The Rep

Heavy Weight Training and Pain Perception in the Elderly

by Johnny Nguyen

A physical therapist, of all people, once told me that physical pain might be a natural part of growing old as human. I had trouble accepting this notion, but the statistics support it. As we age a complex process of physiologic changes occur, such as the onset of osteoarthritis, back disorder, micro-fractures associated with osteoporosis, muscle weakness, and leg and foot ailments. These factors represent the chronic pain that 87% of community-dwelling elderly experience, and 86% of nursing home elderly suffer.

Studies show that chronic pain represents a major public health concern, not only due to the medical costs associated with it but also because of far-reaching social and personal implications: Chronic pain results in loss of strength and decreased movement, limiting the ability to engage in the activities of daily living, such as accomplishing basic errands, contributing to community, and engaging in social activities. This potentially leads to lower quality of life, diminished socialization and depression. In addition, people with chronic pain are likely to suffer from sleep disturbances, impaired cognitive function, mood swings, and loss of independence. Finally, the risk of falling is higher in those with chronic pain, and falls are one of the leading causes of injury, disability and premature death in the elderly.

But just as chronic pain in the elderly can lead to muscle and strength loss, the natural loss of muscles in the aging process (sarcopenia) can also lead to chronic pain. This vicious process strikes at both ends: If you have chronic pain, you’re likely to stop moving; stop moving and you’re likely to have chronic pain.

If you’ve been reading our newsletter for the past 6 years, then you’re probably going to guess that I’ll comment on how exercise can help prevent or decrease the loss of muscles and strength and therefore chronic pain. Yep, that would be easy. You probably already heard it all.

But a recent study published in the Journal of Sports Science and Medicine (K.M. Knutzen, 2007) reports that high resistance weight training decreases pain perception in the elderly, even if their conditions don’t improve.

It is known that pain has a multidimensional construct: sensory qualities of pain, affective reactions to pain, and pain intensity. In the Knutzen study, these three dimensions of pain are measured through the use of a complex questionnaire in order to examine the effect that a whole-body strength-training program has on pain parameters of older adults.

In this study, 97 elderly were assigned to either an exercise group or a controlled group. The exercise group progressively trained with resistance loads of up to 80% of their predicted 1-repetition maximum, which is appreciably heavy weight. They performed one to 3 sets of 11 exercises, with 7 to 10 repetitions in each set. They did this three days a week for 8 weeks.

At the conclusion, the study finds and supports that participants in an 8-week high resistance strength-training program reported reduced pain qualities as compared to the untrained group. This may sound simple and can be easily dismissed as another “needless study” to validate something that is common sense, but we cannot underestimate the implication of removing or decreasing the perception of pain in people, because we are much more willing to participate in activities of any type if we don’t feel pain. It is what keeps us from descending into incapacity and dependency when we age.

Although the physiologic changes that occur with aging might be a fact of life, as my friend the physical therapist said nearly two decades ago, these changes do not have to manifest in pain and disrupt our quality of life.