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Strength Training

Written with: Robert J. Rosneck, MA, RRT
Exercise Specialist, Preventive Cardiology and Rehabilitative Services

Strength training or weight lifting, also called resistance training, conjures up visions of a bulky, muscle bound Mr. Universe. We know, with time, that lifting weights provides and maintains strength, power and increases muscle mass, but does strength training provide any health benefits?

Health Benefits of Strength Training

Research studies show that strength training has many health benefits, particularly with the elderly. Strength training benefits include:

  • Increased strength, energy level and endurance
  • Improved basal metabolic rate, which helps burn calories more efficiently
  • Increased lean body mass and muscle tone, leading to greater satisfaction with your body
  • Improved bone density and decreases the risk of bone fractures in the elderly
  • Possible positive effect on glucose tolerance and insulin sensitivity
  • More independence and self-confidence, and prevent falls in the elderly
  • Improved sense of well-being

A Well-Rounded Exercise Program

A well-rounded exercise program should include three components:

  • Stretching – slow lengthening of the muscles. Stretching the arms and legs before and after exercising helps prepare the muscles for activity and helps prevent injury and muscle strain. Regular stretching also increases your range of motion, flexibility, and muscle function
  • Aerobic exercise – activity that provides cardiovascular conditioning by increasing the rate and depth of your breathing, improving the body’s ability to use oxygen, raising your heart rate, and using your large muscle groups. It is known to increase endurance, decrease risk factors for certain diseases, including heart disease, and enhance a feeling of well-being. Examples of aerobic exercise include walking, cycling or swimming.
  • Strength training – repeated muscle contractions (tightening) until the muscle becomes tired. Strength training improves strength, body mass and bone density.

Is Strength Training Safe?

Strength training is safe for healthy adults and low-risk cardiac patients (stable patients, without symptoms or immediately post angioplasty). Due to lack of current research, strength training is not recommended for moderate to high-risk heart patients, defined by the American Heart Association Council on Clinical Cardiology as patients with:

  • Changes or symptoms that occurred during an exercise-induced electrocardiogram (ECG)
  • Unstable angina (chest pain as a result of insufficient blood supply to the heart)
  • Uncontrolled hypertension (high blood pressure)
  • Severe left ventricular dysfunction (poor pumping ability of the heart)
  • History of heart failure that has not been evaluated and effectively treated
  • Severe valve stenosis (narrow valve opening) or regurgitation (leaky valve)
  • Hypertrophic cardiomyopathy (the heart muscle thickens preventing the heart from pumping properly)
  • Complex arrhythmias (irregular heart beats)
  • Orthopedic complications that prevent exercise
  • Sternal complications that occurred after heart surgery

How should a heart patient begin?

  • Ask your doctor if you may begin an exercise program that includes weight-training.
  • If you have not participated in aerobic exercise, begin an aerobic exercise program for two to four weeks before adding weight training.
  • Speak to a cardiac rehabilitation exercise specialist or trainer who has experience working with heart patients and older adults (if this applies to you). Learn the proper techniques to avoid injury: breathe correctly (naturally, not holding your breath, exhaling during exertion and inhaling during relaxation); avoid straining; use proper posture; and understand the motion
  • A supervised cardiac rehabilitation program may be recommended for some individuals to monitor signs and symptoms of ischemia (decreased blood supply to the heart muscle), blood pressure, heart rate and lifting technique to avoid complications and injury.

What should a weight-training program include?

A weight-training program should be tailored to meet your personal goals. Goals should be created with your age, conditioning, balance, vision, heart disease and any prior orthopedic problems in mind. To achieve results, you may be instructed to use rubber band devices, pulley weights, dumbbells, weight machines, or just your own body weight to provide the resistance.

A weight-training program should consist of performing about 8 different exercises for one set of 10 to 15 repetitions, on two to three days per week. Most heart patients should start at a low resistance and progress slowly. A 1- to 2-pound increase in resistance, every 1 to 4 weeks, depending on your symptoms and fatigue, is suggested.

Elderly patients – Vision, balance, stability and orthopedic considerations should be considered. Weight machines and/or seated exercises may be safer.

All heart patients should be evaluated before beginning a strength-training program to make sure that this activity will be safe for you. If your doctor gives you approval to begin, follow these special guidelines:

  • After heart surgery – you can begin range of motion exercises in the hospital. After 4 to 6 weeks of recovery, you should participate in a cardiac rehabilitation or aerobic activity program. Two to 3 weeks into the program, your health care provider should check your sternum for healing and stability before you can begin weight training. Weight lifting that requires pulling of the sternum should be avoided for about three months.
  • After a heart attack (myocardial infarction or MI) – you can begin range of motion activities two days after your heart attack, depending on your condition. After 4 to 6 weeks of recovery, you should participate in a cardiac rehabilitation program or an aerobic activity program. Two to 3 weeks into the program, you can begin weight training.
  • After angioplasty – you can start a cardiac rehabilitation program or an aerobic activity program after one week of recovery. Then, two to 4 weeks into the program, you can begin weight training.

Strengthen your heart and your muscles. Include weight training with your aerobic exercise and you will feel better inside and out!

To make an appointment with an exercise specialist or to join a cardiac rehabilitation program, contact the Cleveland Clinic Preventive Cardiology - 216.444.9353 or 800.223.2273 ext. 9353.


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