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How Much, How Often

Do strength exercises for all of your major muscle groups at least twice a week. Don t do strength exercises of the same muscle group on any 2 days in a row.

Depending on your condition, you might need to start out using as little as 1 or 2 pounds of weight, or no weight at all. The tissues that bind the structures of your body together need to adapt to strength exercises.

Use a minimum of weight the first week, then gradually build up the weight. Starting out with weights that are too heavy can cause injuries.

At the same time, remember that you have to gradually add a challenging amount of weight in order to benefit from strength exercises. If you don t challenge your muscles, you won t benefit from strength exercises.

When doing a strength exercise, do 8 to 15 repetitions in a row. Wait a minute, then do another set of 8 to 15 repetitions in a row of the same exercise. (Tip: While you are waiting, you might want to stretch the muscle you just worked or do a different strength exercise that uses a different set of muscles).

Take 3 seconds to lift or push a weight into place; hold the position for 1 second, and take another 3 seconds to lower the weight. Don t let the weight drop; lowering it slowly is very important.

It should feel somewhere between hard and very hard (15 to 17 on the Borg scale) for you to lift or push the weight. It should not feel very, very hard. If you can t lift or push a weight 8 times in a row, it s too heavy for you. Reduce the amount of weight. If you can lift a weight more than 15 times in a row, it s too light for you. Increase the amount of weight.

Stretch after strength exercises, when your muscles are warmed up. If you stretch before strength exercises, be sure to warm up your muscles first (through light walking and arm pumping, for example).
Safety

Don t hold your breath during strength exercises. Breathe normally. Holding your breath while straining can cause changes in blood pressure. This is especially true for people with cardiovascular disease.

If you have had a hip repair or replacement, check with the doctor who did your surgery before doing lower-body exercises.

If you have had a hip replacement, don t cross your legs, and don t bend your hips farther than a 90-degree angle.

Avoid jerking or thrusting weights into position. That can cause injuries. Use smooth, steady movements.

Avoid "locking" the joints in your arms and legs in a tightly straightened position. (A tip on how to straighten your knees: Tighten your thigh muscles. This will lift your kneecaps and protect them.)

Breathe out as you lift or push, and breathe in as you relax. For example, if you are doing leg lifts, breathe out as you lift your leg, and breathe in as you lower it. This may not feel natural at first, and you probably will have to think about it as you are doing it for awhile.

Muscle soreness lasting up to a few days and slight fatigue are normal after muscle-building exercises, but exhaustion, sore joints, and unpleasant muscle pulling aren t. The latter symptoms mean you are overdoing it.

None of the exercises you do should cause pain. The range within which you move your arms and legs should never hurt.
Progressing

Gradually increasing the amount of weight you use is crucial for building strength.

When you are able to lift a weight between 8 to 15 times, you can increase the amount of weight you use at your next session.

Here is an example of how to progress gradually: Start out with a weight that you can lift only 8 times. Keep using that weight until you become strong enough to lift it 12 to 15 times. Add more weight so that, again, you can lift it only 8 times. Use this weight until you can lift it 12 to 15 times, then add more weight. Keep repeating.
Sarcopenia: A Word You Are Likely to Hear More About

We know that muscle-building exercises can improve strength in most older adults, but many questions remain about muscle loss and aging. Researchers want to know, for example, if factors other than a sedentary lifestyle contribute to muscle loss. Does age itself cause changes in the muscles of older people? Is muscle loss related to changes in hormones or nutrition? These are the kinds of questions scientists are examining now. The answers may lead to ways of helping us keep our strength as we age.

In this book, we use the word "frailty" to describe the loss of muscle and strength often seen in older people, because it s a word that most people are familiar with. The problem is that "frailty" has more than one meaning. A better word to use, but one that most people haven t heard of, is "sarcopenia" (pronounced sar - ko - PEEN - ya). It s the word researchers use to mean not only the loss of muscle and strength but also the decreased quality of muscle tissue often seen in older adults. It s a word you are likely to hear more about in the future, since sarcopenia is a very active area of research.
There are many alternatives to the exercises shown here. For example, you can buy a resistance band (it looks like a giant rubber band, and stretching it helps build muscle) at a sporting-goods store for under $10 to do other types of strength exercises. Or you can use the special strength-training equipment at a fitness center
About Strength Exercises
Even very small changes in muscle size can make a big difference in strength, especially in people who already have lost a lot of muscle. An increase in muscle that s not even visible to the eye can be all it takes to improve your ability to do things like get up from a chair or climb stairs.

Your muscles are active even when you are sleeping. Their cells are still doing the routine activities they need to do to stay alive. This work is called metabolism, and it uses up calories. That can help keep your weight in check, even when you are asleep!

To do most of the following strength exercises, you need to lift or push weights, and you need to keep gradually increasing the amount of weight you use. You can use the hand and ankle weights sold in sporting-goods stores, or you can use things like emptied milk jugs filled with sand or water, or socks filled with beans and tied shut at the ends.

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How Muscles Work

What makes your muscles look bigger when you flex them - when you "make a muscle" with your biceps, for example?

Muscle cells contain long strands of protein lying next to each other. When you want your muscles to move, your brain signals your nerves to stimulate them. A chemical reaction in your muscles follows, causing the long strands of protein to slide toward and over each other, shortening the length of your muscle cells. When you "make a muscle" and you see your muscle bunch up and bulge, you are actually watching it shorten as the protein strands slide over each other.

When you do challenging muscle-building exercises on a regular basis, the bundles of protein strands inside your muscle cells grow bigger.
Fact

Although they might not notice it as it happens, most people lose 20 to 40 percent of their muscle tissue as they get older. Strength exercise can at least partly restore muscle and strength.
About Strength/Balance Exercises!

Each year, U.S. hospitals have 300,000 admissions for broken hips, and falling is often the cause of those fractures. Balance exercises can help you stay independent by helping you avoid the disability - often permanent - that may result from falling.

As you will see, there is a lot of overlap between strength and balance exercises; very often, one exercise serves both purposes.

Any of the lower-body exercises for strength shown in the strength section also are balance exercises. They include plantar flexion, hip flexion, hip extension, knee flexion, and side leg raise. Just do your regularly scheduled strength exercises, and they will improve your balance at the same time. They can improve your balance even more if you add the following modifications: Note that these exercises instruct you to hold onto a table or chair for balance. Hold onto the table with only one hand. As you progress, try holding on with only one fingertip. Next, try these exercises without holding on at all. If you are very steady on your feet, move on to doing the exercises using no hands, with your eyes closed. Have someone stand close by if you are unsteady.

Don t do more than your regularly scheduled strength-exercise sessions to incorporate these balance modifications; remember that doing strength exercises too often can do more harm than good. Simply do your strength exercises, and incorporate these balance techniques as you progress.

Also do the knee-extension exercise shown in the strength section. It helps you keep your balance by increasing muscle strength in your upper thighs.