You don’t need to be in a shape of a body builder to be athletic. Nor do you need to dead lift twice your weight to protect your back. But how important is hypertrophy and strength training in injury prevention and sports rehabilitation?
Before we begin, let me briefly explain the difference between hypertrophy & strength.
Strength training is the process of exercising with progressively heavier resistance to stimulate muscle development. The primary outcome of regular resistance exercise is increase in muscle fiber size and contractile strength. Secondary outcome would be increased strength in tendon, ligaments and bone density. Doing strength training such as weight lifting would automatically cause some form of hypertrophy (increase in muscle size). But a bodybuilder with a goal to maximise muscle size has different training regime compared to a power lifter who has a goal to maximise strength. This is where things get a little more interesting. Bear with me as I try to make things as simple as possible.
MYOFIBRILLAR VS SARCOPLASMIC HYPERTROPHY
Some form of strength is gained from muscle hypertrophy. After resistance training, muscle tissues will remodel to build stronger and larger muscle fibers. As a result, there are mainly two tissue adaptations. One response is increase in the number of myofibrils that gives greater muscle contraction force (strength). Another response is increase in sacroplasm that surrounds the myofibrils, BUT is not directly involved in contractile process. Thus, sarcoplasmic hypertrophy does not result in greater strength, but does increase in size. This form of hypertrophy is also known as transient hypertrophy. The effect is often known as the “muscle pump” experienced by many people following weight training due to fluid accumulation in the spaces between the muscles but quickly diminishes after exercise as the fluid returns to normal.
In other words, body builders may not be able to lift as heavy as a power lifter who trains for strength because bodybuilders mainly train for aesthetics and size. By understanding 2 different muscle responses allows us to train more effectively according to our goal.
PREREQUISITES BEFORE STRENGTH OR HYPERTROPHY TRAINING
A lot of us want to go straight to building muscle mass or strength. Unfortunately, this is where most injury happens. We skip the basic foundation which is having sufficient range of motion at the joints, good posture and balance, master basic movements first and then only move on to skilled based training program such as strength, hypertrophy and performance training. Before I even consider programming strength or hypertrophy program for my client, I must first evaluate and assess him or her according to my Fitness Model approach.
Person on the left does not have sufficient ROM at his shoulders and chest. By progressively increasing load on his shoulder press with this form will only make him tighter, weaker and may increase his risk of injury at his neck, shoulders and lower back. This is how corrective exercise can play a major role in strength training.
Assuming that all is well, then we can proceed. But it doesn’t mean that we do not initiate any strength training at the early stage. Strength and hypertrophy plays a MAJOR role in rehabilitation and injury prevention. Here is why:
REHABILITATION & CORRECTIVE EXERCISE MYTH
Rehabilitation is the process to regain full function following injury and involves restoring strength, flexibility, endurance and power. It is achieved through various exercises and drills. Rehabilitation is as important as treatment following an injury. Corrective exercise goal in the other hand is to minimize risk of injury by ensuring quality of movements with safe and effective progression. However, common myth or perception regarding these 2 type of program is, it is designed for weaker people or people with some form of disability (injury, disease, deformity, etc.) by adopting light exercises such as resistance bands, light weights with special equipment and modalities (infrared, shockwave, EMS, etc). This is definitely NOT TRUE.
Truth be told, almost EVERYONE needs some form of rehabilitation and corrective exercise. Nobody is perfect or immune to injury. Even the top athletes in the world gets injured from time to time due to poor movements or over exertion. In my personal opinion, strength & hypertrophy MUST be incorporated safely and progressively into rehab and corrective program for optimum recovery and results. When programmed effectively and coupled with proper nutrition, weight loss and muscle gain is definitely possible!
BENEFITS OF STRENGTH & HYPERTROPHY DURING REHAB & INJURY PREVENTION
FUNCTION & CAPACITY
Our body moves in multiple direction and performs movements such as squat, lunge, hinge, rotate, push and pull. To be properly functional, we need strong muscles to support our movements. By building gradual strength with resistance training, it increases our capacity and tolerance to withstand external load and forces (gravity) while protecting our joints and other soft tissues. Repeated resistance training also increases more efficient activation of motor skills for function and movement.
PROTECTION
Building strength help protect joints at your entire body (spine, knees, shoulders, elbows, ankles, etc.). For example, stronger muscles is particularly important for low back health. Strong erector spinae muscles enhance lower back support, control, function and shock absorption (Willemink et al. 2012). The same goes for your knees, shoulders and hips. Strength & hypertrophy also help reduce pain of osteoarthritis and rheumatoid arthritis (Golightly, Allen, & Caine, 2012)
REVERSIBILITY
Adults who don’t lift can lose about 3 pounds of muscle every six years. However, a basic strength training program can add 3 pounds of muscle in 3 months (Westcott et al., 2009). When you stop lifting, you can lose strength at about ½ the rate that was gained. In other words, if you increase your bench press weight by 10kg over a 10 week training period, you would lose 5KG of that strength gain after 10 weeks of no training and the entire 20KG strength gain after 20 weeks without training. This principle of muscle reversibility shows the importance of lifting weights as your lifetime exercise regime, rather than a short term goal. Without strength or hypertrophy training, your muscles gradually become smaller and weaker. This loss of muscle mass is AMPLIFIED when you’re injured. More reasons to lift!
BODY COMPOSITION
Apart from increase in function and physical capacity, strength & hypertrophy based training also reduces risk of osteoporosis, type 2 diabetes, lowering resting blood pressure, improve blood lipid profiles and decreases risk of developing metabolic syndrome. When combined with cardio training and proper nutrition, it can result to favorable changes in body weight, waist circumference, reduction of fat mass and increase of healthy lean muscle mass.
You should already understand by now that by lifting weights or doing some form of resistance training is extremely important for your body. But, by only focusing on “mirror muscles” such as your chest, biceps, quads and abs can cause MAJOR problem in the future. Plus, if you spend too much effort on building strength and hypertrophy while ignoring other major components such as stability, balance, mobility, neuromuscular and motor skills, can also spell disaster for your body.
For my next post, I will discuss key concepts such as number of repetitions and sets to maximise strength or hypertrophy, periodization techniques for safe progression especially during rehabilitation stage after an injury, and how you can build strength & muscle mass while maintaining functional capacity and remain FREE FROM INJURY AND PAIN by applying corrective exercise and biomechanics principles.