Dr. Scotty Butcher
“No citizen has a right to be an amateur in the matter of physical training…what a disgrace it is for man to grow old without ever seeing the beauty and strength of which his body is capable.” – Socrates (~400BC)
There is a problem with our system of ‘health and fitness’. Since the age of modern technology, the vast majority of the world’s societies have become sedentary; progressively less fit; and consequently, riddled with chronic, preventable disease (1). Despite the best efforts of over 40 years of academic study about the efficacy of becoming active and attaining ‘fitness’ for achieving optimal health, today’s society continues to be collectively weak, unfit, and unhealthy – to epidemic proportions. What’s worse is that the world’s greatest classical scholars wrote about this well over two millennia ago and we apparently have not listened. What a disgrace, indeed.
There is no doubt that becoming physically active can ameliorate many of these lifestyle-related diseases. The problem lies in not the knowledge, but in the methods. At the dawn of the modern fitness age in the early 70’s, a dichotomy was emerging between the newly forming ‘aerobics’ movement and the surge in popularity of bodybuilding with Ahnold. I don’t really know for sure why aerobics won out as the ‘health and fitness’ method of choice; perhaps it was that its founder, Dr. Kenneth Cooper, was (is) a respected physician and researcher, whereas Mr. Olympia was (is) seen to be a dumb-sounding musclehead. Or perhaps, it is simply sufficient to say that aerobic exercise (low intensity aerobic exercise such as walking) is vastly easier than strength training. Easier usually means more accessible. Nevertheless, our current system of health and fitness is engrained in the idea that aerobic exercise is ‘best’. In fact, aerobic exercise has become synonymous with ‘cardio’ as the best method of achieving cardiovascular health and fitness. In some cases, noted exercise physiologists, physicians, physical therapists will tell you that it is the only method of exercise you need to stay healthy throughout your life.
Herein lies the problem. First, no one method is ‘best’. ‘Best’ is only relevant along with a discussion of who, what, when, where, and why. Second, there is only so much that low to moderate intensity continuous aerobic exercise can do. Sure, when the intensity is low, and the duration is not too long, it is easy exercise. Compared with sitting on the couch, there is much benefit to be derived from a brisk 20-30 minute walk or play, 5-6 days per week. This recommendation for individuals attain this baseline level of physical activity as a co-requisite to any further training is crucial. This level of activity is sufficient to improve aerobic fitness to the levels needed for optimal prevention of all-cause mortality (2). In fact, from a mortality prevention perspective, further increases in aerobic fitness do not convey further prevention (2).
There won’t be too many arguments against being more physically active for health benefits. Where this issue gets contentious, however; is how an individual then progresses. Within reason, there are more fitness benefits to be achieved by higher intensities of exercise. The research is relatively clear that there is a dose-response relationship between the intensity of exercise and the derived health, mortality, and fitness benefits (2). So, if one follows the established guidelines for exercise for health, this progression means you should now run or jog; and as you get fitter, you should run faster. Right? If your goal is to run a 10K, half marathon, etc., then right. For general health and fitness, for enhancing athletic ability, for weight loss, or for prevention of age related disability, then most likely wrong. The evidence is becoming increasingly clear that this method of progressing aerobic exercise by itself is both ineffective and potentially detrimental to function over time (3,4). That’s right: our current system of prescribing exercise for health and fitness DOES NOT WORK beyond an initial increase in health and fitness. From the evidence presented in the first paragraph, we already know this. Even in those who choose to be active, there is a huge piece of the health and fitness puzzle missing – strength. Strength training is harder, but that’s also the point. It is harder and that’s why it works.
So, why strength training? Physical strength is arguably (although we won’t argue against this) the most important physical quality for everyone, of all ages, and regardless of the goal or physical pursuit. That’s not to say that some of the ‘side benefits’ of strength training are not important, or that one should only do strength training, but that a sufficient level of strength is required for optimal human function. What this ‘sufficient level’ of strength is depends on the person and the circumstances, but in general, the more, the better. Whether it be sprinting to catch a bus, lifting furniture to help a friend move, performing a high-repetition or high load CrossFit WOD, carrying bags of groceries, improving performance and preventing injuries in sports including endurance sports, walking fast enough to cross the street before the light changes, catching oneself to prevent a fall after a trip, or simply getting up off of the toilet; the more strength available, the better those circumstances can be dealt with.
In rapid, point form, here is a snippet of the research on the benefits of strength training (ST) and increasing muscle strength (MS):
- ST increases muscle and movement strength in most populations: including healthy, chronic disease, young children, older adults, and the frail elderly. Aerobic exercise does not increase strength and does not prevent the loss of muscle mass and strength with increasing age; whereas ST can prevent and reverse sarcopenia (3,5-10).
- ST prevents age-related functional decline in healthy and clinical populations (11-17).
- With advancing age, MS and anaerobic power decline faster (18-20), contribute more to functional decline (13,14,21), and are usually more trainable than aerobic power (9,19,20,22).
- MS is a stronger predictor of mortality and morbidity in aging individuals and those with chronic disease than aerobic fitness (23-25). Mark Rippetoe has a well-known quote based on this research that says, “Strong people are harder to kill than weak people, and more useful in general.” There is much truth to that.
- If you have poor aerobic fitness to start, ST increases aerobic fitness similarly to aerobic exercise (true of young and old). So, improving MS is more important than aerobic fitness in many cases, but ST improves aerobic fitness anyway (26,27). Which training method sounds like a bigger ‘bang-for-your-buck” to you?
- Even if you have good aerobic fitness to start, whole body, maximal ST can improve cardiovascular fitness and endurance performance (29-31).
- ST improves metabolism, results in fat mass loss, prevents and treats diabetes by reducing insulin resistance, improves cardiovascular health, reduces blood pressure, improves blood lipids, improves surgical outcomes, reduces pain perceptions, increases bone mineral density, prevents falls, enhances mental health, and can even reverse some factors associated with aging. Most importantly, these effects are at least as effective with ST as with aerobic training; and in many cases, ST is more effective (32-45).
It is increasingly evident that quality, whole body strength training is safe (46) and vastly more effective than aerobic exercise for multiple functional, performance, health, fitness, and rehabilitation benefits. So, why do most exercise guidelines still promote aerobic exercise as the ‘best’ method? So, why are our rehabilitation programs still structured around walking only? So, why are we still telling clients that the best way to lose weight is with ‘cardio’? So, if we know that strength training is better in most of these circumstances, why are we not doing anything about it?
This is your Call to Arms. Strength Rebels is organizing an insurgence. Rise up and challenge the aerobic-only convention. As health, rehabilitation, and fitness professionals, you can rebel against this established system and promote a better way. A way that is not one-dimensional. A way that produces multiple physiological and functional gains. A way that will help clients become masters of their own physical training and truly see the strength of which their bodies are capable. This insurgence is vital to our population health to reverse the epidemic of weakness.
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