Intensity

The intensity you use will depend, as mentioned, on the strength gains you desire and the goals you have set. Think of intensity as a continuum that ranges from no resistance to high resistance. The most common method of determining intensity for a resistance-training program is to discover your 1-, 6-, or 10-lift maximum for each movement. You then set intensity at a percentage of that lift.

Most systems identify a different intensity for each set within a 3-set regimen. This technique works well if you plan to use a gym or fitness center that has varied apparatus and someone who can help you determine your baseline for each movement. Another technique for determining starting resistance levels is based on body weight (Kisner and Colby 2002). The initial lifts are a percentage of body weight: for example, bench press = 30 percent of body weight; leg extension = 20 percent of body weight; leg flexion = 10 to 15 percent of body weight; and leg press = 50 percent of body weight. Otherwise, an easy option is to estimate what you can lift for a movement and then try it. If ten repetitions are extremely easy, then increase the weight the next time; if you cannot complete ten repetitions, decrease the weight.

For a general strengthening program, resistance will then be moderate to high, approximately 80% of maximum. Less resistance combined with a higher number of repetitions (15 to 20) will result in better muscular endurance. With arthritis, one of the most important factors determining the amount of resistance is your comfort level. Resistance training is not supposed to be overly easy, but if you start having more painful symptoms with your arthritis, back the resistance down. Most people tell me they have fewer problems with a low-resistance (about 50 percent) program that uses moderate repetitions (1 set of 10 to 15 reps). I usually initiate strength training with this type of program so that we can see how their arthritis responds.

If you plan to exercise at home, design a program that uses your own body weight, handheld weights, or simple resistance devices such as rubber tubing. You determine the intensity for such activities by the number of repetitions you can complete with full body weight or with a given resistance. If you cannot use your total body weight at first (as in a full push-up), you can start with a position that reduces the amount of weight you have to move, simulating a percentage of a maximum lift. For example, if you can do only one push-up on the ground, start with a standing push-up against a wall (see figure 4.1). This position works the same muscles but reduces the resistance. As you get stronger, you can eventually move to the ground to do your push-ups. Home exercise programs are usually less intense, but you can still gain valuable strength benefits with a properly designed regimen (Baker et al. 2001).

Figure 4.1 Wall push-up