Posts tagged weight training
No Strength Gain Differences Found Between Low and High Load Exercise IF Reps Are Taken To Failure

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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Q and A with Zach Long, PT, DPT, SCS

In my opinion, Physical Therapy patients are often under exercised and do not return to prior levels of activity due to a lack of rehabilitation intensity.  What are some of your recommendations for implementing higher level exercises and strength and conditioning principles for practicing Physical Therapists?

We have a problem in the physical therapy profession where we are fearful of overloading patients in the clinic. Unfortunately many injuries to tissues happen when the demands placed on that tissue exceed what they we prepared to handle. So if we underload we won't build tissue capacity up to a high enough level to reduce future re injuries. 

My biggest reccommendation for orthopedic clinicians wanting help implementing higher level rehab exercises is to work as a coach! I've learned as much in the past year from working with one gymnastics coach as I did from anyone in the actual rehab professions. For those that can't coach, start reading and following some of the more prominent names in strength and conditioning. See what they are doing and the gaps between that and your rehab programs. Then game plan how to close that gap as much as possible. 

2.  In many athletes, a lack of joint mobility presents as a stability or motor control problem.  What are some common clinical patterns/presentations you observe in these athletes and how are you teasing the mobility vs. stability impairment out during your exam?

Before ever assuming mobility or motor control problems, I always perform both active and passive available motion in all joints making up the larger movement pattern we are working on. Skipping this step often leads athletes and clinicians to working on the wrong thing. 

3.   What role does blood flow restriction training play in your clinical practice.  Which patient populations benefit most from this intervention?

Blood flow restriction is a huge part of my practice for anyone needing improved strength and/or hypertrophy that cannot tolerate heavy loading. This may be after a surgery, acute injury, or someone just fearful of heavier movements. BFR allows us to get similar strength and hypertrophy changes at loads as low as 20-3% of their one rep max that we see lifting loads heavier than 70%. 

BFR also has some very cool hormonal benefits such as improved growth hormone release vs heavy training which can potentially help with bone healing, tendon and ligament rehab, and greater reductions in patient reported pain levels. 

4.  The Tar Heels had a great run in the tournament can we expect a repeat in 2018?

Despite being a die hard TarHeel, I'm actually not much of a basketball fan. I was fortunate enough to work with the football team for two years and tend to follow them more. Hopefully having the Number two draft pick in this year's NFL draft will help.

Influence of Heel Wedge on Squatting Mechanics

Squats remain one of the most effective exercises for strengthening the lower quarter and improving sports performance.  It also is a very efficient exercise in the gym because it targets most of the important leg muscles and works them through a large range of motion.  The downside of a squat is its' difficulty.  Many people struggle to perform a squat properly or perform the exercise with an excessive load sacrificing their form in the process.  Most commonly, people will compensate with a forward lean increasing the load on their spine and pelvis instead of placing the load across the proper joints and muscles.  A loss of ankle mobility also contributes to this forward lean and some individuals have learned to squat with their heels lifted (ex: on a weight plate) to improve their mechanics.  

A recent research study in the Journal of Strength and Conditioning Research examined the biomechanics between a flat footed or heels lifted squat (Charlton et al. 2017).  14 trained men performed a weighted back squat in two conditions: barefoot and with their heels lifted by a 1 inch block.   As expected less forward lean was found on the squat when the athletes heels were lifted.  

To learn more about improving your squat performance and mechanics seek out care of a knowledgeable, local Physical Therapist.

Muscle Loss and Aging
aging-atrophy-muscle mass-exercise

All of us will undergo a progressive loss of muscle mass as we age called sacropenia.  The key modifying variable is how quickly an individual loses this muscle mass over time.  Previous research on resistance training has shown a significant reduction in the rate of this loss over time among both experienced and novice weight lifters.  A new study examined which muscles are most susceptible to muscle mass loss with aging allowing for better exercise prescription and prevention.

Ikezoe and colleagues compared the cross sectional area of lower body muscles between 20 year old and 83 year old subjects (Arch Gerontology and Geriatrics. 2011).  The authors then compared the muscle size differences between old and young participants to determine which muscles atrophied the most with the aging process.  The smallest differences in muscle mass were noted in the thigh muscles including the quadricep and hamstring while the greatest differences were noted in the hips.  On average these hip muscles were only 1/2 the size of their younger counterparts.  This study highlights the importance of resistance training among all age groups, especially in the hip musculature.   To learn more about the benefits of resistance training contact your local Physical Therapist.

Strength Training to Failure

A common question we receive in clinic is how many repetitions should I perform of this strengthening exercise?  Clearly, enough repetitions are needed under a given load to promote beneficial changes within the tissues for improvements in both healing and performance.  Ranges of repetitions range from < 5, 8-12 reps, and >15 reps depending on the intended goals of the exercise and the patient/client's capability.  Another repetition goal gaining popularity is performing the exercise until muscle fatigue/failure regardless of the number of repetitions.  The biggest limitation of this training is sacrificing intensity (amount of weight) in order to perform a high number of repetitions.  A study recently compared the effects of training until failure with higher intensity exercises.  

Looney and colleagues had healthy volunteers squat with 50, 70, and 90% of their maximum squat strength (J Strength Conditioning Research. 2016).  Athletes were assessed for muscle activation during these exercises to determine which level of resistance and repetitions produced the most beneficial environment for strength gains and muscle growth.  The authors results were consistent with the previous literature indicating intensity (higher weights) is more effective than training to fatigue (higher repetitions) for muscle performance.  Athletes and clients are encouraged to pick a repetition range consistent with their goals and to lift a weight which leads to fatigue (only 1-2 good reps left at end of the set) within that repetition range.  '

To learn more on how strength training can improve your health and performance contact your local Physical Therapist.  

Improving Throwing Velocity

A common question we receive from young throwers and their parents is how to improve throwing velocity safely without undue stress on their arms.  Our prior posts on throwing have focused on reducing arm stress through injury prevention and lower quarter strengthening.  This post will focus on the research surrounding exercise programs designed to improve a thrower's velocity of their pitches.  Ellenbecker et al. previously reported the lower body contributes 50% towards hand forces, while the shoulder only contributes 15%  (JOSPT, 2007).  As we would expect whole body, multimodal training aimed at the entire body improves throwing velocity both in short and long term training programs.

A recent analysis of the available evidence in the Journal of Strength and Conditioning Research examined the training programs shown to have the greatest impact on ball velocity in baseball, softball, or tennis (Myers, N. 2015).  13 articles were included in the final analysis and included interventions from plyometric training, medicine ball throws, and traditional upper and lower body resistance training.  These articles were scored as moderate to high quality based on a methodological analysis.  The training programs included were as short as 6 weeks or up to 9 months in length in a periodization format.  

The authors noted improvements in ball velocity across sports if the athletes were given whole body exercises focused on the connection between the legs and arm.   Longer term programs were most often used but short term programs, 6 weeks, also reported improvements in velocity.  Specifically, in tennis a 17 and 20 mph serve speed increase was noted with a 4 and 9 month resistance training program.  Athletes should speak with a Physical Therapist to determine how to structure their resistance training, plyometrics, and medicine ball throws in order to have an optimal impact on their ball velocity.