By Jon Stavres MS, ACSM-EP-C
Previously we discussed the benefits and the importance of resistance training following a cardiac event. However, that may have left readers with the question of how exactly to set up a resistance training program, and how do so safely. We are going to review just that.
What are your goals?
The first thing to do, when designing a resistance training program, is to identify what your goals are. Goals can include nearly anything, and will vary greatly between different people. A farmer who recently had a heart attack may have the goal of returning to harvest his crops while a preschool teacher who had a heart attack may have the goal of being able to stand and walk all day again. To achieve these different goals require different programs.
Let’s assume we are designing a program for a retired grandparent whose goal is to remain independent and stay active with their grandchildren.
We would focus on “functional” exercises. These are exercises which use multiple joints, and are relatable to movements that might be performed in everyday life (activities of daily living, or ADL’s). Using these functional exercises allows a person to increase their strength, endurance, and performance during specific movements or tasks. This is referred to as “specificity,” and is used in settings ranging from rehabilitation to athletics. Now that we know what our goals are, and what type of exercise can be used to help achieve those goals, we need to identify limitations.
What are your limitations?
There can be a number of limitations to resistance exercise for a person recovering from a cardiac event. Some examples include:
Restriction of upper body exercise for 8-12 weeks for a sternotomy (after any kind of open heart surgery)
Limited blood oxygen supply in those suffering from congestive heart failure
Musculoskeletal restrictions that will limit range of motion
Understanding these limitations allow you to design your strength training program safely. This does not mean that you can’t exercise, even in the case of limited blood oxygen supply. Instead, these are things that need to be worked around.
In the instance of a sternotomy, the patient would avoid upper body exercise until the wound is healed. Once the wound is healed, the patient can then begin that type of exercise. It is very important to know your limitations when designing a program, but also very important to not let those deter you from beginning a program. Now that we know our goals, limitations, and what types of exercises to use, we can review some safety tips for strength training.
What are the safety tips for resistance training?
One of the most common issues that people who are new to strength training have is breathing properly during exercise. Each type of resistance- based exercise has 2 phases, or contractions. There is a “concentric” phase, and an “eccentric” phase.
The concentric phase is when the weight is moved by the muscle (the upward part of an arm curl), and the eccentric phase is when the weight is returned to the starting position (the lowering part of an arm curl).
To properly breath during a repetition, you want to breathe in during the eccentric (lowering) phase, and breathe out during the concentric (upward) phase. You also want to breathe slowly and steadily, and most importantly avoid holding your breath. Holding your breath is called a Valsalva maneuver, and causes lightheadedness and increased blood pressure.
Another thing to avoid is using over-head free weight. Even though you may be cleared to exercise and haven’t experienced any form of dizziness yet, there is still a risk that you could experience a dizzy spell and drop those weights. Instead, use resistance bands, medicine balls, and other non-free weight type exercises. Creativity is the key when designing these types of programs.
Finally, you will want to perform your strength exercises 2-3 times per week, and separate each session by 48 hours. This way you are not likely to overwork the same muscle groups. In summary, you want to design a resistance training program that will be specific to your goals, work around your limitations, effectively, and safe.
**Always consult with your physician or healthcare provider before starting any exercise program.
*For examples of other variations/exercises look under Multimedia-VDF Exercise Tip
**Jonathon Stavres MS ACSM-EP-C is a guest contributing writer. He is a doctorate student in the Exercise Science/Exercise Physiology dept. at Kent State University
Pescatello, L. S., Arena, R., Riebe, D., & Thompson, P. D. (2014).ACSM’S guidelines for exercise testing and prescription. Baltimore, Maryland: Lippincot & Wilkins