Posts tagged strengthening
No Strength Gain Differences Found Between Low and High Load Exercise IF Reps Are Taken To Failure
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In our previous blogs we have discussed the errors most exercise participants make when selecting intensity (amount of weight) while at the gym. Humans are often poor estimators and when it comes to strength training they often select weights below the intensity required to promote optimal strength and muscle gains. Trying to base a weight off a one repetitions maximum is time consuming, impractical, and possibly contraindicated for some weight training participants. Conversely, research articles continued to support using fatigue as an alternative to the 1 repetition maximum weight selections. Fatigue takes the guesstimation out of exercise weight selection and can be very effective at promoting optimal strength gains.

Dinyer and colleagues in The Journal Of Strength And Conditioning Research randomized untrained women to either a low or high intensity weight training program (2019). All of the women underwent clinical and body mass (% fat free mass) testing before and after the 12 week training program. Each group was assigned to a weight equaling a low (30% of 1 rep max) or high (80% of 1 rep max) intensity for 2-3 sets during 4 exercises (lat pulldown, military press, leg extension, and leg curl). Both groups took their workout sets to fatigue. Authors reported while both groups improved their maximum strength at the end of the 12 weeks there were no differences between the low or high intensity groups. In addition no changes in fat free mass were noted in the groups.

This study highlights the importance of working with a sub maximal weight and lifting it a maximum number of times for optimal strength gains. We recommend selecting a repetition range first (ex. 8-12 reps) then selecting a weight, but adjusting this weight higher if you can perform more repetitions than your established rep range.

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Strengthening Cuts Hamstring Injury Rates In Half
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Hamstring injuries are common and can occur in any sport with any athlete. The three muscles of the hamstring are put through rapid lengthening and shortening contractions making them susceptible to strains or minor tears. Due to the common occurrence of these injuries, it is important to target proper strength and conditioning regimes to decrease the risk of injury to this muscle.

A recent article by the British Journal of Sports Medicine investigated the available research on the effectiveness of hamstring strengthening utilizing the Nordic Hamstring Exercise and its’ impact on injury rates (van Dyk. 2019). The review included over 8,459 athletes and found when the athlete's strengthening program included the Nordic Hamstring Exercises, the risk of injury to the hamstring decreases by 51%. As mentioned by a previous blog, the Nordic Hamstring Exercise recruits the hamstring more evenly with a eccentric contraction (contraction of muscles while lengthening) consistent with the demands of sport.

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Strengthening Exercises For Patellofemoral Pain
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Patellofemoral pain, or pain around the kneecap, is one of the most common types of knee pain we treat at MEND. It impacts up to 23% of the general population and 40% of those people have persistent symptoms that can last for years! Exercise programs targeting the hip and the knee have been proven effective in managing hip and knee pain.  Most of the exercise programs studied to date have either not provided sufficient exercise progression to improve strength and power or have not been extended long enough to sustain gains in strength or power (which may result in recurrence of symptoms).

 A recent study (Barton et al 2019) reported significant improvements in patellofemoral pain, function and hip muscle capacity with a 12-week progressive strengthening program that can easily be performed at the gym. The key differentiator of this study was that the exercises were progressive – either the challenge of the exercise increased (ie: 2-leg squat to 1-leg squat) or the resistance of the exercise was progressed to ensure participants stayed in a perceived exertion range of 7-9 (which typically means you are only able to perform 1-2 reps in your set).

The exercises included in this study were:

1.     Bridging – 3 sets of 12 repetitions

Double to Single leg

2.     Hip abduction - 3 sets of 12 repetitions

a.     Sidelying to Standing Progression

3.     Plank progressions 3 x 60 sec

a.     Front and Side Planks

4.     Optional quad exercises including squats and single leg squats.

5.     Hamstring Strengthening including body weight and machine.

Authors concluded the 12 week progressive resistance training program was safe and effective for improving pain and function in patients with patellofemoral pain. Stay tuned to our social media for an exercise videos.

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Significant Cervical Weakness Found Among Patients With Migraine
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According to the Global Health Burden studies, Migraine is the 3rd most prevalent disorder (14.7% of global population: 1 in 7 people)  and 3rd most cause of disability in those under 50 years old. It is more prevalent than diabetes, epilepsy and asthma combined. Migraines occur with 17% of women and 6% of men.  Symptoms of migraine include: Headache on bilateral or unilateral sides around temporal region, with or without visual disturbances.

A recent study (JOSPT 2019) investigated the role of the musculature in the cervical spine in those with migraines. A lack in neck endurance strength of the neck musculature has been shown to be correlated with chronic migraines. The authors found a significant difference in neck extensor and flexor strength with those with and without migraines. The findings of the study suggest addressing the strength of the musculature of the neck to assist in management of headaches

Research Shows Most Participants Select Inadequate Weights For Strength Training
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Money and time is some of the finite resources in life. As our lives become busier with work, family, and life commitments our exercise time must become more effective and efficient. One of the biggest and most common mistakes individuals make in the gym is an ineffective cardiovascular or strength training intensity selection. Although any movement of large body parts will contribute to a caloric deficit, selection of a low intensity of exercise will prevent participants from developing cardiovascular or strength gains. Research shows both novice and experienced weight trainers choose inadequate weights for strength development.

Glass and colleagues found novice lifters selected weights between 42-57% of their 1 repetition maximum (J Strength Cond Res. 2004). A second study found similar mistakes in sedentary individuals who initiated a strength training program (Elsangedy et al. J Phys Ther Sci. 2016). These self selected weights were all found to below the 60% value shown to create muscle growth and strength gains among novice lifters. Surprisingly, the influence of a personal trainer does not ensure participant reach intensities recommended by the strength and conditioning research. Ratamess and colleagues randomized females with weight training experience to either a self selected or a weight intensity selected by a personal trainer (J Strength Cond Res. 2008). Although selected weight intensities were improved (51% vs. 42%) in the personal training group authors found both groups selected weights below recommended intensities.

In our previous blog we discussed the value of using repetition in reserve to determine an appropriate intensity during weight training. This method of selection reduces the human error associated with weight training ensuring selected weights are appropriate for strength gains.

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Optimizing Strength Gains Using Repetitions In Reserve
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Strength training remains one of the most important components of your exercise program. Research supports its’ utilization for improving pain, function, flexibility, strength, injury rates, and overall health. While a single session of strength training can lead to significant gains in strength and muscle hypertrophy research supports training large muscle groups 2-3 days per week. Another important component of strength training exercise prescription is intensity. Selecting an appropriate weight for a set of exercises can be challenging for most individuals and errors often lead to less than optimal improvements in injury and sports performance.

Traditionally, individuals would select a weight based off their tested 1 rep max on a given exercise which may or not be appropriate for every individual. More recently Physical Therapists have been advocating for a repetitions in reserve prescription where weights are selected based on how many repetitions an individual could complete at the end of a given set. For example, if a weight was selected and performed 5 times the individual would be asked how more repetitions they could complete with good form. If the answer is more than 2 repetitions the weight would be increased to dial in the appropriate intensity. A recent study compared the benefits of these two methods of repetition selection.

Graham and Cleather in the Journal of Strength and Conditioning Research randomized 31 experienced weight trainers to one of two programs (2019). The first program, fixed load, based weights on a percentage of the athletes 1 rep squat max. Conversely, the second group adjusted their weights based on the number of repetitions in reserve at the completion of their set. Volume (reps, sets, days per week) was standardized between groups. Each individual completed their 12 week squat training program based on these prescriptions. Authors reported both groups improved their front and back squat performance, but significantly better results were found in the repetitions in reserve group.

This study highlights the benefits of the repetitions in reserve model. In short, this model reduces operator error in weight selection because intensity is always adjusted to the individual.

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