EFFECTIVE, SAFE AND SUSTAINABLE EXERCISE

As anyone who knows me, has read my blog or is connected to me via social media would probably know, I am an exercise enthusiast.


I've read well over 100 exercise related books by now, countless articles, participated in numerous online forums, attended seminars, been to personal trainers, paid for phone consultations, have trained others and even took a shot at competitive bodybuilding.


I started exercising regularly about 1981.


While not claiming that an of this makes me an expert, I do feel my opinions are somewhat informed.


So as my title indicates, I want to talk about effectiveness, safety and sustainability when it comes to exercise and how, without all three, your exercise program may, if not in the short term, than definitely in the long term, do you more harm than good.


So first, effectiveness because, believe it or not, I think that's the easy one. Virtually every "exercise like activity" will produce results. Note that doesn't mean that anything is better than doing nothing but I will come back to that when I get to safety and sustainability.


Some benefits will be derived from walking programs, running and other steady state activities, and I believe even far more significant benefits will come from resistance training whether it be calisthenics, free weights or machine based. Playing sports will also yield conditioning benefits as will gardening or other manual labour. Obviously the variation in effectiveness from this list will be quite broad.


Next I'm going to point out that the actual benefits of even the best exercise, have been vastly exaggerated and/or misrepresented. This is either from cognitive errors (selection bias) or commercial interests/unethical motives.

Selection bias, in that we make the natural mistake of confusing correlation with causation. Very fit people, including world class athletes, body building champions and magazine cover models do exercise, however their superlative results have more to do with having the right parents than their specific exercise regimens, and copying their programs will not yield anywhere near the same results for the genetically average or below average. They are, by definition, extreme outliers. In fact, I think a strong argument could be made that their results, in many cases are achieved DESPITE the programs they espouse rather than BECAUSE of them. (The evidence you see vs the evidence you don't see: We see the gold medalist, we don't see the dozens, perhaps hundreds or thousands of others who suffered acute or chronic career ending injuries as a result of trying to follow similar programs). As far as commercial interests coupled with lack of ethics, these outliers can and have been paraded as examples of what you can achieve if you only buy the right supplement, or use the right machine, etc.

Having said that, the actual results that can be achieved from exercise are truly impressive and may be even more important to each of us individually.

Exercise ranks in importance with proper sleep and nutrition, in that it truly is necessary for life, but for 90% or more of us (99%?) , it will not turn us into magazine cover material or make us impervious to disease, injury or old age.

It can, however, from a a health standpoint, put the odds in our favour, and dramatically improve our appearance. (Diet is obviously also important but will leave for another post)

Side note: I will be honest, and I doubt I'm alone, health should be my primary motivator, but I don't kid myself, appearance is a bigger source of motivation for me, and the health benefits are an extremely nice bonus. (Read book "The Red Queen" and see how sex is central to almost all motivation)


Back to health, let's say that some genetic test was suggested you had a very high likelihood of getting heart disease, say 2 out of 3 odds in your lifetime. Perhaps (I'm using numbers to make a point and making no claims as to their specific validity) exercise could improve that to 1 out of 3. 1 out of 3 still sucks and is far from invincibility but that is still a dramatic improvement. And maybe the first heart attack, if it comes, will do so a decade later, be less life threatening and your recovery may be quicker.

These are important benefits despite nowhere near the invincibility that is too often implied and leads people to delusional assumptions. "But I work out regularly, how could this happen to me?"


Most importantly, in my opinion, is the extension of years of functional ability that can be obtained from proper exercise. Using the washroom unaided and being able to play with your grandchildren is pretty amazing and something you would really miss. (My personal goal is to dance at my great grandson's wedding. I have a 19 year old grandson now, and at 58, this goal is possible)


As for looks, my advice is, don't compare with magazine cover models or elite professional athletes, which is unattainable for almost everyone (including many of the actual models who are photo shopped or hit a "peak" they do not come close to maintaining all year round, not to mention drug use).


Rather, sit in a mall and watch how many people are in horrible condition and focus on how much better you can look from that standard! Almost everyone CAN attain this.

(Note: you should really only compare to yourself at another point in time as, whether it is fitness, financial success or any other aspect of life, it is much healthier to just strive to be your best rather than trying to "beat others". I'm just using comparisons to provide context and manage expectations.)

So, how does exercise actually provide benefits, and what are those benefits.... that is a complex question, and I am going to offer an admittedly oversimplified answer. That answer is: either by producing muscle hypertrophy or preventing sarcopenia..... in other words building muscle or preventing you from losing it as you age. Now muscle is both a benefit and a cause of other benefits.

Muscle provides the "shape" that improves appearance, the functional ability that will allow me to dance at my great grandson's wedding, and it has many hormonal effects that produce a myriad of health benefits. (beyond the scope of a blog post)

(Note: in this blog, I will not engage in a lengthy discussion of strength vs so called cardiovascular fitness vs flexibility but I will acknowledge I'm oversimplifying, albeit, building muscle, I submit, should always be a central if not THE central goal of exercise. I may elaborate more in a future blog post)

So in the end, an exercise program's effectiveness for the purpose of this particular post, will be defined simply by its potential for building or maintaining muscle. A bed ridden hospital patient loses muscle to the point of not being able to walk, and for that individual, recovering that lost muscle will come from extremely minimal exercise. Anything above being bed ridden will have some benefit in that sense.

Different modalities will be more or less efficient in building muscle. Walking or running will make your legs stronger, but nowhere near as efficiently as leg presses, squats or some other targeted strength training. I doubt this point is very controversial.

So strength training typically has some basic tenets that most people can agree on. (here I'm ignoring safety, or sustainability and simply focusing on the potential to build or maintain muscle)

It should involve significant effort. In other words, it should feel like hard work, therefore providing a stimulus for the body to adapt.
It should allow for sufficient recovery between workouts, therefore allowing the body to actualize the adaptation to above stimulus.

Any program, I suggest that has the above will build muscle. Most programs will get people to 90% or more of their genetic potential in a relatively short time, perhaps in the first year or two. For all but competitive athletes 90-95% of your potential is all you will ever need to look better, feel better and be functional into your old age. The other 5-10% can make the difference in a competition, or, for people who just want to be the very best they can be, it can provide an ongoing goal that motivates them, but is not necessary for most of us.

In fact, in the quest for that last bit of improvement, there is significant evidence to suggest that fitness and health may in fact start going in different directions. Elite athletes may in fact pay a very high price for that extra fraction of a second that may win them a gold medal or a lucrative professional contract.

Of course the caveat, to my earlier statement that virtually any reasonably sensible strength training program will get you to 90-95% of your potential is, that it will only do so if you actually stick to it. That is where I move to the aspects of safety and sustainability.

Safety obviously means avoiding injury, but I will go further and specify that injuries can be acute (damaging your lower back while doing deadlifts) or chronic, (destroying your knees from repetitive impacts from running). The latter of course will have to do with sustainability which I will discuss shortly. Ironically, I mentioned earlier that one of the major benefits of exercise is the extension of the functional ability into our senior years. If I've wrecked my spine or my knees, it will likely be impossible for me to dance at my great grandson's wedding. So unsafe exercise practices may help you look better for the beach next summer, but that won't mean much if you need help going to the washroom in your senior years.

So, one of the main ways that injury occurs is when the force exerted on either a muscle, tendon or ligament surpasses its structural integrity. This excessive force can be caused by either improper leverage, (poor form), excessively fast movements (which increase force) or too heavy a load. Often an injury results from one or combination of two of the three factors mentioned, and of course how often (repetitiveness) the connective tissue is exposed to such, either in a given workout or exercise, or cumulatively over time, will compound the risks.

Ideally, one would have great form, and low momentum, which will allow for a lighter load to be more challenging and thus be safer. Unfortunately, in many cases, one or two of these is emphasized in order to counter the lack of the other one or two.

For example with certain sports such as powerlifting or olympic weight lifting, the goal is to have maximum load, and the execution requires momentum, so the safety factor depends solely on proper form, but the degree of safety in this or any activity will be compromised to the extent that any one or more of these factors is missing. With all three missing, it is a recipe for disaster. It should also be noted that even with all three addressed, we are minimizing but not eliminating the chances of injury. However, not exercising at all, is the greater risk, so the idea is to put the risk/benefit ratio as much in our favour as possible.

Interestingly, modalities that may seem diametrically opposed are often wholly condemned by opposing "camps", but I would suggest that each might learn from the other. Crossfit (which often involves high loads and high momentum) could learn from Superslow/HIT enthusiasts who emphasize minimizing momentum, but by the same token, I believe that conversely SS/HIT practitioners (particularly when they train themselves) are able to seemingly "get away" with less than ideal form because the low momentum and load is more forgiving and seems to allow for this.

Anecdotally, while there are fewer injuries during actual execution of SS/HIT workouts, some have reported hurting themselves more easily during recreational or sports activities, if they haven't engaged in these previously. I speculate this may be because they (I) may have been performing exercise over years with improper shoulder positions (just one example) unwittingly creating a weak link.

Because of the high load and momentum, many Crossfit coaches have had to, by necessity, focus on very specific details on form and I believe, the empasis on reducing the high incidence of injury may result in giving the rest of us additional information on how to even further minimize injuries by ensuring we haven't fallen into a rut, due to low momentum/load allowing us to have our form degrade over time.

(Side note: advice to HIT/SS folks who train themselves:

either reduce your weight and focus on being so strict that you achieve momentary muscular fatigue as quickly as possible despite the light load or
have a knowledgeable trainer at least occasionally supervise your workout and point out discrepancies.)

I speculate there may be an argument to be made for engaging in some degree of high force activities to strengthen certain connective tissue, but I'm not convinced the risk/benefit ratio warrants this, and at best I would suggest to proceed with extreme caution as I'm really not sure about this, but just thinking out loud.

Having said that, one may play sports or participate in other activities, either for recreation or because their jobs require it, or just because you need to help someone move furniture. Taking out your high performance car onto a track and driving it at maximum speed occasionally will stress that car, and potentially cause it problems, but then, what's the point of having that car if you just keep it in the garage?

So if you do play a sport because you enjoy it, or your work requires a higher risk activity, I would suggest that maximizing your strength with a safe program will have a protective feature in minimizing injury during those activities, and if there is some benefit from high force, that may be a side benefit, but I would hesitate to encourage anyone from exposing themselves to high force, unless there is an activity they enjoy enough to knowingly take the risk (I play hockey once a week) or because it is necessary for your occupation.

As a side note before moving to sustainability, material for a future blog post might be also to emphasize frequent movement during the day, being very careful of posture, and excessive sitting, particularly when staring at a computer screen, or when using mobile devices, as I believe that additional attention over and above proper exercise is required or one may wind up with chronic issues despite the very best exercise programs, in this world of spending too much time at a desk. I like the book: "Deskbound: Standing up to a Sitting World" which I'm in the middle of reading.

As far as sustainability goes, first of all, there is a major overlap with safety which should be self-evident, in that, if you have an acute or chronic injury, not only will your ability to exercise over time be compromised but may be negated altogether. It is pretty obvious that this will not only negate any benefits but in the end, mean that you may have been better off never taking it on in the first place.

The fact is that most exercise modalities that are popular today will almost inevitably lead to acute or chronic injury. Ironically, most people's adherence to programs is terrible, so most people give up before, at least the chronic injuries.

Everyone knows about the new year's resolution syndrome where commercial gym parking lots are full in January, but by March or April are often empty. I don't know the actual numbers but I think it is safe to say that the vast majority of the population does not exercise regularly. (and most of those who do will tell you about their shoulder, knee or low back issues, it they're honest)

Some will suggest that the low adherence to regular exercise, is a reflection on people's lack of commitment and discipline, I think, this is a very incomplete answer, that best serves to make self-righteous fitness buffs feel superior.

Most programs suggest that you exercise several times a week and do so for an hour or more each time. It is my strong opinion, that the vast majority of people with significant family and career commitments will not stick to this over time.

Even if it could be shown that such programs were vastly superior, what would it really matter if people couldn't stick to them?

My earlier point that virtually any relatively sensible resistance exercise will bring everyone to 90-95% of your genetic potential within a year or two, means that "superior" or "inferior" results, really only means that one would reach their genetic potential earlier or later, but since, by definition you cannot exceed your genetic potential, and the goal is to exercise for life, how much does this really matter? (yes, epigenetics suggests that we may be able to influence our genetic potential to some degree, but the extent to which this is possible is still limited)

So, all else being equal, if your program requires minimum time investment it will, obviously be more sustainable than one that requires a large time investment.

Correspondingly, if your program emphasizes the minimization of acute and chronic injuries, it will obviously be more sustainable than one with a higher risk of injury.

The overlap between the top two points also is that minimal time commitment also means less injuries from repetitive movements over time. On this point, a side note on skill acquisition. If one practices a sport, skill practice almost surely requires a large time commitment, and one should recognize that this will increase odds of chronic injury and do their best to alleviate this. One obvious way, in my opinion is to minimize the odds of injury from ensuring one's actual conditioning program be as brief as possible, thus keeping overall repetitiveness lower. For this reason, your conditioning should be distinct from your skill acquisition.

So, in the end, what do I do? I exercise once a week, doing 3-7 exercises for one set to momentary muscular fatigue, with an emphasis on proper form and minimizing momentum by moving slowly and paying specific attention to turnarounds (the part of a repetition where you change directions which is where injury potential is highest). I would also encourage taking minimal rest between sets to have a greater metabolic benefit.

I also play hockey once a week but this is for recreation, and while I know I'm exposing myself to risk of injury, I enjoy this, and I believe hockey was all about HIIT before High Intensity Interval Training was cool, and it has been shown that short bursts of intense exercise provide equal or similar benefits than drawn out steady state activities. Doing it on a hockey rink is far riskier than just taking minimal rest between sets in my strength training program, but hockey is something I love and willingly and knowingly take on the additional risk to participate in.

I occasionally will do a second weekly workout or a set of pushups, chins etc. Not sure I derive any benefit from this, but I do like "testing" my strength by seeing how many I can do. This is likely more about ego than anything else.

Now, if you work out several hours per week, (and have been doing so consistently for at least 10 years), and you feel that what you are doing is "effective, safe and sustainable" than great, and more power to you. If you feel that you are getting good ROI for that extra time, (and "just because you enjoy it" is good enough for me) than it is not my intention to tell you what you're doing is wrong, but perhaps just to give you some food for thought.

As a final note, I believe, even among proponents of what I've described as sensible exercise, there is an immense amount of "hair splitting" where people debate the relative value of different tools (various machines or free weights), exercise details (how many reps, sets, etc., use of forced reps and ad nauseum), the relative need of for variety or lack thereof.

At the end of the day, if some of these things keep things interesting and help people stick to their program, then I'm all in favour, and of course, if they contribute to safety than, I'm even more in favour, but I've long since stopped caring if, for example, a machine has an ideal strength curve, or is lower friction than another.



Doug McGuff has said, "Just Lift Weights".... which to me indicates, he has come to similar conclusions.... while he hasn't added it, I'm sure he would agree, if I added, "Just lift weights.... safely"....

In any case, if you made it this far, thanks for reading.

Recommendation: check out these links:

http://www.ren-ex.com/wp-content/uploads/2010/11/The-Assumed-vs.-The-Real-Objective-of-Exercise1.pdf

http://www.ren-ex.com/wp-content/uploads/2010/11/Exercise-vs-Recreation.pdf