• Tara Albright DPT

Transitioning to the Gym Part III

In the previous two posts, we focused our discussion on outlining the basic principles associated with exercise and physical activity. The take away from these posts should be the recognition that exercise is an individualized concept that needs to factor in the goals of the participant, and that choosing a particular type of exercise will lead to particular gains in areas of physical fitness according to the SAID principle. Additionally, exercise can be quantified with the concept of volume. Several factors influence volume beyond just reps,

sets and weight – exercise selection and ordering of exercise sessions will play a role as well. The idea with the above information is to better clarify that particular attention is needed to these variables in order to maximize what participation in an exercise regimen will do for an individual. In the next two posts, we will look more closely at the fine details associated with the above concepts.

You may have wondered a time or two, “Where do I even start with exercise? Are the small weights I have at home enough? How about bands? What kind of cardio should I be doing?

How can I tell if I’m exercising hard enough?” Hang on. Back up for a second, and let’s take a broader perspective on these points. What most folks seek with regards to exercise is to be told what is best or most effective. It may not surprise you much by this point to hear this phrase: it depends. Here again we emphasize that exercise is a highly variable concept and there are many ways to go about it. Below you will find a brief overview of some variables to consider when choosing your mode of exercise and how they relate to the exercise being performed.

Heart rate -> Heart rate refers to exactly what you might think – how often your heart is completing once cycle of contraction and relaxation in a given amount of time. It is a direct reflection of metabolic activity and oxygen utilization when exercising by looking at how much faster the heart must beat to circulate blood through the body and to working muscles when active versus when resting. More intense activity = higher heart rate, and vice versa. This is typically measured in beats per minute and many exercise machines/electronic exercise watches (i.e Apple Watch, Garmin) have the capacity to measure heart rate built in. We humans conveniently come equipped with a manual system for measuring heart rate by feeling and counting our heart beats per unit of time using only our fingers! Commonly the radial artery (just below the base of the thumb) and carotid artery (below the jaw line and away from the Adam’s apple) are used for this purpose, where heart beats are counted for 15-60 seconds and multiplied by the appropriate number to obtain a number of beats per minute. There are several equations to calculate a safe maximum heart rate and the optimal heart rate range to work in for particular fitness goals, but are beyond the scope of this discussion. It is highly recommended to consult with your physical therapist or exercise physiologist for numbers specific to you as an individual. The bottom line here: if physical activity does not raise your heart rate sufficiently beyond baseline, minimal gains will be made in regards to fitness goals.

Rating of Perceived Exertion -> RPE refers to a more subjective way of measuring exercise intensity – namely how hard you feel you are working. This is a 0-10 scale where each digit higher on the scale reflects a subjective increase in one’s perceived level of exertion. A full breakdown of the increments and benchmarks within the scale are also beyond the scope of this discussion, but further information is only a quick Google search away! In a nutshell, the scale is a self-reported measure and will use metrics like the ability to hold conversation while exercising to determine the corresponding exercise intensity. Oftentimes the RPE scale and heart rate are used together to provide a well-rounded description of how intense a given exercise experience is. The bottom line here: if one does not perceive levels of exertion during exercise beyond what is experienced at rest, there will be minimal gains made towards fitness goals.

Fatigue -> there are many ways to use the term “fatigue”, however within the scope of exercise and physical activity we take to a particular meaning: reductions in voluntary muscular force production and prolonged muscular effort as a direct result of prior physical activity. Put another way, fatigue is the accumulated effect of using muscles and the brain directing those muscles to the point where recovery is needed to continue at the same level of performance. This encompasses both the mental and physical fatigue felt after exercise, as it manifests both centrally (i.e the brain) and peripherally (i.e the muscles, ligaments, tendons and joints). In order to sustain an effective exercise program, fatigue MUST BE taken into account and managed appropriately. The most impactful stimuli for muscle growth and improvements in fitness metrics come with the accumulation of fatigue, which means we NEED fatigue in order to improve. The trick lies in accumulating a manageable amount of fatigue and taking steps to promote recovery from that fatigue. In the next post we will outline some strategies for this including peaks, tapers and de-loads.

Recovery -> oftentimes used as a buzzword to catch a reader’s eye, “recovery” is a term broadly referring to any action undertaken to help manage fatigue and assist the body in preparing for the next bout of physical activity or exercise. The human body is equipped with a remarkable ability to recover (aka heal and recuperate) from physiological stress imposed upon itself. One only needs to think back to their own injuries ranging from broken bones to cuts and scrapes on the skin to get a sense of this marvelous capacity for healing. When exercise is carried out to a sufficient intensity, there are actually microscopic forms of trauma being done to different body structures in conjunction with widespread use of energy substrates and enzymes to drive the machine that is the human body. Think of this like gasoline, oil and the suspension system on a car – some components are used for fuel, some perpetuate smooth machine operation and some absorb the forces of the external environment while in motion. The difference with the human body versus a car is in our active cellular machinery that constantly is at work patching up the issues as they appear. We have billions of cells and chemical processes operating simultaneously without our direction to keep us moving on the fly, where an automobile most often needs to be taken off the road to be serviced. Recovery, in the context of exercise, ranges from reducing exercise intensity to things like cryotherapy and everything in between. The goals of recovery modalities are to help the body in some way to repair the microscopic damage from exercise, restock our fuel/enzyme supply and prepare for the next session. Here again we encounter a topic with more breadth than can be covered in this blog post, but we will cover some basic ways to promote recovery later in this discussion.

Optimal exercise ordering -> when deciding how to proceed through your workout, it is important to consider the order in which exercises are performed if you want to maximize your efforts. As you may have deduced from the above piece on “recovery”, we enter each workout with a finite amount of energy. As we proceed through a given workout we will steadily chip away at that finite amount of cellular fuel and become fatigued. In order to prolong your ability to generate muscular force and create movement, it is smart to order things with the most energy consumptive exercises first and the least consumptive following. The exercises that require greater force production and more muscle groups to be active should be performed first, followed by more isolation-type exercises requiring less muscle mass to be active. An example of this for a weight lifter performing a leg workout might look like this – first exercise is a barbell back squat, followed by a walking dumbbell lunge, then a barbell Romanian dead-lift and finishing with isolated knee extensions and hamstring curls on a machine. Here you see the most energy consumptive exercise (the barbell back squat) performed first and the most isolated exercises (leg extensions, hamstring curls) performed last. There are no “rules” to dictate which exercises are the most and least energy consumptive. This is largely an educated guess based on perceived exertion levels and analysis of the movement to identify the amount of muscles active relative to other exercises. In our next post, this idea will be expanded upon in a sample exercise program.

Nutritional considerations -> to maximize your exercise and recovery efforts, nutrition MUST be taken into consideration. You may have heard the old fitness adage “abs are not made in the gym, they are made in the kitchen.” Put another way, the work put in at the gym is only as useful as one’s diet. Proper calorie balance and macronutrient distribution is essential for meeting fitness goals. Macronutrients = fats, proteins and carbohydrates that are essential for life vis a vis providing energy and “building materials” for the body. Micronutrients = vitamins and minerals that are also essential for life, but instead aid chemical processes in the body versus directly providing energy. Recall earlier when we said one aspect of fatigue is the depletion of energy substrates used by muscle cells to create muscular force, and therefore, movement. Can you guess the one way to replenish these energy stores? That’s right – by EATING! Take caution here to resist taking this as advice to eat indiscriminately. Not all calories are equal. A deep dive into nutrition is beyond the scope of this discussion, but in a nutshell we are talking about consuming high quality forms of carbohydrates, fats and proteins. A quick overview:

  • Carbohydrates - the sugars, starches and fibers found in fruits, veggies, grains and some dairy products. These can range in complexity from a single glucose molecule to large structures formed from hundreds of intertwined molecules. Carbs, specifically sugar, has gotten a bad rap as a result of trendy diets in recent years, but the truth is these are essential to a healthy diet. The secret lies in your choice of carbs and how you distribute these among your daily meals. Put simply, the most basic form of carbohydrate (glucose) is the choice fuel used by the brain to remain alive and is what supplies short-and-long-term energy stores for many types of tissue, muscle tissue chief among them. Complex carbohydrates (as opposed to simple carbs) are intricately bonded molecules that require energy input to break down into smaller units and therefore aid in expending calories to some degree. Carbs, and glucose more specifically, have much more depth than just relevance to exercise. To learn more, discuss with your physical therapist, primary care physician, nutritionist or registered dietitian.

  • Fats - complex molecules formed primarily out of fatty acid chains. Fats have also seen their reputation tarnished in recent years with the advent of trend diets but their role in keeping us alive could not be more important. Fats play a role in the structure of human hormones, building cellular membranes, insulating the skin and viscera, and much more. The key with fats is in which types are consumed, where the generally accepted pattern is that saturated (animal fats, dairy fats, etc) have a propensity for storage as adipose tissue (body fat) and involvement in the process of atherosclerosis (clogging of arteries due to cumulative microscopic damage). Unsaturated fats (olive oil, nut products, avocado products, etc) tend to contribute more favorably to lipid (fat) profiles in the blood and assimilate into body structures other than adipose tissue more readily. This is not a rule, but a trend. To learn more, discuss with your physical therapist, primary care physician, nutritionist or registered dietitian.

  • Protein - if you have made it this far into the world of fitness and nutrition, there is no doubt you have heard a lot of information surrounding protein. At the most basic level, proteins are intricate molecules containing amino acids and vary in complexity. There are still types of proteins in the body being mapped out and matched to particular body functions, which is a testament to just how much we have to learn about the microscopic worlds inside each of us. Proteins have essential roles as enzymes (substances that facilitate certain chemical reactions in the body to drive physiological processes) and as major structural components to certain parts of cells. One of the most recognizable aspects of protein’s utility is in muscle tissue, where the complex of three distinct proteins (actin, troponin and tropomyosin) allow for voluntary muscle contraction. One important distinction to note here is that there must be some form of stimulus driving the process of muscle growth (hypertrophy) in the presence of protein molecules in order to build muscle mass to a noticeable degree. For example, one would not be able to build a muscular frame just by eating large amounts of protein while not performing the appropriate form of exercise that promotes muscle hypertrophy (remember the SAID principle!). To learn more, discuss with your physical therapist, primary care physician, nutritionist or registered dietitian.

To summarize the above information: to gain the most out of your exercise program, it is essential to make considerations for variables that will affect your performance. How hard you exercise (or how hard you perceive exercise to be), what foods you consume and how you aid your body in bouncing back from exercise will greatly influence the progress made. There is a great deal of depth on these topics and here we present an overview but if you are interested to know more, reach out to your physical therapist, primary care physician or registered dietitian. In our next post, more details about managing fatigue and selecting exercises will be highlighted. Until then – stay healthy, safe and happy!

- Dorian Campisi, PT, DPT

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