Strength training – how and why?

Lifestyle-associated diseases have massively overtaken infectious diseases as the biggest cause of illness and death in our society. Developments in medicine have greatly increased our lifespans, but this has coincided with the occupational demands of modern life being much less physical and more sedentary (commuting, computer work, etc.) for a large proportion of the population. The benefits of strength training extend way beyond stronger muscles. A few sessions per week can reverse the negative impacts on your health of a sedentary job.


Two 30-45 minute sessions per week are enough to significantly improve not just your physique but also your general health. There are many ways to approach this and tailored programming is specific to individual goals, but generally speaking, a good way to train is by doing 4 sets of 6-8 repetitions to a level of either high fatigue or muscular failure (inability to complete another rep), depending on your baseline fitness. Placing a demand on your musculoskeletal system beyond its normal capacity in this way stimulates strength adaptations.

Generally, you want a balanced program incorporating lower limb, trunk and upper limb exercises and a combination of pushing and pulling movements. This might include compound exercises such as squats, deadlifts, push ups, shoulder press and seated row and/or isolation exercises such as calf raises, knee extensions, hamstring curls, lateral raises and biceps curls – depending on your goals.


The benefits of strength training include reducing the risk of cardiovascular disease (heart attacks and strokes), obesity, diabetes, osteoarthritis, osteoporosis, cancer, musculoskeletal (back, knee and shoulder pain) and mental health issues. Lean muscle mass naturally declines over time after the age of 30, (approximately 3-5% per year), leading to increased body fat composition. Strength training reduces subcutaneous and visceral fat and improves lean muscle mass.

These processes happen through a broad range of mechanisms, but can summarised as the following:

Cardiovascular health: Strength training reduces resting blood pressure, type 2 diabetes, blood glucose and cholesterol levels, which are all known risk factors for cardiovascular disease. 

Obesity: Through EPOC (Excess Post-Exercise Oxygen Consumption) – in other words, increasing metabolism for 24 hours by 5-10% after training as your body is adapting, repairing and resynthesizing protein. In addition, improved muscle mass results in more energy output (a bigger motor needs more fuel).

Diabetes: There are two places where the body can store glucose from the bloodstream – the liver and skeletal muscles. Insulin is secreted by the pancreas to stimulate absorption of glucose from the bloodstream. Strength training results in increased insulin sensitivity, greater muscle mass (more storage capacity) and better clearance of glucose from the bloodstream.

Osteoarthritis: The three best things you can do for osteoarthritis prevention and management are reduce your weight (to a healthy range), improve your strength around the affected joints and exercise regularly. Joints can certainly be underloaded leading to reduced capacity and pain – and this is by far the most common cause of pain with arthritis. Contrary to popular belief that if it hurts – rest it, and that pain is structure-based, research is showing that pain in the early stages of arthritis is much more related to function than structure. By improving musculoskeletal function, pain is reduced in the vast majority of people.  

Osteoporosis: Bones are adaptable tissues just like muscles, and regular loading through strength training is the best way to stimulate stronger bones and reduce the risk of pain and fracture.

Cancer: Strength training reduces visceral fat, which secretes inflammatory and cancer-stimulating hormones (such as TNFα) producing a bodily environment conducive to cancer growth. Improved blood glucose levels are also associated with lower cancer risks, and improved muscle mass is also predictive of better cancer treatment outcomes.

Musculoskeletal pain: Musculoskeletal pain is produced by the central nervous system as a protective response against real or perceived dangers. Underloaded musculoskeletal tissues decline in their functional capacity and load tolerance, are then easily overloaded and pain responses are produced as a result. Strength training improves the functional capacity of muscles, tendons, bones and nerves, which in turn prevents overload and results in less musculoskeletal pain.

Mental health: Strength training results in a release of “feel-good” hormones (endorphins) and neurotransmitters (dopamine, serotonin) in your central nervous system. This results in improved self-esteem, cognitive function, improved energy levels, reduced stress, improved sleep, and more motivation. Strength training is a frontline conservative treatment for the prevention and management of depression and anxiety.

The best way to decide the optimal way to train is to consult a physiotherapist or strength and conditioning coach, who can help tailor an individualised program to meet your needs based on your training history, baseline fitness and fitness goals.

This article is for information only and should not be used for the diagnosis or treatment of medical conditions. myHealthSpecialist makes no representations as to the accuracy or completeness of any of the information in this article or found by following any link from this article. Please consult a doctor or other healthcare professional for medical advice.

Mr Daniel Zambon, Specialist Musculoskeletal Physiotherapist

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