Strength Training and Type 2 Diabetes

The American Diabetes Association recommends two to three sessions of resistance exercise per week, on nonconsecutive days, in addition to other types of physical activity. Learn more in this article from Idea Health & Fitness Association, which includes exercise tips from me.


Your "Go To" Workout

It’s that one essential workout that you’ll commit to memory, keep in your back pocket or save on your cell phone. You’ll know the exercises you need to do, the order of exercises; and you’ll easily adapt it to your changing fitness level and goals using the chart below. You’ll get better results too, because you’ll waste less time st the gym - you’ve got a plan and you’re sticking to it.

The program is designed as a circuit of compound or super sets. You work opposing body parts, with continual flow from one exercise to the next, rest only as needed. This maximizes your time and can also help burn more calories each time you Workout.

Beginners focus on building endurance, and do 1-2 sets of 15 repetitions; if you’re doing 2 sets, repeat the super set before going onto the next exercises. If you’re working out on your own, weight selection is trial and error: if you can only do 12 reps, it’s too much weight, if you can do 20 reps it’s not enough weight.

Weight (% 1 Rep Max) Rest*
Low-Moderate (60-70%)
Increase Size
Moderate - High (70-85%)
Maximum Strength
High - Maximal (80-100%)
*when trading with compound sets, the second exercise is considered an active rest periods
Get Your "Go To" Workout" and feel free to let me know if you have any questions.


Stretching is Not Enough

If you feel like you've been stretching a tight muscle forever and not making progress, you're not alone.  Most people do static stretches and some myofascial release (foam rolling), either on their own or in stretching or yoga classes.  These are valuable techniques but they may not be enough to get the results you want and may not target you individualized needs.

Muscles become tight from extended periods of sitting and repetitive motion.  Remember isometric exercises?  Exercises where you hold a muscle in a contracted position to strengthen it?

Sit in front of a computer for extended periods of time and you're doing isometrics.  Literally strengthening and shortening the hip flexors, upper trapezius, chest lats, and anterior shoulder muscles.  At the same time, you're stretching and lengthening the glutes, middle trapezius and rhomboids and shoulder external rotators.

If a muscle is tight and short, the antagonist or opposite muscle is extended and relatively weaker.  That's why static stretching and myofascial release is not enough.  A flexibility programs needs to include active stretches and eccentric (negative phase) strengthening of the tight muscles and strengthening of the antagonist muscles .

The charts below show some examples of complete flexibility programs for common complaints.  Additional illustrated programs are available on my website at programs.caryraffle.com.

Unlike classes which take a one-size-fits-all approach, when we work together, we can personalize a program to your specific problem muscles, needs and goals.  We also will ensure proper form and exercise selection.

Contact me  if you have any questions or want to set up some sessions to develop your personalized program.

Tight Calves - Plantar Fascitis - Achilles Tendinitis
Myofascial Release
  • Calf with foam roller, medicine ball, barbell, other implements
  • Bottom of foot with lacrosse ball or frozen water bottle
Static Stretch
  • Calf
Active Stretch - Eccentric Strengthening
  • “Reverse calf raises” or heel drops - emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening
  • Heel raises to strengthen the anterior tibialis (opposite or antagonist muscle to the calf)

Tight Hip Flexors - Often with Arched Back and Knee Pain
Myofascial Release
  • Quads and hip flexors foam roller and medicine ball especially at the inguinal crease (hip)
Static Stretch
  • Quadriceps and Psoas, kneel with raised arm to lengthen Psoas
Active Stretch - Eccentric Strengthening
  • “Butt Raises” on floor or stability ball -  emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening
  • “Butt Raises”
  • Glute strengthening exercises including single leg press and squats, hip extension, lunges

Rounded Shoulders - Often with Shoulder or Neck Pain
Myofascial Release
  • Chest/pectorals, anterior (front) of shoulders and lats with foam roller or medicine ball
Static Stretch
  • Chest stretches
Active Stretch - Eccentric Strengthening
  • Unweighted reverse fly, weighted reverse fly -  emphasize  “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening
  • Scaption and Reverse fly - ensure shoulders are retracted, on reverse fly emphasize the negative phase when retracted
  • Shoulder external rotation
  • Close grip row, emphasize the “eccentric” or negative phase and isometric contraction when retracted
  • At least a 3:2 ratio of back to chest exercises

Elevated Shoulders - Often with Shoulder or Neck Pain
Myofascial Release
  • Upper Trapezius, Lats, Rhomboids with Roller or medicine ball
Static Stretch
  • Neck Stretch - Sternocleidomastoid, Levator Scapula
Active Stretch - Eccentric Strengthening
  • Scapular Depression - “Reverse Shrugs” on a seated dip machine or dip bar.  Keep elbows straight, raise and slowly lower the shoulder carriage.  emphasize the “eccentric” or negative phase and isometric contraction at the bottom
Reciprocal - Antagonist Strengthening

Tight Low Back - Often with Arched Back
Myofascial Release
  • Hip flexors, quadriceps, lower back, lats, piriformis
Static Stretch
  • Lats, cobra for abdominals, piriformis
Active Stretch - Eccentric Strengthening
  • “Butt Raises” on floor or stability ball -  emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening
  • “Butt Raises”
  • Glute strengthening exercises including single leg press and squats, hip extension, lunges
  • Reduce “Crunches” instead incorporate planks, single leg exercises and other deep core strengthening exercises


15 Minutes Can Get You Better Results and Reduce Your Risk of Injury

Thanks for your readership of my fitness blog. To show my appreciation, I am pleased to offer a complimentary fitness program review .  We will discuss your goals, fitness level, current program and results, and give you a chance to ask questions.  This is a must if any of the following apply:
  • you're just starting out or returning
  • you've been working hard but aren't getting the results you want
  • you've plateaued 
  • you've had an injury, medical issue, pregnancy
  • you're bored, routine has gotten stale
  • you aren't working with a trainer
  • you have a special event -- wedding, trip, beach, etc.
  • you've been a reader for some time and just have some questions
Please note availability is limited and we need to schedule in advance. 


Add Horsepower to Your Cardio: Increase Your Cardiac Ouput

QUESTION: True or false:  to improve your cardiovascular conditioning,  get your heart rate as high as possible in aerobic exercise?

ANSWER: False.  You improve your cardio condition by increasing cardiac output at lower heart rates.   Here's the mathematical equation used by doctors and exercise physiologists:

Q = HR x SV
Your cardiac output, Q,  is the product of your heart rate times your stroke volume - that's the amount of blood exiting the heart from the left ventricle every time it beats.   A strong heart pumps more blood with every beat.  At rest, Q is typically about 5-6 liters per minute.  During exercise it can be 3-6 times as much.  

Extra Horsepower
To improve your cardiovascular conditioning, we focus on improving your Stroke Volume, conditioning the muscle fibers in the heart to pump more blood each time it beats.  Think of it as adding horsepower to a pump.

We do this with a training program designed to increase your heart rate reserve --- the difference between your Resting Heart Rate and your Maximum Heart Rate.  Your Maximum Heart Rate is most widely accepted at 220-age, it is a theoretical number that is the same for everyone.  

We can’t change your Maximum Heart Rate, but we can lower your Resting Heart Rate. Typical Resting Heart Rate for adults is 60-80 beats per minute, if you’re already well conditioned it is probably lower.

The Frank-Starling Law
For over 100 years, doctors have relied upon the Frank-Starling law or mechanism for patients with heart arrhythmias and cardiac failure.  It explains how the heart adapts to changes in heart rate and stroke volume, and applies equally to exercise.

If you train your heart to pump more blood what’s it going to do?  Pump more blood.  You will also see a lower resting heart rate and - as your heart rate reserve increases - an increase in potential cardiac output (Q in the formula discussed above).

If you train your heart to beat faster, what’s it going to do?  Beat faster.  You may not see improvement in cardiac output, in fact it may even decline.  Frank-Starling explains that  if the heart is literally beating so fast that the chambers don’t have time to fully fill with blood, the muscle contraction is not as strong. The muscle can actually weaken slightly over time.  You burn more calories at a higher heart rate, but there's a good chance that you're burning muscle and not just fat.  More about this in an upcoming article on Metabolic Training.

Your Cardio Training Heart Rate
We use the Karvonen Formula to calculate your training zone, also called the Heart Rate reserve formula.  (More elaborate athletic training facilities may use VO2 max as a measurement, but it is difficult to consistently monitor).
  • 60-80% of your Maximum Heart Rate, using the Karvonen formula, is targeted to increase stroke volume, therefore increasing cardiac output and lowering your resting heart rate. Gradually increase intensity of exercise that you are able to do while keeping your heart rate in this range.
  • Above 80% of MHR not indicated for improving cardiac output.  It provides other benefits such as improving lactic acid removal and strengthening fast twitch muscle fibers. So it is part of your program, but not the part that improves cardiac output.
To calculate your Target Heart Rate Zone, take your Resting Heart Rate early in the morning,. preferably when you wake up without alarm or kids or noise and use the following equation:

THR = (220-Age-RHR) * Desired Intensity % + RHR

Do I need a Heart Rate Monitor?
Ideally yes, but you can also use rate of perceived exertion.   The Borg Scale is widely used, easy and scientifically validated,  you rate your perceived level of exertion on a scale of 6-20, where 6 is no exertion and 20 is extremely difficult  A rule of thumb is that you can then multiply by 10 to get an approximate heart rate.   

Proceed with caution

Talk to a doctor and a fitness professional before beginning a new exercise program or substantially increasing the intensity.  I'd be happy to meet with you to discuss your questions, goals and program options.

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