So most of us have had a go at some form of strength training whether it is hitting the big weights at the gym, doing some sit ups watching TV or carrying the shopping in from the car. However what really is strength training and are we doing it correctly to see any results or benefits. When properly performed, strength training can provide significant functional benefits and improvement in overall health and well-being, including increased bone density, muscle, tendon and ligament strength and toughness, improved joint function, reduced potential for injury and improved balance. It can also have an impact on cardiovascular and metabolic health.
1. Exercise selection
There of hundreds of different ways, types and methods of strength training out there and if you go to gym there will often be lots of different machines to work different parts of your body. Choosing the type of strength training that is most effective for you in your rehabilitation program is a matter of working backwards from your goal. Do you need to train for endurance, power or function? Do you have very weak muscles that need to be supported or very strong muscles that lack coordination? Your strength training program will depend on many of these factors and your neuro physio will be very helpful in setting you up with the most efficient program for you to continue, either in therapy or outside as an individual program. Three to five exercises may be plenty to focus on in a session, any more may become too time consuming and you will not be able to work at the required level of intensity needed to over load and see improvements.
2. Frequency of training
Evidence shows that depending on what type of strength training you are doing, 2-4 times a week is best. The rest periods between strength training sessions can not be underestimated, especially in weak muscles. If you are working hard in each training session, more rest may be required. Research shows that muscles continue to build fibers and become stronger for up to a week after a workout that is performed to muscle failure. This means if you perform an exercise until you physically cannot do it anymore you are likely to get better strength gains- this comes with a caveat in muscles that are under undue strain during everyday activities such as in conditions like polio, MND, Muscular dystrophy for instance.
3. Number of sets
The majority of research confirms that if you can do one set to exhaustion, that is probably enough if you are looking at pure strength gains. It is common to perform 2 or 3 sets and continue to load the muscles, however, again this will depend on what you are trying to achieve and why the muscle is weak in the first place.
4. Number of repetitions
The number of repetitions you do in each set will again depend on if you want to achieve in your strength training program. Is your focus on strength, power or endurance gains? Higher repetition sets stimulate the slow twitch muscle fibers and promote muscle endurance. Lower repetitions (at a higher intensity) activate the fast twitch muscle fibers and can increase strength and muscle size. You may need a combination of these strength training features for optimal functional outcomes and your therapist may chose to vary your training methods. In theory, the weight must be heavy enough that you reach fatigue at the last repetition of your set in order to promote muscle growth. For example if you want to build pure strength with a sit to stand activity, you may need to hold additional weights or wear a loaded weight vest that is heavy enough that you are only able to complete approximately 10 reps before you are fatigued and have to stop. If you are training for strength endurance, you may need to perform sit to stand without weights but do significantly more repetitions….. this may be 50 reps. Your therapist may also which to introduce ‘power’ training techniques which add an element of speed to your repetition. All strength training in neurological conditions is best done with close therapy monitoring in the early stages, both to avoid injury as well as to ensure you are getting the most out of your hard work!
5. How important is form/technique?
You must perform your chosen exercise with the correct technique or you will not achieve the result you are hoping for and run the risk of injuring yourself. Common mistakes include; rushing, moving too quickly, your weight being too heavy or your technique being slopping. It can be easy to cause injury to your back and joints if you do not do use correct techniques and graduate your program. Strength training gains can often be seen quite quickly, in a matter of weeks, as your muscles become more efficient at producing force, however it generally takes 10-12 weeks before you see significant improvements in muscle strength, especially if you are looking for growth in muscle tissue.
6. Do you need equipment?
It really depends on what you want to achieve… training against your own body weight can be very effective for functional strength training and endurance training. Additional weights or machines may be required though if you are training for muscle growth.
7. How to get started?
If you have a neurological condition, you may need to get some expert advice and an individually prescribed program from a neurological physiotherapist or neurologically trained exercise physiologist. The assessment will take into consideration your current health status, any associated medical conditions, therapy goals, training logistics and any other issues you may have. Once your program has been prescribed, it will also need to be monitored as you progress to make sure that you are getting the most out of the program and to avoid injury. Strength training can be a very valuable rehabilitation tool and there is alot of evidence supporting it, so contact ARC now to get your program started!