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The Power of Strength

written by Marsha Seidelman, M.D.
on Wednesday, 9th November ,2016

Here’s what drove home the importance of strength training to me. I was helping my daughter get one last piece of IKEA furniture - I must say we are MASTER IKEA furniture putter-togethers! We were able to get the kitchen table into her car, but then came the chore of carrying it up a few flights of steps. It was heavy and packed in a long, thin carton. As we were standing at the foot of the stairs, considering how we might push it up the stairs, a young gentleman came by and asked if we needed help. Usually reluctant to accept help, I said, “Really, do you have a few minutes?” And so the kitchen table made it up the stairs thanks to the strength of my daughter and this young man; no thanks to me.

One of the talks at the Lifestyle Medicine conference some of us attended a few weeks ago was about the importance of strength training. I was already thinking along those lines after my humbling experience. As an aside, how’s this for a ‘small world’ story. The speaker, Jeff Young, is an accomplished exercise physiologist who has developed medical fitness programs in many settings. He mentioned that he’s currently at the Beth Israel Spine Center in NYC, which is where my son received treatment for a back problem recently. Well, it turns out, Jeff helped my son get back to lifting weights. What are the chances that I’d go from Maryland to Naples FL and happen to go to a talk delivered by my son’s trainer from NY?

What was the talk about, you might ask? One consistent theme was the importance of strength throughout life. CARDIO exercise on foot, bike or elliptical, or in a pool, are all beneficial, especially for heart health. But there are other benefits that accrue from STRENGTH training.

Strength is the foundation of movement. It is essential for motor control (stepping over a puddle), work capacity or power (carrying a table up a flight of steps), and agility (moving quickly in a tennis game). In practical terms, by improving balance and preventing falls, it keeps patients out of nursing homes.

Sadly, muscle strength decreases starting at 30 - 50 years old, progresses through age 70 and then continues to decline more rapidly. The good news - strength is NOT a function of age; it IS a function of activity. Strength training is still effective at any age. Even if started at age 70 or 80, a strengthening program is worthwhile. If it’s new to you, it just needs to be approached with caution, staying in a very comfortable zone for several weeks before advancing. I always advise people to skip a few days after a new workout to be sure there isn’t any delayed pain.

In an upcoming post, we’ll describe the many different ways strength training can be achieved - using body weight (think pushups, yoga), free weights, bands/balls/tubing, machines etc. Even doing a couple of exercises every day (rather than a whole 30-60 minute routine) will provide benefits!

An obvious goal of strength training is of gaining local muscle endurance, or eventually being able to lift more weight for a longer time. For the sake of simplicity, for now we’ll talk about a free weight routine. One plan would be to lift a certain weight 8-14 times in a set, gradually increasing to 12-25 times, gaining strength and endurance. Once you’ve reached that goal, you could increase the weight and start again at 8-14 reps and gradually increase. Several different exercises are done in succession to work different muscles. If several of these sets is repeated approximately three times a week, then over the course of 2-3 months, there would be a very noticeable increase in strength. Once you are comfortable with the routine, varying it is also beneficial.

Improved strength all around a joint helps with joint stability. For instance, there are many connections holding the kneecap, or patella, in place. By strengthening all the muscles that connect above and below and on both sides, the knee remains more stable. Similarly for the shoulder and the spine. Good posture is a rewarding side effect of strengthening the core and back muscles.

Then there’s the goal of improved body composition - trying to decrease fat relative to muscle. What this means in practical terms is that you can eventually lose abdominal fat which raises the risk of heart disease and may see better muscle tone. Often people complain that no matter how many sit-ups or crunches they do, their abdomen doesn’t have the 6-pack look. Well, after enough core exercises, the 6-pack might be there, you just can’t see it because there’s a layer of abdominal fat over it. You might admire what is now known as ‘Michelle Obama arms’ or a yogi’s well toned legs. Showing more muscle than fat is achieved through strength training, adequate protein intake and caloric deficit if desired, otherwise known as weight loss.

Next is flexibility. It seems counter-intuitive to build strength to become more flexible. But in fact if you can strengthen through the full range of motion, it improves fluidity in movement. When you’re trying to stretch a muscle, let’s say the hamstring in the back portion of your thigh, it’s best done after you’ve warmed up and maybe even AFTER you’ve finished exercising.  Stretch initially to the first end range, stay there and relax for 20-30 seconds, relax mentally and allow the inhibitory signals to slow (the ones that are keeping you from stretching further). Then slowly stretch a little further. You’ll feel the difference. The prolonged time component of 20-30 seconds is key. Another technique is to do myofascial release with a firm tennis ball or roller. Engage the tightest area, roll firmly, and your muscles will eventually thank you - after the pain of rolling wears off.! It gets less painful over time.

Strength training can also enhance cardiovascular endurance, which is why athletes always ‘cross-train’. Even if their main goal is to be faster and more agile, like runners, or tennis or basketball elite athletes, strength training can improve their performance. Strength training has such high energy requirements that it induces increased mitochondrial density in muscle cells. These mitochondria are the powerhouses of cells and the more there are, the better the cells can use oxygen during exertion, and the longer the athlete can stay below the exhausting ‘anaerobic threshold.’ So strength training enhances cardio performance.

By now you should be totally convinced, as I am, that strength training is as important as cardio training. Stay tuned for more options for strength training. Just go slowly and carefully and you will feel the benefits on a day-to-day basis. Walking with groceries, pushing a stroller up an incline, or carrying a turkey to the dinner table, will all be easier. Then, on special occasions, you could even help carry an IKEA table up a few flights of steps!

Here are some links to get you started.  If you're new to strength training, you should check with your physician before starting, and get the assistance of a trainer initially to ensure correct form.

http://ladydocscornercafe.com/article/push-ups-upper-body-and-core-strength-using-your-own-body-weight/ Jody’s article, with her as model -

Troy’s article on posture - Ann as model

Jody’s article on flexibility - with Thu as model ;-)

I think this workout is ingrained in my brain - still my go-to with some others when I don’t want to think. Me as model - photographed by my son.

Tags: strength training, balance, endurance

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