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- [00:01]
A
5:00am I'm up with a crisp Celsius energy drink running 12 miles today. Grab a green juice, quick change, and head to work. Meetings, workshops. One more Celsius. No slowing down. Working late, but obviously still meeting the girls for a little dancing. Celsius Live Fit. Go grab a cold, refreshing Celsius at your local retailer or locate now@celsius.com. this is important when kids ask you, what can I do? I want to strengthen my muscles. I want to get stronger. There is no age at which it's not appropriate to say, great, crawl like a snake. Start learning how to do planks. There is no data that it is ever unsafe to resist your own bodyweight. Hi, Vanessa.
- [00:56]
B
Hi, Cara.
- [00:58]
A
Okay, I'm really, really into this episode.
- [01:03]
B
Vaness, I am so happy to hear that.
- [01:07]
A
I'm just gonna say that we have been thinking about doing an episode about weightlifting and cross training, but really weightlifting in tweens and teens. I think since we started this podcast, I mean, this is really something that we have both taken an extraordinary interest in. For me, for what it's worth, because I get asked all the time, I bet all the time, like, is it safe for my middle schooler to lift weights? Because usually he. But sometimes she is doing it. Is it safe for my high schooler because their coach says they have to do it? My kid just came home from college and they've been going to the gym and they are using weights, and I just don't know if it's safe and what to do. And if I'm being honest, Vanessa, the reason we have not done this episode yet is that I understood the very general answer, but I would always refer people out to other resources. And it was high time we do our own research and consolidate the evidence and the science and the opinions and. And put them in one place. And so we did that. And I think I'll add that for me personally, my very favorite podcasts, like the ones I listen to in my spare time, are the ones where the hosts totally nerd out around research that they've done and new information they've gathered. And I feel like this is that episode.
- [02:50]
B
And also the reason this comes up over and over and over again is because there's an incredible moment in the zeitgeist around kids in general, boys and young men in particular, to become more muscular, to get jacked, to get ripped, to bulk up like this. Interest in the topic, while sort of generally interesting as we think about health and strength and longevity and all of that, is particularly interesting because There is just an enormous, multi layered, often sort of scientifically questionable conversation happening on social media, online, on sports teams, in gyms, in locker rooms, you know, all over the place. And because adults are kind of flying blind, that often means the kids are also flying blind. And so the research that you've done, Cara, is an effort to give people some reliable information on a topic that feels like there's not a ton of reliable information out there.
- [04:00]
A
I mean, let's just be honest. The kids aren't flying blind, they're flying in a plane built by influencers and voices.
- [04:07]
B
Exactly.
- [04:08]
A
That they are hearing that are really not informed by science. Right.
- [04:15]
B
And often are selling something else on top of the advice they're giving, which
- [04:20]
A
makes them have a supplement for you
- [04:21]
B
even less reliable and also quite possibly and sometimes very openly using steroids to increase their muscularity, which is its own fascinating topic. So this is a really complex, multi layered societal issue. It's not just sort of the sweet little corner of a topic. It actually addresses a variety of cultural phenomena that we and our kids and the kids we care about are experiencing.
- [04:56]
A
And in fact, I want to lay out what we're going to cover because I think this will help people understand the framing for this conversation. So we're going to talk about how kids grow during their growth spurts and why that is relevant to the topic of weightlifting in particular, and also cross training. We're going to talk about what body parts are the most susceptible to injury and why. And then we're going to get into the data specifically around weightlifting first and then cross training so that people understand what studies have been done and what the research shows, and we'll explain how the physiology works. And then we'll land with, okay, so what are kids supposed to do in a world where they are either being encouraged to lift weights or encouraged to specialize in sports or both.
- [05:47]
B
Let's start with growth spurts. And we have a sort of intro episode on growth spurts, which people can refer back to. But this is going to get into the hormones that are involved in growth spurts. What happens and therefore what the sort of vulnerabilities are considerations are for us as we go down the path of this conversation.
- [06:10]
A
Okay, so let's just say all bodies produce, regardless of your female, you're male. All bodies produce growth hormone. Growth hormone is involved in growth spurts. All bodies produce estrogen, and it's the estradiol form that is most involved with growth spurts. All bodies produce testosterone, and the cousin of testosterone, androstenedione, and those hormones are involved in growth spurts. The thing is that the female growth spurt is dominated a little bit more by the presence of estrogen, and the male growth spurt a little bit more by the presence of testosterone because those bodies make more of those hormones. Okay, so how does it actually work? So the sex steroids, the estrogens, and the testosterone basically augment the secretion of growth hormone, okay? And that growth hormone is released out into the body and it stimulates a hormone called insulin, like growth factor one, IGF one, which, if any of you have read any hormonal science at all or familiarized yourself, this is a very, very, very familiar sounding hormone. It is one that is talked about all the time. It is made in the liver. It is also made at the growth plates, okay? And IGF1 promotes cell proliferation. It promotes the multiplication of cells and. And therefore, what's called longitudinal growth, length of the bones, the long bones, because it basically tells the cells at the growth plates to multiply and then they stack on top of each other like a little set of tetris blocks. And that is how your bones grow. When the growth plates fuse, they're at the ends of each of the long bones. And when they fuse at the end of puberty or at some point during puberty, then you can't grow. You can't proliferate cells in that area anymore because it's closed. It's like, you know, the. The construction zone is closed for construction and we're done. What tells the growth plates to fuse and be done? And this is very significant estrogen, and it's both sexes.
- [08:42]
B
Can you talk about why, if a kid has an injury, which will become relevant in a minute, they want to know, is it on the growth plate? Is it not on the growth plate? Can you just give a quickie on that question?
- [08:55]
A
Yes. So when you have an injury along the growth plate and you have the immune system coming in and inflammatory cells coming in to try to help repair the injury, it can mess with the ability for cells to proliferate. Basically. Like, think about it like, okay, you're building a house and you have, oh, I don't know, a tree falls on one part of the frame of the new house. You cannot just build through the tree that has fallen on the house. It obstructs the ability for the house to go up. It's physically blocking it. And that, you know, if you disrupt part of the growth plate and you disrupt the ability of the cells to multiply there, that part of the growth plate won't grow. And here's what's interesting, Vanessa, is sometimes the entire growth plate gets disrupted by an injury. Like, you'll see that across the entire growth plate, there's been a fracture or inflammation or whatnot. Sometimes it's only part. When it's the entire growth plate, that part of the bone can't grow at all. When it's only part, then one side of the bone grows, but not the other, and the bone bends, it starts to arc. So that's really significant. I think it probably also bears mentioning, Vanessa, that lots of things other than bones grow during adolescence. So muscle grows, ligaments get looser, and then we see things like new curves, like widening hips, because you've got the combination of bones growing, ligaments, loosening, muscles developing. Right. So the visible shifts sometimes are just bone growth, but oftentimes there's like, lots of other growth happening in different parts of the body.
- [10:46]
B
Yeah. And based on that, can you talk a little bit about what therefore makes teenagers or adolescents more susceptible to injury? Is it some combination of the hormonal chemistry, the loosening ligaments? What are the factors and what should. What should people be looking out for?
- [11:07]
A
Okay, so a shout out to menopause and perimenopause for a second. Okay. Because women, starting usually in their early 40s, end up getting DEXA scans or bone scans to look at bone density. And the idea behind this is bone is really strong and solid, and the denser that bone is, the less likely it is to fracture. Now, I'm going to point all of our listeners to the book Estrogen Matters and to other resources that we can put in the show Notes where we now understand it's not just the density of bones that make them strong, but it's the flexibility of bones that protect against fracture. What does this have to do with adolescence and the growth spurt? Well, the bone itself in young bodies is strong, just like it is in older bodies when it's dense and flexible. Right. But the growth plates are the most vulnerable spots. They are the weakest link in bone. And it makes sense. Like that's where your, you know, putting the cement and laying the next layer of bricks. And when the cement is wet, it. Those bricks can slide all over the place. So those spots on the bone at either end where the growth plates sit are the most vulnerable to injury when there is a traumatic injury. Let me give you a couple of medical terms that you'll hear with regard to this topic. So the growth plate, we're going to call it the growth plate in this episode, but it's called the physis. Okay. That's the technical medical name. And where the tendons attach are the apophysis. So that's sort of the. The anatomy of it. And then where bone connects to bones, that bones, it's called articulating or articular surfaces, sort of where bones come together in a space, usually inside the space of a joint. When you grow fast, and we're going to define what it means to grow fast, but when you grow fast, then your bones. And go with me on this language because it's confusing, your bones become less resistant to mechanical force. In other words, when you're in a really fast growth spurt and a mechanical force, like, you know, you take a really hard fall, you're in a trauma, Someone, you know, whatever the thing is that creates the injury, a rapidly growing bone is less resistant to that trauma. And that is what makes fractures in or around the growth plate more common.
- [14:08]
B
And are they generally, like, more susceptible or is it just around the growth plate or the existence of an open growth plate that makes them more susceptible?
- [14:18]
A
It's both. So just the existence of an open growth plate increases susceptibility. But when you're in a growth spurt, which in the sports medicine literature is defined as growing at least 7.2 centimeters a year, which is the same as 2.8 inches per year. So if you're growing faster than 2.8 inches a year overall height, or if your leg length, if you're just measuring leg length, if your leg length grows more than 1.4 inches a year, then you're in a growth spurt, and that's where the cartilage becomes even weaker. Okay. And you become really vulnerable to fracture. We'll be right back, but first, a word from our sponsors. I have had photo books on the top of my to do list for years, literally. And it bums me out that I cannot seem to find the time to do this, because there is literally nothing I enjoy more than looking back at old photos of my kids. So it's why I'm thrilled to have discovered Journeyprint. Journeyprint is easy to use. It takes seconds to auto arrange photos into a beautiful book, and it'll even add location maps and dates. Plus, Journeyprint uses sustainably sourced paper. And for every order placed, they plant a tree. The Photobook has moved from a slightly dreaded task that will take so much time to quick and easy. Now, the thing that's going to eat up my time is flipping through all those incredible memories. If you're looking to have a memento of your family's amazing, amazing moments, or maybe some of their awkward ones, give Journey Print a try. Go to journeyapp.com podcast awkward and use the code awkward to get 30 off your next purchase. That's journey spelled J O U r n I app.com podcast awkward and use the code Awkward. I've always been about quality over quantity, especially in my closet. If it's not well made or versatile, it's just not worth it to me. That's why I love Quince. Quince uses premium fabrics like 100% European and linen, 100% silk and organic cotton poplin. They're all perfect for the changing seasons, but they're also built to hold up. And Quince works directly with safe ethical factories, cutting out the middlemen so you're not paying for brand markup or fancy retail stores just for quality clothing. I just got the Italian leather dual compartment toiletry bag in cognac and I cannot wait to use it as I hit the road for my spring speaking travels right now. Go to quince.com awkward for free shipping and 365 day returns. That's a full year to wear it and love it. And you will. Now available in Canada too. Don't keep settling for clothes that don't last. Go to Quincom Awkward for free shipping and 365 day returns. Quints.com awkward predator badlands now streaming on Hulu and Hulu on Disney
- [17:32]
B
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- [17:58]
B
on top of fracture. There's other stuff that happens and we can run quickly through them so we can get to the sort of weightlifting of it all. But like, you know, something like Osgood Schlatters, which I had when I was 12 or 13, I still have the bump under my left knee. One of my kids has it had it. So I'd be interested to know if there's a genetic component. There's other like foot related stuff that we hear. So severs, I mean my family's a wonderful there's many, many children, nieces, nephews, and we're a wonderful array of all of the various adolescent things that can happen. You know, we slip kneecaps is one you hear a lot about. I have lots of wonderful young women who I've coached in soccer who are dealing with that stuff. We're not even getting into the ACL and meniscus of it all and all those tears. So maybe we'll get into that later. Cara, what are some other ones that. That are common?
- [19:01]
A
Yeah, you've hit on a lot of the highlights. So the most common spots where we get either bone or ligament or inflammatory injury, it has to do, like the. Just so you have a sense of what's happening in the body. It has to do with this sort of rapid expansion in the growth plate. And then on top of it, the bone is trying to lay itself down really quickly, and it's forming a matrix, like a scaffold, but it's forming its scaffold faster than it can fill in. So basically, like, you've got bone with lots of whole Swiss cheese bone, if you will, and it needs to sort of fill itself in with more bone cells as that bone then denses. Densifies. Densifies. I don't know if that's a word, but when it's scaffolding itself and it hasn't filled in, it's weak. Okay. And then you have sort of the. The stretchiness, as you described with the ACL reference, the stretchiness of the ligaments, which has to do with the sex hormones and particularly the presence of estrogen, which means that you become sort of overly flexible around a joint. And so you've got sort of none of the nice supportive structure that adult bodies have. You have a lot of really flexible structure. Pros and cons to this, but kids are more at risk for certain injuries in the knee. Certainly ACL tears, especially among athletes. But Osgood, Schlatter, what you described. So anyone who's wondering what that is? It is when the ligament that is connecting the knee to the tibia, the long bone, bigger long bone of the leg, essentially, the bone is growing so fast that the ligament kind of peels off the outer layer of the bone and there's a bump. And actually, if you take two fingers and you put them right below the kneecap where the third finger would sit. So, like, do the number two, turn it sideways like a salute, put it right under the kneecap where the third finger would sit is where. Vanessa, I know you feel that bump.
- [21:16]
B
I can feel it. You can feel it still there, 35 years later.
- [21:22]
A
It's like your puberty memento.
- [21:25]
B
Totally.
- [21:26]
A
And that's what it is.
- [21:28]
B
And the problem with a lot of these, Cara, is you know what helps them feel better?
- [21:33]
A
Rest. Oh, yeah. Well, we're going to get into that.
- [21:36]
B
So just keep that in mind that you know, some of the stuff we mentioned, like an ACL tear, okay, that's could be surgery or pt. Some of these things like severs, like Osgood Schlatters, it's about resting the body. And this is where things get complicated. We will revisit this topic, I promise.
- [21:57]
A
Let's just run through a couple of these common things that you've mentioned because I think people are really hungry for the information. Severs, the larger name is severus. Apophysitis and apophysis, that's the bony outgrowth, that little projection that if you look at the classic picture of like a femur and the femur has the epiphysis, that round ball joint. And then opposite it, it has an apophysis which is sort of like a smaller. It almost looks like a. Just a little appendix or a little like sidebar that pops out on the other side. And it's like a projection, I would say, for lack of a better word. And apophysitis is just inflammation or. And it might just be inflammation for no reason. It might be from a stress injury that causes that little projection to become really tender.
- [22:54]
B
Is the projection where ligaments attach.
- [22:58]
A
It's the bony outgrowth. I mean, it's really like the. Depending upon what bone we're talking about, it's the attachment looks different and the joints are set up differently. But I'll give you the classic one that adults can relate to is tennis elbow, right? So that's an apophysitis, okay. In kids, it's severs and severs happens. It's this very specific spot on the heel and it's like super specific. And you just. If you. Someone puts their feet up and you put your finger press right in the middle of that round heel pad, kids will often jump. It is extraordinarily uncomfortable for them. And it's just where that apophysis projects out and then it gets really inflamed. So that's not a. Usually a fracture. Although apophysitis can be caused by a small stress factor fracture, but it doesn't have to in the hips. Hip pain in adolescence is often caused by apophysitis. So if you look it up, you'll see very clearly that apophyseal area, spine. So spine injuries are very common. I don't know why I was so surprised with the number of spinal injuries that I saw both as a pediatrician and then also as a parent watching my kids Friends kind of rotate through different sports, but, you know, there's scoliosis, which is a curvature in the spine that is genetic. And your. Your spine grows in one direction more than another. Usually there's either a C shape or an S shape, and that can cause its own series of problems. There's also something called sciffy, which stands for slipped capital femoral epiphysis in the hip. If you look at a picture of a femur, the epiphysis. So not the apophysis, which is the projection, but the epiphysis, that rounded ball joint, the growth plate sits between the round ball and the long part of the femur. And if you have too much weight bearing on the epiphysis, the growth plate cannot tolerate the amount of weight over time. And the epiphysis slips off, Literally slips. And that is a very, very painful injury. And so you'll hear scfe skiffy is the shorthand for that. And then finally, in the wrist, you know, distal radial fractures are the most common. Kids are skateboarding or rollerblading or doing whatever, and they fall and they put their hands out on an outstretched arm. And when the growth plates are fused, the part of the arm that breaks is closer to the middle, because that's the weakest point. But when the growth plates are open, the part of the bone that breaks is closer to the wrist, closer to the end, because that's the more vulnerable spot.
- [26:14]
B
Great. So this is super helpful background, right? I mean, we've covered a lot of ground, and we're 25 minutes in, and we haven't gotten to weightlifting. So I'm sure people are eagerly awaiting.
- [26:28]
A
They're starving for weightlifting.
- [26:29]
B
So what the hell does that all mean for weightlifting? I feel like we need to change the title of the episode to be Growth Weightlifting and Cross Training in Teens. So let's.
- [26:41]
A
Although you can't get to weightlifting and cross training without all of that backlight.
- [26:45]
B
No, A hundred percent. It's super important.
- [26:48]
A
Here's why. Because I'm gonna tell you that it turns out we don't call it weightlifting in the literature. It's resistance training. And resistance training is actually safe as young as five years old. Are you surprised to hear me say that?
- [27:11]
B
I'm not. But can you define and make a distinction between resistance training and what people imagine as weightlifting?
- [27:20]
A
Because it depends upon what you're resisting that defines the safety. And I will start with this. While the top of the episode, I said, I've been so excited to do this episode because I've Been so excited to dive into the research. One thing I have known for 25 years and a fact that I imparted very enthusiastically to my children the entire time they were growing up and going through adolescence was there is a very big difference between resistance training and, quote, weightlifting. Insofar as when you are resisting your own body weight, there is almost no data that that is unhealthy. So go for it. Okay? Do push ups, do pull ups, do frog jumps, do bear crawls, do hopping, do jump roping, do any that is resisting your own body weight. And we are designed for that resistance training. We think of it as cardiovascular sometimes, but it's really in many ways resistance training.
- [28:32]
B
I mean, one of my favorite activities that we used to do with our dynamo girls who were between the ages of 4 and 11 is we would have them write a story. Like they would break them into teams and they would write a story about animals and. And each animal would have a. A movement. Right? Kari, you mentioned frog jumps and bear crawls and crab walks and all of those things. And they had to write a story that involved all those movements. And then the class would do all those movements together while someone read the story. And not only was it totally adorable and there you ever want to meet the most creative people on earth, get a group of six year olds together and they will blow your mind. So not only was it adorable, but. But it was rigorous and it was wonderful to see all the ways they can move their bodies and for them to recognize how strong they are and all of the ways that they can really use all parts of their bodies. God bless them, do it now while they're young. Use all parts of their bodies. And so there's so many ways to do it that don't feel intimidating or scary or like, oh, you know, I can't do a plank, but I could be like a really powerful snake. Right? So getting kids to be creatively involved in that is really wonderful.
- [29:54]
A
And listen, I mean, what our kids, our tweens and our teens are asking us about is not resistance training, right? However, we are here to help you reframe because this is safe. And not just safe, it's important. So there was an article in the journal Pediatrics, which is the American Academy of Pediatrics Journal. It came out in 2008. It was revised in 2020. It was reaffirmed in 2024. And this statement basically says, and I'm going to read it. Resistance training is becoming more important as an integral part of comprehensive sports training regimens. School physical education Classes and after school fitness programs. The increasing number of youth who are involved in sports activities, coupled with the health problems of inactivity and overweight have resulted in increased interest in resistance training. It is really important to recognize that there is a formal recognition of the benefit of resistance training. It has, and I quote, no negative effect on linear growth, physical health or cardiovascular systems. Okay, so this is important. When kids ask you, what can I do? I want to strengthen my muscles, I want to get stronger. There is no age at which it's not appropriate to say, great, crawl like a snake, start learning how to do planks, do sit ups, do pull ups. I mean, we have episodes about when that behavior becomes a little bit obsessive or crosses a line. But when we're talking about sort of healthy movement of the body in moderation, there is no data that it is ever unsafe to resist your own body weight. Here's what kids are asking about. Kids are asking about formal weightlifting. You know, there is a lot of research here. I'm going to credit open evidence with sourcing all of these articles for me. So anyone who hasn't been on open evidence before, it's openevidence.com, it is an AI platform that only pulls in peer reviewed medical journal articles and then it summarizes them in a way that anyone, whether you went to medical school or not, can understand. I strongly recommend it. You can start inquiring on open evidence about a lot of this stuff and you will get pointed to correct, accurate links that take you to the actual article so you can read the data for yourself. But as I was querying open evidence over the course of the past several days, what I kept going back to was this sort of theme of yes to resistance training, yes to proper technique. So kids, you know, we always say this about adults. Kids need to learn proper technique as well. And when it comes to weightlifting, there is a progression. So there's a very clear recommendation that technique learning should happen with no weights. They, you know, a lot of the articles describe like a wooden dowel or something. That's just like learning. Your body is learning the general movement before you then load the weight. Now here is the summary, Vanessa. This is the sentence every kid is waiting to hear from us and they're not going to like it. Maximal lifts, powerlifting and bodybuilding are not recommended for skeletally immature athletes. If your growth plates are open, if your bony matrix has formed but the bone hasn't filled in, maximal lifts, powerlifting and bodybuilding are not recommended.
- [33:52]
B
And let's Just spend a minute talking about why a kid who is not yet fully grown or is skeletally immature might be interested in doing those things. Right. Let's think about what they're consuming on social media. It would be really great if you're one wondering if your kid is watching Bodybuilders on YouTube and health and fitness influencers sidle up to them this weekend and say, hey, you know what? My TikTok feed is like, all sloths and pandas. I would love to see what's on your TikTok feed. Maybe we can, like, start sharing stuff with each other and see what they're looking at because it will give you really good information about what's influencing their desire to join a gym, start to lift weights, asking you to get stuff to have in the home. And so the idea of proper form, right? So if you feel like, okay, well, I think maybe they're ready to start learning, make sure they're learning from a qualified instructor, trainer, educator at school, somebody who knows what they're doing about proper form. Because it doesn't just protect them skeletally now, it prevents injury throughout a lifetime. Because form is important. No matter how mature you are physically, it's critical. And for those of us on the other side of our development, we're more susceptible to injury. So make sure that you are clear with them, as Car mentioned earlier, about the progression of what they use to lift weights. So maybe have some lightweight barbells at home or things to use that can start them out and let them know. We can revisit this when. Maybe it's at your next pediatrician's appointment. Maybe you have a kid who's having a bone scan. But I want to point out, and this is so important, and we write about it a bit, and this is so awkward. Cara writes about it a lot in Decoding Boys. The pressure for boys to get big is so, so heavy on them psychically. And the late bloomers, the smaller ones, the kids who are quote, unquote behind, never going to be as tall as other people who are just genetically destined to be shorter. There is a tremendous pressure. We hear from boys all the time. I have to get big. People aren't going to find me attractive. If I'm not big, I'm not going to be part of the friend group I want to be friends with. If I'm not big, no one's going to be romantically interested in me. I mean, we cannot imagine how much pressure these kids are under to feel like they fit a certain physical stereotype.
- [36:39]
A
We'll be right back. But first, a word from our sponsors.
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- [38:37]
B
So I think about this a lot because sometimes coaches and the folks staffing weight rooms at schools and gyms are trained and qualified to be guiding kids through these. They're sensitive to different ages and stages of growth, and they're really good at creating progressions for different kids. And sometimes they're not. And this is a moment to get really curious, right? We are not people who advocate getting into everybody's business and sort of interrogating everyone but you. And I have had enough experience as parents of athletes, and I've got tons of experience as a coach myself. It is perfectly within a parent's right to know and understand what training and expertise the adults have who are guiding and teaching kids how to lift weights, when to lift weights, how often to lift weights, what weights to lift. And this is a real opportunity to get respectfully curious, right? Because a lot of you listening are worried, oh, is there going to be retribution? Is it going to affect my kids spot on the team? Is it going to impact playing time? All of those worries, which just breaks my heart. But I do understand why people have those thoughts and get respectfully curious and say, hey, can you let me know who's staffing the weight room? What is their training? Do they have a certification? What is the onboarding process for kids who've never lifted before? What is the progression for them? How heavy are the weights? How much research and understanding are you doing about their stage of growth and development? You know, all of those questions are eminently appropriate. And it's our job to protect our kids well being and prevent injury as best we can. And so this is a moment to, to step in and get some information. Because if you ask your kid, what are they going to say? I don't know, they're going to say
- [40:30]
A
whatever they can say to keep doing it.
- [40:33]
B
Exactly.
- [40:33]
A
That's the reality. So then let's shift over to cross training because this is the other side of the coin and it's a really, really important conversation. If the answer to should I be or can I lift weights before my growth plates have fused and my bones are fully mineralized. If the answer to that is largely no, I'm going to put an asterisk there because you did mention light barbells and that is the gray zone. And I would go with your recommendation that if it's a trained coach or supervisor who knows how to instruct kids in light weights, which is like resistance body resistance plus training, that is a different bucket. And I think, you know, the evidence there is pointing towards that's fine so long as form and technique are proper and it's truly lightweight. But the flip side is how important cross training becomes. So we cannot have the weightlifting conversation without having the cross training conversation. Cross training during rapid growth reduces repetitive stress on the growth plates. It allows for balanced musculoskeletal development, which means that the forces that are pulling on the bones are balanced. They are equal in different directions and not just favoring one direction, which also is healthier for growing bone. I will use my own personal example. My son is a rower. There are two kinds of rowing that you can do when you start rowing in high school. One is called sculling, which uses two oars and one is called sweep which uses one oar. When you use one oar, it's an asymmetric movement. And so the repetitive ask of the muscles and the bones skews to one side or the other. When you do, that's when you do sweep rowing, when you do sculling with two oars, it's balanced. So there was never any question in my mind what form of rowing my son was going to learn on because of the need to for balanced, symmetrical motion. However, cross training is not about just balancing the use of the muscles. It's about doing other sports and using other muscle groups, other joints, other ligaments, putting pressure on other bones and not just repeating the same action over and over and over again.
- [43:23]
B
And I will just say in terms of again, getting curious about if your kid is specializing in a club team or travel team, making sure there is time in the schedule for your kid to be able to play another sport or two on the rec level or just for fun. This is really critical. I know at my kids school, most recently the boys sports program had an official meeting where it indicated that all athletes are expected to play at least one other sport besides one special, you know, their quote unquote sport, and three if possible, which is wonderful. Not every school or every community has the chance to do that. But if there is a chance, even on a rec level, I think it's wonderful. I want to just talk briefly about how we can help kids navigate coaches who are putting the psychic stress on them to specialize. And you can listen to the episode we did with Amanda Stanek on youth sports, Keeping the Joy in Sports. She's a kinesiologist and researcher and she has wonderful guidance about how to navigate those conversations. We did an episode, the two of us on our own, about youth sports specialization and there's a massive chapter in our book about it. It is so complicated and so multilayered and it brings up so much for parents and kids and communities and schools and all of this stuff that we don't even have time to scratch the surface. But again, this is something to be aware of. It's something to be your kid's advocate for. It's something to be in conversation with your kid about because the amount of mental and emotional pressure that kids are feeling around sports specialization is almost unimaginable for many adults.
- [45:19]
A
So I'm going to speak directly to the kids for a second because this is not your parents saying what they want. It is not us saying what we think is best. I'M going to quote some of the really important policymakers out there in health and wellness. So I'm going to start with the American Medical Society for Sports Medicine. Their official recommendation is that young athletes take between two and four months per year away from sport specific training. And they specifically say that means cross training. That's to Vanessa's comment about her school saying you have to do more than one sport. That's what that is. The American Academy of Pediatrics has said that you should delay single sport specialization until at least age 12, ideally later.
- [46:13]
B
Why?
- [46:14]
A
Because the evidence shows that highly specialized athletes have a 59% increased risk of any injury and a 45% increased risk of overuse injury. So using the same muscles, joints, bones, over and over again compared to multi sport athletes, that is massive. An athlete who plays a single sport more than eight months per year has significantly higher rates of both upper extremity and lower extremity overuse injury. And the injury burden. The likelihood that you get hurt is highest at your peak height, velocity, your max gross spurt, right. Which if you listen to the beginning of the episode, you know, has to do with all those things that are happening in and around the growth plate. Here's my last piece of data. The American College of Sports Medicine says take one to two months off of sports specific training every six to 12 months, even for athletes who specialize. And here I'm going to stick the landing. For most sports, delaying specialization until you're between 15 and 16 does not compromise elite athletic achievement. And in fact, it might even promote superior long term outcomes. Meaning if you delay specializing until you're about 16, not only will you not not be an elite athlete, but you have a higher likelihood of being successful in that sport because you have broader motor skill development, you've cross trained and you have less burnout and less injury. So that's a lot of data. That is not just a parent yapping at you, telling you what to do. It is, that's the science and the
- [48:27]
B
burnout is a big part of it. When we think about kids who only play one sport and have an injury that prevents them from playing that particular sport, not only is their sort of worry about not getting back on the team, but they also lose that whole community. They lose that social reality, they lose that sense of self worth. If we give kids the chance to play multiple sports or be involved in multiple kinds of physical activity, that offers them also additional outlets for their brain. It gives them new social opportunities, it gives them new groups of people to spend time with so the burnout is not just the constant doing, but it's also about one group of people, one group of opportunities, and one injury can wipe out their whole community. Cara, let's close with whether there are gender differences in types of injuries and likelihood of injury. And let's just be super clear that historically, research on many of this has focused on male athletes and that only very recently are there new centers for research and focus on research on women athletes. So we're at a disadvantage in terms of what's available, but in terms of what we can access. Cara, what do we know about that?
- [49:48]
A
I mean, your sort of asterisk there is the most important part, because we just don't have an answer yet. So much of the research has looked at the male population that it's very hard to compare male risk versus female risk. What we know is that in male bodies, a greater proportion of the injuries have to do with the apophysis or the physis or the cartilage, whereas in the female bodies, it's bone, tendon, soft tissue. So, like, what does that tell us? You can get granular and you can look at a specific sport. It explains why ACL injuries in females are off the charts. I mean, I will tell you, for every one call I get about an ACL injury in a male, I get three about females, and that goes along with this. But what we really need is a lot more data. We need comparison studies between the two. My hope, Vanessa, is that these studies get increasingly hard to do because kids stop specializing early. They start cross training, they delay weightlifting, and suddenly that's the issue with collecting the data. They're taking really good care of themselves.
- [51:02]
B
Right. And one of the areas we don't have a lot of data on, but there are folks doing this research which is around how female menstrual cycle impacts vulnerability or resistance to injury. There's this site called Ditto Daily, and she does all sorts of incredible research around the menstrual cycle and women's health. So that's one area. You know, things like the overuse is one part of it, but we don't know the hormonal vulnerability yet. And I'd be super interested to learn about that. So TBD and To be continued. But I think this is really good baseline information for adults and for kids. I think this is a great episode for people to share with their kids or to share clips with them, because often, I mean, I know my kids take their information a hell of a lot better from Cara than they do from me. So if you're in the middle of a debate or a battle with a kid, this is a great way to start. And listen. Joining gyms is really expensive. It's a real financial commitment, and I know parents feel pressure to shell out the money for that. But based on this information, getting an app that allows you to do some body weight work, some resistance training, having a few articles of, you know, small weights and things like that in the house will save you some money in the short term. So be in conversation with your kid and get curious about what's driving this new interest in weightlifting and the kinds of weightlifting they're asking to do, which are probably not necessarily safe. And if they're resistant to cross training, understand what's underneath that and the pressures that may be influencing their lack of interest in that. Where is that pressure coming from? And how can you help them navigate that stress as well?
- [53:02]
A
Vanessa, thank you, thank you, thank you. I loved this.
- [53:07]
B
So great, so interesting. Thank you for all the amazing research that you did to pull this together. It was not a light lift. Thanks, Cara.
- [53:19]
A
Bye, Vanessa.
- [53:21]
B
Thank you so much for listening. You can email us with questions, feedback, feedback or episode requests@podcastawkward.com if you want
- [53:32]
A
to learn more about what we do to make this whole stage of life less awkward for everyone involved. Our parent membership, our school health ed curriculum, our keynote talks, and more are
- [53:44]
B
all@lessawkward.com and if you want products that make puberty stuff much more comfortable, visit myumla.com.