Strength Training

When I bring up strength training in the clinic setting, patients often look at me like I am speaking Greek. They are very familiar with aerobic training (walking, running, cycling, etc) but many patients are not at all familiar with strength training. So this month's discussion will hopefully make patients more comfortable with the idea so that they can put it into practice. This discussion will focus on the exercises that a person can do while in the privacy of their own home with minimal equipment. There are many more exercises available to those who belong to gyms but I will leave the gym personnel to instruct on the individual machines and equipment.

There are some basics that everyone needs to know before getting started.
1)Clearance from a physician needs to be obtained. There are certain physical illnesses that can be exacerbated by strength training. There are however, illnesses that are improved with strength training—osteoporosis just to name one.
2)It is recommended that a person work a muscle group and then allow that muscle group to rest and work another muscle group the next day or so. The CDC recommends two days a week of strength training so that in theory the upper body is worked one day and the lower body the other day. This allows the muscle groups a chance to rest and repair.
3)Warm up before beginning with 5-10 minutes of light cardiovascular work (ie walking, stretching, etc). This gets the blood moving and prepares the muscles to work.
4)Pick sufficient weight that allows you to do 8-16 repetitions per set with a goal of 2-3 sets. Rest 30-60 seconds and repeat the set. When getting started in may take a little trial and error. Low weight may be all it takes initially but as you get stronger, add weight to keep the momentum going. Adding weight should be accomplished by adding repetitions initially and then adding weight and dropping the repetitions and working up again. Many dedicated strength trainers will keep detailed records of the amount of weight and number of repetitions and sets completed for each muscle group.
5)Pain is NOT good. If it hurts, stop.

For the CHEST:
1)Bench press: while lying on the back, hands/weights are initially at shoulder width apart. Extend arms/weights until elbows are nearly fully extended. Feet should be flat on the floor. Slowly lower the weights to the chest to complete the repetition.
2)Push up: start face down on the floor with arms extended and shoulder width apart. Back should be flat and feet together. Lower the body to the floor until the chest touches the floor—keeping the back parallel to the floor (no saggy tushes and no bending at the waist). Push the body back up the the starting position slowly with control until the elbows are fully extended.

For the BACK:
1)Back extensions: Lying face down with hands on the floor (or behind the head for extra challenge). Contract the abdominal muscles and keep them contracted through the exercise. Squeeze the back to left the chest off the floor. Lower the chest slowly to the floor and repeat.
2)Plank: Lie face down on the floor with elbows resting on the floor next to the chest. Push your body off the floor and rest on the forearms/elbow or hand (more like a push up position) with the toes being the pivot point. Contract the abdominal muscles and keep the body in a straight line from head to toes. Hold for 30-60 seconds. Additional challenge will be to hold the Plank for as long as you can.

For the SHOULDERS:
1)Lateral raise: Standing or sitting with arms extended at side with hands grasping weights and hands facing inward. Slowly raise the weights with arms extended until arms are shoulder height. Slowly lower the weight to the starting position.
2)Front raise: Standing or sitting with arm extended in front of body with palms facing legs. Raise weight with arms extended until arms are parallel to the floor (approximately shoulder height). Lower weights slowly to the starting position.
3)Overhead press: With the weights in the hands begin with hands at shoulder level and hands facing forward. Push arms/weights up until arms are fully extended. Lower the weights slowly to the beginning position of hands at shoulder height.

For the ARMS:
1)Biceps curl: Grasp the weight in the hands with hands facing away from the body and slightly wider than shoulder width apart. Stand with back erect, feet shoulder width apart, and knees slightly bent. Raise the weight in the arc of the elbow up to the shoulder. Slowly lower the weight until the arm is fully extended.
2)Triceps extension: Place one hand on the opposing leg or a bench for support. With the weight in the working arm, raise the weight up the hip height by bending the elbow. Straighten the elbow (extend) so that the arm with the weight is parallel to the floor. Slowly flex the arm at the elbow to return to the starting position.

For the LEGS:
1)Squat: With weights in hands, place hands/weights on the shoulders. Back is erect. Feet are shoulder width apart with toes facing forward.
2)Lunges: Begin with weights in hands at sides with arms extended. Feet should be shoulder width apart. Head up and body erect. With the right foot take a large step forward while keeping the left foot in place. Lower the upper body by bending at the right knee until the upper leg is parallel to the floor. The left knee bends slightly as well but the foot remains in place. Push with the right foot into the floor in an upward and backward direction to return to the erect posture. This can be repeated with the left foot forward in an alternating fashion.
3)Leg extensions: With weight attached to ankles and back well supported be comfortably seated. Extend the knee so that the leg is fully extended. Slowly return the weight to the starting position by flexing the knee.
4)Leg curls: Body is positioned on the abdomen flat on the floor. Weights are on the ankles and knee is flexed until the heels are as close as possible to the buttocks. Slowly extend the knee to return the weight to the starting position.
5)Calf raises: Stand erect with the ball of the foot positioned on a stable elevated surface (ie a stair or a ledge)--hand weights may or may not be in the hands. Keep the body straight and press with the ball of the foot and lift the heel as high as possible. Slowly lower the heel to the starting position on the ground.

For the ABDOMINALS:
1)Crunches: Lie face up on a soft surface with knees bent and feet brought close to the buttocks. Fold the arms across the chest and tuck chin into the chest. Lift the upper body with abdominal muscles towards the thighs while keeping the lower back on the floor. Lower shoulders and upper body slowly to starting position.
2)Oblique sit ups: Life face up on a soft surface with knees bent and feet brought close to the buttocks. Rotate the hips so that the knees are resting on the mat and you are twisting at the waist. Fold the arms across the chest and tuck chin into the chest. Lift the upper body with the abdominal muscles. Slowly lower the body to the starting position. Rotate the hips to the other side to allow symmetric strengthening.

Sources:
http://www2.gsu.edu/~wwwfit/upperbod.html
http://www2.gsu.edu/~wwwfit/abs.html
http://www2gsu.edu/~wwwfit/strength.html
http://exercise.about.com