As a physical therapist, I have the opportunity to work with a variety of individuals with unique rehabilitation goals. Elite athletes, post-operative individuals, and patients dealing with the consequences of multiple medical issues or ageing enter the doors of Sapphire Physical Therapy every day. Physical therapists are movement specialists. Following a comprehensive evaluation and working diagnosis, each patient works with a physical therapist to create a strength training program to achieve their goals. The challenge and reward of physical therapy is creating the correct type of strength training program and documenting its effectiveness over time.

I often hear inaccurate statements regarding strength training (endurance athletes do not need to strength train. Young athletes should not strength train. Older individuals should not strength train. If you don’t look like a body builder, then you are not strong). Two simple strength training truths are:

Every individual regardless of age or athletic ability will benefit from strength training.

An effective strength training routine must be designed around the unique physical abilities, functional goals, or athletic goals of an individual.

Online strength training routines and one-size-fits-all classes often ignore important facts of athletic ability, age, injury history, and sport-specific goals. Physical therapists are trained to look at the complexities of every person we work with. Understanding five basic principles of strength training is important so you can safely and effectively reach your goals.

Absolute and Relative Strength

Building muscle strength to produce force is important regardless of age, size or ability. Bone health, connective tissue health (bone, ligament, tendon) and muscle composition are positively impacted by strength training. A strong body provides more support to surrounding joints and improves athletic performance. For some, building enough strength to get out of a chair or rise from the floor unsupported represents a huge safety accomplishment. Building absolute strength refers to how much weight a person can lift regardless of body weight. Relative strength refers to how much a person can lift divided by their body weight, which allows the ability to compare strength between individuals of different body size. Relative strength is a better predictor of athletic related power and performance than absolute strength.

Explosive Strength or Power

Strength training exercises done with explosive movements through a wide range of motion improves speed and propulsive force. Rapid or explosive muscle contractions utilize Type II (fast twitch or power generating muscle fiber type) muscle fibers. Plyometric exercises are designed to build speed, acceleration, and tissue tolerance to ballistic movements and impacts for bone health. Running athletes and distance runners alike should add explosive strengthening exercises to their weekly routine. The load associated with explosive strengthening exercises will vary based on individual goals and athletic goals.

Muscular and Cardiovascular Endurance

Endurance is simply the ability to perform a repeated task or activity over an extended period of time. Muscular endurance requires a high capacity to withstand repetitive muscle contraction and utilized Type I muscle fibers (slow twitch or endurance muscle fiber type). Cardiovascular endurance requires specified aerobic training methods to improve the efficiency of oxygen uptake and utilization in the body. As an endurance athlete, muscular and cardiovascular endurance is where I train 80% of the time. However, I balance my cardiovascular training with absolute and explosive strengthening exercises to improve performance, build durability, and reduce injury risk.

Balance and Agility

Balance and agility training must be included in every strength training program. Falls represent one of the greatest causes of injury in elderly individuals. Balance and agility skills in elite athletes often make the difference between a caught pass and a dropped pass in the end zone. Sport-specific agility drills replicate high level movements, building muscle memory and improving performance. For an individual recovering from and orthopedic surgery, however, balance and agility training will focus on trusting the involved extremity to increase safety and expedite a return to daily activities and sports.

In summary, strength training is multi-faceted, is appropriate for all ages, athletic abilities, and daily or athletic goals. Physical therapists understand the importance of incorporating strength, power, endurance, and agility into an effective and efficient strength training program. Whether an individual is new to exercising, rehabbing following a surgery, running their first marathon, or an elite athlete, building the body’s capacity to perform work will reduce injury risk and improve performance across the lifespan.