INVITED COMMENTARY

Are Young Athletes Strong Enough for Sport?

Not too long ago, countless hours working on the farm For example, in the late 1980s, the 50th percentile for modified
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and playing outside prepared young bodies for the physical pull-ups for 6- to 9-year-olds in the United States ranged from
demands of challenging life events. However, contemporary 6 to 10 repetitions, but the present 50th percentile for this
childhood is different, with global reports indicating that same group is now 2 to 4 repetitions (10). This is just one
children and adolescents are not as active as they used to be, example of a disturbing trend in muscular strength deficits
and this decline in daily physical activity appears to begin which, consequently, predispose children and adolescents to
early in life (1,2). Technological advances have decreased yet higher levels of physical inactivity and sedentary behav-
the need to move, physical education is considered expend- iors. Recently, the term pediatric dynapenia has been used to
able, and many children have less exposure to ‘‘free play’’ characterize this phenomenon (11). Pediatric dynapenia, an
because of safety concerns and issues of access. Based on acquired and treatable condition in youth characterized by
these observations, many question whether or not young muscle weakness and dysfunction not caused by neurologic or
athletes are strong enough for the physical demands of sport muscular disease, has broad consequences for the children in
practice and competition. which it is found (12). Children with greater adiposity, for
Much research supports the contention that muscular instance, have been found to have impairments in muscle
strength underpins many of the biomotor qualities influencing composition and velocity-related strength which may influ-
athleticism and sports performance (3Y5). Yet too few young ence their overall functionality and health-related quality of
athletes participate in year-round strength and conditioning life (13). Dynapenic obesity is a recognized risk factor for
and achieve a level of physical performance that optimizes functional decline in older adults (14), and it appears that the
their potential to run faster, jump higher, and be stronger (5). synergistic relationship between dynapenia and obesity also
Prerequisite levels of muscular strength are needed to break may limit performance in youth.
through a ‘‘strength barrier’’ to allow weaker young athletes Participation in youth sport alone does not ensure that
to catch up to their stronger teammates. If young athletes are young athletes will attain a level of muscular strength that
not exposed to an environment with regular opportunities to will optimize performance, reduce injury risk, and improve
enhance their muscular strength, they will be less likely to health. Nor does youth sport participation ensure adequate
develop the prerequisite skills and abilities that are needed for levels of physical activity: reports indicate that youth sport
ongoing participation in sport activities. It is naive to believe practices do not provide a sufficient amount of moderate-
that young athletes will simply ‘‘outgrow’’ muscle weakness; to-vigorous physical activity (MVPA) to meet daily recom-
rather, there is evidence that low levels of muscular strength mendations because too much time is spent in sedentary or
during the growing years tend to track into adulthood (6). light physical activities (15,16). Weaker youth are less likely
to perform as well as their stronger peers (17,18) and more
A Growing Deficit likely to suffer a sports-related injury (19,20). It is likely
Secular trends in measures of muscular strength indicate that that this gap between weaker and stronger youth will widen
modern day youth are weaker than previous generations (7Y9). over time without purposefully targeting the strength deficits
in the former. From a public health perspective, contempo-
1
Department of Health and Exercise Science, The College of New Jersey, rary trends in youth physical inactivity and sport-related
Ewing, NJ; 2Division of Sports Medicine, Nationwide Children’s Hospital, injuries will continue unabated.
Columbus, OH; and 3Centre for Exercise and Sport Science Research, New insights into the design of long-term athletic develop-
Edith Cowan University, Joondalup, WA, Australia
ment programs underscore the importance of general physical
Address for correspondence: Avery D. Faigenbaum, EdD, FACSM, preparation for sport, with a particular focus on strength de-
FNSCA, Department of Health and Exercise Science, The College of New velopment, since a certain amount of force production and force
Jersey, 2000 Pennington Rd, Ewing, NJ 08628; E-mail: reduction is needed to perform athletic movements proficiently
[email protected]. (4,21). These findings are supported by recent meta-analytic
1537-890X/1801/06Y08
data that indicate that youth should perform resistance training,
Current Sports Medicine Reports building a foundation of strength, prior to power-type training
Copyright * 2019 by the American College of Sports Medicine (22). From coaches to clinicians, those caring for young

6 Volume 18 & Number 1 & January 2019 Invited Commentary

Copyright © 2018 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
athletes will eventually need to address strength deficits as unexpected stressors. From this perspective, strength reserves
part of prehabilitation or rehabilitation programs through- have a protective function against the adverse consequences
out the individual’s career since muscle weakness at any age of sport, such as musculoskeletal injury. In support of these
predisposes athletes to functional limitations and adverse observations, weaker lower-extremity muscle strength has
health outcomes. been found to predict traumatic knee injury in young female
athletes (19).
Building Strength Reserves The theoretical construct of strength reserves illustrated
While enhancing muscle strength to improve fitness and in the Figure may serve as a conceptual framework that
performance is not a novel concept (23), a new model that explains interindividual differences in health and perfor-
targets strength deficits and builds strength reserves is needed mance trajectories throughout childhood and adolescence:
to provide a logical and evidence-based approach to strength The DREAM model highlights five phases of strength
development in children and adolescents. Greater strength development: 1. Dynapenic, 2. Reduced, 3. Emerging,
reserves can enhance neuromuscular fitness, improve athletic 4. Adapting, and 5. Mighty. The Dynapenic phase is char-
performance, and reduce sport injury risk (3,24,25). From acterized by abnormally low levels of muscular strength that
an epidemiological perspective, population-based handgrip limit a child’s ability to perform activities of daily life, such
muscle strength measures have been found to be a signifi- as climbing stairs. Youth in this phase do not move effi-
cant determinant of summer Olympic games medal success ciently and often struggle to perform basic movement skills.
(26). The importance of acquiring and maintaining high When weak children get stronger by performing general
strength reserves to enhance athletic performance and reduce physical activities they enter the Reduced phase as they be-
injury risk should not be overshadowed by generic recom- gin to move and play. Youth in the Emerging phase make
mendations to simply increase MVPA. Leading professional remarkable gains in muscular strength as they gain confi-
organizations within the fields of physical education, sport dence and competence in their abilities to activate targeted
science, and pediatric medicine support participation in youth musculature and lift heavier loads by regularly participating
resistance training programs that are well-designed and su- in structured resistance training. As youth continually build
pervised by qualified fitness professionals (27). their strength reserve, they enter the Adapting phase whereby
Without developmentally appropriate interventions that increases in muscular strength translate to observable
target muscle weakness, relatively weaker boys and girls improvements in power performance. The final Mighty
may be unwilling and perhaps unable to catch up with their phase is achieved by youth with high muscular strength
peers who possess higher levels of strength and motor skill reserves, enhanced athletic abilities, and a reduced risk of
prowess. Since prerequisite levels of muscular strength are sports-related injuries.
needed to move proficiently, there is a critical need during The starting point and amount of time in each phase will
childhood and adolescence to increase muscular strength depend on various factors including each participant’s
and build strength reserves to develop healthy, resilient, and health history, initial strength level, and resistance training
capable young athletes who are prepared for ongoing partic- skill competency. As children learn basic movements and
ipation in sport (5,28). Strength reserves can be used (or not) build their strength reserves, their ability to perform more
to meet the demands of sport participation and overcome complex exercises will be influenced by their exposure to

Figure: The DREAM model highlights five developmental phases of muscular strength development and the functional importance of
building and maintaining muscular strength reserves. This model focuses on muscular strength and does not include other important biomotor
qualities that influence performance.

www.acsm-csmr.org Current Sports Medicine Reports 7

Copyright © 2018 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
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8 Volume 18 & Number 1 & January 2019 Invited Commentary

Copyright © 2018 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.