Back Clinic Power & Strength Training. These types of conditioning programs are for both athletes and the general population. They can reach higher levels of personal power and strength, making them capable of achieving their personal fitness goals. Power is defined as the ability to generate as much force as fast as possible. It’s needed for athletic movements such as workouts (clean & jerk), swinging a bat, golf club, tennis racket, and running through a tackle.
Power requires strength and speed to develop force. Strength is the amount of force muscle/s can exert against an external load. One rep maximum test is performed where individuals assess the greatest weight they can lift while maintaining proper form. The movement’s speed is not important in a strength test. Dr. Alex Jimenez offers insight into various stretches and exercises and explains the possible risks of injury on strength training through his numerous article archives.
Today, more than ever, individuals are less physically active and sitting down for more extended periods causing the gluteus muscles to be used less and weaken. Weak, inactive, or tightening glutes can cause instability in the lower spine, the hips, and the pelvis to shift out of alignment. This leads to low back and buttock pain. The pain is constantly dull, aching, pulsating, then when moving, getting up, it throbs and stings. Gluteal strengthening exercises can strengthen the muscles and alleviate the pain.
Gluteal Strengthening
Every individual has a unique physiology. The body develops asymmetrically as the individual favors one side or area of the body over another. This can cause imbalances in the muscular system, leading to awkward positioning that causes pain. The muscle groups that support the lower back consist of the:
Core muscles
The gluteal muscle group includes:
Gluteus Maximus
Gluteus medius
Gluteus minimus
Pelvis muscles
Hamstrings
Quadriceps
In some cases, the development or lack of level of an individual’s upper back strength can also affect the amount of strain on the lower back.
Gluteal Strengthening Difference
Many joints connect in this area that can have functional problems. The muscles within the lower back need:
Stretching allows the body to enhance the limits of its flexibility and mobility. Most of the stretches are involve the hip joint, as this is one of the most effective ways to loosen the gluteal regions. It’s essential to warm the muscles slightly with a light activity while stretching them to elongate naturally.
Seated Figure 4 Stretch
Sitting in a chair.
Cross the right leg over the left.
With the right ankle resting on the left knee.
It should resemble the number 4.
Bend forward at the hip, placing slight pressure onto the left leg.
Hold this stretch for ten-twenty seconds.
Stretch the other side.
Placing the left foot on the right knee.
Repeat this three times.
Downward Dog
This yoga pose engages all the muscles along the back. With the glutes at the top in this position, it forces them to activate, allowing them to stretch fully.
Hold this pose and focus the attention on the glutes.
Squats naturally engage the glutes. This is a variation on a squat that focuses on developing gluteal strength.
Stand with the back facing the wall.
Place a Swiss stability ball between the wall and the back.
Lean back into the ball for balance.
Lower the torso until the knees reach 90 degrees.
Return to standing.
Repeat for ten reps.
Do three sets.
Body Composition
Analysis An Effective Tool
Opportunities to increase physical activity lead individuals in a positive direction. The most common reason for reducing and stopping healthy changes is a lack of motivation and feedback. Strategies that provide immediate feedback are essential to:
Monitor progress for establishing a baseline.
Set appropriate and attainable goals.
Track changes over time.
Ensure success.
Monitoring changes with a simple weight scale or Body Mass Index calculator provides limited ability to accurately track changes that only highlight weight changes and not track progress in muscle gain or fat loss. In less than 45 seconds, the InBody Test provides doctors, trainers, and physical therapists with easy-to-understand, accurate and objective measurements to evaluate body composition that includes:
Assessing muscle distribution.
Target areas weakened by condition or injury.
Identify muscle and fat imbalances in each area of the body.
Monitor changes to determine the efficacy of the treatment plan, exercise program, and diet plan to ensure long-term success.
References
Akuthota, Venu et al. “Core stability exercise principles.” Current sports medicine reports vol. 7,1 (2008): 39-44. doi:10.1097/01.CSMR.0000308663.13278.69
Distefano, Lindsay J et al. “Gluteal muscle activation during common therapeutic exercises.” The Journal of orthopedic and sports physical therapy vol. 39,7 (2009): 532-40. doi:10.2519/jospt.2009.2796
Glaviano, Neal R et al. “Gluteal muscle inhibition: Consequences of patellofemoral pain?.” Medical hypotheses vol. 126 (2019): 9-14. doi:10.1016/j.mehy.2019.02.046
Jeong, Ui-Cheol et al. “The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients.” Journal of physical therapy science vol. 27,12 (2015): 3813-6. doi:10.1589/jpts.27.3813
Macadam, Paul et al. “AN EXAMINATION OF THE GLUTEAL MUSCLE ACTIVITY ASSOCIATED WITH DYNAMIC HIP ABDUCTION AND HIP EXTERNAL ROTATION EXERCISE: A SYSTEMATIC REVIEW.” International Journal of sports physical therapy vol. 10,5 (2015): 573-91.
Regularly doing planks can support/strengthen the spine and prevent back pain no matter the fitness level. It’s estimated that 70% of adults will experience back problems and pain. One of the best ways to keep the spine healthy is by strengthening the core muscles. The more these muscles are built up, the healthier the body will become. The plank position activates the entire core taking the pressure off of the spine.
Core Anatomy
The core is the center of the body. It contains all the muscles surrounding the torso. These muscles work together to:
Stabilize the body during movement.
Prevent injury when engaged in physical activity/exercise.
Provide spinal support.
The core is split into two groups of muscles: The inner core and the outer core.
The deep abdominal muscle in the lower back sits on either side of the lumbar region of the spine.
Transversus Abdominis
Located between the lower ribs and the top of the pelvis.
Pelvic Floor
This base group of muscles stretches from the tailbone to the pubic bone.
Diaphragm
A dome-shaped muscle that rests below the lungs.
Outer Core
Rectus Abdominis
These are more commonly known as the abs.
External Obliques
These muscles are located on either side of the rectus abdominis.
Internal Obliques
These muscles are located below the external obliques, inside the hip bones.
Erector Spinae
These muscles surround the spine and extend up both sides of the vertebral column.
Planks and Back Pain Prevention
When the core is not strong enough, the spine and back muscles overcompensate to keep the body standing correctly. Studies have shown how planks effectively activate the muscles responsible for spinal stabilization. The exercise targets the entirety of the core and strengthens the shoulders and glutes. Strengthening these muscles improves posture, helping to alleviate back problems and pain. However, it’s recommended to talk to a doctor before beginning a plank regimen if back pain is present. If done incorrectly, they could aggravate the back muscles.
Proper Form
Choose an area clear of furniture where the whole body can stretch out. Follow these steps:
Begin with hands and knees on the floor.
Extend the legs back while keeping the elbows directly below the shoulders and the wrists below the elbows.
Keep the head down, looking at the space just above the hands.
Engage the abs and keep the body rigid.
Imagine a perfectly straight line from the neck to the toes.
Hold the position for 10 to 60 seconds, depending on fitness level.
Lower the body gently to the floor.
Make sure not to curve the back as curving means that the abdominal muscles are being engaged, and tilting the head up can strain the neck.
Both can lead to injury, which is why maintaining proper form is essential.
Plank Variations
There are variations of this exercise for different levels of physical fitness. Once the modified and full plank has been mastered, various planks can target other areas of the body. These include:
Side Plank
These involve shifting the weight to one forearm while extending the other arm into the air.
One-arm Plank
These involve lifting one hand off the ground, then alternating.
Anybody can work up to a plank at any age at any fitness level; it just takes time. Once achieved, it is a great way to keep the body’s core strong, healthy and helps prevent back problems.
Body Composition
Band Lateral Raise
The lateral band raise is an excellent workout for the shoulders. It works out the lateral deltoid, anterior deltoid, and serratus anterior.
Grasp one band in one hand.
Step on the free end with the opposite foot.
Right hand and left foot and vice versa.
Slowly extend and raise the arm until they are parallel to the floor.
Lower the arms in the same manner.
If the shoulders are healthy and strong enough, try adding dumbbells or kettlebells to increase the resistance.
References
Calatayud, Joaquín et al. “Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain.” International journal of environmental research and public health vol. 16,19 3509. 20 Sep. 2019, doi:10.3390/ijerph16193509
Youdas, James W et al. “Magnitudes of muscle activation of spine stabilizers in healthy adults during prone on elbow planking exercises with and without a fitness ball.” Physiotherapy Theory and practice vol. 34,3 (2018): 212-222. doi:10.1080/09593985.2017.1377792
Many individuals are trying to get fit and stay active through physical activity and exercise. Getting back to a previous fitness routine is an achievable and realistic goal. Fitness means having the energy and strength to perform physical activity and the body feeling as good as possible. Getting fit improves total health. But it does not require training like an athlete. Just walking for a half-hour every day can help individuals reach an adequate fitness level that helps them feel better and increase energy levels.
Benefits of Getting Fit
Getting the body fit and in shape:
Increases endurance
Increases muscle strength
Delivers oxygen and nutrients to tissues
Improves cardiovascular health
Helps release toxins
Improves overall energy levels
Improves sleep
Handle stress better
Being fit allows the body to work harder without as much work, the mind is better focused, the body burns more calories, even when at rest, and proper weight is maintained. Fitness reduces the risk of falls, heart attack, diabetes, high blood pressure, and certain cancers.
How Much Physical Activity Is Needed?
Experts say the goal should be one, or a combination, of these:
Moderate aerobic activity, like brisk walking, for at least 2½ hours a week.
It is up to the individual how many days to exercise, but it is best to be active at least three days a week.
Activity is recommended at least 10 minutes at a time. For example, an individual could:
Take a 10-minute walk three times a day, five days a week.
Take a half-hour walk three days a week.
On the other four days, take a 15-minute walk.
Take a 45-minute walk every other day.
Vigorous exercise is recommended at least three days a week for at least 10 minutes at a time. This activity makes the body breathe harder and increases heart rate. More vigorous activities, like running, could be included for at least one hour a week. This can be spread out 75 minutes, whichever way is more convenient for the individual. For example, an individual could:
Run for 25 minutes 3 times a week.
Run for 15 minutes 5 times a week.
Children as young as preschool age need activity as well. Encourage children ages 6 to 17 to engage in moderate to vigorous exercise for at least 1 hour every day.
Types of Physical Activity
Aerobic fitness
This makes the body breathe faster and makes the heart work harder.
Activities include walking, running, cycling, and swimming.
It is also known as cardio or cardiovascular training.
Muscle fitness
Muscle strength means building stronger muscles and increasing the length of time they can be used.
Activities like weight lifting, push-ups, squats, and resistance bands can improve muscular fitness.
Flexibility
Flexibility is the ability to move the joints and muscles through their full range of motion.
Moderate physical activity is safe for most individuals, but it’s recommended to talk to a doctor before engaging in physical activity/exercise. To help get started:
Make physical activity part of everyday
Make a regular habit of using stairs, not elevators, and walking, bicycling to do errands near home.
Start walking
Walking is a great fitness activity that most individuals can do.
Make it a habit to take a daily walk with family, friends, coworkers, or pets.
Find a workout partner
Working out with a partner can make exercising more enjoyable.
Find fun activities that you can stick with
Vary activities, so they don’t become boring and monotonous.
Use a calorie-burning application to determine how many calories are burned during exercise and daily activities.
Body Composition
Damaged Collagen
There are several reasons the body’s collagen production can slow down or become less efficient. The quality of the collagen made can decrease as well. Environmental factors can be avoided to protect collagen production; however, damage from disease and natural processes is inevitable. Aging is the most common cause of decreased natural collagen. As the body ages, collagen production and quality decrease. This leads to thinner, more fragile skin and achy joints. Certain chronic diseases like lupus and rheumatoid arthritis cause collagen deficiency, leading to issues that include:
UV exposure can accelerate the average rate of collagen damage that comes with aging.
UV exposure damage can also play a role in certain skin cancers.
Excessive sugar and fat intake increases inflammation and decreases protein synthesis.
References
American College of Sports Medicine, et al. (2009). Position stand: Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41(7): 1510–1530.
Anspaugh DJ, et al. (2011). Building muscular strength and endurance. Wellness: Concepts and Applications, 8th ed., pp. 111–137. New York: McGraw-Hill.
Centers for Disease Control and Prevention (2004). Strength training among adults aged 65 or older. MMWR, 53(2): 25–28.
U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: www.health.gov/paguidelines/guidelines/default.aspx.
Williams MA, et al. (2007). Resistance exercise in individuals with and without cardiovascular disease: 2007 update: A scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation, 116(5): 572–584.
Walking for a healthy back. This simple form of exercise can:
Trim the waistline.
Elevate mood.
Reduce the risk of chronic disease.
Improve back health.
Chiropractors recommend walking because of the ease of the workout and the health benefits it provides. It is a simple, low-impact exercise that can significantly improve the body’s overall health in a short amount of time. It improves back health by:
Strengthening the muscles that support the spine.
Improves posture.
Facilitates strong circulation.
Improves bone strength.
Walking For A Healthy Back
Strengthens Muscles
Walking engages all of the muscles which keep the body upright, including the core, leg, and back muscles. Muscle strength increases, providing optimal support of the spine.
Optimize Bone Health
Bone is living tissue like the muscles, and exercise stimulates bone the same way as muscle, gradually increasing strength.
Studies have found that walking improves bone density and reduces bone loss.
Poor posture is one of the most common reasons why individuals have back pain.
Poor posture affects mobility and places a significant amount of strain on the back.
Walking a few times each week engages and strengthens the back muscles keeping the body straight.
Reduces Weight
Many individuals have lower back pain that is caused by excess weight.
The added weight causes the front of the body to shift forward, placing additional strain on the lower back.
Walking reduces the load on the lower back.
Improves Flexibility and Range of Motion
Combined with stretching, walking improves flexibility and range of motion, making it easier to perform everyday activities reducing the risk of back injuries.
Improves Circulation to the Spinal structures
Walking improves blood circulation, delivers nutrients to the soft tissues, and removes toxins.
Added Benefits include:
Stress relief.
Better sleep.
Improved skin tone.
Lower risk of diabetes.
Reduced risk of depression.
Improved cardiovascular health that lowers the risk of:
High blood pressure.
Heart disease.
Stroke.
Before Exercising
Before beginning an exercise program, it’s essential to consult a doctor or chiropractor for individuals that have not exercised for a while or are dealing with underlying condition/s. They will educate and recommend how much exercise is appropriate given their current fitness level and overall health. To maximize the benefits of walking and prevent injuries:
Use High-Quality Tennis or Walking Shoes
Walking is much more enjoyable and safer when the body is comfortable.
Improving comfort levels is by using a pair of high-quality walking shoes or trainers.
They will provide proper support, cushioning, and adequate traction.
Maintain Proper Posture
Stay aware of body position when walking. A few key points to keep in mind:
Place the heel down first.
Then roll through each part of the foot, ending on the point of the toes.
Keep the shoulders back and head up.
Lift from the hips to reduce the impact on the lower joints.
Keep a slight bend in the arms and smoothly swing them back and forth.
Turn Walking Into a Healthy Habit
In the beginning, aim for at least 5 to 7 walks each week that last 25 minutes.
Speed does not matter as the objective is to get out and walk.
Once walking starts turning into a healthy habit with improvements in health, then start walking faster and longer.
Interval Walking
Interval walking involves short periods of high-intensity walking followed by alonger period of slow walking.
This increases cardiovascular fitness and muscle strength.
Begin with a 1-minute interval of fast walking.
This is followed by 2 minutes of slower walking.
Take On Easy Obstacles
Makes the walks more challenging by walking up or down a hill.
They will help strengthen the arms, shoulders, and upper back.
Body Composition
Building Lean Body Mass
Lean Body Mass is the body’s total weight minus the fat. This includes all the weight of the muscles, organs, and total body water. The best way to develop muscle and Lean Body Mass is to adopt a resistance training program. As stronger muscles are developed, the size and amount of the muscle cells increases. The muscles then require more intracellular water, which allows them to function at optimal levels. As the muscles grow and take in more water, Lean Body Mass increases.
References
Morris, J N, and A E Hardman. “Walking to health.” Sports medicine (Auckland, N.Z.) vol. 23,5 (1997): 306-32. doi:10.2165/00007256-199723050-00004
Nauman, Javaid et al. “Walking in the Fast Lane: High-Intensity Walking for Improved Fitness and Health Outcomes.” Mayo Clinic proceedings vol. 94,12 (2019): 2378-2380. doi:10.1016/j.mayocp.2019.10.020
Vanti, Carla et al. “The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials.” Disability and rehabilitation vol. 41,6 (2019): 622-632. doi:10.1080/09638288.2017.1410730
Kettlebell training for the back muscles and back pain prevention can be part of a recommended treatment plan. When experiencing low back pain, many sports medicine experts recommend kettlebell exercise to strengthen the core and posterior chain. However, if not used correctly, kettlebell exercises can worsen back pain.
Kettlebell
They are made of cast iron or steel and are named for resembling a tea kettle with an oversized handle. They can be used in one and two-handed movements.
Exercises and Movements for Back Pain
For individuals that are not experiencing back pain, kettlebell training can be excellent for maintenance and injury prevention. They strengthen the core and back muscles.
The kettlebell swing is an essential exercise and is one of the most important exercises when dealing with back pain issues.
A kettlebell is placed on the floor about 12 inches in front while standing with the feet a little wider than hip-distance.
The hips become the hinge.
Extend the arms down to the bell and grip it.
Begin swinging it up and down through the legs and then upward and outward to chest level.
The shoulders are to stay relaxed.
The hips are used to thrust and create momentum to swing the kettlebell.
Keep the spine neutral throughout the exercise to prevent injury.
The arms are to hold the bell only.
Don’t swing with the arms or shoulders, but push through with the hips.
The exercise can be swung up over the head but is not recommended for those with back pain.
Benefits
They are portable and don’t require a lot of space.
With kettlebells, an individual can train more easily than with barbells.
Kettlebell workouts provide strength training and cardiovascular fitness.
Once the proper technique is learned, individuals can set up a regular regimen at home.
Proper Form and Mistakes
Proper form is crucial. The primary movement most individuals have difficulty with is getting the proper hinging motion at the hip. Most individuals flex at the lower back and place increased pressure on the discs. Proper hip hinge motion means:
Keeping the low back straight
Flexing at the hip
Pushing back out with the buttocks when performing the swing motion.
When done correctly, an individual should be able to stop at any stage and hold that position.
Posture Form Tips
Form issues with kettlebells include:
Hip Hinge
When picking up the kettlebell, remember to hip hinge instead of squatting to maintain the back in a neutral position.
Drive the hips back in the same way when sitting down on a low chair.
Arching the back
If the pelvis is tilted too far forward, the back arches a lot.
This can narrow where the nerves leave the spine in the low back.
Keep the abdominals tight to prevent the pelvis from tilting forward.
Using the incorrect weight can also cause problems; this could be going too heavy or too light.
Too heavy increases the risk of straining the body and back.
A kettlebell that is too light does not provide the correct resistance to strengthen the muscles.
Another common mistake is overtraining. Specifically, individuals over 50 whose bodies don’t recover as quickly.
Individuals over 50 are recommended to spread out the workout days with more than one rest day.
Common Injuries
Proper training before working with kettlebells is highly recommended, especially for those already dealing with back pain. Individuals are encouraged to work with a physical therapist, sports chiropractor, or personal trainer who can teach proper techniques and specific exercises, observe the individual’s process, and make corrections. Improper technique can lead to:
Muscle strains.
Muscle spasms.
Compressed or pinched nerves.
Added stress to pre-existing low back conditions.
Impact injuries to the wrist and forearm.
Body Composition
Exercise Ball Pikes
Exercise ball pikes are an advanced total body workout. Muscle groups worked out include:
Deep abdominals
Hip abductors
Quadriceps
Deltoids
Scapula stabilizers
Pectoralis major/minor
To do the exercise:
Start in a pushup position with the arms on the floor in front.
Lift the legs, so the tops of the feet rest on the exercise/stability ball.
Knees should be bent to start the movement.
Extend the legs out as straight as possible.
Hold the position for a few seconds.
Return to the starting position.
References
Common Injuries Associated with Kettlebells: ACSM’s Health & Fitness Journal (March/April 2017) “Managing Risks of Training with Kettlebells to Achieve Optimum Benefits.” journals.lww.com/acsm healthfitness/Fulltext/2017/03000/MANAGING_RISKS_OF_TRAINING_WITH_KETTLEBELLS_TO.6.aspx
When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.
Back muscles development
With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:
Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.
Guidelines while using weights
When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:
Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s
Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.
Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.
Smaller weights build strength progressively
Effective ways to strengthen the spine.
Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches
Exercise machines can be recommended instead of free weights.
Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.
It is recommended to combine regular walking activity with a weight training program.
Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.
Training program and benefits
Gaining the most benefits from strength training, tips to keep in mind:
Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.
Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.
Body Composition
Carbohydrates and Muscle Growth
Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.
Carbs prevent muscle weakness.
Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.
Carbs help muscles recover after exercise.
Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.
References
Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325
Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
There are different types of muscle from a biological perspective, however, there is no such thing as lean muscle. Lean suggests the absence of body fat. But the fact is that all muscle is lean muscle. It is important to build muscle mass as the body ages, however, it is more important to build lean body mass. Here is the difference.
Lean Body Mass
Lean Body Mass is the total weight of an individual’s body minus all the weight from the fat mass.
Lean Body Mass (LBM) = Total Weight – Fat Mass
Lean Body Mass includes the weight of the:
Skin
Body Water
Bones
Organs
Muscle Mass
Because Lean Body Mass consists of various components, any change in the weight of these areas is recorded as changes in lean body mass. However, the weight of the body’s organs will not change. Bone density does decrease with time and age, but will not significantly affect the weight of lean body mass. With lean body mass, 2 areas of focus include:
Body water
Muscle mass
Lean Muscle
Sometimes, individuals use the term lean muscle referring to the shape of the muscles. However, both types of muscle are lean and fat-free.
The difference between muscle mass and lean muscle
The strict definition of muscle mass is the weight of the muscles of the body. When individuals say they are gaining muscle mass, they typically mean that the muscles look and feel bigger.
Lean muscle masson the other hand is a term often used when someone is referring to the weight of the muscles, not factoring in the amount of fat that could be present within a muscle.
Combining Lean Gains
Increases in Skeletal Muscle Mass are also an increase in Lean Body Mass. What tends to happen is individuals combine them as lean mass gains or lean gains. However, an increase in Lean Body Mass does not always increase muscle.
This is because body water makes up a significant portion of an individual’s Lean Body Mass. For example, a body composition analysis of a 174-pound male.
98.1 Total Body Water + 35.5 Dry Lean Mass = 133.6 Lean Body Mass
Water makes up more than 55% of total body weight
This is normal for healthy adult males
Lean Body Mass consists of three components, two of which are water.
Everything else grouped together makes up the individual’s Dry Lean Mass.
This includes bone minerals, protein content, etc.
Muscle gains contribute to Lean Body Mass gains, but so does water. The difference is that water levels can fluctuate throughout the day depending on:
Hydration levels
Diet
Physical activity
The muscle tissue itself contains a significant amount of water. Muscle tissue is comprised of up to 79% water. Research has shown that resistance training increases intracellular water in both men and women. This creates an issue when looking at lean gains.
Lean Mass gains can happen quickly, and the increases are mostly body water
Measuring Lean Body Mass and Muscle Mass
What not to do
Don’t try to use a scale to calculate changes in Skeletal Muscle Mass. A popular method used is to estimate muscle gain from the number on the scale and applying fitness websites/magazine tips. The problem with this technique is that estimating progress has many factors that can influence an increase in body weight. These include:
It is the difference between total body weight and body fat weight. However, these calculations are more for helping physicians determine the appropriate amount of prescription medication/s or if an individual will be undergoing anesthesia and not a computation of overall body composition.
Paying Attention to Weight Loss
Paying attention to weight loss is an inaccurate reflection of lean body mass, muscle mass, or lean mass.
Weight loss, or gain, does not reflect overall health and body composition.
Resistance training/weightlifting workouts combined with added protein will generate a muscle mass percentage increase
Skeletal Muscle Mass is connected with Lean Body Mass
Everyone’s body composition is different, making the proportion of an individual’s skeletal muscle mass to Lean Body Mass unique.
Lean Mass or Lean body mass is the safest term to use to describe gains.
Which Is More Important?
When it comes to tracking muscle gain or fat loss, it all comes down to what tools are being used to measure progress.
If working with just a weight scale, an individual will only know their weight increases or decreases.
This is difficult to see the difference in weight gain from water, muscle, or body fat.
For individuals that want accurate measuring of their muscle gain and assessing their health, then body composition analysis is the key.
Body Composition Difference
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Galán-Rioja, Miguel Ángel et al. “Effects of Body Weight vs. Lean Body Mass on Wingate Anaerobic Test Performance in Endurance Athletes.” International journal of sports medicine vol. 41,8 (2020): 545-551. doi:10.1055/a-1114-6206
Köstek, Osman et al. “Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer.” Cancer chemotherapy and pharmacology vol. 83,4 (2019): 735-742. doi:10.1007/s00280-019-03779-5
Ribeiro, Alex S et al. “Resistance training promotes an increase in intracellular hydration in men and women.” European journal of sports science vol. 14,6 (2014): 578-85. doi:10.1080/17461391.2014.880192
Ten Haaf, Dominique S M et al. “Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial.” Journal of cachexia, sarcopenia and muscle vol. 10,2 (2019): 298-310. doi:10.1002/jcsm.12394
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