Dear Doctor: Worried about injuries from strength training? Consult a professional coach

By Don S. Sipe Last updated Dec 29, 2021

DEAR DR. ROACH: There are a huge number of sports injuries reported every day, for men and women and for every sport that comes to mind. Strength training is central to most, if not all, athletes in sports, from golf to baseball, etc. The injury rate seems to be increasing, or maybe there are more in-depth reports. In any case, how does “borderline” strength training affect the risk or likelihood of injury? Also, is there a practical limit for a given athlete, and how is it determined? – RDL

ANSWER: Strength training using resistance, usually with weights, has many benefits for the body, including benefits that are difficult or impossible to achieve through aerobic activity that does not involve resistance, which is why Elite athletes mainly incorporate weight training.

The risk of injury in bodybuilding is low, on the order of one per 1,000 hours of training at Olympic level. It is much less than in contact sports.

For non-elite athletes, the biggest risk is probably trying to lift too much weight, too soon. I highly recommend bringing in a professional coach to help you with proper form and advice on types and amounts of lifting. This will help to minimize the risk of injury.

Any athlete will develop a performance plateau over time, but it is impossible to predict what that might be in an untrained person. Increasing resistance will lead to greater strength, along with other medical benefits like improved bone strength and reduced insulin resistance.

DEAR DR. ROACH: I am a 79 year old female with osteoporosis. My doctor prescribed alendronate (Fosamax) for me. I had understood that this medication was supposed to prevent a hip fracture, but now she says it will also strengthen other bones in my body, including those in my back. Is it true? – CM

ANSWER: Alendronate and similar drugs are the most common initial treatment for osteoporosis, a condition of bone loss and strong bones. Although we often focus on hip fractures, which are associated with an increased risk of death, vertebral fractures are more common and cause a lot of pain and reduce quality of life. Your doctor is correct that when used correctly – that is, both in the right patient and for the right duration – Fosamax and other medicines reduce the risk of hip fractures and spine.

Part of the reason these drugs have gained an unwarranted bad reputation is that they weren’t always used correctly. Doctors who are not experts in the treatment of osteoporosis have sometimes prescribed these drugs for women and men who do not have osteoporosis, but only with low bone density, and those who are not at high risk. fracture. If a drug has little potential for benefit, then even a small risk of harm leads to the drug being worse than useless.

In addition, it is not a drug that a person normally takes for the rest of their life. Most often, a person takes it for three to five years before a thoughtful reassessment of the continued need for the drug. Staying on the medicine for too long carries a risk of a fracture of another type, called an atypical fracture of the femur.

The fact that the drug could be misused is not a reason to avoid it. Women and men at high risk of fracture due to osteoporosis and other risk factors benefit from the reduced risk of hip and spine fractures with a low risk of adverse events.

Dr Roach regrets not being able to respond to individual letters, but will fit them into the column where possible. Readers can email their questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.