ArticlePDF Available

Abstract

Many individuals perform Resistance Training (RT) as a part of their routine conditioning programs to increase muscular strength and/or hypertrophy. However, RT is often overlooked in its role in musculoskeletal injury prevention and rehabilitation. This is problematic in that RT results in many adaptations, such as an increased bone mass, lean mass and tensile strength that could aid in the prevention and rehabilitation of musculoskeletal injuries. The aim of this review is to demonstrate that RT should be considered an integral component, in any exercise program designed to prevent and rehabilitate musculoskeletal injuries. To date, most of the limited original studies, reviews and meta-analysis on RT and musculoskeletal injuries have focused on one particular intervention, injury type/location, sport or studied other relatively narrowly defined research questions, effectively not allowing for a full quantification of intervention effect estimates. This review demonstrated a dearth of literature regarding the role of RT in musculoskeletal injury prevention and rehabilitation. It also focuses on the preventive effect of several different forms of RT revealing novel and interesting information, enabling proposals for future directions in the field of musculoskeletal injury prevention and rehabilitation using RT. Findings of this review specifically indicate that while high-intensity strength-type resistance training plays an essential role in the prevention and rehabilitation of musculoskeletal injuries, more user-friendly forms of RT, such as hypertrophy RT and muscular endurance RT need to be examined. While this review advocates the role of RT in the prevention and rehabilitation of musculoskeletal injuries both for its safety and efficacy, further examination and quantification of specific RT exposures and a differentiation of acute and overuse outcome effect estimates is still lacking.
Gavin Publishers
Gavin Journal of Orthopedic Research and Therapy
Volume 2016; Pages 5
Shaw I et al.
1
www.gavinpublishers.org
Research Article
Keywords
Rehabilitation; Resistance training, Sports Injuries; Strength
training; Weight training
Introduction
Resistance Training’s (RT) benecial relationship to health
factors and chronic disease has been recognized only recently
[1,2]. Prior to 1990, RT was not a part of the recommended
guidelines for exercise training and/or rehabilitation for either
the American Heart Association or the American College of
Sports Medicine (ACSM) [3]. Many individuals now perform
RT as a part of their routine conditioning programs to increase
mainly muscular strength and hypertrophy [1,4]. Despite RT’s
proven ability to increase a multitude of physical parameters,
such as muscular strength, power, hypertrophy, and muscular
endurance, RT is oen overlooked in its role in injury
prevention and rehabilitation [5].
Review of the Role of Resistance Training and Muscu-
loskeletal Injury Prevention and Rehabilitation
Ina Shaw1, Brandon S Shaw1*, Gregory A Brown2 and Ardalan Shariat3
1Department of Sport and Movement Studies, University of Johannesburg, Doornfontein, Republic of South Africa
2Department of Kinesiology and Sports Sciences, University of Nebraska Kearney, Kearney, USA
3Department of Occupational Health, University Putra Malaysia, Selangor, Malaysia
Abstract
Many individuals perform Resistance Training (RT) as a part of their routine conditioning
programs to increase muscular strength and/or hypertrophy. However, RT is oen overlooked in its
role in musculoskeletal injury prevention and rehabilitation. is is problematic in that RT results
in many adaptations, such as an increased bone mass, lean mass and tensile strength that could
aid in the prevention and rehabilitation of musculoskeletal injuries. e aim of this review is to
demonstrate that RT should be considered an integral component, in any exercise program designed
to prevent and rehabilitate musculoskeletal injuries. To date, most of the limited original studies,
reviews and meta-analysis on RT and musculoskeletal injuries have focused on one particular
intervention, injury type/location, sport or studied other relatively narrowly dened research
questions, eectively not allowing for a full quantication of intervention eect estimates. is review
demonstrated a dearth of literature regarding the role of RT in musculoskeletal injury prevention
and rehabilitation. It also focuses on the preventive eect of several dierent forms of RT revealing
novel and interesting information, enabling proposals for future directions in the eld of
musculoskeletal injury prevention and rehabilitation using RT. Findings of this review specically
indicate that while high-intensity strength-type resistance training plays an essential role in the
prevention and rehabilitation of musculoskeletal injuries, more user-friendly forms of RT, such as
hypertrophy RT and muscular endurance RT need to be examined. While this review advocates the
role of RT in the prevention and rehabilitation of musculoskeletal injuries both for its safety and
ecacy, further examination and quantication of specic RT exposures and a dierentiation of
acute and overuse outcome eect estimates is still lacking.
*Corresponding author: Brandon S Shaw, Department of Sport and Movement Studies, University
of Johannesburg, Doornfontein, Republic of South Africa, Tel: +27 115596789; E-mail: brandons@
uj.ac.za
Citation: Shaw I, Shaw BS, Brown GA, Shariat A (2016) Review of the Role of Resistance Training
and Musculoskeletal Injury Prevention and Rehabilitation. Gavin J Orthop Res er 2016: 1-5.
Received: 26 April, 2016; Accepted: 18 May, 2016; Published: 01 June, 2016
Volume 2016; Issue 1 2
Citation: Shaw I, Shaw BS, Brown GA, Shariat A (2016) Review of the Role of Resistance Training and Musculoskeletal Injury Prevention and Rehabilitation.
Gavin J Orthop Res er 2016: 1-5.
While the utilization of RT for injury prevention is not
a new concept [6], many athletes, and health and tness
professionals still do not see RT as a necessary addition to an
injury prevention and/or rehabilitation workout plan [5].
While some clinicians do understand and incorporate RT for its
benets relating to injury prevention and rehabilitation, this
lack of emphasis on RT in a clinical setting has also resulted
in limited scientic evidence for RT’s eectiveness in injury
prevention and/or rehabilitation workout plans [5].
However, those few studies that have examined RT’s role in
injury prevention and/or rehabilitation, have conrmed that
the incorporation of RT in athletic training decreases the
risk and severity of injury [5]. Although injuries are never
completely unavoidable due to the physically demanding
nature of sports, there are ways to reduce the risk and severity
of such injuries by progressively increasing the tensile strength
of connective tissue. is includes injuries that are sustained
through contact situations such as tackles in American
football and rugby, and non-contact injuries which are oen
more preventable. Studies reporting the direct eect of RT on
injury prevention and/or rehabilitation are limited. However,
the physiological adaptations on bone, connective tissue and
muscle do imply enhanced protection against injury and re
injury for individuals engaging in RT [6].
Physiological adaptations to resistance training
Several adaptations to RT could aid in the prevention and
rehabilitation of musculoskeletal injuries. Specically, RT may
promote growth and/or increases in the structural integrity
of ligaments, tendons, tendon to bone and ligament to bone
junction strength, joint cartilage and the connective tissue
sheaths within muscle [5].
Decreases in muscle mass and subsequent reductions in
muscle strength not only results in a loss of functional ability,
but also increases the risk for musculoskeletal injury [7]. RT
programs may then reduce the risk for musculoskeletal injuries
related to muscle imbalance, expressed as either as a bilateral
comparison or an agonist to antagonist ratio. Correction of an
existing imbalance through a RT program is important in
reducing the individual’s risk for muscle injury [6].is agonist
to antagonist ratio constitutes an element of functional
specicity of a joint, but is subject to numerous factors of
variations such as the joint considered, dominance, sex, age,
physical activity, and velocity of movement. is ratio has been
supposed to constitute a clinical element in the functional
analysis of the joint, and provide either an index of the risk
of developing certain sports injuries, or a guide control in the
modalities of rehabilitation [8].
To date, there has been little research conducted on the
direct eect of RT on connective tissue adaptations. ose
studies that have done so have reported increases in both the
size and strength of tendons and ligaments [7]. In this regard,
tendons and ligaments have been shown to respond to RT by
increased metabolism, thickness, and strength [9]. In addition,
research demonstrates that damaged tendons and ligaments
regain strength at a faster rate when RT is performed aer
the damage has occurred [9]. Further, while collagen content
increases with training, comparisons between untrained
individuals and bodybuilders suggest that the increase in
collagen content is proportional to the increases in muscle size.
us, increases in muscle mass are likely met by increases in
the size and strength of the connective tissue [7], leading to an
increased tensile strength.
Studies involving humans and animal models have also
demonstrated that RT can cause increased bone mineral
content and therefore may aid in prevention of skeletal injuries.
Bone tissue has the ability to remodel and adapt to the physical
stresses imposed on it. In general, physically active individuals
have been found to be at a reduced risk for osteoporosis,
fractures or other ailments related to bone deterioration [7],
possibly as a result of an increased bone density and turnover.
Although bone will respond to many types of training
programs, studies demonstrate that exercise, such as RT and
those with high strain or impact such as running or jumping,
provide the greatest osteogenic eect [7].
Rationale for resistance training
RT provides a multitude of benets [10,11] and is
particularly benecial for improving the function of most
cardiac, frail, and elderly patients, who benet substantial-
ly from both upper- and lower-body exercise [10,12]. While
the introduction of RT for athletic performance, and general
health and tness are well known, the eect and mechanisms
of RT on musculoskeletal injury prevention and rehabilitation
has not yet been well documented.
With regards to musculoskeletal injury prevention, many
acute muscle strain injuries are thought to occur during the
eccentric phase of sudden, forceful muscle actions [13]. In
addition, repeated eccentric muscle actions during exercise are
also thought to contribute to microscopic muscle and tendon
damage, leading to chronic muscle strains, muscle rupture
and tendinopathy [13]. In terms of musculoskeletal injury
rehabilitation, trauma to the musculoskeletal system due to
injury or surgery oen leads to relative inactivity of the aected
area. is disuse then results in muscular atrophy and
weakness of the aected muscle groups [14], eectively
necessitating the need for strength RT and hypertrophy RT.
Previous studies suggest that a major benet of RT is learning
to coordinate the dierent muscle groups involved in the
training movement rather than intrinsic increases in strength of
the muscle group being trained [15], implying that coordinat-
ed muscles are capable of smoothly decelerating joint motions
even if the muscles themselves are relatively weak. e most
common cause of impaired neuromotor coordination is prior
injury. As a protection against further injury, the central
nervous system creates an alternate pattern of muscle
recruitment, referred to as a motor engram, to avoid stressing
the damaged so tissues [16]. If adequate rehabilitation does
3Volume 2016; Issue 1
Citation: Shaw I, Shaw BS, Brown GA, Shariat A (2016) Review of the Role of Resistance Training and Musculoskeletal Injury Prevention and Rehabilitation.
Gavin J Orthop Res er 2016: 1-5.
not take place, this motor engram then persists long aer
the injury has healed predisposing an individual to re injury.
In this regard, RT has been found to enhance motor neuron
excitability and induce synaptogenesis, both of which assist in
enhancing communication between the nervous system and
the muscles [17].
Specially, a study was undertaken of injury rate and time
lost to rehabilitation in a cohort of high-school athletes and
determined that all athletes utilizing RT as part of their exercise
program suered an injury rate of 26.2% compared to 72.4%
of those that did not [18]. In addition, the authors found that
the rehabilitation ratio (time lost to rehabilitation due to injury
per number of athletes performing in the studied group) was
2.02 days in those who utilized RT compared to 4.82 days for
those not engaging in RT. As such, that study demonstrated
fewer and less severe injuries in individuals engaging in RT. In
addition, those individuals engaging in RT were able to return
to sport much sooner.
Safety of resistance training
Several case study reports and retrospective questionnaires
have demonstrated that in many clinical and educational
contexts, RT is presumed to be dangerous [19]. However, there
is no convincing evidence that RT is particularly perilous, with
the majority of literature indicating that RT is markedly safer
than many other sports and exercise modes, especially when
supervised by qualied professionals [18]. Resistance training
is even considered both safe and benecial in the elderly [20],
and in those with low- (younger individuals, asymptomatic
with no more than 1 risk factor threshold) to moderate-disease
(older individuals with 2 or more risk factors) risk [21].
Types of resistance training
It is typically believed that high loads and low repetitions
are best to increase muscular strength, while lower loads and
higher repetitions are best to increase muscle endurance [7].
However, this over implication of RT program design, by not
only the general population but also by health professionals,
limits optimal physiological and physical adaptations [1]. As
RT encompasses a myriad of subtypes of exercise, it is essential
for clients, patients, and health and tness professionals to
understand and dierentiate between these subtypes as they
have dierent impacts on injury prevention and/or rehabilita-
tion [5]. In this regard, strength RT training requires training at
a load of 85% or more of one Repetition Maximum (1RM) for
6 or less repetitions of 2-6 sets with rest periods of 2-5 minutes,
power (single-eort) RT training requires training at a load of
80-90% 1RM performed at maximum speed for 1-2 repetitions
of 3-5 sets with rest periods of 2-5 minutes, power (multiple-ef-
fort) RT training requires training at a load of 75-85% 1RM
performed at maximum speed for 3-5 repetitions of 3-5 sets
with rest periods of 2-5 minutes, hypertrophy RT training
requires training at a load of 67-85% 1RM for 6-12 repetitions
of 3-6 sets with rest periods of 30 seconds to 1.5 minutes, and
muscular endurance RT training requires training at a load of
67% or less of 1RM for 12 or more repetitions of 2-3 sets with
rest periods of 30 seconds or less [22].
Prescription for patients with musculoskeletal
injury
While it appears that RT may have a signicant role in the
prevention and rehabilitation of musculoskeletal injuries, it
is also clear from the literature that there is no single optimal
design of RT for all populations and/or conditions [5].
Although RT programs using heavy weights yield high levels of
muscle activation, there may be a need for alternative types of
RT dependent on the individual, aims of the RT programme,
type of musculoskeletal injury, disorder, surgery and/or agonist
and antagonist muscle strength imbalances.
When designing musculoskeletal injury prevention and
rehabilitation programs, RT program design should focus
on all necessary RT subtypes. Muscle endurance RT training
will enhance a muscles’ ability to work repeatedly without
fatiguing and becoming injured/reinjured. In addition,
while heavy/strength RT exercises should be included in
musculoskeletal rehabilitation programs to induce sucient
levels of neuromuscular activation to stimulate muscle growth
and strength, even low-load (hypertrophy and muscle
endurance) RT can increase the elasticity of tendon-aponeuro-
sis structures [9]. Importantly, RT programs for the restoration
of connective tissue, such as ligaments should focus on
eccentric muscle actions [23], since eccentric actions generate
more tension, less waste products (and less chemical irritation
of nerves), and require lower oxygen consumption and lower
energy requirements than concentric work [24]. In recent years,
eccentric exercise has been used in rehabilitation to manage a
host of conditions, such as tendinopathies, muscle strains, and
in Anterior Cruciate Ligament (ACL) rehabilitation [24].
However, the collagen metabolism in healthy tendons seems
not to be aected by eccentric training [23], possibly limiting
eccentric training role in the prevention of connective tissue
injuries. In addition, where signicant muscle atrophy has
occurred as a result of injury or surgery, conventional
hypertrophy-RT should take place to restore muscle bulk [15].
Studies have also previously shown changes in muscle strength
following RT to be specic to the length and speed at which the
muscle has been trained [15].
Further, training isolated muscle groups may not be the
most eective way of increasing functional performance in an
attempt to prevent and rehabilitate musculoskeletal injuries as
the major adaptations are task-specic [15]. As such, health
and tness professionals should also make use of sport, cross
training and/or motion specic RT exercises as these may
reduce the incidence and recurrence of various types of
injuries, especially overuse injuries [6]. is is essential since
RT has been found to be the only modiable risk factor that
signicantly contributes to the incidence of sport injuries [25].
To further prevent injuries, health and tness professionals
should perform range of motion exercises to reduce muscle
Volume 2016; Issue 1 4
Citation: Shaw I, Shaw BS, Brown GA, Shariat A (2016) Review of the Role of Resistance Training and Musculoskeletal Injury Prevention and Rehabilitation.
Gavin J Orthop Res er 2016: 1-5.
tightness [26]. Prior to the implementation of RT musculo-
skeletal injury and rehabilitation programs, it is essential to
screen individuals for agonist and antagonist muscle strength
imbalances. is may assist the professional in identifying
those individuals possessing a predisposition for injury or
re-injury. Resistance training may then be performed to
correct the imbalance and therefore reduce the incidence of
injury or the recurrence of an earlier injury [6]. Specically,
Askling et al., [27] found that just one to two days weekly of
eccentric hamstring exercises for 10 weeks, works eectively, in
maintaining muscle group balance.
Further, in the case of musculoskeletal injury rehabilita-
tion, RT program design should be tailored to the appropriate
stage/phase of rehabilitation, namely early-phase, mid-phase
and late- or nal-phase [28]. In early-phase rehabilitation, the
aim is to progressively load the damaged tissue and restore its
tensile strength. As such, RT in this phase should take the form
of gentle exercises, such as muscle endurance RT, which allows
the damaged tissue to heal. Mid-phase rehabilitation should
involve progressively increasing RT load, in the form of strength
training, and diculty (from machines to free weights) to
progressively load the connective and bone tissue in an attempt
to develop tensile strength. is increased tensile strength
would then produce a healed tissue that will be able to
better withstand the stresses and strains of daily life, exercise
and sporting demands [28]. e Late- or nal-phase of
rehabilitation should focus on increasingly functional RT with
appropriate volume and intensity, whether it be hypertrophy,
strength or power RT, to ensure adequate tissue adaptation.
e aim of this phase is to eectively and eciently return to
activities of daily living, occupational demands and/or the
specic sport during which the injury occurred and it is
essential to perform RT exercises that replicate activities and
movements in that activity, occupation and/or sport [28].
Conclusion
To date most of the limited original studies, reviews and
meta-analysis on RT and musculoskeletal injuries have focused
on one particular intervention, injury type/location, sport or
studied other relatively narrowly dened research questions.
is is problematic in that although these studies demonstrate
RT may have an eect on musculoskeletal injuries, these
narrowly dened research studies do not allow for a full
quantication of intervention eect estimates. As such, while
this review advocates the role of RT in the prevention and
rehabilitation of musculoskeletal injuries both for its safety and
ecacy, further examination and quantication of specic RT
exposures and a dierentiation of acute and overuse outcome
eect estimates is still lacking.
References
1. Shaw BS, Shaw I, Brown GA (2015) Resistance exercise is medicine:
Strength training in health promotion and rehabilitation. Int J Ther Rehabil
22: 385-389.
2. US Department of Health and Human Services (1996) Physical activity and
health: A Report of the Surgeon General. Atlanta, GA: US Dept of Health and
Human Services, Centers for Disease Control and Prevention, National Cen-
ter for Chronic Disease Prevention and Health Promotion, USA.
3. Pollock ML, Franklin BA, Balady GJ, Chaitman BL, Fleg JL, et al. (2000) AHA
Science Advisory. Resistance exercise in individuals with and without cardio-
vascular disease: benets, rationale, safety, and prescription: An advisory
from the Committee on Exercise, Rehabilitation, and Prevention, Council on
Clinical Cardiology, American Heart Association; Position paper endorsed by
the American College of Sports Medicine. Circulation 101: 828-833.
4. Fleck SJ, Kreamer WJ (1997) Designing resistance training programs. 2nd-
edn, Human Kinetics, Champaign, IL, USA.
5. Shaw I, Shaw BS (2014) Resistance training and the prevention of sports
injuries. In: Hopkins G (ed.). Sports injuries: Prevention, management and
risk factors. Nova Science Publishers, NY, USA. Pg no: 123-136.
6. Fleck SJ, Falkel JE (1986) Value of resistance training for the reduction of
sports injuries. Sports Med 3: 61-68.
7. Hoffman J (2016) Resistance training and injury prevention. ACSM Current
Comment, IN, USA.
8. Calmels P, Minaire P (1995) A review of the role of the agonist/antagonist
muscle pairs ratio in rehabilitation. Disabil Rehabil 17: 265-276.
9. Kubo K, Kanehisa H, Miyatani M, Tachi M, Fukunaga T (2003) Effect of low-
load resistance training on the tendon properties in middle-aged and elderly
women. Acta Physiol Scand 178: 25-32.
10. Shaw I, Shaw BS, Brown GA, Cilliers JF (2010) Concurrent resistance and
aerobic training as protection against heart disease. Cardiovasc J Afr 21:
196-199.
11. Shaw BS, Shaw I, Krasilshchikov O (2009) Comparison of aerobic and com-
bined aerobic and weight training on low-density lipoprotein cholesterol con-
centrations in men. Cardiovasc J Afr 20: 227-232.
12. Billson JH, Cilliers JF, Pieterse JJ, Shaw BS, Shaw I, et al. (2011) Compar-
ison of home-and gymnasium-based resistance training on exibility in the
elderly. S Afr J Res Sport Phys Educ Recr 33: 1-9.
13. Pulla MR, Ranson C (2007) Eccentric muscle actions: Implications for injury
prevention and rehabilitation. Phys Ther Sport 8: 88-97.
14. Hart JM, Pietrosimone B, Hertel J, Ingersoll CD (2010) Quadriceps activation
following knee injuries: a systematic review. J Athl Train 45: 87-97.
15. Rutherford OM (1988) Muscular coordination and strength training. Implica-
tions for injury rehabilitation. Sports Med 5: 196-202.
16. Monls MH, Plautz EJ, Kleim JA (2005) In search of the motor engram: motor
map plasticity as a mechanism for encoding motor experience. Neuroscien-
tist 11: 471-483.
17. Adkins DL, Boychuk J, Remple MS, Kleim JA (2006) Motor training induces
experience-specic patterns of plasticity across motor cortex and spinal cord.
J Appl Physiol (1985) 101: 1776-1782.
18. Hamill BP (1994) Relative safety of weightlifting and weight training. J
Strength Cond Res 8: 53-57.
19. Faigenbaum AD, Myer GD (2010) Resistance training among young athletes:
safety, efcacy and injury prevention effects. Br J Sports Med 44: 56-63.
20. Latham NK1, Bennett DA, Stretton CM, Anderson CS (2004) Systematic re-
view of progressive resistance strength training in older adults. J Gerontol A
Biol Sci Med Sci 59: 48-61.
21. Shaw BS, Shaw I (2005) Effect of resistance training on cardiorespiratory
endurance and coronary artery disease risk. Cardiovasc J S Afr 16: 256-259.
22. Baechle TR, Earle RW, Wathen D (2008) Resistance training. In: Baechle TR,
Earle RW (eds.). Essentials of strength training and conditioning. (3rd edn),
Human Kinetics, Champaign, IL USA. Pg no: 381-412.
23. Langberg H, Ellingsgaard H, Madsen T, Jansson J, Magnusson SP, et al.
(2007) Eccentric rehabilitation exercise increases peritendinous type I colla-
gen synthesis in humans with Achilles tendinosis. Scand J Med Sci Sports
17: 61-66.
5Volume 2016; Issue 1
Citation: Shaw I, Shaw BS, Brown GA, Shariat A (2016) Review of the Role of Resistance Training and Musculoskeletal Injury Prevention and Rehabilitation.
Gavin J Orthop Res er 2016: 1-5.
24. Lorenz D, Reiman M (2011) The role and implementation of eccentric train-
ing in athletic rehabilitation: tendinopathy, hamstring strains, and ACL recon-
struction. Int J Sports Phys Ther 6: 27-44.
25. Boström A, Thulin K, Fredriksson M, Reese D, Rockborn P, et al. (2016) Risk
factors for acute and overuse sport injuries in Swedish children 11 to 15 years
old: What about resistance training with weights? Scand J Med Sci Sports
26: 317-323.
26. Cejudo A,Sainz de Baranda P, Santonja F, Ayala F (2016) Scanning proce-
dures and reference values in the range of motion of the hipathletes. A tool for
the prevention of injuries? Sport TK Revista Euroamericana de Cienciasdel
Deporte 5: 35-45.
27. Askling C, Karlsson J, Thorstensson A (2003) Hamstring injury occurrence in
elite soccer players after preseason strength training with eccentric overload.
Scand J Med Sci Sports 13: 244-250.
28. Mallac C, Joyce D (2015) The athletic knee. In: Joyce D, Lewindon D (eds.).
Sports injury prevention and rehabilitation: integrating medicine and science
for performance solutions. (1stedn), Routledge, London, UK. Pg no: 322-336.
... While it is clear that RT plays an important role in injury prevention and rehabilitation [54], it is also clear that there is no single optimal RT program for all sports yet to our knowledge. Thus, an appropriate training program should take into account the following variables: characteristics of the participants, the main aims of the program, and the type of injury to be prevented, as well as the muscle imbalances between agonists and antagonists [55]. Some researchers stress the importance of evaluating muscle imbalances between agonist-antagonists, as well as the same muscle groups at different extremities, with the aim of detecting athletes with a greater predisposition to injury [28]. ...
... On the other hand, although RT improvements in performance [72] and health [73] are well known, the effect and mechanisms of RT on injury prevention have not yet been well documented [55]. Having said this, it is impossible to avoid injuries completely, although there would seem to be ways of reducing the risk and severity of injuries by progressively increasing the tensile strength of the tissue [55]. ...
... On the other hand, although RT improvements in performance [72] and health [73] are well known, the effect and mechanisms of RT on injury prevention have not yet been well documented [55]. Having said this, it is impossible to avoid injuries completely, although there would seem to be ways of reducing the risk and severity of injuries by progressively increasing the tensile strength of the tissue [55]. However, the results obtained from this study failed to find any improvements in CORE and flexibility training, bearing in mind the existing confusing literature and the need for more studies that delve deeper into the different training systems of each content as well as the different injuries. ...
Full-text available
Article
Stand-up paddleboarding (SUP) is an increasingly popular sport but, as in other sports, there is an injury ratio associated with practicing it. In other types of sport, some factors have been linked to the likelihood of suffering an injury, among which stretching, core training and resistance training may be considered the most significant. Therefore, the main aim of this study was to identify the training factors that could influence injuries suffered by participants in international SUP competitions. Ninety-seven questionnaires were collected from paddlers who participated in an international SUP circuit, with epidemiological data being gathered about injuries and different questions related to the training undertaken. A multi-factor ANOVA test was used to identify the factors which influence the state of injury. Results showed that almost 60% of injuries occurred in the arms or in the upper thoracic region, around 65% of which were in tendons or muscles and, in almost half of cases, were related to overuse. Likewise, the results showed that athletes with injury performed fewer resistance training sessions per week (p = 0.028), over fewer months per year (p = 0.001), more weekly training sessions (p = 0.004) and, lastly, a greater volume of weekly training (p = 0.003) than athletes without injury. Moreover, the most important training factors that reduce the likelihood of suffering an injury were taken into account-in. particular, resistance training alone (p = 0.011) or together with CORE training (p = 0.006) or stretching (p = 0.012), and the dominant side of paddling (p = 0.032). In conclusion, resistance training would seem to reduce the likelihood of injury among SUP practitioners, and such benefits could be obtained by resistance training alone or in combination with CORE training or stretching.
... As shown in Table 3, except for two studies, only an older population was included. This finding suggests that the mentioned LP device with SSL stimuli may be a suitable alternative for the rehabilitation process, which is currently very complex, and strength training overall has its own place in the modern physiotherapy approach [26]. This finding has been documented by numerous research studies, such as the inclusion of strength training after total knee arthroplasty [27][28][29]. ...
Full-text available
Article
Background: The purpose of this scoping review was to analyze the evidence of acute and long-term effects of the application of leg-press strength training with or without serial stretch-loading stimuli on various biomechanical and physiological outcomes. Methods: This review was performed in accordance with PRISMA for Scoping Reviews recommendations, and two researchers independently searched the following databases: PubMed, Web of Science, Scopus, ScienceDirect, ProQuest, Cochrane, and Google Scholar. All studies that used unique leg-press device for testing, acute responses and long-term adaptation were included in this review, irrespective of the measured outcomes. A total of 13 studies were included in this review, with 5 focused on the testing capabilities of the device and acute training responses and 8 focused on the long-term adaptations in various physical and physiological outcomes. Results: Regarding the acute responses after leg-press strength training with or without serial stretch-loading stimuli, visible changes were observed in the muscle force, rate of force development, and hormonal concentrations between pre- and postmenopausal women (only one study). Long-term studies revealed different training adaptations after performing leg-press strength training with unique serial stretch-loading stimuli. A positive trend for leg-press strength training with serial stretch-loading was recorded in the young population and athletes; however, more variable training effects favoring one or the other approach were achieved in the older population. Conclusions: In summary, this review shows the uniqueness and usability of a leg-press device that is capable of various exercising modes, including special serial stretch-loading stimuli. The use of this device can serve as a positive addition to training regiments, and the main application appears to be suitable for rehabilitation needs.
... 34 For example, the positive muscular strength adaptations from heavy resistance training can protect bones, joints, and muscles when under stress/impact. 40 Prior research reported a significant reduction in MSKI risk for military personnel undertaking resistance training. 41 Ultimately, our recommendations for practice are to incorporate heavy resistance training with power exercises as part of traditional training in order to optimize physical performance and potentially reduce MSKI risk. ...
Article
Introduction Physical training is important to prepare soldiers for the intense occupational demands in the military. However, current physical training may not address all fitness domains crucial for optimizing physical readiness and reducing musculoskeletal injury. The effects of nontraditional military physical training on fitness domains have been inconsistently reported, which limits the design of the ideal training program for performance optimization and injury prevention in the military. The aim of this systematic review was to identify the effects of exercise training on various fitness domains (i.e., aerobic fitness, flexibility, muscular endurance, muscular power, muscular strength, and occupationally specific physical performance) that contribute to occupational performance and musculoskeletal injury risk in military personnel. Methods An extensive literature search was conducted in January 2021 and was subsequently updated in July 2021 and December 2021. Included studies consisted of comparative groups of healthy military personnel performing traditional and nontraditional military physical training with at least one assessment representative of a fitness domain. Study appraisal was conducted using the PEDro scale. Meta-analysis was conducted via forest plots, standard mean difference (SMD, effect size), and intertrial heterogeneity (I2). Results From a total of 7,350 records, 15 studies were identified as eligible for inclusion in this review, with a total of 1,613 participants. The average study quality via the PEDro score was good (5.3/10; range 4/10 to 6/10). Nontraditional military physical training resulted in greater posttraining values for muscular endurance (SMD = 0.46; P = .004; I2 = 68%), power (SMD = 1.57; P < .0001; I2 = 90%), strength via repetition maximum testing (SMD = 1.95; P < .00001; I2 = 91%), and occupationally specific physical performance (SMD = 0.54; P = .007; I2 = 66%) compared to the traditional group. There was no significant difference for aerobic fitness (SMD = −0.31; P = .23; I2 = 86%), flexibility (SMD = 0.58; P = .16; I2 = 76%), and muscular strength via maximal voluntary contraction (SMD = 0.18; P = .28; I2 = 66%) between training groups. Conclusions The current systematic review identified that nontraditional military physical training had a greater posttraining effect on muscular endurance, power, strength measured via repetition maximum, and occupationally specific physical performance compared to traditional military physical training. Overall, these findings suggest that nontraditional military physical training may be beneficial in optimizing occupational performance while potentially reducing musculoskeletal injury risk.
... The resistance exercise (RE) is an important method used for prevention, rehabilitation, maintenance of health, and quality of life, increasing practitioners' number, regardless of age or sex. (1,2) These individuals aim to achieve through RE benefits such as increased strength, muscle mass, and sports performance. (3) RE with high load training (HLT) appears as the most effective method for developing muscle strength, and, since the last two decades it has been a field of increasing research due your beneficial effects in health human. ...
Full-text available
Article
Background: Photobiomodulationtherapy with static magnetic field (PBMT/sMF) stands out for being a non-pharmacological resource with bioenergetic effects capable of accelerating muscle recovery, delaying muscle fatigue and potentiate gains in different training protocols. In recent years, blood flow restriction (BFR) associated with low load exercise (20-30% 1RM/MVC) has demonstrated positive effects on muscle performance. However, the effects of PBMT/sMF combined with BFR training are still unknown. Objective:Verify the effects of PBMT/sMF associated with BFR training and compared with high load training (HLT) in the muscle strength, muscle damage, inflammation, and the oxidative stress. Methods:This are a protocol of a randomized, double-blind, placebo-controlled clinical trial. Theparticipants will be healthy men between the ages of 18 to 40 years, with no practice in upper limb strength training in the previous three months. The voluntaries will be randomly divided into four groups: (1) PBMT/sMF + BFR;(2) PBMT/sMF + HLT; (3) placebo + BFR; (4) placebo + HLT. The PBMT/sMF will be applied immediately before strengthening protocol (4 sets x 20 repetitions of elbow flexion). The BFR groups will undergo to exercise with low load (30% of MVC), while the HLT groups will performed the same protocol with 80 % of MVC. The primary outcome will be muscle strength, measured in baseline, fourth, eighth week of training and detraining period. The secondary outcomes include measured the fatigue resistance, arm circumference, muscle damage, inflammatory and oxidative stress levels in one session, during, after intervention and detraining. Discuss:This trial will elucidate the effects of PBMT/sMF when when used in association with BFR training or HLT.Keywords:Phototherapy; Muscle performance; Occlusion vascular; Oxidative stress; Exercise
... Weight training is one type of training to increase the strength and size of the skeletal muscles, especially by using bars, dumbbells and other equipment. In general, weight training is needed for sports such as bodybuilding and weight lifting, but now it is used in many other sports, such as volleyball training to improve athlete performance and reduce the frequency and severity of injuries [26]. Physiologically intensive and high-performance training processes have the potential to cause negative effects. ...
... Weight training is necessary for sports like bodybuilding, weightlifting and powerlifting where strength, power, and/or muscle mass are necessary. It is used in many other sports, such as football, wrestling, and rowing, in order to increase the performance of athletes and reduce the frequency and severity of injuries [6]. Increased strength also improves the capacity to perform everyday tasks more easily. ...
... Weight (or resistance) training with bars, dumbbells and/or other equipment is necessary for sports like bodybuilding, weightlifting and powerlifting where strength, power, and/or muscle mass are needed. It is also used in many other sports, such as football, wrestling, and rowing, in order to increase the performance of athletes and reduce the frequency and severity of injuries [1]. Weight training has many benefits for non-athletes as well, since it can reduce the signs and symptoms of many diseases and chronic conditions [2,3]. ...
Full-text available
Article
Increases in strength and muscle mass can be achieved with weight training and adequate recovery (including nutrition and sleep). The time course of recovery and adaptation (super-compensation) for different number of sets has not been adequately investigated in the literature. A 40-year-old well-trained male exercised the chest with (a) 3 sets of bench press, (b) 5 sets of bench press, (c) 5 sets of bench press and 4 sets of dips, all to momentary concentric muscular failure during a 6 months body split program. The recovery was assessed by comparing the number of repetitions of the first bench press set to the previous training session. The results showed that with 3 and 5 sets to failure adaptation (+1 repetition) took place after 5 days. 9 sets needed 7 days for recovery and no adaptation took place. The adaptation was faster when exercising the chest without training the back and/or legs, indicating that Selye's adaptation energy (resources potential) might be applicable to weight training as well. Delayed onset muscle soreness (DOMS) and motivation (mood) were found to be useful indexes of recovery. Implications on training volume and frequency and how the findings can be applied in practice are discussed.
Article
Background — Musculoskeletal pain is one of the most common problem among office workers. The main reason is related to the long time spent sitting and the associated lack of physical activity. Musculoskeletal pain can affect not only their work-related performance, but also their personal performance and quality of life. Research has mainly focused on the effects of physical activity in managing musculoskeletal pain in office workers, while research is sparse pertaining to the possible role of mental imagery on reducing musculoskeletal pain in office workers. While mental imagery has only a minor effect on pain modulation in healthy individuals, its effect appears to be more pronounced in those with chronic pain. Aim — This commentary attempts to present beneficial mental imagery techniques that can be used solely or in combination with physical exercise in an office-based setting to improve musculoskeletal pain to enhance work performance and quality of life among office workers.
Article
Objectives Blood flow restriction training (BFRT) provides an alternative approach to traditional strength training. The purpose of this study was to determine differences in quadriceps muscle activation, subject reported pain, and perceived exertion between three exercise conditions: low-load resistance BFRT with (1) regulated and (2) standardized devices, and (3) high-load resistance exercise without BFRT. Design Randomized cross over study Setting XX University Biomechanics laboratory Participants Thirty-four healthy subjects (18 male/16 female) each completed three randomized sessions of knee extensions using Delfi’s Personalized Tourniquet System (R) at 30% of 1 repetition maximum (1RM), the B-Strong™ device (S) at 30% 1RM, and high-load resistance exercise (HL) at 80% 1RM. Main outcome measures Quadriceps EMG activity, numeric pain rating scale (NPRS), and perceived exertion (OMNI-RES) were recorded. Results Average and peak EMG were greater in HL sessions than both S and R (p < .001). NPRS was greater in the R sessions compared to both S (p < .001) and HL (p < .001). OMNI-RES was greater in the R sessions compared to S (p < .02) and HL (p < .001). No differences (p > .05) in average or peak EMG activation were found between S and R sessions. Conclusions Quadriceps EMG amplitude was greater during high-load resistance exercise versus low-load BFR exercise and there were no differences in EMG findings between BFRT devices.
Full-text available
Article
Aging results in a natural loss of flexibility, which is especially essential in the maintenance of functional abilities of the aged to perform activities of daily living. Resistance training may provide a stimulus for flexibility, in addition to its extensive health benefits, since its action is through a full range of motion. The purpose of this study was to compare the effects of a home- and gymnasium-based resistance training programme on flexibility in the elderly. Forty-nine inactive elderly males and females aged 55 to 85 years were assigned to either an eight-week, three times weekly home- (HB) (n=25) or a gymnasium-based (GB) (n=24) resistance training programme at a rating of perceived exertion of 11 to 12 (very mild discomfort). Both groups were equally effective at significantly (p<0.05) increasing right shoulder flexion, right shoulder extension, left and right internal rotation, left and right external rotation, and left and right hip flexion. This study demonstrates that a home- or gymnasium-based programme can improve flexibility and allow the elderly to maintain functional ability and lead independent lives.
Full-text available
Article
The benefits of aerobic training in health promotion are well documented, and this mode of exercise training continues to be the gold standard for health professionals when prescribing exercise programmes. However, resistance training has a wealth of unique benefits over those of aerobic training. It is these unique benefits that demonstrate the necessary role of resistance training in health promotion. The aim of this article is to demonstrate that resistance training is equally, and in some cases superior, to aerobic training in its health-promoting benefits, such as the increasing and/ or maintenance of lean body mass and bone mineral density. As such, resistance training should be considered an integral component, along with aerobic and flexibility training, in any exercise programme designed to promote health in all populations. However, it is essential for health professionals to understand and differentiate the subtypes of resistance training as these have different impacts on sports performance, health promotion and rehabilitation.
Full-text available
Chapter
It is generally accepted that regular scientifically-designed resistance training programs result in numerous benefits in both competitive and recreational athletes including improvements in muscle strength and power, increases in muscle size all leading to improvements in sports performance. In addition, resistance training has also been suggested to reduce the risk for musculoskeletal injuries or even reduce the severity of such injuries in athletes. In this regard, resistance training can strengthen muscles, bones and connective tissue making them less susceptible to damage and more able to withstand the demands of sport and physical activity. Although studies reporting the direct effect of resistance training on injury rate reduction are limited, the physiological adaptations seen consequent to resistance training on muscles, bones and connective tissue does imply enhanced protection against musculoskeletal injuries. Reducing the incidence of injury by engaging in a resistance training program is as beneficial for the non-competitive beginner as it is for the competitive athlete. Thankfully, many competitive and recreational athletes already perform resistance training as a part of their usual conditioning programs. However, there is an increasing need to engage in resistance exercises that reproduce the performance of the sport and/or motion specific activities. These specific types of resistance exercise should also be performed following the testing of athletes for agonist and antagonist muscle strength imbalances as such data can be utilized to identify athletes with a predisposition for injury. In these cases, resistance training may then be performed to correct the observed imbalance and hopefully reduce the incidence and/or severity of future injury. While evidence suggests that a targeted resistance-based approach can prevent musculoskeletal injuries or even reduce the severity, recent evidence suggests that resistance can also be utilized to accelerate recovery from such injuries and is increasingly being used in this role as an excellent alternative method of rehabilitating sports injuries. However, it must be noted that the improper execution of resistance exercises can themselves be cause for injury, especially in the youth. As such, resistance-focused workouts should be performed with proper form and technique or under the supervision of qualified and certified trainers. In conclusion, despite the old belief of resistance training being ineffective and unsafe, resistance training has been shown to decrease sport injuries and their severity, rehabilitation time relative to non-resistance trained individuals and should be considered as an important component to include in any fitness or sport-performance program, even in the youth due to their ever- lengthening and increasingly earlier competitive careers.
Full-text available
Article
The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction.
Full-text available
Article
This study was designed to compare the effects of aerobic and concurrent aerobic and resistance training on their ability to slow the rate of development and progression of coronary heart disease (CHD) in young adult males at low risk, as determined by the Framingham risk assessment (FRA) score. Subjects were assigned to 16 weeks of three-times weekly aerobic training (AT) (n = 13), concurrent aerobic and resistance training (CART) (n = 13) or no exercise (NO) (n = 12). Both AT and CART resulted in significant (p < 0.05) changes in total cholesterol (from 173.67 ± 29.93 to 161.75 ± 26.78 mg.dl(-1) and from 190.00 ± 38.20 to 164.31 ± 28.73 mg.dl(-1), respectively), smoking status (from 12.25 ± 5.08 to 10.33 ± 5.37 cigarettes per day and 12.00 ± 4.71 to 8.77 ± 5.10 cigarettes per day, respectively), high-density lipoprotein cholesterol (from 47.00 ± 11.85 to 57.50 ± 5.99 mg.dl(-1) and 34.00 ± 8.53 to 46.77 ± 14.32 mg.dl(-1), respectively), systolic blood pressure (from 126.17 ± 7.00 to 122.33 ± 3.17 mmHg and 131.54 ± 9.28 to 121.69 ± 7.87 mmHg, respectively) and therefore FRA score (from 3.58 ± 2.19 to 1.33 ± 2.27 and 5.77 ± 3.09 to 2.46 ± 2.90, respectively). Both modes of exercise were found to be equally effective in reducing CHD risk. These findings support the inclusion of resistance training into an aerobic training programme to lower CHD risk, which will afford subjects the unique benefits of each mode of exercise.
Article
To determine the 1-year self-reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross-sectional study was defined as a sport-related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48-51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50-55% vs 46%, 95% CI 43-48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport-related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Article
Many acute muscle strain injuries are thought to occur during the eccentric phase of sudden, forceful muscle actions. Repeated eccentric muscle actions during exercise are also thought to contribute to microscopic muscle and tendon damage, leading to chronic muscle strains, muscle rupture and tendinopathy. Conversely, eccentric training has been demonstrated to have a positive effect in the prevention of muscle damage and injury. The properties of eccentric muscle actions which lead to this protective effect remain to be elucidated but are thought to include cellular, mechanical and neural adaptations. This clinical commentary is an attempt to analyze the potential role that eccentric training may have in both the contribution to and prevention of muscle injury by exploring the effect of various parameters on muscle structure and function. Guidelines as to the appropriate design of eccentric training programmes are also provided.
Article
This paper discusses statistics derived from surveys and competitions. Analyses of previous publications and comparative data from other studies appear to contradict a general view that weight training is safer than weightlifting, when the latter is defined according to the International Weightlifting Federation's rulebook. Both activities appear to be safer than many other sports. The age group considered is largely school age. (C) 1994 National Strength and Conditioning Association