Injury Trends and
Prevention in Youth
Resistance Training
Avery D. Faigenbaum, EdD, CSCS,1 Greg D. Myer, PhD, CSCS,2,3 Fernando Naclerio, PhD, CSCS,4 and Adrian A. Casas, MS4
1
Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey; 2Sports Medicine
Biodynamics Center and 3Human Performance Laboratory, Cincinnati Childrens Hospital Medical Center, Cincinnati,
Ohio; 4Department of Physical Activity and Sport, European University of Madrid, Madrid, Spain; and 5Department of
Physical Education, National University of La Plata, La Plata, Argentina
SUMMARY
RESISTANCE TRAINING HAS BE-
COME A POPULAR METHOD OF
CONDITIONING FOR CHILDREN
AND ADOLESCENTS IN SCHOOLS,
RECREATION CENTERS, AND
SPORTS TRAINING FACILITIES.
HOWEVER, THE GROWING POPU-
LARITY OF YOUTH RESISTANCE
TRAINING AND THE COMPLEX
NATURE OF SOME TRAINING
PROGRAMS RAISE NEW QUES-
TIONS AND CONCERNS ABOUT
THE SAFETY OF THIS TYPE OF
TRAINING FOR YOUTH. IN THIS
ARTICLE, THE INCIDENCE, SEVER-
ITY, AND ETIOLOGY OF YOUTH
RESISTANCE TRAINING INJURIES
ARE REVIEWED, RISK FACTORS
FOR RESISTANCE TRAININGRE-
LATED INJURIES ARE IDENTIFIED,
AND INJURY PREVENTION STRAT-
EGIES FOR YOUTH WHO PER-
FORM RESISTANCE EXERCISE ARE
DISCUSSED.
INTRODUCTION
esistance training is a popular
R activity that is performed by
a growing number of children
and adolescents (8,34). Current public
health initiatives now aim to increase
the number of youth who engage in
muscle-strengthening activities, and
contemporary physical education cur-
ricula include lessons that improve
36 VOLUME 33 | NUMBER 3 | JUNE 2011
muscular strength (31,40). Moreover,
training programs specifically designed
to enhance sports performance have
become a popular fitness trend among
young athletes (39). Yet there is sub-
stantial interest from youth coaches,
physical education teachers, and sports
medicine professionals regarding the
best techniques to maximize safety and
improve the efficacy of resistance
training for young lifters.
At present, there is a need to review the
incidence, severity, and etiology of
youth resistance training injuries and
examine the relative safety of resistance
training activities for children and
adolescents. Furthermore, it is impor-
tant to identify risk factors for re-
sistance training injuries and discuss
injury prevention strategies for youth
who perform this type of training. The
purposes of this article were to review
the latest evidence regarding the safety
of youth resistance training and pro-
vide general guidelines for reducing the
risk of injury associated with resistance
exercise. This information will aid
professionals who instruct youth to
participate in resistance training activ-
ities as part of physical education,
sports training, or recreation.
In this article, the term resistance
training refers to a specialized method
of physical conditioning that uses
a wide range of resistive loads, different
movement velocities, and a variety of
training modalities, including weight
Copyright National Strength and Conditioning Association
machines, free weights (barbells and
dumbbells), elastic bands, medicine
balls, and body weight. The terms
weightlifting and powerlifting refer
to sports in which athletes attempt to
lift maximal amounts of weight in
competition. The term children re-
fers to boys and girls who have not
developed secondary sex character-
istics (a period of development called
preadolescence), and the term ado-
lescence refers to a period between
childhood and adulthood (generally
girls aged 1218 years and boys aged
1418 years). For ease of discussion,
the term youth refers to both
children and adolescents.
INCIDENCE AND SEVERITY OF
YOUTH RESISTANCE TRAINING
INJURIES
In the 1970s and 1980s, resistance
training was not often recommended
for children and adolescents because of
the presumed high risk of injury
associated with this type of exercise.
A few retrospective case reports pub-
lished during this era highlighted the
potential for injury to the growth
cartilage from resistance exercise and
contributed to the misperception that
this type of training was unsafe for
young lifters (1,16,20,36,41). However,
improper lifting techniques, poorly
KEY WORDS:
strength training; weightlifting; injury
prevention; children; adolescents
chosen training loads, or lack of
qualified supervision caused most of
these injuries. For example, in a case
report, a 13-year-old boy suffered a
bilateral fracture of the distal radial
epiphyses when he attempted to press
30 kg overhead while exercising in
a makeshift gymnasium at home
(20). Others reported that a 16-year-
old football player suffered a fracture of
the left distal radius with dorsal
displacement when he lifted 48 kg on
the bench press exercise without
supervision (41). It is unclear from
these reports if these young lifters
received any instruction on proper
lifting techniques or training proce-
dures from qualified professionals.
Injury to the growth cartilage has not
been reported in any prospective youth
resistance training study that provided
qualified guidance and instruction
(10,23). Although growth cartilage is
prebone and is weaker than adjacent
connective tissue (25), the perception
that resistance training is inherently
injurious to the developing musculo-
skeletal system is not consistent with
clinical observations and research find-
ings (10,23). Furthermore, no scientific
evidence indicates that resistance train-
ing will negatively impact growth at
any stage of development during child-
hood and adolescence (12,23). Para-
doxically, most of the forces that youth
are exposed to in various sports (e.g.,
gymnastics and martial arts) and rec-
reational activities (e.g., running and
tag games) are likely to be greater both
in exposure time and in magnitude
than competently supervised and sen-
sibly progressed resistance exercise.
For example, jumping and landing
activities during competitive sports
and play have been found to induce
ground reaction forces of up to 57
times body mass (7,24).
Myer et al. (29) recently queried the U.S.
Consumer Product Safety Commission
to evaluate resistance trainingrelated
injuries presenting to U.S. emergency
rooms by age, type, and mechanism of
injury. They found that as age-group
increased (813, 1418, 1922, and
2530 years), the number of accidental
injuries decreased significantly for each
successive age-group. In this report, the
mechanism of injury was considered
accidental if it resulted from dropped
weights, improper use of equipment, or
tripping over equipment. Of note, 77%
of the reported injuries in the 8- to
13-year-old age-group were categorized
as accidental (29).
These researchers also noted that two-
thirds of the injuries sustained by 8- to
13-year-old patients were to the hand
and foot and were most often related to
dropping and pinching in the safety of resistance training, weightlift-
injury descriptions (Figure 1) (29).
These observations are supported by
epidemiological findings from Kerr
et al. (22), who reported that children
aged 12 years and younger suffered
a larger proportion of hand and foot
injuries than older resistance training
participants. In the aforementioned
report (22), 65% of the reported injuries
were caused by weights falling on the
person and in 10% of the cases a body
part was smashed or crushed between
weights. Although many factors need
to be considered when examining
these data, the importance of proper
exercise technique, gradual progression
of training loads, and qualified instruc-
tion should not be overlooked.
Although the majority of youth re-
sistance training injuries are the result
of accidents that appear to be prevent-
able with increased supervision and
adherence to stricter safety guidelines,
resistance training as with all physical
activities does carry some degree of
injury risk. A retrospective survey of
resistance training injuries in 354
adolescent American football players
found 27 injuries (causing more than
7 days of missed participation), which
resulted in estimated injury rates in
junior high school athletes (mean age,
13.3 years), high school freshman/ju-
nior varsity athletes (mean age, 15.6
years), and high school varsity athletes
(mean age, 17.2 years) of 0.11, 0.091,
and 0.51 per person year, respectively
(35). In that study (35), only 36% of the
training sessions performed by junior
high school athletes were supervised
by a coach. Brown and Kimball (3)
Strength and Conditioning Journal | www.nsca-lift.org
estimated an injury rate of 0.29 per 100
participant hours in adolescent power-
lifters who presumably trained with
maximal or near-maximal loads on the
bench press, deadlift, and back squat
exercises. Of potential relevance, the
average powerlifter in this report
trained 4.1 times per week (99 minutes
per training session), and a majority of
the training sessions were performed
without supervision from a strength
and conditioning coach (3).
Although data comparing the relative
ing, and other sports are limited, in
a retrospective evaluation of injury
rates in adolescents, it was noted that
resistance training and weightlifting
were markedly safer than many other
sports and activities (17). In that study
(17), the overall injury rates per 100
participant hours were 0.8000, 0.0035,
and 0.0017 for rugby, resistance train-
ing, and weightlifting, respectively. In
support of these findings, Pierce et al.
(32) followed 70 competitive weight-
lifters (aged 716 years) over a 1-year
period (1,224 lifts were performed in
competition) and reported no injuries
that limited training or required medical
attention. Other researchers reported
significant gains in muscular strength
without any report of injury when
weightlifting movements (e.g., snatch,
clean and jerk, modified cleans, and
pulls and presses) were incorporated
into youth training programs (9,14).
At present, little if any scientific
evidence indicates that properly per-
formed and sensibly progressed
weightlifting movements performed
during practice or competition are
riskier than other sports and activities
in which youth regularly participate
(10,17). However, these lifts involve
more complex neural activation pat-
terns than other resistance exercises;
professionals should be knowledgeable
of the progression from basic exercises
(e.g., front squat) to skill transfer
exercises (e.g., overhead squat) and
finally to the competitive lifts (e.g.,
snatch). Youth should learn proper
exercise technique with a wooden
dowel or a lightweight aluminum
37
Injuries in Youth Resistance Training

Figure 1. Percentage of injuries in the youngest and oldest age categories. Note that the small prevalence of leg injuries in the 813
years age categories provides invalidated results and should be interpreted with caution. Reprinted from Myer et al. (29).

barbell under the watchful eye of
a strength and conditioning profes-
sional to enhance fundamental move-
ment patterns (Figure 2).
Regardless of the type of resistance
exercise, all professionals who work
with youth need to be aware of proper
resistance training procedures because
the lack of qualified supervision and the
improper use of exercise equipment can
be injurious (2,3,22,29). Of note, there is
Figure 2. A strength and conditioning coach reinforcing proper barbell position
during the first pull of the power clean.
an increased risk of injury to children
and adolescents who use exercise
equipment at home (15,21). It has been
reported that young children are more
likely to be injured from home exercise
equipment than older age-groups due,
in part, to unsafe behavior, equipment
malfunction, and lack of supervision
(15). There is also the potential for
a catastrophic injury if safety standards
for youth resistance training are not
followed. In a case study report,
a 9-year-old boy died when a 23-kg
barbell rolled off a bench press support
and fell on his chest after he had jarred
the supports while trying to get up (13).
These findings underscore the risk of
injury in the unsupervised and informal
setting of a childs home; fortunately,
this risk is removed with qualified
instruction of youth.
A related concern regards the perfor-
mance of plyometric exercises for
children and adolescents. This type
of training typically includes hops and
jumps that exploit the muscles cycle
of lengthening and shortening to
increase muscle power. Although
most playground activities, such as
hop scotch and jumping rope, can be
characterized as plyometric, some
observers have a very narrow view
of plyometric training and suggest that
this type of exercise can wreak
havoc on the skeletal system of
young athletes (37).
Although advanced plyometric exer-
cises should be reserved for trained
strength/power athletes to increase
speed of movement and power pro-
duction, there are many examples of
plyometric exercises, such as double-
leg hops and throws with a lightweight
medicine ball, that can be part of

38 VOLUME 33 | NUMBER 3 | JUNE 2011

a youngsters fitness program. Indeed,
regular participation in an age-appro-
priate resistance training program that
includes plyometric exercises has been
found to enhance movement biome-
chanics, improve functional abilities,
and decrease the number of injuries in
youth sports (6,18,27,28). However,
the focus of plyometric training should
be on learning proper jumping and
landing techniques along with a sensi-
ble progression from double-leg to
single-leg exercises.
Nonetheless, injury or illness can result
if the intensity, volume, or frequency of
plyometric training exceeds the ability
of the participants. In a case report (4),
a 12-year-old boy developed exertional
rhabdomyolysis after he was instructed
to perform more than 250 repetitive
squat jumps in physical education class.
Clearly, the volume of plyometric
training needs to be carefully pre-
scribed and consistent with the needs,
goals, and abilities of the participants.
Efforts made to improve instruction
and jumping mechanics during plyo-
metric training can reduce the risk of
injury to youth who may have limited,
if any, experience participating in this
type of structured training. Specific
guidelines for designing youth strength
and conditioning programs are beyond
the scope of this article but are avail-
able elsewhere (11,30).
RISK FACTORS AND PREVENTION
Although data from the pediatric liter-
ature indicate a relatively low risk of
injury in children and adolescents who
follow age-appropriate resistance train-
ing guidelines (10,23), professionals who
prescribe and supervise youth resistance
training programs should be cognizant
of the potential for injury with this type
of training and should attempt to reduce
injuries through the identification of risk
factors and injury patterns in young
lifters. For example, Quatman et al. (34)
reported that the trunk was the most
frequently injured body part for both
men and women between the ages of 14
and 30 years who presented to U.S.
emergency rooms because of an injury
related to resistance exercise.
In support of these observations, others
reported that low back pain was the
most frequent injury in adolescent
athletes who participated in a resistance
training program (2,3,35). Because low
back pain among adolescents has
become a significant public health
issue, with prevalence rates in adoles-
cents approaching those in adults (19),
there appears to be a role for pre-
ventative interventions that specifically
strengthen the trunk and posterior
chain musculature (e.g., erector spinae,
gluteus maximus, and hamstrings).
From our experience, young lifters
who do not receive instruction from
qualified professionals on proper pro-
gram design spend too much time
training their so-called mirror muscles
(i.e., biceps and chest) and not enough
time (or no time at all) strengthening
the musculature on the posterior side
of their body. Of potential relevance,
neuromuscular training protocols that
target deficits in trunk and hip control
may alleviate high-risk biomechanics
in adolescent female athletes (26).
In addition to the aforementioned
concerns regarding poor posterior
chain strength, other risk factors that
have been associated with resistance
training injuries in youth are outlined
in the Table. A recurring theme in
most youth resistance trainingre-
lated injuries is the lack of qualified
adult supervision. All professionals
who work with youth need to be
aware of age-appropriate resistance
training procedures because im-
proper exercise technique and the
aggressive progression of training
loads can be injurious (2,3). Without
qualified supervision and instruction,
youth are more likely to attempt to
lift weights that exceed their abilities
or perform an excessive number of
repetitions with improper exercise
technique (15,21,29). Because chil-
dren are more susceptible to central
(i.e., nervous system) fatigue than
adults (38), the volume of resistance
training needs to be carefully pre-
scribed and sensibly progressed over
time to avoid overtraining. Modifi-
able risk factors associated with
Strength and Conditioning Journal | www.nsca-lift.org
youth resistance training injuries,
which can be reduced or eliminated
with qualified supervision and
instruction, are outlined in the Table.
Although there have not been any
preventive trials that have focused
specifically on measures to prevent
resistance trainingrelated injuries in
youth, it seems reasonable to suggest
that qualified professionals who un-
derstand pediatric resistance training
guidelines and genuinely appreciate
the physical and psychosocial
uniqueness of children and adoles-
cents should provide supervision and
instruction. Ideally, professionals
who teach and coach youth should
have a level of knowledge commen-
surate with a college degree in
physical education, exercise science,
or a related field. Furthermore, if
youth participate in advanced train-
ing programs (e.g., weightlifting clas-
ses), professionals should have
additional knowledge and practical
experience to properly teach young
lifters this type of training. Although
respected certifications are available
from the National Strength and
Conditioning Association, the United
Kingdom Strength and Conditioning
Association and USA Weightlifting,
professionals who work with children
and adolescents should be able to
properly instruct and sensibly pre-
scribe or advance resistance training
programs for youth with different
needs, goals, and abilities.
Basic education on weight room
etiquette, proper exercise technique,
and fundamental training principles
should be part of all youth resistance
training programs. Although there is
no minimum age for participation in
a youth resistance training program,
all participants must be able to follow
coaching instructions and undergo
the stress of a resistance training
program (8). In general, most 7- and
8-year-old children are ready for some
type of resistance exercise. However,
regardless of the starting age, all youth
should receive safety instructions on
appropriate starting weights, proper
spotting, the correct use of collars,
39
Injuries in Youth Resistance Training

Table
Modifiable risk factors associated with resistance training injuries in children and adolescents, which can be reduced
(or eliminated) with qualified supervision and instruction
Risk factor Modification by qualified
professional

Unsafe exercise environment
Improper equipment storage
Unsafe use of equipment
Excessive load and volume
Poor exercise technique
Poor trunk control
Muscle imbalances
Previous injury
Sex-specific growth
Inadequate recuperation
Adequate training space and proper equipment layout
Secure storage of exercise equipment
Instruction on safety rules in the training area
Prescription and progression of training program driven by technical performance of
prescribed exercise movement
Clear instruction and feedback on exercise movements
Targeted neuromuscular training
Training program includes agonist and antagonist exercises
Communicate with treating clinician and modify program
Targeted training to address deficits
Incorporate active rest and consider lifestyle factors, such as proper nutrition and
adequate sleep

and the proper handling of barbells, safety and efficacy of youth resistance Greg Myer is
dumbbells, and plates. This is particu- training. Specifically, qualified profes- a sports biome-
larly important in schools and recrea- sionals who possess the required chanist in the
tion centers because untrained youth knowledge to safety and effectively Sports Medicine
tend to overestimate their physical teach topics related to youth resistance Biodynamics Cen-
abilities and this may increase their risk training may provide the most effective ter at the Cincin-
of injury (33). This type of instruction interventional approach to reduce re- nati Childrens
not only enhances participant safety sistance trainingrelated injuries in Hospital Medical Center.
and enjoyableness of the training expe- youth. Continuing education seminars,
rience, but direct supervision of youth in-service training, and a nationally Fernando
resistance training programs can im- recognized certification in pediatric Naclerio is
prove program adherence and optimize strength and conditioning may help a professor in the
strength gains (5). alleviate high-risk behaviors and en- Department of
The available data suggest that well- hance the training experience for Fundamentals of
designed educational interventions are children and adolescents. Motricity and
needed to enhance participant safety Training at the
and create an enjoyable exercise expe- European Univer-
ACKNOWLEDGMENT
rience so youth can feel good about sity of Madrid.
The authors thank Jim McFarland from
their performances (e.g., the ability to the Hillsborough High School in New
properly perform a back squat or Jersey for his contributions to this article. Adrian Casas is
power clean). Because there is evi- a professor in the
dence to suggest that most of the Department of
injuries related to youth resistance Physical Educa-
training are preventable, efforts are Avery Faigen- tion at the Na-
needed to minimize this risk with baum is a professor tional University
qualified supervision, sensible progres- in the Department of La Plata.
sion of training loads, and a safe of Health and
exercise environment. Additional ef- Exercise Science at
forts toward the development of spe- The College of
cific methods for teaching multijoint New Jersey. REFERENCES
lifts and prescribing the optimal train- 1. Benton J. Epiphyseal fractures in sports.
ing volume are needed to enhance the Phys Sports Med 10: 6371, 1982.

40 VOLUME 33 | NUMBER 3 | JUNE 2011

 2. Brady T, Cahill B, and Bodnar L. Weight
training related injuries in the high school
athlete. Am J Sports Med 10: 15, 1982.
3. Brown E and Kimball R. Medical history
associated with adolescent power lifting.
Pediatrics 72: 636644, 1983.
4. Clarkson P. Case report of exertional
rhabdomyolysis in a 12 year old boy. Med
Sci Sports Exerc 38: 197200, 2006.
5. Coutts A, Murphy A, and Dascombe B.
Effect of direct supervision of a strength
coach on measures of muscular strength
and power in young rugby league players.
J Strength Cond Res 18: 316323, 2004.
6. DiStefano L, Padua DA, Blackburn J,
Garrett W, Guskiewicz KM, and Marshall S.
Integrated injury prevention program
improves balance and vertical jump height
in children. J Strength Cond Res 24:
332342, 2010.
7. Dufek J and Bates B. The evaluation and
prediction of impact forces during landings.
Med Sci Sports Exerc 22: 370377, 1990.
8. Faigenbaum A, Kraemer W, Blimkie C,
Jeffreys I, Micheli L, Nitka M, and Rowland T.
Youth resistance training: Updated position
statement paper from the National Strength
and Conditioning Association. J Strength
Cond Res 23(Suppl 5): S60S79, 2009.
9. Faigenbaum A, McFarland J, Keiper F,
Tevlin W, Kang J, Ratamess N, and
Hoffman J. Effects of a short term plyometric
and resistance training program on fitness
performance in boys age 12 to 15 years.
J Sports Sci Med 6: 519525, 2007.
10. Faigenbaum A and Myer GD. Resistance
training among young athletes: Safety,
efficacy and injury prevention effects. Br J
Sports Med 44: 5663, 2010.
11. Faigenbaum A and Westcott W. Youth
Strength Training. Champaign, IL: Human
Kinetics, 2009. pp. 169210.
12. Falk B and Eliakim A. Resistance training,
skeletal muscle and growth. Pediatr
Endocrinol Rev 1: 120127, 2003.
13. George D, Stakiw K, and Wright C. Fatal
accident with weight-lifting equipment:
Implications for safety standards. CMAJ
140: 925926, 1989.
14. Gonzales-Badillo J, Gorostiaga E, Arellano
R, and Izquierdo M. Moderate resistance
training produces more favorable strength
gains than high or low volume during
a short term training cycle. J Strength Cond
Res 19: 689697, 2005.
15. Gould J and DeJong A. Injuries to children
involving home exercise equipment. Arch
Pediatr Adolesc Med 148: 11071109,
1994.
16. Gumbs V, Segal D, Halligan J, and Lower
G. Bilateral distal radius and ulnar fractures
in adolescent weightlifters. Am J Sports
Med 10: 375379, 1982.
17. Hamill B. Relative safety of weight lifting
and weight training. J Strength Cond Res
8: 5357, 1994.
18. Hewett T, Riccobene J, Lindenfeld T, and
Noyes F. The effects of neuromuscular
training on the incidence of knee injury in
female athletes. Am J Sports Med 27:
699706, 1999.
19. Jeffries L, Milanese S, and Grimmer-
Somers K. Epidemiology of adolescent
spine pain. Spine (Phila Pa 1976) 23:
26302637, 2007.
20. Jenkins N and Mintowt-Czyz W. Bilateral
fracture separations of the distal radial
epiphyses during weight-lifting. Br J Sports
Med 20: 7273, 1986.
21. Jones C, Christensen C, and Young M.
Weight training injury trends. Phys Sports
Med 28: 6172, 2000.
22. Kerr Z, Collins C, and Comstock R.
Epidemiology of weight training-related
injuries presenting to United States
emergency departments, 1990 to 2007.
Am J Sports Med 38: 765771, 2010.
23. Malina R. Weight training in youthGrowth,
maturation and safety: An evidenced based
review. Clin J Sport Med 16: 478487, 2006.
24. McNitt-Gray J, Hester D, Mathiyakom W,
and Munkasy B. Mechanical demand on
multijoint control during landing depend on
orientation of the body segments relative to
the reaction force. J Biomech 34:
14711482, 2001.
25. Micheli L. Preventing injuries in team sports:
What the team physician needs to know.
In: FIMSTeam Physician Manual (2nd ed).
Chan K, Micheli L, Smith A, Rolf C, Bachl N,
Frontera W, and Alenabi T, eds. Hong Kong,
China: CD Concepts, 2006. pp. 555572.
26. Myer GD, Chu DA, Brent JL, and Hewett TE.
Trunk and hip control neuromuscular training
for the prevention of knee joint injury. Clin
Sports Med 27: 425448, 2008.
27. Myer GD, Ford K, Brent J, and Hewett T.
The effects of plyometric vs. dynamic
stabilization and balance training on power,
balance, and landing forces in female
athletes. J Strength Cond Res 20:
345353, 2006.
28. Myer GD, Ford K, Palumbo JP, and Hewett T.
Neuromuscular training improves
Strength and Conditioning Journal | www.nsca-lift.org
performance and lower-extremity
biomechanics in female athletes. J Strength
Cond Res 19: 5160, 2005.
29. Myer GD, Quatman C, Khoury J, Wall E,
and Hewett T. Youth vs. adult
weightlifting injuries presenting to United
States emergency rooms: Accidental vs.
non-accidental injury mechanisms.
J Strength Cond Res 23: 20542060,
2009.
30. Myer GD and Wall E. Resistance training in
the young athlete. Oper Tech Sports Med
14: 218230, 2006.
31. National Association for Sport and Physical
Education. Physical Education for Lifetime
Fitness (2nd ed). Champaign, IL: Human
Kinetics, 2005.
32. Pierce K, Bryd R, and Stone M. Youth
weightliftingIs it safe? Weightlifting USA
17: 5, 1999.
33. Plumert J and Schwebel D. Social and
temperamental influences on childrens
overestimation of their physical abilities:
Links to accidental injuries. J Exp Child
Psychol 67: 317337, 1997.
34. Quatman C, Myer GD, Khoury J, Wall E,
and Hewett T. Sex differences in
weightlifting injuries presenting to United
States emergency rooms. J Strength Cond
Res 23: 20612067, 2009.
35. Risser WL, Risser JM, and Preston D.
Weight-training injuries in adolescents. Am
J Dis Child 144: 10151017, 1990.
36. Ryan J and Salciccioli G. Fractures of the
distal radial epiphysis in adolescent weight
lifters. Am J Sports Med 4: 2627, 1976.
37. Stinchfield K. Little athletes, big injuries.
Kids suffer when coaches and parents pile
on too much training. What to watch for.
Time. February 25, 2008:51.
38. Streckis V, Skurvydas A, and Ratkevicius A.
Children are more susceptible to central
fatigue than adults. Muscle Nerve 36:
357363, 2007.
39. Thompson W. Worldwide survey reveals
fitness trends for 2010. ACSMS Health
Fitness J 13: 916, 2009.
40. United States Department of Health and
Human Services. 2008 Physical Activity
Guidelines for Americans. Available at:
www.health.gov/paguidelines. 2008.
Accessed June 28, 2010.
41. Weiss AP and Sponseller PD. Salter-Harris
type I fracture of the distal radius due to
weightlifting. Orthop Rev 18: 233235,
1989.
41