Here’s a quick story that you need to hear.
It explains why I have such a problem with the false notion that cardio training is something that only happens on a treadmill or bike, and that weight training somehow is not good for your heart.
Recently a patient came to see me for a severe back problem.
One of the worst I’ve seen.
Fortunately, I knew I could help him, and after a couple treatments there were noticeable improvements.
But he was extremely deconditioned. The muscle wasting from years of illness and inactivity was profound. He was going to need months of conditioning to reclaim adequate strength to support his spine and maintain the improvements he was getting from our therapy sessions.
Earlier in the year, he had a heart attack, and needed open heart surgery to clear the blockage.
He spent months and months going to “cardiac rehab”, which involved having to walk hunched over on a treadmill 3-5 x/week.
After cardiac rehab was exhausted, it was time for him to have his back checked out by me.
Clearly his strength and mobility were contributing to his back pain, and PT treatment was required.
However, since he exhausted his insurance benefit because of his 5 months in cardiac rehab, he couldn’t get treatment in PT.
The treatment that would have improved his strength, pain, bone density, posture, fall risks, AND cardiac health was not allowed because of one thing:
The patient, cardiologist, and primary care practitioner wrongly believed, as so many others do, that cardiovascular training is limited to prolonged, sustained aerobic training on a machine.
If they were aware that resistance training is cardiovascular training, than he would have received the proper care that his insurance provides for.
This is not my opinion.
It is fact that cardiovascular function and performance are improved by resistance training.
It is a fact that risks of cardiac disease, including heart attack, are reduced by resistance training.
Some studies even show that resistance training is more effective than aerobic training for improving cardiac health.
Imprint this in your mind: resistance training is cardiac training.
Try this test: do 10 lunges, 10 rows, and 10 pushups. Check your heart rate. It’s elevated, right? Then you just did cardio. If it’s not, go to the hospital because something is really wrong.
If my patient received resistance training for true cardiac rehab, he would have been taking steps to concurrently increase muscle mass, improve bone density, improve strength, reduce fall risks, lower blood pressure, lower cholesterol, lower stress, lower risk of depression, improve cognitive performance, AND improve cardiac performance and lower risk of subsequent heart attack, stroke, diabetes, and death! All the while, it would have addressed the underlying impairment related to his back pain.
He would undoubtedly been healthier and in less pain by now. It would have cost less too.
You would think that lecturing hospital systems, nurses, and physicians would help this. I do my best to inform them through my national lectures that have mostly PTs in attendance. So it’s mostly preaching to the choir. I would love to speak to local hospitals, but they are very territorial seeing me as a competitor to their outpatient services.
So I think the best option is you, the general public. Being empowered with information will help you and loved ones make better decisions about your care. You can tell your providers that they need to know this information: share this information. You can send them this email, or send them to my blog detailing the evidence of why resistance training is cardio. Even better, send them to one of my workshops.
Since I last wrote my article detailing the evidence of how resistance raining is cardiovascular training, there has been even more evidence showing this.
A recent Harvard study showed that those who were able to perform more than 40 pushups had a 96% lower risk of heart attack compared to those who were able to do 10 or less. Yang J, Christophi CA, Farioli A, et al. Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men. JAMA Netw Open. 2019
Now, a few things to consider. First, the average age of the participants was 40 years old, and they were all men. So this doesn’t extrapolate to all populations. But is does reveal an interesting trend: strength tends to strongly correlate with risk of cardiac disease. And based on the studies reviewed here, the process of strengthening not only reduces cardiac disease, but it improves cardiac performance.
Hopefully the message is getting clearer for you: if you want to have a healthy heart, work on strength training. When you are super busy and overwhelmed, trying to figure out where to start, or what’s the least I can do to get the biggest benefit, start with resistance training.
At the very least, if you don’t enjoy running, sitting on a stationary bike, or plodding along on an elliptical, you can be assured that by doing strength training you are still working on improving your cardio.