In Your Pants with Dr. Susie G - Science Behind Strength Training for Your Health

Starting point is 00:00:00 on this episode when it comes to hormones so hormones during puberty absolutely they're driving a lot of the growth we see but after that the short answer you're listening to the in your pants podcast i'm your host dr suzy gronski your penis friendly pelvic health physical therapist sex counselor and educator helping you get in the know down below Skeletal muscle is the unsung hero of our bodies, playing a crucial role in our overall health and well-being. But here's the catch. While resistance training like weightlifting is the gold standard for building stronger,

Starting point is 00:00:46 bigger muscles, it often feels like an intimidating feat for many, leading to a shocking statistic. Over 80% of the population does not meet current resistance training guidelines. Why is that? how can we make resistance training more accessible and effective for everyone? Well, today we're diving headfirst into the science behind resistance training as we discuss a groundbreaking publication that aims to uncover the secrets to maximizing muscle growth, strength, and functional capacity through resistance training. Our guest today is a true expert in this field. Brad Courier, a PhD candidate at McMaster University in Ontario,

Starting point is 00:01:26 Canada is here to enlighten us with his extensive research on muscle health and exercise. Brad's work has garnered recognition from esteemed organizations such as the American College of Sports Medicine and the Natural Sciences and Engineering Research Council of Canada. Whether you're a seasoned gym goer or someone who's been hesitant to pick up those weights, stay tuned as we unlock the key components of effective resistance training programs and reveal how they can benefit everyone, regardless of their fitness level. So let's flex some knowledge and get those muscles working smarter, not harder. Without further ado, let's welcome Brad Corrier to the show. Brad, welcome to the show. Thank you so much for having me, Susie. Yes. So

Starting point is 00:02:13 can you explain why skeletal muscle is so crucial for overall health? And what are some of the benefits of having strong muscles absolutely so muscle like you said is critical for our health obviously we can think we need it to move around so whether that's crossing the street climbing a flight of stairs carrying our groceries all these things involve having strong and enough muscle in our body so beyond just movement though muscle plays a huge role in our health because it's actually the largest site of blood sugar disposal or storage in our body. So when our muscle, if we don't have enough of it, or if it kind of declines, whether just as we age or because of an injury, things like our risk for type two diabetes or other non-communicable

Starting point is 00:03:03 diseases goes up drastically. So the muscle is important for moving around, but it's also really important for our metabolic health as well. Very cool. It sounds like very important and needed to address. So talk to us about what are the current resistance training guidelines for general health? Yeah, so currently the World Health Organization and other governing bodies suggest that people complete at least two days per week of muscle strengthening activities. And admittedly, they're kind of vague with what they recommend. So they just say muscle strengthening. They don't really specify anymore. It's not as clear cut as something like aerobic exercise where they say 150 minutes spaced out maybe four or five times a week. It really is

Starting point is 00:03:52 just about two days of muscle strengthening activity. So there is a lack of clarity in the guidelines, but that's what they say right now and have said for the last few decades. So it's surprising to hear that over 80% of the population doesn't meet these current resistance training guidelines. What are some of the common barriers that prevent people from engaging in resistance training? Yeah, over 80% don't meet these guidelines, like you mentioned. And that's actually by self-report. So if anyone's done research or read it, they'll know that people are a bit more generous with self-report. And I would wager that's actually a bit higher, maybe upwards of 90% of people not meeting these guidelines. Obviously, there are barriers to

Starting point is 00:04:34 completing resistance exercise. And the most frequently cited is time. So people don't have enough time to complete it. And whether that's because of jobs, kids, you know, life's busy, it happens. And it's tough to prioritize something like resistance training amidst everything else going on. But another barrier that people often feel when it comes to resistance training specifically, is that it's complicated. It's not quite as straightforward as say, putting on your shoes and going for a walk or going for a run or a cycle. You get into a gym, it's loud, there can be lots of people there's all these weird looking machines you don't really know what to do and of course in our world of social media too right there's a lot of people saying you need to lift

Starting point is 00:05:19 this way for this long there's this is a way to the ultimate gains and there's a lot of noise around it and whether that's you know a college-aged individual all the way up to someone who's in the later decades of their life you know that can be intimidating and it prevents people from ultimately doing any resistance exercise at all yeah i mean i can definitely relate to that as someone who who in my day uh was was also intimate like what do i do uh how much do i do who do i go to which usually ultimately was if i was serious about it i hooked up with a personal trainer or someone who knew more than me on this topic uh and and now that i'm in the profession that I'm in as a physio. I know a lot more. So having that knowledge and also knowing that

Starting point is 00:06:08 variability and it doesn't have to be complex really helps. So we'll dive into your publication in just a moment, but I do want to circle back to asking you about the misconceptions and the myths around resistance training that you've encountered either through your research or among the general population that you'd like to debunk for us today? Yeah, I guess first I'd say there's two I'd like to debunk. The one is that for a long time people have heard you need to lift really heavy weights to benefit from resistance exercise. We see people with massive amounts of weight on a bar that they're lifting and this really strong bar looks like licorice. It's bending because there's so much weight on it that's what they need to do to benefit from resistance exercise

Starting point is 00:06:58 and that's just not true you know if people are looking to maybe add a little bit of muscle improve their physical function it can be very light weights that you can lift upwards of 30 times it doesn't have to be these really heavy weights that you can only lift once or twice to to see some benefit and there's a lot of work that's come out of Stu Phillips whose lab I'm working in now, as well as others around the world. Brad Schoenfeld is another key player in that, that have really shown, you know, there's a lot of benefit to be had from lifting lighter weights. The one other I'd say is that people are scared about resistance training because they don't want to bulk up too much, you know, and particularly younger females, you know, that's

Starting point is 00:07:42 a concern. They don't want to get huge and massive. And I think that's one, maybe the best example I can say for why that doesn't need to be a concern is there's a lot of people who have lifted weights for a long time. And I can say myself too, where it's really hard to build muscle to get to a point where you are massive and bulky takes decades of hard, consistent training. By going to the gym or lifting weights a few times a week, you're not going to get so big and bulky. I'm smiling over here because I'm nodding and it's in my own experience I've recently over the past year or so have gotten really into lifting lifting heavy and if you look at my body type it it is petite and most people would not think that I can deadlift 200 pounds

Starting point is 00:08:32 so you know it's it's the breath is clapping over here so and and again you're right because bigger bulkier doesn't necessarily mean stronger and that this is a beautiful segue into your publication of the publication is called resistance training prescription for muscle strength and hypertrophy in healthy adults a systematic review and bayesian network meta-analysis so here it is fantastic paper really really well done research honestly i commend you and your team it's not easy doing research like this. And honestly, this is sensible and practical and effective and empowering individuals, as you said, to not be afraid to go into the gym for whatever reason that might be holding them back. So in this paper, you aimed to determine essentially the most

Starting point is 00:09:23 effective resistance training programs for muscle growth, strength and function. What were some of these key findings from your research? yeah so i have to shout out the team too like you said it's a massive endeavor to take on a project like this and everyone there on the author line did huge amounts of work for it wouldn't be possible without them so what we aim to do yeah is find the best resistance training program to get stronger build muscle and improve our physical function and the three most studied resistance training prescription variables we call them are load or how heavy is the weight we're lifting sets, which is how many times we do each exercise and frequency. How many times do we train each

Starting point is 00:10:06 week? So we looked at every combination of these variables compared to each other, as well as compared to a non-exercising control group. And what we ultimately found was that any combination of these variables was substantially better than no exercise at all. And I think that's one main takeaway. We talked about all the noise that people hear or the confusion and complication that can seemingly come with resistance training really you know if you're doing nothing and you just do something you're going to see a huge amount of benefit for how strong you are and your physical function you'll improve the muscle you have so that that's really our main takeaway from that when it comes to comparing different resistance training programs we did find that

Starting point is 00:10:52 if you are going to try to maximize your strength lifting heavier weights is better than lifting lighter weights and if you're going to try to maximize how much muscle you're building you want to do exercises more so instead of just doing an exercise once or twice do it four or five six times but to circle back to our earlier point you know that's talking about maximizing results and i think this is a huge point when i listen to podcasts or read other people's papers something that's missed is that most people aren't concerned with maximizing results they just want to see some improvement you know for 99 of us myself included you know i'm just a mere mortal i'm not looking to break any world records uh doing something is going to be a lot better than doing nothing

Starting point is 00:11:37 that is such an important message there that you don't have to this doesn't have to be complicated doing something is better than nothing i love that because it's easy it it just simplifies everything grab a weight do something with it add some load and have fun while you do it you know so yes what a great this is again this is so amazing not only for people who are watching and listening who are interested in exercise strength training resistance training but also for practitioners and clinicians to hear as well that we don't really ever have to over complicate this this notion around exercise we need to be health promoters and make it easier for folks to access you know access exercise and be able to to you know optimize their health in in the most

Starting point is 00:12:29 simplest ways really absolutely and to your point there too of you know one making it fun and two when you direct it to clinicians or practitioners one of the things that we actually see in this is that all of the programs that we looked at that were actually lower than current guidelines were still very effective. So with the guidelines encouraging training twice a week, even just doing something once a week, we found was substantially beneficial. And we really leveraged the strength of our analysis because this is the largest analysis to date with almost 200 randomized clinical trials in there. And so it's a huge amount of data. And just to even show that you don't even have to meet the guidelines of course we encourage that but if you're doing

Starting point is 00:13:14 nothing and even if you just step up may not even be grabbing weights maybe doing body weight type exercises you know getting towards doing a little bit more than we are right now and making it fun so people want to adhere and continue doing it but that's the most important thing exactly so and i know you mentioned this in your paper but for to clarify for for those listening there's a lot of i think some of the confusions like how many reps do i do how many sets do i do based on your research like do we know i mean do we really know what is optimal or what people should be doing because as you said there's a lot of noise around okay three sets of 10 and i've always wondered where that you know like i'm not sure about that for everyone you know right

Starting point is 00:14:02 absolutely yeah and so that i'd say there's two kind of categories and the first one is load or how heavy is the weight that we're lifting on that side the heavier the weight is you know that's where you're going to maximize strength but outside of trying to optimize your strength well the weight doesn't actually matter when it comes to things like how many sets are you doing or how many times per week are you training it's essentially a dose response so when we see those early increases from maybe doing zero days a week to one day a week you're going to see a huge improvement going from one to two you'll see a substantial improvement but as we get going up to maybe three four five six days a week you'll still see more benefit but the difference is much

Starting point is 00:14:48 smaller the a lot of the bang for your buck is early on when we're going from nothing to something and that would hold true for things like sets as well. With reps, the most important thing is just within each set. So a set being we're going to pick up the weight and do one effort of this exercise. How many reps do we do? How many times do we do that exercise? We want to be getting to a point where we feel like it's challenging. We don't need to be crushing ourselves, but we get to a point where we feel like I might only be able to do this a couple more times or you truly go all the way to i can't do this one more time um you know as long as we feel like we are getting that challenge uh in it working at say an eight out of ten a seven out of ten in the in terms of

Starting point is 00:15:36 our perceived exertion that's perfect awesome again very practical practical and sensible and easy to do because what what feels like you know to the end of fatigue or okay i'm gonna push it maybe not it's so variable i mean there's so many variables as far as what who their people's tissue tolerance capacity you know energy levels etc body genetics all the things right i mean it's way more complicated than sometimes we're often told or it's it's just very reductionistic when we think about our bodies in a way that's like okay this is what we do this is how it goes when there's so many other factors moment to moment that the body's trying to adapt to and um is going to impact outcomes in in a way so absolutely yeah if you're to just summarize it too and that it's

Starting point is 00:16:28 exactly like you said we just need to challenge ourselves yeah you know it doesn't need to be some tremendous feat that we're pushing ourself to do but you know maybe there are days you're feeling a little tired you don't really want to do much you know even just doing one set even if you normally do three just do one that day it might feel a little tougher yeah but as long as we're kind of constantly pushing ourselves our body it's a system that adapts right as long as we're throwing these little challenges at it it's going to adapt it'll get stronger you know we listen to our body we're the best judge of that and things like failure like you mentioned that's it's not necessary to go all the way to muscular failure or fatigue to see these benefits and what

Starting point is 00:17:08 we what individuals perceive as failure is it's very dependent on their training experience so a lot of people don't actually they think they're a lot closer to failure than they are interesting yeah right so what you're saying is like we give are we perhaps maybe mentally we're giving up before our body actually is there yeah yeah and so the uh the failure training they were there you get into the gym circles people talk about reps and reserve or other things like this uh useful but very dependent on having a trained individual that you're working with um most people uh if you say how many times more times do you think you can do this and they might say two or three when say okay keep going and they'll have seven eight nine more uh in them so

Starting point is 00:17:53 i like the uh you know working on a scale out of 10 you know how hard do you feel you're working you think you're working at a seven or eight perfect yeah perfect awesome really great advice I love it. I love it. Now, let's let's go into the research, your research around function. What are what particular aspects around function did you look at? And yeah, what what improved? Yeah, so the function side was something we were really excited about, because ultimately, that's what this is all about, right? It's can we keep up our daily living, remain independent and live on, have a nice long health span throughout our life? We looked at three components of function, mobility, balance, and gait speed. Mobility, we defined as these standardized tests that we have to see how well is someone moving. Gait speed, what walk-in speed does someone have, and balance, how well can they complete certain standardized balance tests. So the function, admittedly, it's a much smaller sample size than we had for the strength or hypertrophy analyses.

Starting point is 00:19:00 Those analyses had upwards of 5,000 individuals in them. The function work, there's just less available data on healthy older individuals, which is what we were looking at here. So there's 500 to 800 roughly people in each of these. And really, it's the same story. doing any resistance training program is going to be better than doing nothing. We weren't able to compare quite as many different programs just because of the lack of data. But with the data that was there, we saw the same take home finding that if you're doing any resistance training program, each of these components of your function is going to benefit.

Starting point is 00:19:42 That's awesome. Because what I'm hearing there is there's a lot of carry over into, hey if your overall fitness is improving just like the domino effect everything else will also follow suit which brings me to my question and you may or may not have insight into the pelvic floor muscles which are skeletal muscle just like the muscles we're talking about in the rest of the body biceps quads hamstrings etc i'm curious if if you do have any insight around pelvic floor muscle and strengthening because my understanding is that even general fitness squats lunges things that we're talking about that improves pelvic floor muscle strength and function as well so it's not necessarily that you have to do some protocol or prescription

Starting point is 00:20:31 around being very specific with that muscle group because this is what my understanding is but I wanted to kind of bounce that off of you. Absolutely. Yeah. So, and I'll be the first to say, I'm not an expert in how you would prescribe something if there was an issue that someone needed to address. That's when you go to an expert like you, right? If something needs to be addressed, we'll go there. But I think resistance training, there would certainly be some preventative benefit, right? If we're keeping strong, I can't comment, like I said, on how would we fix something if something needs to be addressed but in terms of preventing absolutely keeping up adequate whole body strength and having healthy muscle will hopefully uh prolong our

Starting point is 00:21:17 health span and so the compound movements things that are really involving our core and trunk if it's a squat a deadlift um those will certainly benefit uh the pelvic floor um that's something like i think back to and again not professionally trained in this but before i got into research i was looking at the physiotherapy uh or physical therapy i think it's uh i would call it in the states um call it physio in canada here but uh physical therapy and uh you know even just you know watching the professionals teach people how to engage their core muscles you know have appropriate movement with their pelvis um and you know just building it up uh i think resistance training would certainly benefit and hopefully delay or avoid any future issues may develop

Starting point is 00:22:09 around the pelvic floor. Oh, I agree. And that ticks all my biases for sure, because you're right. I mean, like any other muscle in the body that has the potential to atrophy or have sarcopenia, that is going to happen in all skeletal muscle. And as we age, we know our body changes and adaptations may be a bit more challenging or maybe require more effort and if we're not to kind of planting these seeds early on yes that may potentially predispose someone to perhaps something like stress urinary incontinence and things like that so yeah general fitness helps with your pelvic floor we don't have to be overkill as far as being super specific or kegeling 100 million times a day which is also the extreme i'm sure you know just like in all

Starting point is 00:22:59 fitness circles you're gonna have these extremes and we we also like my understanding of reading the research is like doesn't have to be that way in fact you know again squats lunges hip exercises and workouts affect the pelvic floor and in fact perhaps we're thinking about a lot more than just doing cables so it's just interesting yeah i i'm with you on that and um i wanted to to to segue into hormones because there's this i think there's this notion about testosterone being the the miracle hormone of especially i mean as i say in my experience working with men this has often been associated with muscle growth necessary for that can you explain can you explain the roles of testosterone and and other factors that may or may not be

Starting point is 00:23:56 necessary or focused on maybe emphasizes the word i mean no no there's there's it's a necessity but is it do we need to overly emphasize that absolutely i think when it comes to hormones so uh hormones during puberty absolutely they're driving a lot of the growth we see but after that the short answer is no they're not really doing anything for muscle growth so with testosterone in particular the the big thing to think about is what's normally occurring in our body and what are things we're putting into our body so sometimes people will think that okay when we complete a weight lifting session our testosterone our testosterone goes up and that's what's driving the muscle growth and they're right it does go up but it's not driving the muscle growth

Starting point is 00:24:47 and what people say is well look at people taking testosterone they're huge it works you know absolutely it works but the rise in naturally circulating testosterone that we have after a weight lifting session is just a little blip and it only remains elevated for 15-30 minutes after that goes back down when someone's taking exogenous testosterone the amount of testosterone in their body is upwards of 35 times higher than it would be after that one weight lifting session and it remains elevated for weeks so the difference between the testosterone we see slightly increase after a weight lifting session versus someone taking steroids which do work it's completely different ballgame so if we're talking about just a little rise in testosterone

Starting point is 00:25:38 after we complete a weightlifting session it happens but it's not driving muscle growth and the same is true with something like growth hormone so growth hormone is another one that people will see or think they need to supplement with and the exogenous supplementation side people are taking it to those extremes right those supra physiological levels normal time people with their uh or their normal amount of growth hormone in their body it's not going to change the amount of muscle we can build and a good example of this is actually looking at people with hyper pituitary ism or hypo so people who are naturally born with higher or lower levels of growth hormone and if you look at them they're either very tall or very short

Starting point is 00:26:26 but the muscle mass they have is proportional to their stature so growth hormone is just dictating stature not muscle mass um so i think those are two i hear a lot i get asked a lot about people will be supplementing with i see the new hot testosterone boosting supplement and the long story short is uh if it's just a supplement or you're thinking about what's happening to you inside your body after your lift weights um they're not doing anything ah they're just really expensive probably a lot of expensive pee as well very expensive yeah and the trouble with these supplements too since we're on the topic is that they're not regulated i mean we don't know the safety or the advocacy of these things often and

Starting point is 00:27:14 they can be potentially dangerous. Yeah, it is there's supplements, it is scary. I don't think people realize how easy it is to make something and just put it on a shelf in a store. So if you are looking at any supplements, I would say, you know, talk to an expert like yourself, Susie on who, you know, what might be worth supplementing with, because there are some things that are worth supplementing with, but it's a short list. And, you know, you'll want to be looking for things like third-party testing um right i know north american production is another one that just as a general rule of thumb like made in canada u.s uh pretty safe bet um but still the the third party testing is a huge one for that safety you said definitely consumer labs is one of them and

Starting point is 00:27:58 and uh i will clarify this bit that i i am not an expert in supplementation however in my practice we do have a qualified nutritionist who's a doctor of nutrition and i often refer because you have a list sometimes that folks are taking of supplements things they've been told to take whether it's for muscle building or sexual function which often you know when we're talking about testosterone and and and and increasing libido and sexual arousal and all that i mean it can get really messy real quick and and that is it's a sad truth but it's a hard truth yeah certainly that's great uh your clinic there you've got so many uh wonderful professionals it's a great setup there thank you so much brad appreciate that so for my final

Starting point is 00:28:44 question here is it's for anyone who's listening out there and and is maybe apprehensive you know to start resistance training for for whatever reasons right all the things we named you know what advice would you would you give them to help motivate them to kind of get started how can we how can we make this easier for them yeah it uh it can be intimidating for the reasons we talked about, and I think sometimes people find themselves in a situation where the road ahead just seems too long. You know, they look at it and say, it's going to take me so long to see these improvements. I don't know if I want to embark on this months or year long journey. And in some places, I really encourage people to just give it a shot, even for a short period of time, because I think you'll be

Starting point is 00:29:28 surprised where even after a few weeks of maybe doing a strength training session once or twice a week you'll be pretty surprised with the benefits you see maybe in your muscle strength yes because that will improve very quickly but also just in your mood it can feel good and I think I would just reiterate what we said earlier where it's relative to yourself you know your body best and the point is just we want to challenge our body a little bit so for some people that may look like just standing you know a foot away from a wall and doing a hip hinge back into the wall, right? And maybe that's just where they're at in terms of learning a movement that eventually could progress into something like picking a dumbbell up off the ground or a deadlift

Starting point is 00:30:16 and, you know, wherever someone's at, you know, that's okay where you are and there's progress to be made and that you can do it. It's just getting started. I think even trying it for those first few weeks, people will be surprised with the amount of benefit they see in the shorter period of time definitely and if that's not a motivator for you guys out there penis function might be so erectile erectile function is crucial if you want to maintain a healthy penis for sexual function exercise is key yes exercise it's a wonder that does all it is a wonder that does all that's right if we could get exercise in a pill we there'd be some a lot of money to be made that's right it does benefit uh everything oh that's right exactly

Starting point is 00:31:08 exactly but this sensible advice brad i'll tell you what it's not sexy you know no it's not it's definitely not and that's uh that's something we've been saying as we've been talking about this paper with others you know this isn't groundbreaking you know we say anything's better than nothing people say well of course it is we say well here's some research some darn good evidence showing it. And, uh, if anything, we hope it is liberating, um, in that sense for both clinicians, practitioners, in terms of, it doesn't need to be complicated what you're advising and for individuals, um, you know, really what this paper did show is that, uh, and it's not sexy, but anything is better than nothing. And so whatever you're doing right now, if you're able to

Starting point is 00:31:51 do a little bit more, there's tremendous benefit to be had for your skeletal muscle. Amazing. Love it and on that note brad where can people connect with you if they wanted to learn more i will link your paper to our the show notes and in the in the youtube description so everyone can check out but yeah where where are you on the on the interwebs these days yeah on the on the interwebs so uh all my research or anything science i'll uh share via twitter uh just brad underscore courier and then I'm also on LinkedIn. If you want to connect on either of those places, I would love to do that. That's where you can find me. Cool. Awesome, Brad. Again, thank you so much for being on the show. I really appreciate all the work you and your team have done to sexify simple advice. I love it.

Starting point is 00:32:40 Simple, practical, and effective. Thanks a lot. Thank you so much, Susie. All the best. Thank you. To all of our listeners and viewers out there, thanks so much for watching. Until next time, this is Dr. Susie G in loving wellness for your pelvis. Thanks for listening to today's episode. Be sure to visit my website, drsusieg.com for show notes and related resources on today's topic. If you like what you're hearing, head on over to YouTube and subscribe to my channel. On my YouTube channel, you'll find content related to sex, pelvic health, and expert interviews for men if you got a question or a topic that you'd like me to answer on my channel be sure to type it in the comment box below

In Your Pants with Dr. Susie G - Science Behind Strength Training for Your Health

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