Tag Archives: strength training

Women Reduce Risk of Cardiovascular Disease and Diabetes With Strength Training

That's a dumbbell in her right hand. I work-out with those myself.

That’s a dumbbell in her right hand. I work-out with those myself.

I don’t have access to the full scientific report, but I’ve posted part of the abstract below.

The biggest problem with the study at hand is that physical activity apparently was surveyed only at the start of this 14-year study. Results would be much more robust if activity was surveyed every year or two. My overall activity level seems to change every two or three years. How about you?

Moving on.

“Compared to women who reported no strength training, women engaging in any strength training experienced a reduced rate of type 2 diabetes of 30% when controlling for time spent in other activities and other confounders. A risk reduction of 17% was observed for cardiovascular disease among women engaging in strength training. Participation in both strength training and aerobic activity was associated with additional risk reductions for both type 2 diabetes and cardiovascular disease compared to participation in aerobic activity only.

CONCLUSIONS: These data support the inclusion of muscle-strengthening exercises in physical activity regimens for reduced risk of type 2 diabetes and cardiovascular disease, independent of aerobic exercise. Further research is needed to determine the optimum dose and intensity of muscle-strengthening exercises.”

PMID 27580152

Source: Strength Training and the Risk of Type 2 Diabetes and Cardiovascular Disease. – PubMed – NCBI

Steve Parker, M.D.

PS: Cardiovascular disease includes heart attack, cardiac death, stroke, coronary angioplasty, and coronary artery bypass grafting.

Improve Knee Osteoarthritis With Strength Training

Osteoarthritis, aka degenerative joint disease, is quite common in folks over 45 and eventually may require knee replacement surgery. Recovery from that surgery is slow and painful; best to avoid it if you can.

Having good strength in the muscle that extends the knee helps to preserve the knee joint. That muscle is the quadriceps.

Click below for the evidence:

“Although limited, the reviewed studies suggest that participation in a resistance training program can potentially counteract the functional limitations seen in knee osteoarthritis; positive associations were found between increased muscle strength and walking self-efficacy, reduced pain, improved function, and total WOMAC score. Notably, improvements were greater in maximal versus submaximal effort testing, possibly due to a ceiling effect.”

Source: Strength training for treatment of osteoarthritis of the knee: A systematic review – Lange – 2008 – Arthritis Care & Research – Wiley Online Library

To get started on strengthening the quadriceps muscle, consider the following four-minute video that is two minutes too long:

Note her mention of ankle weights.

Steve Parker, M.D.

PS: If you’re overweight or obese, you lower limb joints will last longer if you lose the fat by following one of my books.

For Seniors On Weight-Loss Diet, Strength Training Beats Aerobics For Preserving Bone Mineral Density

according to an article at MedPageToday.

"One more rep then I'm outa here!"

“One more rep then I’m outa here!”

The two experimental groups had about 60 participants each, so it was a relatively small study. (In general, the larger the study, the more reliable the findings.) Most participants were white women; mean age was 69. The experimental intervention ran for five months. An excerpt:

In one trial, the participants were randomized to a structured resistance training program in which three sets of 10 repetitions of eight upper and lower body exercises were done 3 days each week at 70% of one repetition maximum for 5 weeks, with or without calorie restriction of 600 calories per day.
In the second study, participants were randomized to an aerobic program which was conducted for 30 minutes at 65% to 70% heart rate reserve 4 days per week, with or without calorie restriction of 600 calories per day.

The beneficial bone effect was seen at the hip but not the lumbar spine.

Thin old bones—i.e., osteoporotic ones—are prone to fractures. Maintaining or improving bone mineral density probably prevents age-related fractures. In a five-month small study like this, I wouldn’t expect the researchers to find any fracture rate reduction; that would take years. 

Most elders starting a weight-training program should work with a personal trainer. I don’t quite qualify as elderly, but click if interested in my personal fitness program.

Steve Parker, M.D.

PS: Strength training is also known as weight training and resistance exercise.

Exercise for the Diabetic

GENERAL EXERCISE BENEFITS

Regular physical activity postpones death, mostly by its effect on cancer, strokes, and heart attacks.

Consider a personal trainer if you're not familiar with weight training

Consider a personal trainer if you’re not familiar with weight training

Exercise is a fountain of youth. Peak aerobic power (or fitness) naturally diminishes by 50 percent between young adulthood and age 65. Regular exercise increases fitness (aerobic power) by 15–20 percent in middle-aged and older men and women, the equivalent of a 10–20 year reduction in biological age.

Additional benefits of exercise include: 1) enhanced immune function, 2) stronger bones, 3) preservation and improvement of flexibility, 4) lower blood pressure by 8–10 points, 5) diminished premenstrual bloating, breast tenderness, and mood changes, 6) reduced incidence of dementia, 7) less trouble with constipation, 7) better ability to handle stress, 8) less trouble with insomnia, 9) improved self-esteem, 10) enhanced sense of well-being, with less anxiety and depression, 11) higher perceived level of energy, and 12) prevention of weight regain.

EFFECT ON DIABETES

Eighty-five percent of type 2 diabetics are overweight or obese. It’s not just a random association. Obesity contributes heavily to most cases of type 2 diabetes, particularly in those predisposed by heredity. Insulin is the key that allows bloodstream sugar (glucose) into cells for utilization as energy, thus keeping blood sugar from reaching dangerously high levels. Overweight bodies produce plenty of insulin, often more than average. The problem in overweight diabetics is that the cells are no longer sensitive to insulin’s effect. Weight loss and exercise independently return insulin sensitivity towards normal. Many diabetics can improve their condition through sensible exercise and weight management.

Muscles doing prolonged exercise soak up sugar from the blood stream to use as an energy source, a process occurring independent of insulin’s effect. On the other hand, be aware that blood sugar may rise early in the course of an exercise session.

EXERCISE RECOMMENDATIONS

You don’t have to run marathons (26.2 miles) or compete in the Ironman Triathlon to earn the health benefits of exercise. However, if health promotion and disease prevention are your goals, plan on a lifetime commitment to regular physical activity.

For the general public, the U.S. Centers for Disease Control and Prevention recommends:

  • at least 150 minutes per week of moderate-intensity aerobic activity (e.g., brisk walking) and muscle-strengthening activity at least twice a week, OR
  • 75 minutes per week of vigorous-intensity aerobic activity (e.g., running or jogging) plus muscle-strengthening activity at least twice a week. The muscle-strengthening activity should work all the major muscle groups: legs, hips, back, abdomen, chest, shoulders, arms.

I’m working on a program of combined aerobic (high intensity interval training) and strength training for just 70 minutes a week, but it’s not yet ready for prime time.

STRENGTH TRAINING

What’s “strength training”? It’s also called muscle-strengthening activity, resistance training, weight training, and resistance exercise. Examples include lifting weights, work with resistance bands, digging, shoveling, yoga, push-ups, chin-ups, and other exercises that use your body weight or other loads for resistance.

I prefer free weights over machines, but that's just me

I prefer free weights over machines, but that’s just me

Strength training just twice a week increases your strength and endurance, allows you to sculpt your body to an extent, and counteracts the loss of lean body mass (muscle) so often seen during efforts to lose excess weight. It also helps maintain your functional abilities as you age. For example, it’s a major chore for many 80-year-olds to climb a flight of stairs, carry in a bag of groceries from the car, or vacuum a house. Strength training helps maintain these abilities that youngsters take for granted.

According to the U.S. Centers for Disease Control and Prevention: “To gain health benefits, muscle-strengthening activities need to be done to the point where it’s hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8–12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-strengthening activities, but to gain even more benefits, do 2 or 3 sets.”

If this is starting to sound like Greek to you, consider instruction by a personal trainer at a local gym or health club. That’s a good investment for anyone unfamiliar with strength training, in view of its great benefits and the potential harm or waste of time from doing it wrong. Alternatives to a personal trainer would be help from an experienced friend or instructional DVD. If you’re determined to go it alone, Internet resources may help, but be careful. Consider “Growing Stronger: Strength Training for Older Adults” (ignore “older” if it doesn’t apply).

Current strength training techniques are much different than what you remember from high school 30 years ago—modern methods are better. Some of the latest research suggests that strength training may be even more beneficial than aerobic exercise.

AEROBIC ACTIVITY

“Aerobic activity” is just about anything that mostly makes you huff and puff. In other words, get short of breath to some degree. It’s also called “cardio.” Examples are brisk walking, swimming, golf (pulling a cart or carrying clubs), lawn work, painting, home repair, racket sports and table tennis, house cleaning, leisurely canoeing, jogging, bicycling, jumping rope, and skiing. The possibilities are endless. A leisurely stroll in the shopping mall doesn’t qualify, unless that makes you short of breath. Don’t laugh: that is a workout for many who are obese.

But which aerobic physical activity is best? Glad you asked!

Steve Parker MD

Not ready for this? Consider interval walking then.

Ideally, it’s an activity that’s pleasant for you. If not outright fun, it should be often enjoyable and always tolerable. Unless you agree with Ken Hutchins that exercise isn’t necessarily fun.

Your exercise of choice should also be available year-round, affordable, safe, and utilize large muscle groups. The greater mass and number of muscles used, the more calories you will burn, which is important if you’re trying to lose weight or prevent gain or regain. (Exercise isn’t a great route to weight loss in the real world, although it helps on TV’s Biggest Loser show.) Compare tennis playing with sitting in a chair squeezing a tennis ball repetitively. The tennis player burns calories much faster. Your largest muscles are in your legs, so consider walking, biking, many team sports, ski machines, jogging, treadmill, swimming, water aerobics, stationary cycling, stair-steppers, tennis, volleyball, roller-skating, rowing, jumping rope, and yard work.

Steve Parker MD

Yes, this is exercise, too

Walking is “just what the doctor ordered” for many people. It’s readily available, affordable, usually safe, and requires little instruction. If it’s too hot, too cold, or rainy outside, you can do it in a mall, gymnasium, or health club.

MEDICAL CLEARANCE  

Check this link.

SUMMARY

All I’m asking you to do is aerobic activity, such as walk briskly (3–4 mph or 4.8–6.4 km/h) for 30 minutes most days of the week, and do some muscle-strengthening exercises three times a week. These recommendations are also consistent with the American Diabetes Association’s Standards of Care–2013. This amount of exercise will get you most of the documented health benefits.

Steve Parker, M.D.

Surprising Results of a Three-Week Fitness Lay-Off

MP900182524[1]I’m reminded of a quote from a famous violinist: “If I don’t practice for one day, I can tell.  If I don’t practice for two days, my conductor can tell.  If I don’t practice for three days, the audience can tell.”

A few months ago, I laid off all exercise for three weeks straight, partly due to a long vacation, partly to see how much my fitness would deteriorate.

Here’s what I found:

  • My time for the one-mile run increased from 8 mins and 54 seconds to 9 mins and 30 seconds
  • My maximum number of push-ups increased from 32 to 36
  • My maximum number of sit-ups increased from 32 to 34
  • My maximum number of pull-ups increased from 8 to 9

CLOSING THOUGHTS

Strength measures increased, surprisingly.  Was it just a good day, or did my muscles need the time off to rest and re-build?  Over-training is a real problem for some folks.  At 20 minutes of weight-training twice a week, I doubt I was anywhere near what most consider over-training.  I don’t fiddle-fart around during my exercise sessions, but I’m not puking either.

So I won’t feel too bad in the future if I take a couple or three weeks off from strength training periodically.

My endurance for running deteriorated significantly.  Is it related to the lack of strength training, the lack of treadmill interval work, or both?

Your mileage will vary.

Steve Parker, M.D.

New Fitness Self-Experiment No.3

OK, here’s the program I started May 21.

For aerobic and cardiovascular endurance:

  • twice weekly 15-minute treadmill high intensity interval training
  • FYI, it took me three months to build up to this starting from a sedentary baseline 18 months ago.

For strength:

Twice weekly…

Why dumbbell weights?  ‘Cuz that’s what I’ve got.

I chose push-ups over bench presses because the former probably uses more muscles.  I thought about including pull-ups/chin-ups, then decided I’m already working those muscles enough in the other exercises.

Rather than counting sets and repetitions (e.g., three sets of 10 push-ups), I’m going to continue using the exhaustion technique Chris Highcock taught me in Hillfit:

  • 90 seconds on each exercise
  • use enough weight that I’m exhausted after the 9o seconds
  • 10 seconds up and 10 seconds down for each repetition

I can probably get the resistance training done in 20 minutes.

My current fitness measurements are recorded elsewhere.  I’ll recheck after about six weeks.

None of this is etched in stone.

My goals are here.  Comments?

Steve Parker, M.D.

Notes

My fitness experiment No.1 was Mark Verstegen’s Core Performance.  No. 2 was Chris Highcock’s Hillfit.

Update May 22, 2012

The first workout went well.  I need to review the various types of dumbbell presses and decide which one I want to stick with.   I hope I’m a little sore tomorrow.  These are the dumbbell weights I used today:

Dumbbell squats: 25 lb (11.4 kg)

Push-ups: 25 lb (11.4 kg) in backpack

Dumbell presses: 15 lb (6.8 kg)

Romanian deadlift with dumbbells: 30 lb (13.6 kg)

Bent-over one-arm rows: 25 lb (11.4 kg)

Update May 25, 2012

I was sore in the back, quads (anterior thighs), and arms the day after the first workout.  I even postponed my second workout of the week for one day to allow lingering right arm soreness to resolve.  For my workout today, I reduced the overhead press weight from 15 to 10 lb.

Update May 27, 2012

Right arm/shoulder soreness is gone.  Now I’ve got soreness in my left hamstring, likely a strain related to the deadlifts.  Started 24 hours after my second workout in this experiment, and persisting 36 hours at this point.

Update May 28, 2012

Right hamstring soreness almost gone.  Instead of 30 lb dumbbells with the Romanian deadlift, I cut to 25 lb to avoid aggravating that hamstring.  Probably back to 30 lb next time.  With bent-over rows, I’m ready to progress to 30 lb.

Update June 9, 2012

It’s going well.  No injuries; no unusual aches.  Here are the dumbbell weights I carry in each hand: for squats – 30 lb; for push-ups – 25 lb in backpack; for dumbbell presses – 25 lb; for Romanian deadlifts – 40 lb; for bent-over row – 30 lb.  The set of dumbbells my wife got for me (used) in CraigsList was from 5 to 30 lb.  So I had to go buy a 40-lb pair, which set me back about $80 (USD).

Update June 26, 2012

Going well.  No injuries.  Haven’t missed any sessions.  Had to decrease backpack push-up weight from 25 to 20 lb  about 10 days ago—I just couldn’t keep up the exercise for 90 seconds at the higher weight.  A couple weeks ago I increased the bent-over row and squat weights to 40 lb.  I’m noticing much use of back and shoulder muscles when I’m doing exercises that superficially seem to target other muscles. E.g., the Romanian deadlifts and squats target the buttocks and thighs, but having to carry 40 lb in each hand works out my arms, shoulders, and back.

Your Fitness Program Is Different From Mine

Eighteen months ago I was sedentary.  I had developed some mysterious shoulder pain that I was able to cure with a rehab program.  Soon after that, the family went bowling for the first time in years.  After just three lines (games), my bowling arm got weak and sore.  That was a wake-up call for me. 

I needed a fitness program with a strength training component.

Assembling a fitness program for yourself is like figuring out your weight loss and management plan.  Lots of idiosyncrasies and variables to consider.  You have to determine what works for you, sometimes through trial and error.  Your plan may not work for your neighbor.

You could always go to a personal trainer who’ll devise a plan for you and supervise implementation.  That’s not a bad idea at all, and probably the best choice for someone not familiar with exercise yet serious about long-term health and weight management.

Future posts will address exercise-related issues peculiar to people with diabetes.  These are important.

I remember reading somewhere on the ‘net over the last year about “the big five” exercises for strength training (aka resistance training).    Turns out there are lots of Big Five lists.  Here’s one:

  • squats
  • deadlifts
  • bench press
  • overhead press
  • chin-ups
And another, similar list (a blog commenter said these were the five free-weight exercises at the top of Dr. Doug McGuff’s list):
  • squats
  • deadlifts
  • bench press
  • standing overhead press (same as military press?)
  • bent-over barbell row

If you’re not familiar with these, go to YouTube and browse.

In case you’re wondering, I’m not interested, at my age, in growing large muscles. My goal is to be injury resistant and as strong as I can be without spending too much time at it, regardless of muscle size.  Size doesn’t necessarily translate directly into strength.  My wife, on the other hand, appreciates large arms—think  Thor in The Avengers movie.

I’m tempted to put together a program composed of man-makers, Turkish get-ups, High Knee Walk to Spiderman With Hip Lift and Overhead Reach (HKWTSWHLOR?), and treadmill HIIT.  I’m saving that for another day, however.

I’ll share my new program tomorrow.

Steve Parker, M.D. 

PS: In case the appropriate link above is broken, the shoulder rehab exercises I did were from an online pamphlet from The Nicholas Institute of Sports Medicine and Athletic Trauma, probably in the Physical Therapy section.

Hillfit Strength Training and Me

Last January I wrote a favorable review of Chris Highcock’s Hillfit strength training program for hikers.  Ten days ago I finished a six-week trial of actually following the the program, and I still like it.  It’s an eye-opener.

See my prior review for details of the program.  Briefly, you do four exercises (requiring no special equipment) for fifteen minutes twice a week.  Who doesn’t have time for that?

I did modify the program a bit.  I included high-intensity intervals on a treadmill twice weekly, right after my Hillfit exercises.  Here’s the 15-minute treadmill workout: 3 minute warm-up at 5.3 mph, then one minute fast jogging at 7–8 mph, then one minute of easy jog at 5.3 mpg. Alternate fast and slow running like that for 6 cycles.  So my total workout time was 30 minutes twice weekly.

Why the treadmill HIIT (high intensity interval training)?  For endurance.  I’m still not convinced that strength training alone is adequate for the degree of muscular and cardiopulmonary endurance I want.  I’m not saying it isn’t adequate.  That’s a self-experiment for another day.  In 2013, I’m planning to hike Arizona’a Grand Canyon rim to rim with my son’s Boy Scout troop.  That’s six or eight miles down, sleep-over, then six or eight  miles back up the other side of the canyon.  That takes strength and endurance.

One part of the program I wasn’t good at: Chris recommends taking about 10 seconds to complete each exercise motion.  For example, if you’re doing a push-up, take 10 seconds to go down to the horizontal position, and 10 seconds to return up to starting position with arms fully extended.  I forgot to do it that slowly, taking five or six seconds each way instead.

I’ve preached about the benefits of baseline and periodic fitness measurements.  Here are mine, before and after six weeks of Hillfit and treadmill HIIT:

  • weight: no real change (168 lb or 76.2 kg rose to 170 lb or 77.3 kg)
  • body mass index: no change (23.3)
  • resting heart rate and blood pressure: not done
  • maximum consecutive push-ups: 30 before, 34 after
  • maximum consecutive pull-ups: 7 before, 8 after
  • maximum consecutive sit-ups: 30 before, 37 after
  • time for one-mile walk/run: 8 minutes and 45 seconds before, down to 8 minutes and 35 seconds after
  • vertical jump (highest point above ground I can jump and touch): 108.75 inches or 276 cm before, to 279.5 cm after
  • waist circumference: no real change (92 cm standing/87 cm supine before, 92.5 cm standing/87.5 cm supine after)
  • biceps circumference: no real change (33 cm left and 33.5 cm right before; 33 cm left and 33 cm right after)
  • calf circumference: 39.5 cm left and 39 cm right, before; 38.5 cm left and 37 cm right, after (not the same child measuring me both times)
  • toe touch (stand and lock knees, bend over at waist to touch toes: 7.5 inches (19 cm) above ground before, 8.5 inches (22 cm) after

If these performance numbers seem puny to you, please note that I’m 57-years-old.  I’m not sure exactly where I stand among others my age, but I suspect I’m in the top half.  I’m sure I could do much better if I put in the time and effort.  My goal right now is to achieve or maintain a reasonable level of fitness without the five hours a week of exercise recommended by so many public health authorities.

Take-Home Points

Overall, this program improved my level of fitness over six weeks, with a minimal time commitment.  I credit Hillfit for the gains in push-ups, pull-ups, sit-ups, and perhaps vertical jump.

My time on the one-mile run didn’t improve much, if at all.  This fits with my preconceived notion that strength training might not help me with leg muscle  and cardiopulmonary endurance.

The Hillfit exercise progressions involve adding weights to a backpack (aka rucksack or knapsack) before you start the exercise.  I’m already up to 80 lb (36 kg) extra weight on the modified row, and 85 lb (39 kg) on the hip extensions.  That’s getting unwieldy and straining the seams of my backpack.  I can’t see going much higher with those weights.

I expect I could easily maintain my current level of fitness by continuing Hillfit and HIIT treadmill work at my current levels of intensity.  In only one hour per week.  Not bad at all.

It’s possible I could get even stronger if I stuck to the program longer, or slowed down my movements to the recommended 10 seconds each way.

The key to muscle strength gain with Hillfit seems to be working the muscles steadily, to near-exhaustion over 90 seconds, gradually adding a higher work load as the days or weeks pass.

I’m setting Hillfit aside for now, only because I want to start a new self-experiment.

Hillfit is an excellent time-efficient strength training program for those with little resistance-training background, or for those at low to moderate levels of current fitness.

Steve Parker, M.D.

Note to self:

When doing a mile run on the treadmill, I tend to start out too fast, then burn out and have to slow down.  That may be impairing my performance.  Next time, start at 7 mph for a couple minutes then try to increase speed.  Running a mile at 7 mph takes nine minutes.  A mile at 7.5 mph takes 8 minutes.  A mile at 8 mph takes 7 minutes and 30 seconds.

Aerobic Versus Strength Training?

“Resistance training, similarly to aerobic training, improves metabolic features and insulin sensitivity and reduces abdominal fat in type 2 diabetic patients,” according to a recent report in Diabetes Care.

Italian researchers randomized 40 type 2 diabetics to follow either an aerobic or strength training program for four months.  The increase in peak oxygen consumption (VO2 peak) was greater in the aerobic group, whereas the strength training group gained more strength.  Hemoglobin A1c was similarly reduced in both groups, about 0.37%.  Body fat content was reduced in both groups, and insulin sensitivity and lean limb mass were similarly increased.  Pancreas beta-cell function didn’t change.

According to this one study, neither type of training seems superior overall.  If you’re just going to do one type of exercise program, choose your goal.  Do you want more strength, or more sustainable “windpower”?

The Pennington Biomedical Research Center found somewhat different results in their larger and more complex study published in 2010.  However, they were primarily testing for diabetes control (as judged by hemoglobin A1c improvement), rather the improvements in strength or aerobic power.  They found the combination of aerobic and strength training is needed to improve diabetic blood sugar levels.  Both types of exercise—when considered alone—did not improve diabetes control.

As for me, I do both strength and aerobic training.

By the way, I only read the abstract of the current research, not the full report.

Steve Parker, M.D.

PS: PWD = people or person with diabetes.  Do you like that term or would you prefer “diabetic”?

Reference:  Bacchi. Elizabeth, et al.  Metabolic Effects of Aerobic Training and Resistance Training in Type 2 Diabetic Subjects
A randomized controlled trial (the RAED2 study)
Diabetes Care.  Published online before print February 16, 2012, doi: 10.2337/dc11-1655

Review of Chris Highcock’s Hillfit

 

Chris Highcock over at Conditioning Research has just released a new ebook on strength training for hikers: Hillfit: Strength.  Hiking is one of my favorite hobbies.  I particularly like walking up hills and mountains.  If you’re ready to reap the benefits of resistance training, this jargon-free plan is an excellent starting point, and may be all you’ll ever need.  Even if you never go hiking.

Chris is a fitness columnist for “TGO (The Great Outdoors).”  He lives and hikes in Scotland.  Chris’s goal with the program is to increase your enjoyment of hiking by increasing your level of fitness. 

He clearly presents four basic home exercises requiring no special equipment; they’re bodyweight exercises.  You get it done in 15 minutes twice a week!  The key is to do one set of each exercise, slowly, to exhaustion.  What’s slow?  Ten seconds for both lift and lowering.  For instance, when you do the push-up, you push up over  the course of 10 seconds, then let your body down slowly over 10 seconds.  The exercises are for both upper and lower body.

I’m reading about similar exercise ideas from Skyler Tanner, Doug McGuff, Nassim Taleb, Jonathan Bailor, and Doug Robb.  Bailor, in his recent book, also recommends only four exercises.  Highcock’s look a little safer for rank beginners. 

The idea is to recruit three different types of muscle fiber during the muscle’s movement.  If you move explosively and finish too soon (get your mind out of the gutter!), you’re only using  one type of muscle fiber (fast twitch, I think).  You want to stimulate a strength and growth response in all three types of muscle fiber.  And explosive or rapid movements are more likely to cause injury, without any benefit. 

Once you get the basic program down, Chris takes you through some easy variations (called progressions) to make the exercises gradually harder, so you continue to improve your strength and fitness. 

Chris understands that many folks can’t do a single push-up.  He takes you through pre-push-up movements to get you prepared  to do actual push-ups.  This goes for all four exercises.  I bet even my little old lady patients could use this program.  (This is not blanket clearance for everybody to use this program; I don’t need the lawsuits.  Get clearance from your own doctor first.)

The exercises incorporate our five basic movements: push, pull, squat, bend/hinge, walk/gait.  The four exercises are: wall sit (squat), push-up, modified row, and hip extension.

My only criticism of the book is that Chris should have used young, attractive, bikini-clad models to illustrate the exercises.  (That’s right, my wife doesn’t read this blog.)  The existing photos are clear and helpful, however.

But seriously, the only suggestion I have for the next version of Hillfit would be to mention that it will take a couple or three weeks to see much, if any, improvement in strength once you start the program.  Same for when you increase the workload with the exercise progressions.  Perhaps this is in there, but I missed it.  You don’t want people quitting in frustration that they’re not seeing progress soon enough.

The author provides scientific references in support of his program, so he didn’t just make this stuff up.  Only one of the references involved mice!

Several “take home” points for me personally are: 1) stretching before or after exercise does nothing to prevent injury or soreness, and may hurt short-term athletic performance, 2) don’t hold your breath, 3) train to “momentary muscular failure.”  I’m not entirely sure what momentary muscular failure means.  It may not be Chris’s term, but it’s prominent in one of his best scientific references.  I use free weights and don’t think I can safely go 100% to momentary muscular failure.  Hitting momentary muscular failure, by the way, is more important than the amount of weight you’re moving.

Highly recommended.

Steve Parker, M.D.

PS: I’d like to see Hillfit available on Amazon’s Kindle and Barnes and Noble’s Nook.

PPS: When you go to the Hillfit website to order, you’ll find the price is £9.95 (that’s GBP, British pounds sterling).  I’ve never ordered anything priced in GBP.  In today’s U.S. dollars, that’s a little under $16.00.  You can pay via PayPal or a major credit card.  I assume the conversion from one currency to another is automatic and seamless.  I don’t know if there’s a extra fee by the payment processor for doing the conversion.

Disclosure:  Chris kindly sent me a free digital copy of his ebook.  I don’t know Chris.  I will receive no remuneration for this review, nor for book sales.