Tuesday, July 17, 2007

Are You Pressing Your Luck in the Weight Room?

Two pieces of fitness advice happened to cross my radar over the last couple of days.

The first one was in Outside magazine. Thanks to the efforts of an impressively persistent door-to-door salesman, I believe I hold the longest subscription to a single periodical in human history. Should global warming sink, roast, or suffocate us all, I'm told an enterprising band of cockroaches will continue to deliver Outside to any single-celled organism that carries even a trace of my DNA.

That's okay, though, because I like the magazine. I drool over the cool outdoor gear even if I have no idea how to apply it; I carefully memorize the tips on surviving in the wilderness with a comb, a stapler, and some needle-nosed pliers, because, you know, anything could happen. One moment you're living in air-conditioned comfort in the suburbs of LA, the next moment? Boom, you're dropped from a helicopter into piranha-infested waters without so much as a clean pair of longjohns.

The advice in question came up in a piece called "Your Heart," which is part of their "Owner's Manual" series about taking care of various injury-and-disease-prone parts of your body. One of their suggestions on cardiac care was "Lift Less." The authors argue that strength training can be detrimental to cardiac health, citing cardiologist Dr. Abraham Friedman, who says that "Isometric exercises don't do much to help your heart... In fact, they can be potentially harmful if that's all you do, since it can thicken the heart muscle." The conclusion is that people should lift moderately, with lighter weights -- no more than half of body weight -- to avoid causing spikes in blood pressure.

In other words: lifting is bad for your heart.

The second fitness tip was in Forbes, under the headline "Weight Training Benefits Elderly, Too." According to the article,

"Pumping a little iron can help elderly nursing home residents and heart failure patients gain strength for everyday life, the American Heart Association says... The heart association statement cited one study of a 10-week period of resistance training among nursing home residents with an average age of 87 that resulted in improvements in strength and stair-climbing power. In a study of older women who were heart failure patients, 10 weeks of resistance training resulted in a 43 percent increase in muscle strength and a 49 percent increase in the distance covered in a six-minute walk.

The statement also notes that elderly people and women who suffer from coronary heart disease...can benefit from...resistance training...Dr. Art Labovitz, cardiology director at St. Louis University School of Medicine, said that despite increasing knowledge about the benefits of resistance training, the public perception is likely that it's largely off-limits for heart patients.

In other words, lifting is good for your heart.

Forbes or Outside? Dr. Abraham Friedman or Dr. Art Labovitz? Prudence or perseverance?

Hedging my bets, I'd say the answer is, in a way, both...ish. How's that for a definitive answer? Just call me Randy Jackson.

Let me explain: two impulses pull fitness trainers in diametrically-opposing directions. On one hand, like our brethren in medicine, we seek to "do no harm" to clients, so we're on the lookout for any movement that might injure them, evidence of poor dietary or sleep habits, any sign of fatigue or over-training. On the other hand, in order to get results, we DO have to shove them -- sometimes kick them rather forcibly, out of their comfort zone. Some very beneficial forms of exercise involve an element of discomfort. A hard workout will cause soreness for up to a week afterwards. Exercise is itself a form of stress, and microtrauma to working muscles is an essential part of the exercise-recovery equation. So a trainer is always caught between the need to take care of clients--to help them recover from injury and feel good--and the need to push them to exercise with sufficient intensity to create a beneficial training effect.

The best trainers have an uncanny ability to sense what their clients need on a given day. They may come to the gym, clipboard in hand, ready to grind a client to a fine powder with their superset of step-ups and Bulgarian split squats, only to see the person waddling in, lower back torqued up to beat the band. Those trainers will scrap the program they had planned and improvise a workout based around flexibility and relaxation. Equally, if a client is feeling full of energy on a planned recovery day, those same trainers might throw the client under the squat rack till he begs for mercy.

This is one of the subtler skills of being a trainer and can spell the difference between having a client list that's always full of energy and making progress and one that's always falling down tired, injured and sick. One-on-one, at least the trainer has has a fighting chance of matching each workout to the needs of each client.

But what if that same trainer had to write a fitness program for literally everyone? What if he were charged with creating a workout across the board for every single man, woman, and child, in the world? Impossible, you'd say, and you'd be right. But in a sense, that's what groups like the American Heart Association, and, to a lesser extent, popular fitness magazines, are trying to do.

So, given that admittedly impossible task, the writer-trainer might choose to be as prudent as possible: he might take the approach that it's better for a large number of people not to progress than for one person to get hurt, and so his guidelines might be very gentle and rehabilitative. Equally, knowing that few people push themselves hard enough when they exercise, he might choose to make his recommendations exceptionally challenging, ensuring good results for people already in decent shape, while at the same time alienating, and possibly injuring, a portion of his audience.

In a way, that's the primary difference between the Outside and the Forbes prescriptions: the one takes the careful path, the other a more encouraging one.

As you can probably guess, I'm inclined to favor the advice given by the American Heart Association. For one very obvious reason, it's made by a whole group of experts rather than the single doctor cited in the other article. If I were a betting man, I'd wager that Outside simply took an old-school tack and had the bad luck of releasing their article just as the AHA released their newer, less stringent set of recommendations about strength training as it pertains to heart health.

Part of my reasoning, of course, is biased by experience: I'm a lifelong lifter and so any news that supports my zealotry is, in a way, all right by me. But even objectively, the supporting evidence cited in the Outside blurb is fairly vague and somewhat misleading. Dr. Friedman talks about the dangers of isometric muscle contraction, which only represents a small fraction of what most weight trainers do at the gym. Ironically, there is far more isometric muscle contraction in the average yoga session -- a form of exercise typically associated with improving heart health and lowering blood pressure -- than there is in the average strength training workout, where muscle contraction is primarily concentric and eccentric.

I understand that weight training can enlarge the heart muscle, as can many other forms of exercise, and that people who die of heart disease often have enlarged hearts as well. But I'd be interested in seeing evidence that exercise-induced hypertrophy of the heart itself causes health problems, or whether in fact an enlarged heart is simply a coincidental similarity between people on opposite ends of the heart-health bell curve.

Finally, Dr. Friedman, who, it must be noted, is himself a distance runner, says that strength training can be a problem "if that's all you do." Yet for many people, strength training is ALL they can do. Aerobic exercise is, to my mind, a much more difficult entry-level fitness activity than strength training, where the level of resistance and intensity can be controlled much more precisely. I'm not yet among the elderly, but I had nasty childhood asthma that prevented me from running, but after a few years of strength training, running became easier, then actually pleasurable, and now, finally, an activity in which I compete with some (modest) success. I suspect that the same would hold true -- on a reduced scale, of course -- for older exercisers: the local muscular strength built through resistance exercise would enable them to walk further, climb stairs more easily, and generally move with more ease and freedom.

So when it comes down to it, I suppose I'm not being as Randy-Jacksony as I thought. Unless you've got a compelling reason to think you're the exception, I'd say it appears that lifting can be of great benefit to your quality of life, your mobility, and your ticker. Dawg.


mamacita chilena said...

boo, I was hoping this post was going to tell me to stop lifting all together.

I hate strength training! I only do it because if I didn't my arms would have wing flab!

Anonymous said...

Because of being a competitive rower for 9 years and something of a student of the sport during that time, I became aware of a condition known as "rower's heart" that was diagnosed, believe it or not, almost 100 years ago. There has been strenuous debate about this in the rowing community, but not recently. It has been generally accepted since the 1970's in the rowing community that the hypertrophy of the heart muscle and the accompanying extremely low resting heart rate in elite athletes is a harmless adaptation to the cardiovascular demands of the sport. That being said, the enlargement of the heart muscle tends not to go away once the rower stops rowing.

Andrew said...

Mamacita, I'm SURE you can find lifing protocols that you find enjoyable! Bodyweight work in the park? Swinging from a jungle gym?

Anon, thanks for the post about rower's heart, hadn't heard of it. My gut tells me that the hysteria around 'enlarged heart' is excessive, and any risk that exercise exposes you to is overwhelmed by the benefits (I'm paraphrasing Joe of morningcupofjoe-dot-com who just sent me an email about this same topic).

Still, it's interesting to note that both the very healthy and the very unhealthy share this condition.

Thanks to you both for reading!