I have been fortunate to work both with athletes in search of peak performance and individuals in search of regaining/maintaining physical function. This is one of the many benefits of the wide scope in physical therapy. The performance side and the health side paint different perspectives that can complement each other.
One question I have received over the past year from some patients is as follows—
“My legs feel stronger since starting to walk or run more. Why do I have to do strength training?”
This can be a tough sell. How can you refute that? Running or walking certainly does not make one weaker.
Something as simple as walking, for someone who has been inactive, can be enough to stimulate some gains in muscle mass in the legs. It would be reasonable to conclude that this also applies to running.
As an endurance athlete, it can be hard to understand that our cohort makes up a small percentage of the population. There are far more people going from zero —> something for exercise than people are banging out 10-20 hours of training per week.
Why strength?
There is no question that getting on a walking or running program is beneficial to one’s health. In fact, there is some evidence that strength can be increased by walking. At least that is what part of a study by Yoshiko et. al 2018 found1. The argument from my patients that they feel stronger from walking might have some legitimacy. Many of these people have no formal exercise background so the bar is lower to make these gains.
However, there is more on the table. The same study had an experimental group that performed both walking and traditional strength training. This group was determined to have even better muscle quality than the group that only walked.
I hate to be moving the goalposts. “I need MORE exercise?!” …but there are some benefits acquired through lifting something heavy that cannot be acquired through other means.
Why might this be?
A great review by Spiering et. al 20232 lays out some foundational principles of what resistance training does, that walking may not.
•Resistance training may recruit different fiber types than just walking
•Joints are loaded in different positions and through a full range of motion
•A forceful muscle contraction is enough to stimulate overload to which the body adapts with proper recovery…walking is often not a high enough demand for the muscle
Building up as much of a buffer in terms of strength and maintaining it as we age may also have functional significance.
Can you get off the floor, lift some heavy items into a cabinet, go up a set of stairs, or carry in the groceries?
Moreover, what about your arms, back, and core? Walking or running may not be enough to maintain or improve bone density or muscle mass in these areas.
I see benefits in focusing on total body health.
Your legs don’t always work independently from your arms.
Your muscles don’t always work independently from your aerobic system.
When one is strong and aerobically fit, there are major implications for
Maintaining function
Decreasing fall risk
Decreasing the burden of injury if one were to fall
Not to mention, this level of fitness opens the door to a ton of opportunities to engage in activities that create memorable moments.
My bias shows that I trend toward recommending what is regarded as “optimal”. Of course, doing only walking or running is much better than doing nothing and bonus points are on offer if you enjoy it!
Clinical mentors and peers have shown me that it is best to lay out the recommendations for the client: “Here is what we know.”
Let the client make the decisions on what they can commit to doing: “Where are you starting from?”
And then offer solutions for how that looks in the context of that person: “I can help you get on a path and stay on it.”
Accountability.
Everybody is an athlete is a cliché statement but it holds some truth. The competitive athletes I coach and the people I see in the clinic both face task demands. Physical preparedness is at the heart of the matter. We can (and should!) spice it up and make it fun, but at the end of the day, that is a simple approach that can be a breeding ground for health or athletic success.
My goal is to validate current healthy habits and suggest how to maintain them. In that case, it may be best practice to train your heart and your muscles in a way that drives you toward your goals.
Yoshiko, A., Tomita, A., Ando, R. et al. Effects of 10-week walking and walking with home-based resistance training on muscle quality, muscle size, and physical functional tests in healthy older individuals. Eur Rev Aging Phys Act 15, 13 (2018).
Spiering, Barry A.1; Clark, Brian C.2,3; Schoenfeld, Brad J.4; Foulis, Stephen A.1; Pasiakos, Stefan M.1. Maximizing Strength: The Stimuli and Mediators of Strength Gains and Their Application to Training and Rehabilitation. Journal of Strength and Conditioning Research 37(4):p 919-929, April 2023.