How to Structure Your Weight Lifting Routine

Nobody wants to walk into a gym to lift weights knowing nothing about weight training.  First of all, it is obvious, and who wants to look as clueless as they feel?  But you are not clueless if you have read my “perfect workout” series. You know to immediately roll and loosen up your joints, to then move into some corrective work, then to do movement preparation drills.  Now you are ready to lift…

Let’s start with my basic “Rules of Lifting”

First, begin by working the biggest muscles first, then moving to smaller ones.  If you are going to include your legs into your lifting that day, start with squats or deadlifts.  If you are giving your legs a day off, start with back exercises.

Second, focus on complex moves.  Complexity is in…isolation is out.  A “complex” lift is one that uses several muscle groups, and as a consequence, movement occurs at multiple joints.  A squat is a perfect example of a complex lift. In the squat, you not only use the gluteals and hamstrings to extend the hips, but you also use the quadriceps, hip flexor group, and the stabilizing muscles of the entire core.  Compare this to the knee extensor machine, a classic isolation movement occurring at a single joint. In this move, you sit on a chair, hook your ankles under a pad, and extend your lower legs.  This is an isolation move occurring across the knee..not only that, but it is an isolation move that you almost never do in real life.  Below is a sampling of both types of lifts.  An isolation move or two won’t hurt, but focusing on the complex moves is better overall approach.  Additionally, if you are going to do both types of lifts, do the complex moves first. The biceps curl can wait till the end (for all of you mirror gazers…).

Complex lifts (multiple joints move): Squat, Deadlift, Lunges, Bench press, standing military (overhead) press, Horizontal rowing, pull ups

Isolation lifts (single joint movement): biceps curls, adductor/abductor machines, triceps extension, leg extension, seated hamstring curl

Third, learn perfect technique.  If you do this first and foremost, and you focus continually on technique (even when you fatigue) you will not get injured.  On the other hand, if you are sloppy, it is very possible that you will hurt yourself as you lift heavier loads.  This cannot be over-emphasized.  We are not talking rocket science, though.  I learned by reading books and watching others.  These days, not only can you read, but YouTube makes it easy to learn the basics. Just make sure you are watching a trained professional, not an actor/actress from a reality TV show (you know who I’m talking about).

Begin lifting light.  For the first few weeks, you get stronger NOT by lifting heavy, but simply by training your nervous system how to do the moves.  Once you have good form and the movement patterns are grooved into your brain, it’s time to get serious.  Begin light for a warm up set or two, and then work hard! You will not “bulk up.”  The last repetition of your work sets should be difficult.  If the final repetition is easy, or even moderately easy…go heavier!

Take a day or two off between lifting for the same muscle group.  You have made teeny little tears in the muscle fibers by asking them to lift heavy weights.  But don’t panic…this is good.  If you feed your muscles and rest them appropriately—they heal and come back even stronger.  This is the whole point of weight lifting.  It is called Specific Adaptation to Imposed Demand (SAID principle for you exercise physiology nerds).  Your body adapts to what you ask it to do.  If you want it to get stronger, you must ask it to lift heavier objects than it is used to lifting.  It then adapts, and, poof, you are stronger.

Now that the basics are covered, how about the more specific questions of what moves, how many exercises to do, how many reps and sets to do, with what frequency should I lift, and how hard should it feel.  How will I know if I am doing too much?  Too little?

A beginner should try to work every muscle group at least twice a week.  Once a week…not good enough unless you are just trying to maintain the muscle mass you already have (and even then, twice/week is better).  Three times a week is even better, but only by a little bit, so if you are really working hard to fit it in, at least get in two workouts per week.  What are the muscle groups to target?

Legs: Both front (quadriceps) and back (hamstrings) of the thighs.  Think lunges, squats, stability ball hamstring curls, step-ups, and more lunges

Hips: Extensors (that would be the butt, Bob), and flexors (these are usually very tight and mostly need to be stretched).  Think squats, more squats, deadlifts,  kettlebell swings, lunges again

Back: Huge muscle groups!  Latissimus dorsi is the big one (lat pull downs, pull ups, rowing movements), anything where you pull something toward the center of your body either horizontally or vertically

Chest: Pectorals and anterior shoulder:  Think push ups, bench press (flat, inclined), dumbbell flies

Shoulders: Three heads to your deltoid muscles, so they like to be worked at different angles.  Exercises here include vertical pressing moves like the military press, with bar or dumbbells,  lateral raises (bend over an inclined bench for a different angle), dumbbell forward raise, and my favorite, kettlebell clean and press.

Abdominals:  Plank holds (front and side), bicycle, stability ball curls, regular curls, dumbbell or kettlebell renegade row (killer), Russian twist

Arms: both front (biceps): rows, pull ups, biceps curls, and back (triceps): triceps press or kickback, pushups, horizontal and vertical pressing moves

Is your head spinning?  Like I said, it is NOT COMPLICATED!  Pick one move from each group (some exercises overlap groups because they are complex, and therefore work across multiple joints).  Study the precise form from books, YouTube, friends who know, or a trainer before you try each exercise. Start light.  Warm up first.  Then gradually add weight until the last repetition is fairly difficult.  In the beginning, strive for two sets of 10-15 repetitions of each exercise.  In exercises where you hold for time, aim to increase your time by 5 seconds each time you do the move.

KEEP TRACK OF YOUR PROGRESS.  I know it looks silly.  But if you don’t know what you did the last time, how can you progress?  You have to challenge yourself by doing a tiny bit more or holding for a few seconds longer than the last time.  I carry a workout log around with me.  I look to see what I did on that exercise the last time I did it.  Then I will either increase the weight, or the number of reps, or decrease the rest between sets.  Only a tiny bit.  It’s all about baby steps and consistency.

Step Five of the Perfect Workout: Strength Training

I almost forgot I had a few steps to go in describing my perfect workout.

Here is why (David Letterman style) I think strength training needs to be a key component in your workout–especially if you have CF:

10) You can seriously increase your appetite, especially if you are doing a heavy lifting program.  Lifting heavy and the consequent eating like a horse is how I gained six pounds in six weeks.  Doesn’t sound like much, I know, but it’s about 6% of my body-weight (you do the math).  The only time I’ve ever been able to gain that much weight was the first year of college.  Man did I love that all-you-can-eat cafeteria.

9) It’s great to beat your son at arm-wrestling.  OK, so he’s only 12.

Maintaining bone density is pretty important, unless you want to crumble into a heap of skin and bones in your old age.  Yes, I did say ‘old age.’  It will happen.

7) In CFTR-able people (code name for those without CF), lifting weights increases insulin sensitivity.  There is no reason to think this won’t be true in CF as well.  If you CFRD or are on the verge, or, if you don’t want to develop CFRD, a little weight training can absolutely not hurt!

6) You get to buy new clothes when you ‘outgrow’ your old shirts, pants, etc.  Ladies, don’t worry–I’m kidding.

5) Who wants to be soft?  Weight training will firm up those abs and legs and arms in very little time.  Try it.  You will be amazed.  In addition, who wants to be skinny and wimpy?  This will not be the case if you adhere to a regular lifting schedule.

4) Being stronger will make the regular chores of life easier.  Easier means requiring less energy.  Requiring less energy means requiring less oxygen.  Less oxygen required means even if you have sucky lungs–that’s a technical term–you will still be able to carry on, soldier.

3) Coughing is easier and more effective if you have strong abdominal muscles.  This is just true.  Given that we cough, and the effectiveness of our coughs is directly proportional to our health…strong abs are very important.

2) Let’s face it, body image can be impaired in CF.  It’s not hard to imagine why this is true, but this is a very important issue, especially in kids. One very good way to improve body image is to develop muscle.  Development of muscle is not impaired in CF (as long as you eat and digest food).  We can ALL do it.  And when you do develop muscle that is visible to the naked eye…you feel better about the way you look.  Even if you cough.  Even if your fingernails look funny.

1)  I left this for last because it is my favorite reason to lift.  You are in control when you lift.  Not CF.  CF doesn’t affect your strength.  CF doesn’t stop you from developing strong muscles.  There is absolutely no difference between you and normal Joe GymRat, when it comes to getting strong.  Booyah.

These are good reasons to add resistance training to your workout.  The next post will discuss how to design your program.

 

Step Four of Perfect Workout: Movement Preparation

It’s kinda crazy that it took four steps to get to “movement preparation,” but this is just what active stretching is called.

Remember back in the days when you would hold static stretches before you exercised?  I still see people doing this…going straight from the locker room to the stretching mat and doing seated forward bends and holding calf and quad stretches before going to the elliptical machine or treadmill. We know better now.  First, it’s not good to stretch cold muscles.  If you must do static stretches, it’s much better to do five minutes of jumping rope or fast walking first, as the increased blood flow to the muscles helps to warm them up and may increase their elasticity.  It also turns out that stretching a muscle statically (holding the stretch for 20-30 seconds) may actually decrease its ability to perform strength and power moves.  So if you are intending to lift weights, it will benefit you  to find better ways to stretch prior to your workout, and do the static stretches at the end.

A better way to stretch cold muscles and get them ready to work is to stretch them actively.  This simply means to stretch your muscles while they are in the act of moving.  This is a dynamic process. Nothing is held for time.  You simply wake your muscles up by asking them to move into stretched positions.  A great example of this is the “inchworm,” one of my favorites.  Here is a great example of this.  Notice that the hamstrings and calves get a great stretch as they are working.

Another great exercise for the upper body targets the front of the shoulders and the upper back.  This is much harder than it looks, especially when you keep your butt, upper back, head, forearms, and wrists touching the wall the entire time.  Check it out here:

Walking lunges are a great way to warm up for running or lower body weight lifting.  To increase the stretch in the hip flexors, add a twist in the direction of the forward lunging leg.  Check this out here:

These are some of my favorite movement preparation exercises.  I will also do a few sets (if I am lifting weights) or a few minutes (if I am doing cardio) at a much lighter intensity level than what I do normally as more movement prep.  After all, the best way to prepare to do something is to do it…with a very light load.  This tells both your muscles and your brain to get ready for what is to come.

Step Three of Perfect Workout: Corrective Exercises

Now that you have rolled for five minutes (see here), and done ten minutes of mobility work (see here), you are well into your workout and have yet to do any “exercises!”  It’s time to start working your muscles.  Corrective exercises are best done now, while you’re fresh and sufficiently loosened up.

Corrective exercises are meant to do exactly what you would guess, namely to “correct” any structural imbalances which lead to vulnerable muscle groups. These types of exercises have also been termed “prehab,” with the idea that if you do them, you avoid injury, pain, and the need for “rehab.”  Why would imbalance lead to injury?  I’m glad you asked.

As I mentioned in the previous post, we all (and by “we” I mean those of us with CF) tend to develop a somewhat kyphotic (hunched forward) upper back, and usually the end result of this is an overarched, or “lordotic,” lower spine.  This lordosis combined with  hours and hours of sitting lead to tight hip flexors (the muscles that work to hinge your hips forward—think bringing your thighs to your belly-button).  Tight hip flexors tend to go along with weak gluteal muscles. This stick figure here shows the problem.  Tight low back and hip flexor muscles along with weak abdominals and gluteals.   The picture of imbalance.  This is a set up for low back pain.

These are the areas that I focus on in my “prehab” work.  I do exercises to strengthen my gluteals and abdominal muscles, and work to stretch and strengthen my hip flexor group and low back extensors.  In the YouTube video below, I go through a few of my favorite “glute” activators, and some good abdominal exercises using a stability ball.  Try these, and let me know what you think.

In the next post, I’ll talk about some corrective exercises for that pesky hunchback.

 

 

 

Step Two of The Perfect Workout: Just Move It

After  you have read “The Perfect Workout,” you will have a basic understanding of the eight steps, in the right order, to use as the backbone of your workout.    Step One  (discussed here) of your workout,  involves rolling out soft tissue knots and tight areas with the foam roller, or a small ball (or pair of balls).

Now it is time to move on to Step Two, which is all about improving mobility.  Mobility is becoming one of my favorite subjects lately, and I have been working diligently to improve my own.  It is not a complex subject; mobility is simply the ability to move.  As it relates to exercise, mobility is about the ability of every joint in your body to move through its natural range of motion.  Now, there are many, many joints in your body…somewhere between the mid 200’s to mid 300’s (the definition of “joint” is a bit fuzzy).  Most of those don’t need a lot of your attention. But before you stress your body with exercise, it is good to circulate a bit of synovial fluid (the stuff that lubricates joints) and wake up the millions of mechanoreceptors that live around your major joints…especially the ones you plan on taxing during your workout.

I have many tight and not so smoothly moving areas that I like to focus on, but the one area I’d like to talk about at length here, because I am certain that we all share this issue, is the thoracic spine.

Think about your posture.  Adults with CF very commonly have poor posture, and most of us with poor posture know that it is a problem.  The causes of the problem are many.  First, we are getting older, and with age comes increasing reinforcement of poor movement patterns.  The body adapts perfectly to what is asked of it.  If you start slumping your shoulders when you sit at the computer, or drive, or breathe, the body decides this is the position it is to always assume. Second, with age comes bone loss (especially in CF), which can lead to osteoporosis and subsequent hunching of the upper spine (technically called kyphosis).  Finally, as breathing mechanics change with increasing lung disease, there is consequential structural alteration of the thoracic cavity that worsens kyphosis.

Why is this?  Because the body tries to offset or balance the  increased hunching (kyphosis) of the thoracic spine with an over-pronounced swayback of the lumbar spine, also known as lordosis.  This leads to pelvic and hip problems, and the result is a mess. Sounds bad, right?  It is, and the worst part is that all of this leads to a very common problem in adults with CF, back pain.  The picture below illustrates this problem.

The thoracic spine is actually supposed to be very flexible.  It is supposed to flex, to extend and to rotate.  In contrast, the lumbar spine is designed more for stability and less for flexibility.  Sadly, most people have this backwards, and tend to use the lumbar spine more than the thoracic and hips for bending and rotating.  This often leads to pain, and commonly to injury.  Because the thoracic spine in CF tends to be even more “frozen” in place because of the above-mentioned issues, pain is extremely common.

But wait, there’s more.  Pain is bad enough, but what is worse is that the combination of poor posture and pain leads to inhibited airway clearance, less expansion of lung tissue and deteriorating lung function. Stiff and unmoving thoracic vertebrae also increase the work of breathing (isn’t it hard enough?).  None of this is good.  Not good at all.

But here is the good news:  Some of the postural problems in CF can be corrected.  Those having to do with muscle  and soft tissue tightness are reversible!  Stiff joints can be mobilized with specific exercises and soft tissues can be stretched to allow for normal alignment and movement.

This is why at least 10 minutes of your workout should be spent waking up and moving your thoracic spine.  If you are like me, you literally need to teach your brain exactly where this part of your back is, and how to move it because of something called sensory-motor amnesia.  This is exactly what it sounds like:  When you don’t move a body part much, the brain 1) forgets where it is, and 2) forgets how to move it.

I’m Convinced.  What Should I Do?

First, take a breath and don’t panic.  Then, check with your doctor and make sure these are safe for you, especially if you have osteoporosis. Next, to get a rough assessment of the amount of kyphosis in your upper spine, do this test.

Lie down on your back with your feet on the floor, knees bent to about 90 degrees.  Now press your low back into the ground and keep it there as you do the following:  bring your arms up and over your head, keeping them straight with your biceps muscles close to your ears.  Don’t move into pain, but see if you can bring your wrists and back of hands to the ground above your head.  If you have normal thoracic mobility, this is a breeze.  If you can’t, you are like me and have some pretty stiff and sticky thoracic vertebrae.  The following exercises are for you.  If you can, and want to keep it this way, the following exercises are for you.

1)Spend quality time with your double tennis ball contraption (link) every day…before your workout as I discussed in the previous article, and also throughout the day, especially if you sit at a desk a lot.  If you are bigger and have more muscle mass, you might graduate to double lacrosse balls.  This is not in my future.

2) Roll your upper back with a foam roller.  As you do this, bring your hands behind your head and keep your elbows close together (this gets your shoulder blades out of the way).  Slowly roll up and down the spine, stopping at the neck above, and the lowest rib below.  Try to “curl” yourself around the roll by aiming the top of your head to the ground.  If you have tight spots that are slightly uncomfortable, spend some time there.

3) Get on hands and knees and push your butt slightly back toward your heels.  Now take one hand (for example, the right) and place it behind your head by bending your elbow.  Now, keeping your butt back, rotate your spine by reaching the right (bent) elbow toward your left knee.  Come back up and do this several times, slowly.  Repeat on the other side.

4) Stay on hands and knees, but  this time sit all the way back onto your heels.  Take right hand again behind your head, and now rotate it up, toward the ceiling, trying to open your chest to the ceiling as well.  Don’t move your butt–this is keeping the lumbar from moving, thus isolating the upper back.  Repeat on the other side.

The sensory-motor amnesia problem is a bit more complicated, but can also be remedied with some drills taken from a system called Z-health.  I am currently immersed in learning Z-health and will write more about it in future posts, but these are some basic exercises that will begin waking up and mobilizing the spine.  Try them and then retest with the “raising the hands over the head” exercise.  My bet is that it will improve.  I don’t start my workout until I can do this without discomfort (but it has taken awhile to get there).  Start slowly, but be persistent and patient.  Your spine and lungs (and posture) will thank you.

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