Pete's Blog - July 2021
Muscle Strengthening Activities
I have had a short hiatus from writing my blog while I have recovered from Bi-Lateral Knee Replacement Surgery at the end of March. The last three months have been a very interesting journey in sleep and pain management, rehabilitation, regaining normal joint function, learning how to walk properly again and a slow, gradual return to my regular exercise routine. Above all I have had to keep my enthusiasm in check and be patient with the healing and rehabilitation process. As my Orthopaedic Surgeon keeps reminding me, the rehab process is likely to take somewhere between 9 and 12 months to return to full strength and function in both knees. Furthermore, the process cannot be hastened; too much exercise too early, at too high a level of intensity can lead to pain and inflammation in one or both joints and can slow down the healing process. Perhaps the most important aspect to my recovery has been the need to make sure I move daily and incorporate some form of muscle strengthening activity as part of my daily routine.
A recent publication (September 2020) from the Australian Institute of Health and Welfare reported on participation in Muscle Strengthening Activities by Australian Adults. This research found that on a weekly basis, on average, only 4 in 10 Australian Adults aged 18 – 64 are doing the recommended amount of muscle strengthening activities. (This was slightly higher than a previous estimate provided by the 2017-18 Australian Bureau of Statistics National Health Survey.) Men and younger people are more likely to be doing muscle strengthening activities than women and older people. The most popular activities included gym workouts, running, swimming and cycling.
As outlined in previous blog entries, it is well known that participating in regular physical activity can have significant health benefits – it reduces the risk of chronic conditions and other disease risk factors such as overweight and obesity, and also improves social and emotional health and wellbeing (AIHW 2018). Physical activities that improve the strength, power, endurance and size of skeletal muscles (referred to as muscle strengthening activities (MSAs) have specific health benefits and are an important part of regular physical activity. (Brown et al. 2012; Seguin & Nelson. 2003; Stamatakis et al. 2018). MSAs are often associated with activities such as lifting free weights, using gym equipment, or one’s own body weight. However there is evidence to suggest that there are many other types of physical activities or sports that involve major muscle groups, which can improve muscular strength and endurance if they are done often enough and for long enough (Foster & Armstrong. 2018; Oja et al. 2015).
In 2014, Australia’s Physical Activity and Sedentary Behaviour Guidelines were modified to include a specific recommendation that Australian adults (aged 18 – 64) should do MSAs on at least 2 days per week. While approximately 50% of adult males aged 18 – 34 were meeting these guidelines in 2017/18 on a regular basis, this number decreases steadily with age, with only 19% of males aged 55 – 64 performing MSAs twice a week on a regular basis. This number was also slightly lower for females aged 55 – 64. The 4 most common activities classified as ‘definitely MSA’ that Australian adults reported participating in were gym workouts (26%), running (18%), swimming (15%) and cycling (13%). This data also includes people who may have undertaken these activities on fewer than 2 days per week, therefore not meeting the MSA guideline of 2 or more days per week.
For the purpose of this study, activities that were definitely considered resistance training were: bodybuilding, boot camp, calisthenics, circuits, CrossFit, gym workouts, powerlifting, weight training and weightlifting. Additional activities (from a Health Survey for England) that were included as definitely muscle strengthening include canoeing/kayaking, cycling, football, running/jogging, swimming and tennis. Activities were classified as potentially muscle strengthening if people reported that they felt muscle tension. For example, many of our daily activities—including climbing stairs, gardening and housework—require muscle strength (Hillsdon & Foster 2018). Other potential MSAs include basketball, golf, hiking, Pilates and yoga.
Since the Australian Physical Activity guidelines were modified in 2014 to specifically include muscle strengthening activities, there has no doubt been an increased awareness by Australians aged between 18 and 34 to include regular (2/7) strength training activities in their weekly exercise program. However, as people age, there is quite a significant decrease in the participation rate in organised strength training activities, dropping to less than 1 in 5 for males aged 55 – 64 and slightly less for females in the same age bracket. These numbers are most likely to drop even lower for Australians over the age of 65. There are no doubt some barriers to participation in regular strength training activities, such as poor health or injury but regular physical activity, including strength training, is important throughout our lifecycle.
While attending a gym and completing a supervised program 2 days per week is the most optimal method to do this, having access at home to some resistance bands and dumbbells can provide the opportunity to ensure you can still do some strength training on a regular basis, e.g. 3 - 4 days per week. The most important message is to make an effort to move each day in as many ways as possible. This includes doing some strength training activities. Keep it simple, buy some resistance bands and some light dumbbells to use at home if you can’t get to the gym, or use the fitness equipment at one of the many parks in the lower north shore, even regular body weight calisthenics are better than not doing any regular strength training.
Move each day and repeat for life.