If I were to write one article that would do me out of a job, this would be it.
As an osteopath, I treat people's aches and pains. If you want to know the number one thing that reduces your risk of injury, and helps you to overcome injury faster, it's this:
That's it. Get stronger. It really is that simple.
Having strength protects your joints and gives your tissues resilience to strain. It improves your balance and makes you less likely to fall. It also builds muscle, which helps a whole host of metabolic and hormonal functions around the body.
Sounds too good to be true? Well, there is one caveat.
I'm asking you to train for the rest of your life.
As long as you are alive, you need to do strength training. Sorry.
Think of it like showering. Did you take a shower in 2013 and call it a day? No. It's an on-going process of self-care.
You need to aim for at least one day a week (although three days would be best) ... for the rest of your life. But, it will be fun! I can promise that.
So, how do you get strong?
When I'm taking a case history with my patients and ask them if they do any strength training, the most common answer I get is, 'yes, I walk every day'. Walking is like a superfood for the body. It's wonderful. It is fantastic low-intensity cardio that helps us live longer and clears the mind. It is not, however, strength training.
What about HIIT training, yoga or Pilates? Well, we're getting closer, but there are some very specific features that make a workout strength training. If we're not careful, our training can fall into the 'muscular endurance' bucket, or the 'anaerobic conditioning' bucket.
To optimise your training for strength, you need to think about three things:
'Time under tension' is the time your muscle fibres are under tension in your training. This is where 'reps' and 'sets' come in. Each time you move a weight (or your body), this is a rep. Once you have done as many reps as you can, this is a set.
We can go a little deeper than this and improve the quality of our time under tension by thinking about how we do our reps. We can label our reps with four numbers. The first number is how long it takes to lower the weight. The second number is how long we pause before changing direction. The third number is how long it takes to push the weight. And the fourth is the rest at the starting position. A good rep might be something like '4-1-1-1' where we take four seconds to lower the weight (this is known as the eccentric phase, and it's where we cause the most stress to the muscle), take a one-second pause in the deepest part of the rep (I like to take a breath and check my posture here), explode the weight for one-second with power and control, then take a one-second pause at the top (I do another mental check-in for posture here too).
To begin with, three sets of about ten repetitions per movement would be perfect, but this leads us to the next point; relative perceived exertion.
Relative perceived exertion (RPE), is the fancy way of saying 'how hard do I think I am working?'. In order for something to get us stronger, we need to be working in the 9/10 to 10/10 range. As a complete beginner, you might want to start with 7/10 or 8/10, just while you are refining your technique.
Above, I said that three sets of ten reps is a good approach for your strength movements, so you need to adjust the weight to find your tenth rep a 9 or 10/10 on the RPE scale. If you can do more reps, then increase the weight, if you find it too hard, reduce the weight. More advanced strength trainers will use lower rep counts like 5 or 3 reps per set, or even 1-rep-max attempts, but to begin with, aiming to max out your RPE at 10 reps is a good goal.
Between each set, you need to rest. Once you hit your maximum RPE, all your fibres in a muscle have been recruited and they need a little rest before they can fire again. If you go too soon, your muscles won't be ready, and you won't be optimising for strength; you will be targeting muscular endurance. There are times when this might be what you want, but if you want to get strong, use at least a 90-second rest between sets (advanced athletes may even need up to five minutes).
Now we can look back and answer the question about HIIT, yoga and Pilates. While these things can get us stronger compared to not doing any training, and they can improve our anaerobic fitness, balance and flexibility (all very good and important elements of health), unless they get you to an RPE of 10/10 and you take a rest of 90-seconds before moving again, they are not optimising for strength.
I think of health like a puzzle, and we need all the pieces of the puzzle. Walking is low-intensity cardio. Running and cycling etc, are higher intensity cardio. Yoga and Pilates are great for body control, flexibility, and balance. HIIT is anaerobic fitness. And strength is strength. And that's not even mentioning all the mental well-being and even spiritual benefits all these forms of exercise bring.
To be clear, all these forms of exercise are fantastic; no one thing is better than anything else, they all have a place in our life. But if you want to avoid trips to the osteopath, there is only one winner, and that's to get strong. In my clinic, it is our greatest joy to help get people back to living an active life, free of pain. If you are struggling and want to get back to a more active lifestyle, please get in touch 😊