• Nicholas Kent

The gap...

Updated: Sep 24, 2021

As an exercise physiologist I wear many hats; from coach, to advocate, to educator, to pseudo-counsellor. But my main jam from a practitioner perspective is the teaching and application of (in my opinion) the most clinically relevant techniques and methods of exercise for health and therapeutic purposes, most specifically resistance training.

Why specifically resistance training? There are many roads that lead to this niche, I guess you could say... Exercise globally being quite the broad brush of clinical benefits, from cardiovascular health, bone and joint health, pain, mental health, metabolic health and the list is quite endless. But as the brush is quite broad, there is much overlap of particular helpful outcomes, no matter what mode of exercise you're doing. Odds on that whether you invested much of your time in mainly cardio type activities like jogging or cycling, you'd see many of the similar global health benefits that doing things like yoga or tai chi might get you also.

It is nuanced, but overall the brush is quite broad...

But resistance training, to me, has traditionally been something that I believe is still an underrated quantity in the exercise is medicine sphere. It's universally rated as likely being beneficial, despite probably a historical misrepresentation of being on the more dangerous or risky end of the spectrum in terms of exercise. Connotations like this still exist even today, that lifting is a risk not worth endeavoring and such, but times are changing and I'd say there's more positive and open attitudes to this modality nowadays than not. But it still doesn't really get the love it ought, even today. Lifting still doesn't sit as high at the exercise prescription pecking order as say light to moderate cardiovascular exercise, yoga, pilates and other seemingly "safer" or more appropriate alternatives which still makes it such an underutilized and underappreciated quantity in this game.

The skill, knowledge and instincts of good strength training and muscle building, or more relevant to most people; 'muscle-loss-attenuating' activities is, in my opinion, one of the most important, if not most important health/exercise practice that one should be doing as they age. The reason for this are the multi-faceted positive effects that becomes more and more relevant for ageing and is most unique and specific to the practice of lifting in the gym. Muscle building/maintaining exercises and the physiological importance of muscle tissue, functional strength, mobility and bone density to name a few are key attributes that need most focus and promotion for ageing people and the cascading auxiliary benefits from a stronger, functional and more robust body to serve you later in life. I could yammer on further in depth, but this is a basic "off the top of my head" synopsis of why I believe so strongly in skilled lifting as an important niche clinical practice, synonymous with other self-help practices like psychology and counselling.

But above all else, I've just always liked teaching folks how to lift. I'm by no means shut off to all other modalities of fitness and exercise and their importance, but teaching people to lift to me is fun, and is my best mode of being most impactful with the most impactful exercise modality, in my opinion.

The gap...

Resistance training gets its historical whack from much of the ideas of what's going on from the fringes - it's either seen as being too extreme, or too conservative. You might have health professionals whom aren't familiar with the lifting game with a quite extreme and heavy handed misconception of "how lifting works" and there's a lingering idea that this isn't appropriate or too risky for an injured, ageing and/or sick cohort. Or you have health professionals that are more open to the idea but have a far too conservative misconception of what is useful, safe and possible for the injured, ageing and/or sick. What you ultimately get is a patient that is probably mismanaged (or miscoached) and therefore the best prescription wasn't found, applied and realised. True lifting coaches innately know that the best program for any individual is hardly a standard thing and that there are many layers that go into getting the best result for an individual. We are guided by principles, but factors like most appropriate technique, coaching cues, individual variances by way of physiological, biomechanical and psychological all interact and need to be teased out to find the best path to truly realise the benefits of probably the greatest physical health practice one could do.

Understanding and identifying the unique factors of the patient/trainee in front of you, which takes time. Then building the rapport and trust to teach and coach our way through a usually imperfect path to find the best method for that person, fit to their unique qualities and characteristics to move them forward. This imperfect path is imperfect because it can have setbacks, is rarely linear and inevitably will have points where necessary improvement is not easy or free and can seem counterintuitive to the usually more passive, receptive and instantly gratifying nature of traditional therapeutic practices. The coach needs to have the right intuition to understand how to tap into a very 'difficult-to-quantify' quality that is so imperative and can make skilled lifting such an important and beneficial clinical practice - how to identify and elicit a productive stress. The sweet spot that challenges and stimulates actual adaptation, but doesn't break a person. A constantly moving target that can change from day to day and accounts for everything from the mechanical, physiological and psychological.

Driving the moving target of adaptation, which is not linear, despite exercise science' attempts to make so, is the key make or break of resistance training being the most powerful and impactful health practice for a person, or it falling by the wayside of the too risky / too conservative alternative. Guiding a person through the inevitably murky waters of skill acquisition, useful auto-regulation, motivation, troubleshooting problems and long term improvement are the things that split the difference from the lab to real life for the clinical lifter and the exact qualities that the coaches innate understanding and experience brings to the equation. And this is just the beginning. Bundling this newly discovered self-awareness then packaging and conveying it into a "DIY self-awareness & lifting for dummies", so as they can be learned and have true autonomy of their own newly built physicality that may have let them down in the past, or is still a work in progress but ultimately under their own control.

Leaving the nest is the cherry on top for many a patient and trainee, it is the ultimate goal of the coach and health care professional and is ultimately idealized by health care. But unfortunately, the latter is systematically and reliably left wanting in contemporary health care systems.

It might be an idealised world, a place where everyone who needs it can be adequately taught, coached and realise the importance of exercise for their health, but more specifically, resistance training and skilled lifting as an integral physical practice, worth being made aware of, recognised and surveilled in similar fashion to one's mental health and the encouraged ode to self-help and agency within that world. Educated, taught, coached and integrated into the regularity of life to the point where the biggest pillars of knowing oneself physically and mentally are so ingrained that everybody can be their own coach to a degree and enjoy all the freedom, autonomy and better health that flows from there.

This is the challenge