Get Patients Pumped Up about Resistance Training

Resistance exercise uses more muscles than just walking. It uses upper body muscles that are rarely used in modern society today.  Resistance training also maintains or increases lean muscle. This helps to burn calories at rest throughout the day. This is important for weight control and diabetes management, especially as we age.

The ADA Standards of Care – Section 5 – Lifestyle Management, recommends that people should perform resistance training involving the major muscle groups at least 2 times per week.  How do educators help patients get started?There are many different ways incorporate resistance and strength training. Examples include free weights, resistance bands, rubber tubing, or even our own body weight, just to name a few.

The key is choosing a resistance program that steadily and systematically loads muscles to increase their ability to take greater loads.  

Focus on strengthening major muscle groups:  Start with 6-8 exercises that target major muscle groups (upper body, core and lower body).  It is also important to work opposing muscle groups.  For example, work both biceps and triceps not just biceps.

Getting Started

Start with 2 sets of 8 repetitions for each of the exercises twice a week. With a goal of working up to 2-3 sets of 12 repetitions twice a week. Slow, controlled movement using full range of motion is the goal with each repetition.

Determining level of resistance
Start with a weight or resistance level that is challenging, but doesn’t completely fatigue the muscle after 1 repetition.

Perform that exercise for 2 sets.

• If rating is less than “somewhat hard”, increase resistance.
• If rating is somewhat hard to hard, start with this resistance.

Perform the exercise to momentary fatigue counting the number of repetitions. If person can do more than 12 repetitions without fatigue, then increase the resistance by about 5% in the next session.  If there is momentary fatigue in less than 12 repetitions, keep the resistance the same the next time.

Indicators of fatigue include increased speed of movement, deteriorating exercise form and full available range of motion (ROM) is not completed.

What kind of resistance training equipment do you recommend?

• Look for products that offers multiple options.
• Exercises bands often come in a light, medium, and heavy resistance.
• Look for adjustable weights that give options for increasing weight within one weight.

Weight Max: The average person performing good quality resistance training keeps it at 70-80% of 1 Repetition Maximum (max amount of weight they could use to complete 1 repetition )

Precautions: Make sure patients consult with a provider before exercising if they have any of the following conditions:

• Proliferative retinopathy or current retinal hemorrhage.
• Neuropathy, either peripheral or autonomic or foot injuries (including ulcers)
• High blood pressure (especially if not well controlled)
• Serious illness or infection.

Keeping Safe during exercise:

• Have a blood glucose meter accessible to monitor glucose levels before, possibly during, or after exercise or any time that symptoms of hypoglycemia occur.
• Immediately treat hypoglycemia with glucose tabs or 15 gram carbohydrate source.
• Stay properly hydrated with frequent intake of small amounts of cool water.
• Wear proper footwear, and check feet daily for signs of trauma such as blisters, redness, or other signs of irritation.

Product resources:  Here are just a few places to find exercise bands and weights.

• Online sellers include Amazon
• Goods stores like Dicks Sporting Goods, Sports Authority
• Walmart has Adjustable Free weights. Brands to look for include Athletic Works or Gold’s Gym
• Contact a local outpatient Physical Therapy clinic.

Training Routine Resources

• TheraBand Resistance Training Manual – They have a Theraband Academy that is very good and has Spanish materials. It is free to sign up
• Weight Watchers 10-minute time crunch training with resistance bands DVD (Weight Watchers store, Online)
• Sit and Be Fit (Mary Ann Wilson: videos, You-tube, TV show)
• Go 4 Life – a NIH website that celebrates active aging through exercise. Go4Life.nia.nih.gov
• Diabetes Breakthrough by Osama Hammy M.D., Ph.D. and Sheri Colberg Ph.D.(book)
• Local YMCA (resistance training classes: offered only in some locations)

Other Considerations:
If patients are concerned about starting a resistance training program because they have had injuries in the past, muscle imbalances, or unique physical circumstances, recommend they see a Physical Therapist to identify potential issues and create a program that is specific to their needs. Physical Therapists are truly the movement specialists!

Special thanks to our guest contributor, Diane Britton PT, CDCES, CEEAA. She has been a Physical Therapist for the last 24 years working with adults in a variety of settings, including home health. Diane holds specialties in diabetes, aging and exercise, lymphedema and chronic illness. She resides in Colbert, WA.