Dr. Patrick: So, we were talking about the resistance training, we've mentioned strength training, and then there's power training. And I think this probably has a little bit to do with what you just mentioned, with the problem with aging, right? And so, can you just briefly talk about the differences and maybe where, like, does one shine more than the other with respect to, like, what older individuals should be doing or focusing on? Or is it, like, you know, women versus men, is there any differences there as well?

Dr. Schoenfeld: So, the definitions do somewhat vary, depending upon who you ask. I'll give you mine. So, resistance training is kind of a catch-all for any type of exercise that moves against resistance. This would be body-weight exercise, push-ups, pull-ups, body-weight squats would be resistance exercise, free weights, machines, cables, any of these would be considered resistance exercise.

Strength training often is used synonymously with resistance training but also it can be thought of specific to, let's say, power lifting where you're moving very heavy loads and necessarily, when you're lifting heavy loads, you're moving them very slowly, you can't...if I give you a very heavy load to lift, you can't move that fast or you'd be able to do more than whatever you're doing, you'd be able to do more repetitions than what you're doing. Whereas power is the ability to produce force over time, so, more quickly. The more rapidly you can produce force, the more power you generate. Power is developed on a foundation of strength but it also involves this time component. And there is evidence that at least some training needs to be done, quote unquote, explosively, so, moving weights quickly or, when I say "weights," doing resistance quickly to generate maximal power.

And our group was involved recently in a meta-analysis on older individuals that showed functional improvements were optimized when they did training that involved moving the concentric action quickly and then doing a controlled eccentric. So, I do think it's important for older individuals to incorporate some power training in their programs. It doesn't mean that every set needs to be done in this respect but at least having some of the training that will be devoted towards power training. And I think it's really exemplified by the fact that hip fracture...so, an older individual's fall, and it's a frequent thing now, particularly in those who are sedentary, they are not able to quickly reverse their fall and avoid, you know, the resultant effect of a hip fracture. And studies show that older individuals, when they get a hip fracture, it's been a while since I've looked at the literature, I think it was 50% never recover full function and die within I think two years, half of them going to convalescence, they have to be under constant care, they're not able to be functionally independent. So, I mean, it's a big thing. You know, whereas the younger individuals, they can get their cast signed by their friends, or whatever, and it's not a big deal. But older individuals, these are really important, you know, issues that you want to stave off.

And I would say that having some power training, and then again other types of training, this is another thing I think is really important, we often think in binary terms, "Train this way, not that way," or, you know, there's programs that are devoted, "this is how you should train," we should be thinking of training as combining different concepts to a given goal. Because often, doing some lighter-load training with some heavier-load training, if possible, sometimes that's not possible but sometimes it is, doing, you know, like I said, some power training with heavier-load training or lighter-load moderate training, these are things that, ultimately, can optimize the effects for a given goal.

Dr. Patrick: Thinking about the power training, for me, I would think, well, sounds like it'd be easier if I had lighter weights. I mean, is that still considered power training or does it have to be, like, a fast movement with a heavier...

Dr. Schoenfeld: No, no, no. So, again, you're not going to be able to move...heavy and light are relative terms. So, let's say you're doing what's called a 3RM, the maximum amount of weight you can lift three times. Let's say I'm doing a bench press with a 3RM. Even on my first rep, if I try to move it fast, I'm not going to be able to because, if I could, I'd be able to do more than three reps with that. So, you're going to have to choose a weight that is relatively light. Let's say, you're able to do a minimum of 10 repetitions, right, 8-10. So, again, light exists on a spectrum. 8 is lighter than 3, 3 reps is heavier than 8 reps, 8 reps would be heavier than 15 reps, 15 reps...so, at what point is, you know, that optimal effect? There's no research that indicates that at this point. But I'd say you'd have to go a minimum of eight repetitions, 8RM. If you could do more, if you could do a heavier load, you're not going to be able to move it quickly enough to get that benefit.

And by the way, there's other things you could do. You can do plyometric training. Now, for some older people, that can be somewhat dangerous. But, I mean, you can throw a medicine ball, that's a way of power training. So, take a medicine ball, and, you know, older people can easily do that for the upper body, these are good upper-body movements that would be I think very user-friendly for people that are older. It can be fun, which, again, I do see kind of this trajectory from youth to getting into our adulthood and then aging, we're making it fun again, a lot of times this is important for older people.