Recruiting all your fibers to keep your muscle

Muscle fibers run the spectrum from being very aerobic (slow-twitch fibers) to being mainly recruited for heavy lifting or near-maximal exercise (fast-twitch fibers), and all types of fibers can exist within a single muscle. For easy work, you use only the very aerobic fibers in the muscles you’re using. But if you increase your workload, you recruit not just the slow fibers but also some of the intermediate-speed ones.

A maximal weight lift brings your slower muscle fibers into play, along with the very fastest ones that created the most power in the shortest time. Why is it so important to recruit all your muscle fibers? Like so many biological systems in your body, if you don’t use these fibers, you lose them over time.

Anyone past the age of 25 is slowly losing muscle mass, which in turn reduces glycogen storage capacity and lowers insulin action.

To keep your insulin working well and your diabetes better managed, you need to retain as much of your muscle mass as possible — and potentially gain more muscle. You can lose body fat at the same time even though you’re eating more and improve how well your insulin works. You can have major gains in your strength even if you train just one day a week, although training two to three nonconsecutive days a week generally works better.

Note: Although training keeps you from losing muscle, expect any noticeable gains in the amount of muscle you have to take more than six weeks. You can tell when it happens — you get more definition in your muscles when you’re working out regularly. It may take doing heavier lifting to get the full effects on muscle mass gains and insulin action (see the later section “Enhancing your insulin action and health”).

Training when you’re on a diet

If you’re on a diet, you really, really need to resistance train. Going on a diet without exercising can cause you to lose muscle, not just fat weight. Being inactive makes the problem worse. Think of muscle atrophy as leading to a smaller gas tank to store carbohydrates that fuel active muscles; not only are you losing more muscle faster by not using it, but your smaller gas tank also remains full without doing training.

Having muscles that are packed full of glycogen makes you more resistant to insulin, whether it’s naturally released, pumped, or injected. Carbohydrates that can’t be stored in muscle or the liver raise your blood glucose and get stored as fat.

Normally when you exercise, your liver releases enough glucose to keep your blood levels optimal. The glucose travels through the bloodstream and enters the muscle cells without insulin. Having more muscle also means you burn more calories doing anything (which only adds to any calorie cutting that you may be doing with your diet).

Enhancing your insulin action and health

Keeping the muscles you have as you age or gaining more muscle can help you manage your blood glucose, as well as your overall health, more effectively. For example, among older Hispanic adults with diabetes, resistance exercise improved their muscle quality, whole-body insulin action, and blood glucose management while lowering the low-level inflammation around the body often associated with heart disease.

If you’re a woman 65 years of age or older with type 2 diabetes, combining aerobic and resistance training may give you even greater improvements in your insulin action. Doing both types of training results in more gains in your muscle mass and bigger loss of abdominal fat than aerobic training alone.

In people with type 2 diabetes, four to six weeks of moderate intensity (40 to 50 percent of maximal) resistance training improved their insulin sensitivity by 48 percent without causing any significant changes in their body fat or muscle mass. Similarly, newly diagnosed type 2 diabetic men who did 16 weeks of progressive resistance training (the resistance lifted was increased over time) just twice a week gained muscle mass, lost body fat (particularly in the abdominal region), and greatly enhanced their insulin action — all despite a 15 percent increase in the number of calories they consumed.

Resistance training can bestow extra health benefits, such as a higher metabolism, greater self-esteem, feelings of accomplishment, and greater strength in as little as one to two weeks (from neural changes that occur before increases in muscle size). This type of training involves repetitive muscle contractions that increase the transport of glucose into your cells, leading to better sensitivity to insulin and blood glucose. These changes are good news because they have the potential to lower the total amount of medication you need.

You may need to ask your health care provider about adjusting your medication doses as you begin your training. (Check out Chapter 3 for information on adapting medication usage for exercise.)

Warming up

You don’t necessarily have to do resistance exercises with aerobic activity, but warming up your muscles before starting any resistance exercises is still important. The best way to warm up if you’re not also doing an aerobic workout is to go through the same motions that you’ll be using for your workout, but without any resistance. Stretching some after you warm up or after you finish working out also works as your muscles and joints are more pliable then.

Take the time to stretch any muscles that feel tight during workouts; that helps increase both your flexibility and your strength.

If you have mobility issues, feel unstable on your feet, or have to stay in a wheelchair, you can still do resistance training. Usually, you can also do many of the exercises that are done standing while you’re seated. Check out some of the seated activities in the later section “Working Out with Easy Resistance Exercises at Home or Work” to get started.

Mixing it up with resistance bands, hand weights, weight machines, and more

You have many different options for your type of resistance and exercises. Choose among using resistance bands, free weights (dumbbells, barbells, or household items), resistance machines, or your own body weight as resistance (for example, doing planks or lunges). The main difference among the options you choose is the intensity of your training. You don’t even have to join a gym to make this type of training happen.

For each workout, try to do at least eight to ten different resistance exercises (at least six to start) that work your full body musculature (upper body, lower body, and core).

The following sections delve into the options you have to choose from when it comes to doing your training. You may choose one over another due to convenience, or you may simply pick one because you find it easier to start with. Whatever your reason, you can’t go wrong with doing some type of resistance training.

Getting in plenty of reps and sets often enough

Adults should ideally do resistance exercises that maintain or increase muscular strength and endurance at least two (preferably three) nonconsecutive days each week. Working the same muscle groups on a daily basis doesn’t allow adequate time for recovery and muscle repair between workouts, but if you want to resistance train more than three days per week, you can alternate muscle groups when you train on consecutive days.

No specific amount of time is recommended for muscle strengthening, but you want to get in enough reps and sets to tax yourself. Strength comes from pushing your muscles to work hard.

You can gain or maintain strength by doing anywhere from 3 to 15 repetitions (reps) per set on each exercise. Also aim for one to three sets, with at least two minutes of rest between multiple sets.

Generally, doing 8 to 12 reps and two to three sets is recommended, although you can gain strength from just doing a single set particularly if the set is a challenge for you and difficult to finish. You should feel the specific muscle or muscles working hard during the last 3 to 4 reps in each set. Try to do each exercise to the point where you’d have trouble doing even one more rep without help, at least on the final set.

If you complete the set without feeling somewhat fatigued, choose a heavier resistance or weight. If you can’t complete your goal number of repetitions, try using a lighter amount.

The actual resistance you should be using is usually determined by your 1-repetition maximum (1-RM), or the most weight you can lift just one time. This number is particularly important to know if you’re using free weights or resistance machines, but it’s less critical if you’re using various resistance bands or your own body weight as resistance.

To be truly effective, your training should be either moderate (50 percent 1-RM) or vigorous (75 to 80 percent 1-RM) for optimal gains in strength and insulin action. But doing lighter work still brings you some gains and may be the place to start if you’re really out of shape or haven’t resistance trained for a long time.

Knowing how much, how often, and how to do resistance training correctly

Here are a few tips as you start resistance training:

• Do two to three sets of 10 to 15 reps per exercise.
• Start with a goal of one to two workouts per week of six to eight exercises. Eventually work up slowly to three days per week and 10 to 12 exercises.
• Don’t resistance train the same muscle groups more often than every other day.
• Gradually increase resistance or weight over time.
• Do exercises with slow, controlled movements.
• Extend and use the full range of motion around each joint you’re working.
• Breathe out throughout the exercise, preferably during exertion, and always avoid holding your breath.
• Stop exercise if you experience dizziness, unusual shortness of breath, chest discomfort, palpitations, or joint pain.

Getting stronger and stronger over time

If you’re just starting out or returning to resistance work after an extended period without doing any, start out on the lower end of the intensity scale to help prevent injuries as you begin to work out more regularly. Your frequency, number of exercises, and repetitions should slowly increase until you’re up to doing 10 to 12 exercises on three nonconsecutive days per week.

If you’re already doing quite a bit of resistance work, using heavier weights or resistance machines helps take you to the next level of strength and muscle mass gains.

Using the right technique

Perform each exercise using slow, controlled motions and a full range of motion. That means you should move your joints gently and slowly through the entire range of whatever motion you’re doing, but don’t push past the point of comfort. As you increase your flexibility, your range of motion increases.

Jerky movements can put too much stress on the joint and cause injuries. You should be in control of your motion throughout every resistance exercise you do.

If you move too quickly, momentum takes over, and you lose some of the benefits of working against gravity. Good posture helps ensure that your joints and muscles are in correct alignment and that you’re getting maximum benefit from the exercises.

When you’re resistance training, be sure to breathe out during the exertion part of each exercise. If you can’t perform the exercise without holding your breath, it’s too hard, and you need to use less resistance. Holding your breath increases your blood pressure.

If you experience pain in your joints, stop the exercise you’re doing and try an alternate one. You can work each muscle multiple ways, so finding another exercise that doesn’t cause discomfort, joint irritation, or injury is always possible.

Pulling your weight with the right plan

If you want to get the most out of your training, follow a plan like the one in Table 11-1. It needs to progress appropriately so you get as much benefit from it as you can.

Going forward, you can progress your training by introducing different resistance exercises, doing additional sets per exercise, or adding in a third training day.

Choosing the right exercises

Select strengthening exercises that involve the major muscle groups in your upper body, lower body, and core. These groups include your back, legs, hips, chest, shoulders, arms, and abdomen. If you work the muscles on one side of a joint, make sure to work the ones on the other side as well (like biceps and triceps muscles in the upper arm or the quadriceps and hamstring muscles in your thighs).

Some sample resistance training exercises include

• Seated row
• Bench press
• Leg press
• Triceps extension
• Seated biceps curl
• Leg curls
• Leg extension
• Shoulder press
• Abdominal crunches

For ideas on other exercises to include in your training regimen, see the following section and Chapter 21.

Knowing what core training can do for you

Core strength and stability training are components of physical health that often get overlooked with aging and weight gain. Having a strong body core is the key to being able to get around when you’re older and take care of yourself. Maintaining a strong core also improves your ability to do walking and other everyday activities.

Core training can greatly benefit your health while making you more fit by

• Strengthening and stabilizing your trunk
• Supporting your spine and boosting your posture
• Preventing or reducing low back pain
• Giving you a strong base of support for all movements
• Lowering your risk of getting injured during exercise and other activities
• Helping you coordinate full body exercises and movements
• Improving your balance and coordination
• Tightening and shaping your core muscles around your waist and hips

Strengthening your core lowers your risk of falling, even if you have nerve damage in your feet that makes you less stable. When you’ve experienced even one fall that injures you, you may become less active to avoid falling again, even though being inactive increases your risk of falling. Start training now to stay active later.

Start working to preserve your core strength before you ever lose it so you can keep doing everything that you want to do in life.

Discovering which core exercises to do

Many core exercises use only your own body weight as resistance, with no special equipment needed. By figuring out which exercises you can easily do on your own, you equip yourself to stay strong and agile enough to live independently throughout your lifetime.

Although many core exercises are possible to do depending on how fit you are, some examples targeting the hips, lower back, and abdominal muscles are

• Planks
• Knee planks
• Side planks
• Knee side planks
• Crunches/crunches with a twist
• Twists with medicine ball
• Bridging/bridging with a single leg raise
• Leg lifts
• Core ball transfers
• Knee fold tucks

Sit-to-stand exercise

Do the exercise shown in Figure 11-1 to build strength in your legs and torso. (This is also great practice to ensure you can get off the toilet on your own as you age.)

1. Sit toward the front of a chair so your back is not touching anything.
2. Fold your arms across your chest, keeping your back and shoulders straight.
3. Lean forward slightly and use only your legs to stand up slowly.
4. Sit back down, finishing with your back straight again.
5. Repeat Steps 3 and 4 about 15 to 20 times at your own pace.

Chair push-ups

You can build more strength in your arms and upper body practicing the move shown in Figure 11-2. This is an easy move to do while you’re at work without anyone noticing.

1. Sit in a chair and grasp the arms of the chair.

   If you don’t have a chair with arms, hold onto the sides of the chair.

2. Slowly push your body as far as you can up off the chair.
3. Hold your weight and then slowly lower yourself back down.
4. Repeat Steps 2 and 3 15 to 20 times.

Chair sit-ups

While easier to do than sit-ups while on your back, the chair version of sit-ups shown in Figure 11-3 can still increase the strength in your torso. Try this at work or at home.

1. Sit up straight in a chair with your feet on the floor and hands to sides for support.
2. Bend forward, keeping your lower back as straight as possible and moving your chest down toward your legs.
3. Slowly straighten up, using your lower back muscles to raise your torso.
4. Repeat Steps 2 and 3 20 times.

Wall push-ups

Push-ups against a wall (as shown in Figure 11-4) are easier to do than normal push-ups, but this is a great place to start if you haven’t been doing any at all. If you are unable to stand, skip this exercise.

1. Stand about 2 feet from the wall and place your hands on the wall about shoulder-width apart.
2. Keep your body in a straight line and start to bend your elbows, bringing your head toward the wall.
3. Straighten your arms and push your body back from the wall.
4. Repeat Steps 2 and 3 about 20 times.

Standing leg curls

This exercise (shown in Figure 11-5) helps build up strength in the back of your thighs. Stand up and do this at different times during the day to take an exercise break from sitting.

1. Place your hands on the back of your chair or on the wall, more than shoulder-width apart, and then bend your right knee.
2. Keeping your knees close together, smoothly lift your right heel up toward your bottom.
3. Hold your heel as close to your bottom as you can lift it for a few seconds before returning your foot slowly to the floor.
4. Repeat Steps 2 and 3 15 times with your right leg, and then switch to the left and repeat from Step 1.

Standing calf raises

Increasing the strength in your calves doing the exercise shown in Figure 11-6 will help you walk up any stairs with more power. It also doubles as a way to improve your balance ability (see Chapter 12). For a more challenging exercise, stand with your toes on the edge of a step when you do these. Holding a weighted object, like a dumbbell or full water bottle, in one or both hands can also increase your workout.

1. Stand behind a chair with your feet about shoulder-width apart.
2. Keep your fingertips on the chair as you raise your heels off the ground.
3. Slowly lower your heels back to the ground.
4. Repeat Steps 2 and 3 20 times.