Elizabeth A. Dorn, M.S.N., C.R.N.P So, now it’s a new year, and, as I mentioned in last January’s Connections, the most common New Year’s resolutions pertain to wanting to get “in shape.” This intent holds SO many different meanings; from losing weight to increasing flexibility. For this month I’m going to discuss resistance training. It must be said at the outset that, before starting an exercise program, it’s essential to discuss with your healthcare provider any health issues that may impact your ability to participate in said activity. It’s important to ensure that proper form and posture is maintained, so consider a consultation with a qualified exercise physiologist or coach. What is resistance training?             Resistance training (also called resistance exercise and strength training) is defined as training methods that utilize exercises that make muscles work against a weight or force. Weightlifting is the most common form of resistance training. Does this make you think of big, brawny people deadlifting heavy barbells? It’s hardly that. Read on as we discuss the different methods used in resistance training.  One method of resistance training involves working with exercise machines, such as those that you would find at a gym. Exercising with machines is as effective as working with free weights, but the machines require much less balance and coordination- two physical qualities that need to be developed to decrease the risk of falls. Exercise machines usually isolate only one muscle group, rendering them ideal for targeting large muscle groups (such as the chest), but don’t require the use of the stabilizing muscle, which can make the body more susceptible to injury. If resistance training is primarily done with machines, it’s beneficial to incorporate some free weight work as well, as is recommended by the American Council on Exercise.   Working with free weights (e.g. dumbbells) requires the body to recruit more than just the targeted muscle to stabilize movement. These exercises strengthen muscles and their surrounding connective tissues, such as tendons and ligaments, that attach to muscle fibers. Strong stabilizing muscles are necessary for preventing injury, maximizing caloric utilization, and balancing muscle training. Free weights allow more natural movements – also referred to as functional movements – that better resemble the patterns of daily activities. An analysis of resistance exercises using either machines or free weights was performed at the Department of Sports Medicine at Goethe University in Germany. This study concluded that resistance exercise performed with free weights may be more effective for individuals aiming to prevent falls or athletes seeking to improve performance. Isotonic exercises (e.g. push-ups, biceps curls) are those in which the weight on the muscles stays constant during the exercise, but the muscles are moved through a full range of motion during the exercise. Isotonic exercises are very effective at building and preserving strength, as well as in improving mobility and flexibility. Isotonic exercise can be performed using body weight, free weights or machines. Isometric contractions are also utilized in strength training. These are exercises that strengthen and engage muscles without moving them. An example of an isometric exercise is squatting down into a low squat and holding the position for an extended period of time, from 10-20 second contractions to up to 60 seconds. This type of exercise can help improve the ability to maintain a squat position over a longer period of time and would strengthen the muscles utilized, but it will not increase the ability to do more repetitions of the exercise. Isometric exercises are well-suited to people who are attempting to build strength after an injury or who have problems with their joints, including those who suffer from arthritis.  Exercise bands are another tool used in resistance training. These large rubber bands have become a mainstay of workout regimens for gym veterans and fitness training newcomers. They’re easy to use, versatile and powerfully effective. The force it takes to stretch the bands strengthens muscles the way using free weights or machines do, and they’ve been shown to be as effective in doing so as traditional weights. Use of resistance bands began as a way for nursing home residents to build strength. As people discovered the ease of use of these rubber bands, their use became more mainstream. A 2022 review in Exercise Physiology of 18 trials involving 669 people demonstrated that resistance band exercise reduced body fat, particularly in those who were overweight or obese. Bands come in sets; color coded with greater tension (weight) as the band colors get darker. As more strength is required for an exercise, more resistance is necessary for that challenge. A benefit of using resistance bands is that the reps and resistance may change based on the individual, and, by switching the color of the band, it’s fairly easy to do so. In this way an individual can tailor the exercise to best fit their abilities. What are the benefits of resistance training? The first and most obvious is what it can do for the way you look. Weightlifting can shape and tone more than 400 muscles that make up and form the body. When weightlifting to improve body appearance, you are increasing and maintaining lean muscle mass. Sarcopenia is age-related, involuntary loss of skeletal muscle mass and strength that begins as early as the 4th decade of life, leading to a decline of up to 50% of mass being lost by the 8th decade of life. Resistance exercise (RE) has been shown in multiple studies to counteract age-related sarcopenia. Weight training can also prevent bone loss and build new bone. The stress that comes from the tugging and pushing on bone that occurs during strength training results in stronger, denser bones, particularly those of the hips, spine and wrists, which are the sites most likely to fracture. This is essential in minimizing the risk of fracture due to osteoporosis, the brittle bone disease that affects an estimated eight million women and two million men in the United States. Weight training also has been demonstrated to reduce arterial blood pressure, improve recovery from musculoskeletal disorders, increase sports-related motor performance, and improve glycemic control, thereby reducing the rate of type 2 diabetes. Beyond this, RE also has been discovered in multiple clinical trials to enhance brain function! Strength training, when performed in a circuit or stage training format can increase cardiovascular capacity. Circuit training is a form of body conditioning that involves endurance training, resistance training, and aerobics to build strength and muscular endurance.  We certainly can’t forget about aerobic activity. Federal physical activity guidelines recommend muscle strengthening activities two to three times a week in addition to at least 150 minutes per week of moderate-to-vigorous aerobic physical activity for health benefits. It’s important to build up gradually if you haven’t been engaged in aerobic activity, and, as always, to check with your healthcare provider first. Brisk walking, bicycling, swimming, jumping rope, rowing, jogging, tennis, pickleball… any activity that gets your heart rate into your target heart rate range (THR) and keeps it within 50-75% for 20-30 minutes is going to be beneficial to your health. How to figure out your THR?             Check out the site https://www.brighamand womens.org and search for Target Heart Rate to find the recommended ranges for different ages. So consider strength training as part of a total fitness program. Staying strong and keeping fit is tantamount to maintaining good health and preventing injury. Have fun experimenting with regimens that work for you and that you enjoy. Exercise has been recognized as an important tool in supporting mental and emotional health, BUT, that’s a story for another issue.