When lifting weight has nothing to do with getting stronger
Several weeks ago I shared my experience with knee pain, which I believed was damage to my meniscus, and the effect of performing a Turkish get-up with a 40kg bell.
I had only recently purchased the 40kg ‘Bulldog’ so lifting it overhead was to be honest a little terrifying. From memory I’d only done it once or twice before hurting my knee. The only thing going through my mind was dropping it. Was I strong enough? How would I get out of the way (which I knew full well I couldn’t)? Would it wreck the floor (or more importantly me)?
Attempting a new PB Turkish get-up with a painful knee just sounds like a stupid idea and an accident waiting to happen, but I’m male and had a new toy and was going to do it regardless. My knee hurt before the lift and it hurt again after the lift but I wasn’t aware of any pain at all while perform the lift; ALL of my mental focus was on not being crushed. My knee didn’t enter my mind at all. Pain is like that.
Getting stronger is often an incidental effect of ‘strength training’ and not the main benefit or intended outcome.
‘Tissue’ encompasses muscle, tendon, ligaments, fascia and bone. When we apply a weight to the body, the stress of external load has a range of effects far beyond and more physiologically beneficial than simply increasing the structure’s ability to general force and tolerance load, although that in isolation is also a good thing.
The human body is designed to manipulate load and adapt to it in an active way; picking up an infant and sitting down into a chair, tripping and saving ourselves from a fall, hitting and catching a ball etc.
The co-ordinated recruitment of muscle against a load is an incredibly complex sequence of events yet we perform them subconsciously – bending down to the ground to pick up an object then lifting it overhead and placing it into a cupboard. Increasing the load increases the neuromotor demand substantially and focuses of attention.
The greater the load, the higher the perceived risk of danger and potential injury. If someone has back pain, they may also have a sense of fragility and fear associated with movement and developed a conditioned response to bending forward i.e. when it bends forward it hurts. The very thought of bending forward to pick up heavy load in this instance may cause pain and be so threatening to make the task impossible due to avoidance.
Pain can be a useful and necessary experience particularly in the presence of tissues damage, but it can often be emotionally and psychologically unhelpful and physically disabling.
The act of being able to bend forward, pick up a reasonably heavy load off the floor and lift it overhead is psychologically powerful. It can un-couple a disabling conditioned response, violating any expectation of increased pain, tissue damage and fear of movement or injury. Persistent disabling pain can quite literally disappear in an instant. Having the confidence and sense of safely to exposure ourselves to loading with tolerable pain can desensitise the movements associated with it.
Performing the same thing repeatedly increases tissue tolerance to load, resilience and a sense of robustness. We don’t just become physically stronger, we become mentally stronger. Having a structured, supervised program of training with load, using specific exercises for a specific effect is exercise-medicine. It costs nothing and has no serious side effects.
In addition to the beneficial structural, neuromotor and psychological changes, there are hormonal and cardiovascular benefits which decrease all-cause mortality.
This is why providing specific exercises for specific effect is the foundation of Physiotherapy.
Feeling physically competent and robust directly translates into other activities. Nobody needs to be able to swing a kettlebell or perform a Turkish get-up, but you can bet that if they can, it will certainly change their beliefs about resuming other activities which are more meaningful and important to them at work and at play.
Rehabilitating is not about fixing, but more about facilitating; focusing on what they can do and getting better at it, rather than what they can’t do. Being active, not passive. Being strong and adaptable changes what we do and how we do it.
In most cases, the solution to improving physical health is progressive loading and load management. It can be that simple.
This approach and the principles of loading are simple but humans are complex. A specific exercise for a specific exercise doesn’t suggest that anything needs to be “fixed” – that is rarely if ever the case. The human ecosystem is an incredibly plastic an adaptable organism. As Mick Thacker has recently indicated in podcast with Jack Chew, anything which has the potential to do good, also has the potential to do harm. The same can also be true of exercise (see earlier post about self-inflicted tendinopathy).
“Move every day for the pure joy of being alive”. Thomas Plummer
Lift something every day because it makes you better. “Soreness isn’t a terminal condition, and you aren’t that hurt. Stop spending so much time prehabbing and actually lift something!” Dan John
A weight is not impressive. People move heavy things poorly all the time – be careful when you blindly follow the masses; sometimes the ‘M’ is silent. Use kettlebells – skill is impressive. Chase that instead.
Hat tip to Erik Meira, Greg Lehman, Adam Meakins, and Jack Chew to name a few who make me smarter about loading.