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Weight Training & Diabetes
Yes, it's Okay for Teenagers

Have you ever wondered if weight training is for you? Maybe a better term to use is strength training. Body building, and power lifting are often driven by competition but weight training can help in sports performance as well as help kids lower body fat which is becoming an epidemic. Maybe your perception is it is for the "muscle heads" at the gym or the women on ESPN who flex for the cameras. In reality they make take it to an extreme or even use illegal substances to look the way they do but everyone can benefit from a resistance program of some type. For teenagers, weight training exercises that are supervised, pertinent to your age, and safe offers many benefits. A strength training program may mean going to the gym for many but working out at home with dumbbells or even bands can help get you started. For middle school and high school students often times an assistant coach becomes the "strength coach" at the school for athletes looking to improve his or her performance. The strength coach may suggest a program based on age, size, skills, and sports interest.

A basic recommendation from the American College of Sports Medicine and promoted by the American Diabetes Association is to train a minimum of two times per week, doing 8-12 repetitions per set of 8-10 exercises targeting major muscle groups. As with diabetes this can be individualized but as long as you are in good control there is no reason why you should not participate in a strength training program. Discussed will be the benefits of weight training, common terminology, principles, individual goals, and safety precautions around diabetes.

Benefits of Weight Training

Resistance training (weight training) can help maintain lean body mass which will help in weight management, decrease the chances of osteoporosis, prevent injuries, and even increase sports performance. In diabetes, weight training will help increase glucose uptake by the muscles and help the body store glucose. The stored form of glucose is called glycogen which must be replenished after exercise so any help storing glucose is a plus for people with diabetes. Weight training will increase your metabolism even after you are done working out. This will not only help burn more calories but help insulin work better too. Of course, anytime you start an exercise program or add in weight training make sure you check with your healthcare team so adjustments in insulin or oral medications can be made if needed.

Common Terminology

There are many terms used in the fitness industry when describing weight training. In fact weight training, weight lifting, and resistance training are often used interchangeably. To get a basic understanding of the terminology table 1 outlines basic words or phrases used in weight training with a brief definition.

Table 1
Bar The metal shaft that forms the handle of a barbell or dumbbell.
Barbell A bar used with weighted plates on each end to create a resistance
Bodybuilding A sport that involves lifting weights to develop your muscles to their greatest capability.
Breathing (Proper) Inhale through your nose just before performing the exercise and exhale through your mouth when you exert. Inhale on the way back and exhale when you lift the weight again.
Burn A sensation felt in a muscle when it has been worked intensely. It is caused by exhausting the muscle thereby creating microscopic muscle tears.
Circuit Weight Training A program which mixes light to moderate-intensity weight training with aerobic training. A circuit program may involve 10-15 stations set up at close intervals. The goal is to move from station to station with little rest between exercises, until the entire circuit has been finished
Dumbbell A one-handed barbell. Dumbbells are shorter and usually of a lighter weight. This is often incorrectly spelled (dumbell) in many fitness centers and articles on fitness.
Failure Working the muscles to a point where you are unable to perform the exercise.
Free Weights Versatile dumbbells and barbells free from machine support or pulley assistance. Many athletes like using this form a weight training.
Form (Proper) Moving a weight in a controlled and smooth manner through a range of motion without locking out your joints.
Hypertrophy An increase in size of a muscle as a result of high-intensity weight training.
Isolation Narrowing an exercise to one muscle.
Overload The amount of force against which a muscle is required to work that surpasses the weight which it ordinarily handles.
Power Lifting A sport that involves lifting the heaviest weight possible for one repetition (e.g., Squat or Dead lift). Athletes will power lift by using heavy weights with few reps to increase power (e.g., vertical jump in basketball)
Progression To methodically increase the stress a muscle tolerates during an exercise. This can be accomplished by increasing the weight, number of repetitions, number of sets, or by decreasing the rest interval between sets.
Repetition Is often called a "rep" and involves moving a body part through a complete range of motion and back to the starting point. When an exercise has progressed through one complete range of motion and back to the beginning, one repetition has been completed. (i.e. lifting a weight up and down once).
Resistance The actual weight against which a muscle is performing. This can be free weights, machines, rubber bands, or even one's own body weight.
Rest Interval A breather between sets that permits the body to recover and get ready for the next set of exercises. This may consist of a 1 minute rest between sets.
Routine A program with a distinct schedule of exercises (upper body routine or lower body routine).
Selectorized Machines A weight stack with pulleys and cable systems which enables you to push or pull through a predetermine range of motion. A pin is placed at the desired weight before performing the exercise. Often found in gyms or home weight equipment.
Set A succession of repetitions done without rest (10 reps = 1 set).
Spotter A person who stands close by to give some assistance when performing an exercise. A spotter is usually needed when lifting free weights or weights that are too heavy for an individual.

Principles of Weight Training

It is important to understand the basic concepts of weight training. The Overload Principle is a concept based on "overloading" the muscles by lifting more than it is use to doing. This is all relative. A sedentary older person may overload the muscles with 3-5 pounds whereas a young athlete may need to lift 250 pounds to get the desired results. As the muscles become stronger there is a need to increase the overload but once the desired strength is achieved there is not a need to continuing overloading. A less challenging or maintenance approach may suffice. The overloading does not necessarily mean more weight or resistance but can be accomplished by increasing the number of repetitions, decreasing the rest time between sets, or increasing the number of exercises in a workout. If too much weight is used, the form of the exercise may suffer and injury is more likely to occur. If too little weight is used, the body does not have to adapt to an overload and gains become harder to achieve. Progressive resistive training must be done to overload the muscle. This is a strength training modality in which the overload is constantly increased to facilitate adaptation.

Progressive resistive exercises were first witnessed by the Greeks when a young man lifted a calf each day until it reached its full growth. It was well documented that the size of skeletal muscle is affected by amount of muscular activity performed. In order to increase the size or strength of a muscle a progressive resistive approach must be taken. Everyone has a genetic ceiling when it comes to how much someone can lift. For most people the risks outweigh the benefits so lifting a weight to one's maximal potential is not recommended unless it is part of a competition or possibly for sports performance. People with diabetes will need to be more conservative when lifting heavy weights especially if retinopathy is present.

Individual Goals for Weight Training

Before starting a weight training program it is important to know your goals. For example an athlete who competes in speed-strength sports may perform low repetition, high intensity exercises during or immediately prior the competitive season. A person interested in body building may perform more sets and repetitions of exercises and more exercises per body part than weight lifters or strength athletes. Their goal is to build large, defined, symmetrical muscles.

A person may want to "tone up" which may involve 1-3 sets of 8-10 reps 2-3 times per week. People may vary in the rate they gain strength. Some of these differences can be credited to the proportion or type of fibers a person has. Endurance athletes will tend to have more slow-twitch fibers whereas strength athletes will have more fast-twitch fibers. People with more fast-twitch fibers tend to gain strength faster. The bottom line is that genetics plays a role but training can influence strength gains too. Getting Started

Before starting a weight training session it is best to get your core body temperature up a couple degrees. This can be accomplished by walking on a treadmill or riding a stationary bike for 5-7 minutes. A good indicator is to have a light sweat across your forehead. Next stretch the muscles you will be working (i.e., arms or legs). Holding a stretch for 30 seconds doing 2-3 reps should be enough. It is also a good idea to stretch between sets so you can maximize your rest periods.

Spending 30-45 minutes doing 5-7 weight training exercises is plenty when first getting started. Remember the muscles need time to recuperate so never work the same muscle group two days in a row. For someone who trains three days a week a Monday, Wednesday, Friday schedule or Tuesday, Thursday, Saturday is ideal. A good rule involving the order of exercises is to start with large muscle groups (chest) then followed by small muscle groups (biceps).

When determining the amount of weight to use the correct weight should cause fatigue by the last couple of repetitions in each set. If you are lifting at 3 sets of 10 reps the 9th and 10th rep should be difficult while maintaining proper form. Good lifting technique should maintain proper posture while moving through the lift in a slow, controlled fashion. A 2-4 count for the push or pull and a 4-6 count on the recovery phase or return to starting position are recommended.

For many years weight training for kids and teens was considered dangerous especially in growing individuals. After years of research this myth was put to rest by well respected fitness organizations. The American College of Sports Medicine, the National Strength and Conditioning Association, and the American Academy of Pediatrics all recommend strength training for kids with certain guidelines to adhere to. According to Avery Faigenbaum, EdD, CSCS, Assistant Professor in the Human Performance and Fitness Department at the University of Massachusetts, Boston noted, "Growth plate injuries have not occurred in any youth strength training study that followed established training guidelines. In fact, recent findings suggest that strength training during childhood and adolescence may actually make bones stronger."

Safety Precautions for Kids

Table 2
Some basic guidelines or safety precautions for a person with diabetes who wants to start a weight training program are as follows:
  • Keep you healthcare involved when starting a weight training program and if any problems with your control arise during it.
  • Start with low weights and higher reps while concentrating on form
  • DO NOT do maximum lifts but concentrate on how much you can lift say ten times
  • DO NOT hold your breath (Valsalva Maneuver) when you lift weights. You will be able to lift more weight but this will create blood pressure to increase and well as pressure around your eyes. (not a good idea for people with diabetes)
  • If using free weights (i.e. free weight bench press) always have an experienced spotter.
  • Avoid doing an exercise that causes a sharp pain. A burn is okay in the muscle but any pain within the joint is not usually a good sign.

Strength Training Guidelines for Children

Table 3

Considerations for age groups:
7 or younger - Introduce child to basic exercises using little or no resistance; develop the concept of a training session; teach exercise techniques; progress from body weight calisthenics, partner exercises, and lightly-resisted exercises; keep the volume of required effort relatively low.

8-10 - Gradually increase the number of exercises; practice exercise technique in all lifts; start gradual progressive loading of exercises; keep exercises simple; gradually increase training volume; carefully monitor toleration of the exercise stress.

11-13 - Teach all basic exercise techniques; continue progressive loading of each exercise; emphasize exercise techniques; introduce more advanced exercises with little or no resistance.

14-15 - Progress to more advanced developmental programs in resistance exercise for adolescents; add sport-specific components; emphasize exercise techniques; increase volume.

16 or older - Move individual to entry-level adult programs after all background knowledge has been mastered and a basic level of training experience has been gained.

*Adapted from Strength Training for Young Athletes by Kraemer, W.J., & S.J. Fleck, Champaign, IL: Human Kinetics, 1993.

Rick Philbin, MBA, M.Ed., ATC

November 2004

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Last Updated: Friday September 07, 2012 11:14:34
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