenbaum A, Micheli L, Faigenbaum A, Micheli L, Pediatric Annals Pediatric Annals
29=15629=156--161, 2000161, 2000
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Strength Training: ChildrenStrength Training: Children
•• Safe?Safe?•• Increase ? (Mechanism)Increase ? (Mechanism)
•• Benefits? Benefits?
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Sports Training: Sports Training: The Child AthleteThe Child Athlete
•• Cardiovascular Cardiovascular
•• MusculoskeletalMusculoskeletal–– StrengthStrength
––FlexibilityFlexibility•• NutritionNutrition•• SkillsSkills•• PsychologicalPsychological
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Flexibility Training: Flexibility Training:
Do Kids Really Need It?Do Kids Really Need It?
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Sitting InactivitySitting Inactivity
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FlexibilityFlexibility
•• Ballistic (Sport/Dance Specific)Ballistic (Sport/Dance Specific)•• Slow Stretch (30 sec.)Slow Stretch (30 sec.)•• Facilitative (PNF)Facilitative (PNF)
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Sports Specific: Sports Specific: GymnasticsGymnastics
Enhanced shoulder flexibility in female gymnasts Enhanced shoulder flexibility in female gymnasts decreases low back pain extension stress decreases low back pain extension stress
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The Child Athlete The Child Athlete Sports Training:Sports Training:
•• Cardiovascular Cardiovascular •• MusculoskeletalMusculoskeletal
–– StrengthStrength–– FlexibilityFlexibility
•• NutritionNutrition•• SkillsSkills•• PsychologicalPsychological
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Nutrition: The Young AthleteNutrition: The Young Athlete
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The Young Athlete: The Young Athlete: Nutritional Concerns: Nutritional Concerns:
•• DehydrationDehydration--Increased heat Increased heat succeptabilitysucceptability
•• Junk food/Fast food: Vitamin, mineral deficiencyJunk food/Fast food: Vitamin, mineral deficiency•• ObesityObesity•• Eating disordersEating disorders
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Nutritional Concerns: Nutritional Concerns: The Young AthleteThe Young Athlete
•• DehydrationDehydration--Increased heat susceptibilityIncreased heat susceptibility
•• Junk food/Fast food: Junk food/Fast food: Vitamin, mineral deficiencyVitamin, mineral deficiency
•• ObesityObesity•• Eating disordersEating disorders
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Typical Adolescent Food Habits
•Meal Skipping•Snacking•Consumption of Fast Foods•Dieting*Vulnerable to Nutrition Deficiencies*•Calcium•Vitamin A •Iron, Ascorbic Acid
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Nutritional Concerns: Nutritional Concerns: The Young AthleteThe Young Athlete
•• DehydrationDehydration--Increased heat susceptibilityIncreased heat susceptibility•• Junk food/Fast food: Vitamin, mineral deficiencyJunk food/Fast food: Vitamin, mineral deficiency
•• ObesityObesity•• Eating disordersEating disorders
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Adolescent ObesityAdolescent Obesity
•• Caloric IntakeCaloric Intake•• ExerciseExercise•• ComplianceCompliance•• FamilyFamily
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Nutritional Concerns: Nutritional Concerns: The Young AthleteThe Young Athlete
•• DehydrationDehydration--Increased heat susceptibilityIncreased heat susceptibility•• Junk food/Fast food: Vitamin, mineral deficiencyJunk food/Fast food: Vitamin, mineral deficiency•• ObesityObesity
•• Eating disordersEating disorders
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Female Athlete TriadFemale Athlete Triad
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Female Athlete Triad (ACSM)Female Athlete Triad (ACSM)
•• DisordedDisorded eatingeating•• AmenorrheaAmenorrhea•• Premature osteoporosisPremature osteoporosis•• Overuse injuries: Stress Overuse injuries: Stress FxFx. .
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Body CompositionBody Composition
Female Athlete / DancerFemale Athlete / Dancer> 13% BWF> 13% BWF
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Nutritional SupplementsNutritional Supplements
•• Males More LikelyMales More Likely•• Females: Calcium, IronFemales: Calcium, Iron•• Performance EnhancementPerformance Enhancement•• CreatineCreatine
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Nutritional SupplementsNutritional Supplements
•• Males More LikelyMales More Likely
•• Females: Calcium, IronFemales: Calcium, Iron•• Performance EnhancementPerformance Enhancement•• CreatineCreatine
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Nutritional SupplementsNutritional Supplements
•• Males More LikelyMales More Likely•• Females: Calcium, IronFemales: Calcium, Iron
•• Performance EnhancementPerformance Enhancement•• CreatineCreatine
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Nutritional SupplementsNutritional Supplements
•• Males More LikelyMales More Likely•• Females: Calcium, IronFemales: Calcium, Iron•• Performance EnhancementPerformance Enhancement
•• CreatineCreatine
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Anabolic SteroidsAnabolic Steroids
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Faigenbaum, A., Westcott, W. et al. Faigenbaum, A., Westcott, W. et al.
Anabolic Steroid Use by Male and Anabolic Steroid Use by Male and Female Middle School StudentsFemale Middle School Students
Pediatrics 101: E6, 1998Pediatrics 101: E6, 1998
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Anabolic Steroids: RisksAnabolic Steroids: Risks
•• Liver=Failure, tumorsLiver=Failure, tumors•• Mood Change: ”Mood Change: ”RoidRoid Rage”Rage”•• Heart DiseaseHeart Disease•• Growth ArrestGrowth Arrest•• Female=Female=HursationHursation, , baldlessbaldless•• Acne Acne
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Androgenic = Androgenic = MasculinizingMasculinizing
Anabolic = Tissue buildingAnabolic = Tissue building
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Growth HormoneGrowth Hormone
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Drug TestingDrug Testing
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Nutritional Supplements: Nutritional Supplements: DopingDoping
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Carbohydrate LoadingCarbohydrate Loading
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Strength, Endurance and Body Strength, Endurance and Body Composition are more important than Composition are more important than
body weight.body weight.
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SleepSleep
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Sports Training: Sports Training: The Child AthleteThe Child Athlete
•• Cardiovascular Cardiovascular •• MusculoskeletalMusculoskeletal
–– StrengthStrength–– FlexibilityFlexibility
•• NutritionNutrition
•• SkillsSkills•• PsychologicalPsychological
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Sports Training: Sports Training: The Child AthleteThe Child Athlete
•• Cardiovascular Cardiovascular •• MusculoskeletalMusculoskeletal
–– StrengthStrength–– FlexibilityFlexibility
•• NutritionNutrition•• SkillsSkills
•• PsychologicalPsychological
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Organized SportsOrganized Sports
ConcernsConcerns
•• Emotional StressEmotional Stress•• Endurance/Heat stressEndurance/Heat stress•• InjuryInjury
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Sports PsychologistSports Psychologist
•• FocusFocus•• Competitive StressCompetitive Stress
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Who Does The Training?Who Does The Training?
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IOC Consensus Statement: IOC Consensus Statement: Training the Elite Child AthleteTraining the Elite Child Athlete
REFERENCESREFERENCES
IOC Consensus Statement: Training the Elite Child Athlete. IOC Consensus Statement: Training the Elite Child Athlete. BJSM 2008; 42:3 163BJSM 2008; 42:3 163--164164
IOC Consensus Statement: Training the Elite Child Athlete. IOC Consensus Statement: Training the Elite Child Athlete. ClinClin J of Sp Med. 2008, 18:2; 122J of Sp Med. 2008, 18:2; 122--123123
The Adolescent Athlete: A Practical ApproachThe Adolescent Athlete: A Practical ApproachMicheli L, Purcell L eds. 2007 Springer Micheli L, Purcell L eds. 2007 Springer VerlagVerlag; 410; 410--413413
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