If your goal is to lose weight, that is going to be a very different progression, time progression, than when am I going to feel stronger. Focus first on building muscle and then worrying about, okay, let's think about fat loss and calorie deficits. Once you have that muscle built in, you've you've built that metabolic engine that we talked about last time, like that's gonna be a real, real key.
If you've ever felt like you're doing everything right, working out, eating well, but your muscles just aren't showing up how you want, this episode is just for you. Spoiler alert, most of us are missing at least one key piece of this puzzle. And today we're gonna break it all down, why your efforts might not be paying off, the biggest mistakes we make when trying to build muscle, and most importantly, what to do instead. You need enough work to challenge your body, but you also need enough rest to let that muscle grow. And if you're not fueling properly, you can forget about seeing those muscle gains. This is the episode that's going to take you from frustrated to finally seeing results. Joining us today is doctor Keegan Ziemba.
Doctor Ziemba is a board certified pediatrician and pediatric intensivist who has additional certifications with the Institute for Functional Medicine and the American College of Lifestyle Medicine. She has additional training in female exercise physiology, nutrition, heart math, and homeopathy. She served as the medical director at Index Health and most recently Tegrity Health, a practice focused on precision medicine and health optimization. Her services are available through Tegrity Health across the country, and you can find her at integrityhealth.com or on Instagram at Tegrity Health. Let's get started.
We get into this, oh, we've gotta eat less and lose weight, and we get into this vicious cycle where we just get so used to eating less that we're completely undernourished, we're completely under fueled. We don't recognize how much it is that we actually have to eat.
Keegan, thank you so much for coming on here. This is gonna be a really important conversation for women, and I think we just hit the ground running. We talked last time on our episode really about the importance of strength building and the importance of different types of exercise, and now we really wanna get into the nitty gritty of how we do this.
And I think especially one of the most frustrating things for women is why isn't it working. Right? We both had patients come and say, I'm doing exactly what I should, and I'm not seeing results. So why don't we first talk about women and strength training and what are some of the things that you see patterns that aren't working? So I think there's a couple of things.
First off, consistency is really key when it comes to building muscle. If we're doing something different every single workout, we're not going to see the results because you need that consistent stimulus to the muscle that's going to get you the investment on your return. Mhmm. So we need to have that piece of it. Another one is that many of us just try to jump in and do it all at once.
And we're not taking any rest days. And rest is actually when the magic happens. So if we're working out every single day, we're never getting that time for our muscles to kinda relax, reset because it's the reset is actually when the building happens. It's not in the gym with that stimulus, it's just the start of it. And you need that healing of the muscle to get bigger and stronger.
So we don't take rest days, that's gonna be a problem. The other piece of the consistency is progressively overloading the muscle. So we want a program built for us that allows us to progress gradually through whether that's six weeks, eight weeks, however it's set up. You want to have something where, okay, this week it was six reps, next week it's seven reps, next week it's eight reps, and you're working up slowly. It's not gonna be, hey, I can do five reps this week, ten reps next week.
No, it's gonna be slow, and that's okay if you're only going up by one rep per week on that exercise. That's still adding to that stimulus. But we do need to progressively add on, whether it is going up with the weight or it's going up with the number of repetitions. The other piece, in addition to that lack of rest is, really coming around to how are we properly working out. Do we have good form so that we're hitting the muscles appropriately, not just with the weight and the repetition, but actually in the form that we're doing it?
Because if we're, you know, we talked about hip failure last time, which is working up to the point where you can no longer do a single repetition with good form. If we're trying to eke out those additional repetitions and you're jacking your body all over and you're contorting, you're not gonna gain what you're truly hoping to gain with that. And actually there's been studies that have looked at that, that have compared people who've gone to failure with good form and those people who try to eke out some additional bad form repetitions and their progress was the same. So why put your body through that contortion and potentially cause an injury just using proper form? And if that means working with a trainer so that you learn how to do the proper form, then that's what needs to happen.
Or staying away from moves that you are not completely comfortable with until you can work on it with somebody and sticking to things that you know you can do, which I think is a nice way where machines come into this picture too, is, you know, they're guiding you through the movement and so it's harder to do it with bad form. Not impossible, of course, but harder to do it with bad form. And then I think the last piece of why aren't we seeing these results really comes down to are we fueling our body? Are we fueling our workout itself? Are we fueling ourselves throughout the course of the day?
As women, we talked about it last time. We do more and eat less and expect that to be the magic combination, and it's the antithesis of the magic combination. It's setting us up for for actually failing. And we're gonna feel awful. We're gonna feel sluggish.
We're gonna feel tired. Our workouts aren't going to progress. So fueling both the workout and then throughout our day is essential. So that's not just protein, it's carbohydrates too, but all of it is really important. Wow.
That was such a great jumping off point. And I wanna go back to a couple of those things. Of course, when we're talking about outcomes, you know, and not frustration with not getting outcomes, I wanna go back and talk a little bit about what those expectations are because I think also it's helpful to have an expectation of timing too. Obviously, when we're talking last time we talked a lot about the benefits of strength training and most of those are lifelong. Right?
Mhmm. Avoiding frailty and living longer and avoiding disease states. And those are going to come as we're getting these, movement routines and building muscle throughout our lives. But most of us are less patient than that. We we wanna say, like, how long until I look better or how long until I feel stronger?
How long until I see, my progress? How long until I see the number on the scale go down? Can you give us any sort of expectation about for some of those outcomes? Because this is a slow process for the most part, will you go through kind of what are the earliest outcomes that that we can anticipate seeing as we're starting a strength training regimen? What are those earliest outcomes we see and then what are the outcomes that kind of stack up over time?
Yeah. No. That's a great question. And I'm gonna say it it's first starts with what is your goal. Because all of those little questions that you just asked, each of them is a very different goal.
If your goal is to lose weight, that is going to be a very different progression, time progression, than when am I going to feel stronger? So let's start with the easier one. When am I going to feel stronger? I like to think of it as pretty quickly. When you are in the gym and just get one good workout in, you can find yourself in, or you can find strength in yourself.
So you're you know, it's kind of an immediate. And you will start to see those those gains pretty quickly in terms of flat out strength. Hypertrophy And you'll see that you can lift more. More? Last time you did this one, and then the next time you lift some heavier weight.
A little bit. Yep. You're able to hit, a greater number of repetitions or a greater amount of weight. So is that, like, over a couple weeks, you think, over a month? Yeah.
Yeah. And if you're not seeing that, that makes me worry that you're not in a progressive overload program. The only time we're not going to see that when you're following a progressive overload program is if you've been in a prolonged deficit. What we start to see- Calorie deficit. Calorie deficit, exactly.
That you will start to see that you just don't have the capacity to do that, which is gonna go back to the fueling that I mentioned before. If we're not fueling our workouts, we're not gonna see that progression. And so there's two different goals going on there. If you're trying to progress your strength and muscle gain and be in a deficit, those are two opposing goals. And I highly recommend not going after both of those goals at the same time.
If you are completely new to strength training, you have this wonderful thing called newbie gains, and that can help offset that a little bit if you were to be in a calorie deficit and you've never strength trained before in your life. You will see gains in that regard. And you will see it in the first couple of weeks to first couple of months, that build of muscle. But if that deficit continues on, you will start to lose that forward progress and you feel like you're stalling. Again, that's because a deficit is around weight loss.
Our workouts that are strength based, resistance training are not intended to be a source of weight loss. Now, they can promote weight loss definitively and there are some nice studies coming out to show that on a molecular level. It is part of a well rounded weight loss program, because you can actually trigger the breakdown of fat tissue with a resistance training program. So that's good, but it is not going to be something that we want to see long term combined, the calorie deficit and the working out piece of it. So thinking about, okay, I'm not in a deficit.
I'm just a regular maintenance, just getting started. Again, you're going to start to see those strength gains within the first couple of weeks. You're going to feel it, you know, very quickly. If you have been doing, if you've been lifting for a long time, you're probably not the person I'm I'm talking to right now in that you you are understand where your progress is gonna be and it's gonna be a lot more drawn out the longer you've been lifting, the more years you have under your belt, and that's that's okay. But if you're new to this, you should start to see some some strength and some hypertrophy gains earlier on in those first four to eight weeks.
They may not be huge but they're gonna be there. Everything that we're talking about is slow and incremental progress no matter what. It takes a long time to build muscle. And it's it's all of it, we're going back to the long game anyway. Right?
We've talked about longevity and and what do we wanna be able to do when we're a hundred years old. Well, think about it. We gotta fill that space. So if you're 50 years old right now, that's another fifty years of slowly progressively building up. We're not gonna be, you know, if you wanted to take performance enhancers steroids, maybe you could do the process a little faster.
But it's not meant to be a fast progress. And I think in our society, we always want these results nowadays. We want instantaneous. And honestly, if you're looking for instantaneous, you're going to continue to be disappointed, I think. And it's more of a shift in mindset of setting up consistent behaviors, consistent goals that are gonna allow you to progress slowly, methodically to that ultimate goal.
And I love that you set the expectation of getting stronger because that is measurable, and we can see that as we go along. You know, you can really see I was able to do this many reps, and I was able to do this much weight, and now I'm doing more. And I think that's one of the most frustrating things about exercise and and really body or health change in general is knowing what we're measuring and knowing what we're tracking. It is the long game, and it's annoying. Right?
It's frustrating to say, like, I am working so hard, and I'm not moving the needle of what I wanted to see. So I think, first of all, like you said, setting that expectation of, like, well, that needle is gonna move really slowly. But at the same time, there are things we can track earlier. I think seeing, seeing the progress we're making in that strength is one of the is one of the great things that we can see along the way. I do think, energy is another thing that a lot of people talk about, although I find that quite variable.
You know, some people are like, I started exercising. My energy popped right up. I feel so much better when I'm exercising. And I don't think that's necessarily the case for everyone. I think some people start exercising and actually do feel more tired for a while before they actually feel energized by by exercise.
Do you want to comment on that? I think part of that is that we got to look at the other factors for them. You know, how is their sleep and how is their fueling. Exactly. Because if if exercise is really draining your battery, that probably is a warning that your battery's already been draining from these other aspects, stress, sleep, nutrition.
And so stepping back and saying, how are those? Are those in line? Because if they're not, then yeah, you're right. Exercise is gonna be a complete drain on the system. So we've gotta really have all those foundations in place.
Yeah. I'm glad you said that because I do think when people are starting on a health journey, of course, most of us try to kind of engineer it ourselves when we're starting. Right? Some people will start with a physician or with a coach who, like, creates it from step one to step a hundred, but most people are kind of trying things on their own to start with, which is great. And I do think some people expect, like, I'm so mad.
I've been waking up early to exercise like I'm supposed to and I feel terrible. Like, that's data. We should use that data to to evaluate what else is going on in the body. I also think in terms and then we'll move on. But in terms of expectations, tell me if you agree with this.
I think that by the end of three months, I don't necessarily expect to see a bunch of body composition changes. Mhmm. But by six months, you should really be seeing some I mean, this is hugely variable. Right? Because it depends on the nutrition piece.
It depends where you're starting. But I think by six months of consistency, you can see pretty obvious, gains and changes, lab changes. Would you agree with that? Would you put that earlier or later? I I think six months is a very reasonable goal to to especially if we're on more of that newbie spectrum.
Yeah. Now, will it be your optimal body composition? Right. Probably not. Yeah.
Or or your optimal goal composition. Thinking how most women are aiming for that leaner physique or too many women are aiming for that leaner physique, that may not happen overnight. Or it may be six months. But thinking about that as more of a longer progression of twelve, even twenty four months in terms of body composition goals. Because to be honest with you, the most effective that I've seen around are those who really focus first on building muscle and then worrying about, okay, let's think about fat loss and calorie deficits.
Once you have that muscle built in, you've built that metabolic engine that we talked about last time, like that's gonna be a real, real key. But I do think, as you said, you know, within six months, we definitely start to see the lab changes, which are wonderful. You know, we do see impacts on our cholesterols, our inflammatory markers, because muscle has both, it is an inflammatory process, but it has this nice anti inflammatory component to it. So we can lower levels of inflammation in the body. So we start to see those beneficial aspects as well.
So I would say it's very reasonable by the six month mark. Presuming I mean, again, I'm gonna caveat that of we've got good nutrition, we've got good sleep in the background, we're working on our stress. It may not be perfect, but those pieces have to be there to see the best benefit. Yeah. For sure.
Okay. I wanna go back to something you said earlier and you were talking about the importance of rest. And I I really want to I'd love for you to explain to us a little bit more about the science and the physiology behind that because I think it's really fascinating and a little bit counterintuitive from what most of us have learned and most of us have taught, which is like, well, if you if you're overweight, then you should run more. Right? Like, you should do more.
You should, walk more. You should rest less. Right? Whatever it is, rest less and that will be better. So explain to us the importance of rest and actually kind of the science and the physiology.
You mentioned that it's during rest that we're actually seeing that growth. And then if you'll also mention in that piece, you just mentioned you threw out there, that it's an inflammatory process, but then has some anti inflammatory benefits. So if you'll tie all of that in together of this actual physiology of muscle building because I think it's I think it's really interesting. Yeah. No.
It's it's it it is. So the actual workout. So you go into the gym, you pick up the weights, you start doing some dumbbell curls. Well, in your bicep, what you start to have is a tearing, a damage to the muscle. So the the workout itself is not creating muscle.
It's creating a damage that then has to be healed. So it's during your recovery phase. So that's resting for forty eight, seventy two hours before you do it again. That's when the healing part of it takes place. So that initial damage there, there are little cytokines, little chemical messengers that are released by the muscle, and that starts to trigger the healing phase.
And it's in the healing phase that the neuromuscular connection, the connection between your nervous system and the muscle, so the nerves and the muscle together, build stronger. The actual cells of your muscle get larger and you can have more of them. And all of that takes place when we're resting, when we're recovering. So if we're going in and we're hitting the gym and we're hitting the same body part every day, you're never giving your body that time to truly recover, and you're just compounding damage, which in the long term is gonna lead to injuries. It's gonna be completely ineffective for your goals.
Now if you're in the gym every day and you're rotating body parts such that you're hitting a body part every seventy two hours, then that probably is okay. But at the same time, we as a whole in our nervous system and our total body does need time away from the gym resting. Same thing applies to, running. You had mentioned running earlier. I know that's not the focus of our of our talk right now.
But having rest, having these reduced loads are gonna allow for those exact same processes related to our cardiovascular system. So it's it's not during the insult, which is the workout, that creates the the long term benefit. It's in the healing phase, the recovery phase that creates that long term benefit. And if we're fueled, we have the components around the carbohydrates, the muscle glycogen, the protein to be able to have that build there of what we're aiming for. Okay.
Well, let's now move on and say, like, how do we do this? Because it's starting to sound a little bit complicated, starting to sound a little bit complex. How do we actually get started with this? How do we design a workout and come up with a workout program where we can incorporate all of these elements appropriately of rest and progressive overload and proper form, how do we actually put that together? Is it is the only way we do that with a program or a trainer or are there some ways we can get started on our own?
So I think you can definitely get started on your own if you know a few basic moves. The the main ones that we try to think about are pushing, pulling, hinging, and squatting. And so most of us kinda have intuitively understanding what those are, and maybe we watch some YouTube videos. And that can that can kinda get us on our our goal. But I would say for most folks, there unless they've taken courses to be a trainer and understand the aspects of programming, it's very reasonable to go out and seek out a program out there.
And there's some wonderful ones out there. I personally don't make my own workouts. I follow programming. And one, I love that I don't have to think about it. I, you know, I've got enough on my brain.
I don't have to build anything. I don't have to tell my I just follow what I'm told. So it's a little bit of a mental reprieve to do that. But there are some really, really, really good folks out there that are doing some beautiful work to create these programs that are geared towards your goals. If your goal is truly muscle hypertrophy and you wanna go all the way to like a bodybuilding type focus, then there's gonna be programs that are geared towards you.
If you're kind of middle of the ground and you're like, hey, I wanna be practical about my workouts and I want to be someone that can balance life and the workout and not have to spend hours in the gym. There are more practical programs out there. So it's really kind of what your goal is, in terms of looking for a program, but I I I think it's a very reasonable way to not have to worry about, you know, am I progressing? Am I giving myself that progress? But if you really feel like, hey, I wanna start at home, I wanna start with, you know, these these weights that I have, and I know these couple of exercises, then let's let's work through that.
Your overall with a hypertrophy based program, we're looking at somewhere between five and thirty repetitions. 30 repetitions, I don't know about you, but that sounds highly unappealing. And and truly, it's hard to at that upper end of the spectrum to gauge, are you close to failure? Are you just hitting your take point? And let me go back for a second because I I love where you're going, and I wanna go back and catch this one thing.
If you're looking for an online program, are there things to look for or things to run from that you would say? So first off, running from anybody that's guaranteeing quick fixes. Mhmm. We just talked about how these are slow, longer progressions. If we are seeing something that's like, hey, get fit in six weeks or bikini body ready.
Those types of programs, I'd probably step away from. They're not thinking about your longevity. You wanna be as you're picking a program, something that you can do long term, both for your lifestyle, your interests, your goals, all of the above. So looking for someone that has a trainer certification. There there are a number out there and sometimes it's easy to get lost and not know what what the best ones are.
There's the American College of Sports Medicine that has several certifications. There's N1 programming that is a very, very solid program. They have certified trainers. Those are two that you can kind of look for. But but there are a number of other ones out there too.
But making sure that it is somebody that has a background in training, maybe looking through their social media, what is their messaging? That's another kind of thing to be looking at. Again, quick sells are are not set up for longevity. So those are those are probably the biggest aspects to look at. And then the time commitment.
Mhmm. Is it something that you can commit to? Some of them are set up so that it's more four to five days a week. Other ones are a lot more flexible. Like, say, you only have three days a week.
You only have two days a week. So ones that are more flexible might appeal more. So that's the other piece to look at too. Okay. That's super helpful.
And then before we move on to to kind of starting yourself, you have mentioned a couple times this idea of hypertrophy. Will you just explain what that means and how how that's fitting in here? So we're we're clear on that. So hypertrophy is gaining size of the muscle. We talk about strength.
Strength is actually your ability to lift a total amount of weight. So moving an object with force, through space. If your strong metric may be that I can lift, my total maximum weight goes from a hundred pounds to 200 pounds. That's true strength. Hypertrophy is the actual size of the muscle.
So we talk about big biceps. That's hypertrophy. So growing in that size, You can actually, I mean, as you're doing hypertrophy, you're gonna gain some strength. But if you're looking for absolute strength, it's a slightly different way that the programming is gonna be set up. Most people are looking for hypertrophy.
The reason is that's what's building actual muscle. Strength is an absolutely important aspect of it and should be a factor in any programming, but it's not the one that's gonna make large muscle. If that makes sense. So hypertrophy is the most common type of programming out there. And again, it's because most of us are looking to add muscle, to build muscle.
And I'm gonna caveat again, women, you're not gonna get bulky. It's so incredibly hard for women to get bulky, without the use of steroids and additional, enhancers there. But you will be able to build some amount of muscle. And then when there's that body composition change, you might actually have that lean and tone look from actual building of larger muscles. So Thank you for that.
So strength would be more like when you see in the Olympics the power lifters who can lift one giant weight one time. And what we're talking about is increasing the tone of the muscle and the look of the muscle. And maybe we can't lift, you know, 500 pounds, but we're overall getting those more toned larger muscles that are going to give us those metabolic benefits and and the benefits we talked about last time. Exactly. Hey there, listeners.
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Okay. Now let's go back then to to getting started on your own at home. You started talking about a number of reps. So we're saying, okay. I I know how to do a few moves.
I've gone to the gym. I've worked with a trainer in the past. So if you give me a list of exercises that's like biceps curl bicep curls and push ups and squats, like, okay. I can get started with that. And now I wanna kind of make sure that my program is building hypertrophy, which we just learned about.
I wanna make sure my program is progressive and and giving me those gains. So go ahead and explain to us how what a good program should look like when we're we're looking for hypertrophy. Okay. So, again, the there are different ranges for repetitions for muscle. Yeah, I kind of skipped over that piece of it.
If we're aiming for strength, our repetitions are actually going to be really low. It's going to be one, two, three, four, maybe five in terms of a set where we're working towards strength. Because, again, strength is that one time ability to lift your maximum weight. Versus hypertrophy, we're gonna be in a much larger range and we're gonna be in a higher number of repetitions, so in that five to 30. When you're setting up your program, you're probably gonna be somewhere in that five to maybe 15.
And the reason I say that is going over 15, at some point you're losing your ability to track, am I getting close to failing, which we talked about last time and and to reiterate, failing is that inability to complete a repetition with good form. And it's okay to hit failure. That's that's not the problem. But if after 15 repetitions, there's actually moving into what's called muscular endurance, where we have lactate buildup in our muscle. And we may stop because it hurts, not because the muscle failed, but because it hurts from that lactate buildup.
And it's not lactate, it's the protons and the acid buildup, but that buildup becomes uncomfortable. And so we stop because it's uncomfortable. You're not going to very well hit that if you're in that five to 15 range. So sticking in that five to 15 range. Now within that, there is gonna be some variation.
If you're following a program, you may see that they stick with a six to 10 range or an eight to 12 range or 12 to 15 range. And that's really getting into kind of the finer points of it. And I don't think, you know, as a starting out, we need to worry so much about that. But if you're following a program, great. They're they're gonna understand how to really fine tune those pieces.
But all right. So we're in the five to 15 range. So you do you you you pick up two dumbbells and you do a bunch of curls and it hit your like at 15 reps, you're like, I could have done another 15 and I could have gotten up to that 30, right? Well then what we're working with there is we're really far from that failure point. We have tons of repetitions in reserve.
So repetitions in reserve or RIR is how many repetitions do I have in my back pocket that I could still do when I stop doing this weight? The closer we can get that repetition in reserve to that failure point. So fewer and fewer and fewer in reserve, the more likely we're going to trigger this muscle hypertrophy. And it's been studied quite a bit and really in zero, meaning no repetitions in reserve and failure to about four to five is that sweet zone that we wanna be in. So if I pick up the next suite of dumbbell carols and I do 10 and I'm like, alright.
I think I could do five more. That's five repetitions in reserve. But if I pick it up and I'm like, oh, I've only got I might be able to squeeze out one more. That's one repetition in reserve. So a progressive program that you're following using this RIR metric, you would slowly start out from maybe four to five repetitions in reserve, three to four repetitions in reserve, and each week, inch it up just a little bit.
Maybe go from three to four to three to two to three to two, and you're slowly incrementally pushing it. And I can tell you, most people learning and just getting started, they're gonna try to go for failure in that last week if you're doing a progress program and you hit the week six or seven and you're like, alright. This week, we're we're bringing our all our lifts to failure. And you, you're like, okay, well, last week I did 10. All right.
Eleven's gotta be my failure point. Right? And then they surprise themselves and they're like, woah, I did 15. So they were definitely sandbagging it a little bit. And that happens.
We know that it happens and that is a newbie thing until you really test your waters and you start to go to failure to feel what failure feels like. Most of us are usually sandbagging, myself included. I, that's actually one of my favorite things. I love to surprise myself in that failure point and be like, I did three more than I was anticipating. And that's kind of a cool feeling.
So when you talk about, Hey, when am I going to feel strong? When am I going to start to see these changes? That's a great example of it because you're like, wow, I did way more than I thought I could. And so using that metric of five to 15 in the back of our head, and we're working up on this slow progression each week of working closer and closer to failure over, say, four to six weeks, that's your progressive overload. And so maybe you hit that fifteenth rep and you're like, well, I could have done a couple more.
All right. Now it's time to go up and weigh. So that's, that's how you kind of use those ranges is you hit the top end of your range. It's time to add weight. And when you do that, you know, okay, well, I went from 10 pounds to 15 pounds and now I can only do eight repetitions instead of 15 repetitions and that's okay.
But that's, that is that progress, that progression. And I highly recommend writing this down. Depending on the programming that you're following, some of them have apps now where you can record that. But I highly recommend having some sort of data that where you're able to track this so that, because, you know, even if it's only been a week, if I go back, I'm like, I don't remember how many I did last week. And, you know, make yourself a little note, tell yourself, you know, if you used a machine or a dumbbell, you know, keep track.
That will help with the whole progress too because then you can look back and say, hey, six weeks ago, I was doing this with two and a half pounds and now I'm doing it with 10 pounds or 10 pound to 30 pounds, you know, depending on, you know, what it is and what exercise it is. Breaking that down are, you know, in terms of the types of exercises that we're gonna do, I talked about those four main push pull, hinge, squat. How you're gonna set that up is entirely dependent on what equipment you have available, and what exercises you're comfortable with at home. I could list off a whole slew of types of exercises, but I I don't think that that's the true goal here. But we wanna kinda hit a couple of those with each workout if we're doing total body workouts.
Okay? If you are able to only do two to three days a week, I would recommend probably sticking with more full body type stuff so that you're hitting each of those points. If you are able to get in four or more days, that's where we wanna have upper body, lower splits where one day is dedicated to upper body, one day it's dedicated to lower body. It gives you more rest in between, more recovery in between, between, you know, before you go and do that next one. And some people can make those workouts shorter because you're just working on upper body or you're just working on lower body, depending.
But that's how you kinda wanna think about it. If you're only able to do two days a week, definitely make them full body so that you're hitting all of those muscles. And as far as the number of sets go within that, so say I I pick dumbbell curls and I'm doing them in a range of eight to 12. Well, now I need to figure out how many of those I'm gonna do and how many sets I'm gonna do. Usually somewhere in the four range per week as a minimum for hypertrophy, you can certainly do more, but try and hit at least four sets per week.
So if I say I do regular standing dumbbell curls twice on Monday, and then when I do another set of upper body on Thursday, I do hammer dumbbell curls, which is a slightly different rotation. And that will still give you four sets of bicep curls per week, but it will, be two two types of exercises if that makes sense. Yeah. Well, I I love that you went through that. I do think you kinda talked me into just buying a program.
But, but here's the thing I love about that is I think that when you go through that and you understand kind of the science that goes into building it, that's not what most of us are doing. You know, for a long time when I first got started, which I'm I'm a late starter. I was I'm not athletic. I'm not a I have not had long periods of time where I've been super into an exercise routine. But as I've gotten more into exercise over the last several years, I think when I first started, it was like turn on this YouTube video or turn on this random yoga video or turn on this random Peloton video.
And I think that's a great way to start. I think finding the ways just to to be consistent showing up can be great. But it can get really frustrating because then you're like, here I am showing up all the time and I'm just not seeing a lot of, like, am I stronger? Like, I guess, I did that yoga video last time and now I'm a little stronger now. Or I I did that video before and maybe I feel like I can do it a little bit easier.
But what I love that you're talking about is really being efficient. And most of us are busy enough that we don't really want to spend hours at the gym if we don't need to. I I do think there are some people who really, really love the gym and really just enjoy being there and doing those things. And and I'm very happy for those people to have found that that passion in their lives. But for most of us who want the gains, but we don't want to make it our, you know, second career, we really want to just get in, get get it done, and get out.
I think that's exactly what you're explaining is how to make it really count and how to make it really efficient so we can get in, get the progress done, and then and then go do whatever else we wanna do with our lives. A %. I mean, I full admission, I don't wanna spend hours in the gym. Yeah. Unless it's a truly, like, rainy day, I have so many more things I'd rather do outside.
And that's whether it's summer or winter, I'm probably going hiking. And so I want my workouts to be efficient and I want them in in a way I've picked a program that's gonna support my goals around cycling and hiking because those are where my passions lie. Now say, you're like, Well, I don't do any of those other things. An efficient program is still a good idea if you have anything outside of the gym that you enjoy for life. And that's exactly what you're talking about.
Running around chasing your children, driving them here, there, another way you, you don't have time to spend the, that two hours, three hours that some people are able to do and more power to them. But I'm right there with you is let's make it efficient and let's let's use our time wisely to get the biggest bang for our buck. Yeah. For sure. The other thing that I wanted to bring up, I do think we covered this on the last episode a little bit, but I I think there is such this benefit of confidence that comes from doing this type of workout.
I think any type of movement brings confidence because as we move our bodies and feel comfortable with it, that's a really lovely thing. And I think if you enjoy dancing or Zumba or, you know, whatever, that has its own benefits. Mhmm. But I think I've seen a lot of my patients who have, and in myself, who have gone through this more structured strength training program of with the goal of getting stronger. Right?
That's the main goal is to say, I am getting stronger. One of the things that I see them coming and telling me is how much they enjoy kind of the the art of it, the the game of it a little bit to say, like, hey. I did this last week. I've been tracking. I knew exactly what I could do.
And just like you said that you kind of found that enjoyment in, like, hey. Look at that. Like, I thought that I was maxed, and now I had five more in me. That's pretty fun because before, I didn't. And I do think even though it sounds a little nerdy, I do think there's a lot of people find a lot of joy and fulfillment and satisfaction and self confidence in that idea of seeing themselves get stronger in ways that you may not with other exercise forms like yoga or trail running, which I'm I'm a big fan of both of those.
And they're just different for me. They're just I love them and they're I I love them. But for this, you really get to see yourself making that progress. I don't time myself on a trail run, so I'm not really trying to progress. I'm more, you know, enjoying nature, inventing, and whatever.
But in strength training, you can really see that progress and kind of, you know, happily nerd out a little bit about it. Like, hey. Look what I did. Like, I'm Yeah. Absolutely.
Absolutely. And and really, if you're and and you're making that progress and you're like, I can do that in the gym. I can do pretty much anything else in my day. Yeah. Right?
Like, I'm I'm sitting in this meeting and I'm over it with my boss and I'm not enjoying that, but I can get through this because this morning I lifted, you know, x amount of pounds and it was awesome. So, you know, there there is that capacity building to yourself and throughout the rest of your day. And I will say, you know, to the the piece of doing the other things outside, I think there's some confidence built when you are able to do those other enjoyment activities with more capability. Yeah. You know, when I'm when I'm going up a mountain and I'm like, wow, okay, this doesn't hurt as bad as it did, you know, the year before because I spent the whole winter working on my lower body and improving that.
And then all of a sudden I'm able to do these things with more efficiency and and and more strength. That's a huge, you know, because you can enjoy that activity that much more. Yep. So yeah. There's a lot of benefits all around.
Yeah. Well, I wanna ask you a couple questions about, supporting the strength training outside of the actual exercise. But before we do that, anything else you wanna add to the actual strength training routine? Is there any any pearls that we've missed or anything that you want to add before we talk a little bit more about fuel and a couple other things supporting this? Yeah.
And and and you may touch on this in the next bit, but I do wanna say as far as when we're working out, with this routine really doesn't matter. It when you can fit it in is the most important part. So if you're like, well, some days it's in the morning and some days it's in the evening, that's okay. I I mean, ideally, if you're gonna be doing one in the evening and one the next morning, there are different types of workouts, you know, upper and lower body or something like that if if that's how your schedule works out. But in general, you know, the time of day really, really doesn't matter.
There were some studies that tried to look at that. And there was some question like to say that women could have, could build their upper body better if it's done in the afternoon. It was a single study, you know, and I wouldn't put a lot of faith in that because if you can't get your workout in in the afternoon, what does it matter? Right. So I I wouldn't hang my hat too much on those.
I would say time of day truly doesn't matter. It's when you can get it in. Awesome. Yeah. Well, one of the questions two of the questions that I get the most are creatine and testosterone.
I am treating a lot of perimenopause and menopause, so I'm a fan of testosterone for other reasons, in the inappropriate situations. But will you tell us testosterone in terms of, muscle building or strength training and then creatine as well? Well, I'm a big fan of creatine, so I'm gonna jump the gun to that one. I think it's something every woman can benefit, every man can benefit. Women more so because, men men can hold on to their creatine more efficiently than we can.
But it is something I'm I'm a big fan of for all women. I think women that are more on the vegetarian, vegan spectrum are gonna benefit even more from it because they're not getting as much from their dietary gains. But even if you are a meat eating person, you have to eat a lot to get in the appropriate dose of creatine. So even if that is the case, you still are gonna benefit from taking creatine daily. It's pure energy is the way to think about it.
It not only benefits our muscles, and our capacity to do things, but it also benefits our brain. So there's some great studies that have been done around sleep deprivation and creatine that have shown a benefit. It's safe in kids. It's safe in pregnant women. So I just I can fawn over creatine all day long and it it really is a wonderful molecule.
There are mild side effects if you try to do big loading phases with it. So some protocols out there will say take twenty grams for five days and then cut back to the daily three to five grams. It's also been shown that you can easily just start with a three to five grams, per day, and that will get your stores up over the next couple of weeks without the GI side effects that come from a large load. So that's that's what I usually what I tell folks to do. And does it matter when you take it compared to exercise?
No. So, you know, early on it was shown that, you know, or it was felt that we had to do it during your workout and that was but no. Actually, they they've done plenty of studies that as long as you get it in that day, that's really what's most important. I can say if you take it in the evening, it may impact your sleep. So probably first half of the day is ideal.
The one thing about creatine is it actually was studied in terms of hot and cold beverages. It's best if taken with a cold beverage or cold yogurt or, you know, whatever you're mixing into and not hot. That does seem to affect it. So that would be my one caveat, which, you know, you wouldn't think that it would because it's already a broken down molecule, but apparently it does. So avoiding heat with it is is the best.
But otherwise, very few restrictions on when to take it. And then I also find I don't think people feel much from it, but maybe that's I don't talk to them a a ton about creatine and strength training. It comes up. But do you find that when people start it, they're like, oh, I feel better? Or do you feel like it's more taking it on faith of, like, the study's showing it work?
Mixed results on that one. I think there's some people that notice a bigger, you know, a bigger upfront boost. And then there's definitely other folks. I'm actually one of those other folks. I don't notice a big boost right away when I'm taking it, but I do notice if I've skipped it for a while.
Interesting. So if I'm like, oh, I've been out of it for a week or two and thinking about it, my workouts aren't, I'm not feeling it as much. I'm feeling a little bit more of a drag. That's my own personal experience, but I've had plenty of my patients say, wow. That stuff was amazing.
I've had other people say, well, I haven't noticed too much. And that's fair, but I still encourage them to take it because it is just knowing my experience, it's one of those things that you may not recognize while while you're taking it until you don't. Yeah. Yeah. And I think the same thing.
And that's why I tell people because supplements are annoying when you don't feel anything. Right? When you're just like, I think this is doing something for me, but I don't feel it. And there are ones like that that we just that the data is good enough that we just we just do it. We just go in.
Exactly. Tell us, about your thoughts about testosterone, especially when it comes to strength building and muscle building. It's not essential Mhmm. For women. It is something that estrogen actually plays a bigger role in our muscle protein synthesis capacity, especially premenopausal.
And that's why we've seen that there is some influence for when you take HRT in terms of muscle quality and, and muscle building capacity. It doesn't mean you can't. That is very important. Even if you decide, I hate HRT is not for me. And that's the hormone hormone therapies of estrogen, progesterone.
You can still gain and make gains in the gym. That's the that is still a possibility, but there is some some improvement when taking hormone therapy. Testosterone itself is not essential. Will you feel overall like your capacity is reduced if your testosterone is low? Yes.
And so that is something to definitely check with your doctor and, make sure your levels are appropriate and, and, and otherwise, supplement, but it is not the game changer, the end all be all. You're still gonna be able to build muscle even if that's not in the optimal range. Again, it's gonna come down to, hey, maybe I'm not feeling optimal during the workout and it's because your testosterone's on the low side, then definitely. If your testosterone's in the normal range and you're like, I'm not feeling it, it's something else. Yeah.
I agree. It's it's definitely, you know, something else. And we've talked about the number of fillers that are gonna impact that and how we're feeling on the day to day. I'm gonna say go back to fueling over and over and over again because I think many women are under fueling and they're under fueling their workouts. And so you're gonna feel that.
And maybe your testosterone is on the lower side because you haven't been fueling. And if we fuel, then we fix that problem. We don't need a medication. So, I guess that's all to say a boost for fuel is is the most important. Yeah.
I love that. I I see a lot of patients who have already gone to hormone clinics, and the the some of these hormone clinics that that I don't agree with the way that they're run is they're very everything is hormone related. So if you're not feeling well, let's just give you more testosterone. If you're tired, let's just give you more and more and more, and they'll come on really high doses still not feeling well. When I treat patients with testosterone who are really low, one of the things I do see them say is, I feel like I have a little more oomph in the gym.
It's not necessarily fatigue and energy, but it's like Mhmm. I feel like I have a little more rev. But it's fifty fifty. Some women who have super low testosterone don't feel that, so I don't think it's the end all be all, but I do like to test it. And I'll say too, we think about low testosterone and perimenopause and menopause, but I have found many low testosterone levels in younger women too in their twenties and thirties.
And I don't think that the answer is just to give them testosterone, but I do think it can be an indication of how stressed the body is and what may be weighing the body down. And I do think that translates then into our energy in the gym and energy overall. And so Mhmm. It is all all interrelated. It's it's worth looking into if you're feeling like, I go to the gym and I'm trying to do what she's telling me to do.
I'm doing all those things and I just I'm not feeling strong. I think, like you said, it could be testosterone, but it could be one of the other pillars and and really diving into fuel and and making sure that we're supporting the strength training not just by powering through and doing harder and more, but by saying like, I'm this doesn't seem like the typical experience that I've heard of when you start a strength training program and you're making progress and lifting heavier and feeling these wins. If that's not your experience, then then maybe back up and explore some of the other support around strength training. Absolutely. I I think it's it's almost epidemic at this point, especially among women that that we've run into this issue.
You'd be amazed how many how many are are are under fueled. Yeah. Yeah. And honestly, like, it's annoying. Right?
It's annoying to really fuel your body appropriately. Like, I kind of hate that I have to spend as much mental energy as I do on fueling my body. Like, some days you definitely think it would be easier if someone gave you the the proper macro mix in, like, just a powder. Like, the only thing I ever had to do was just add water through the day. And, of course, that's not great because we lose joy of food and all of that.
But, man, the it it is annoying. It's annoying to think through things and to recognize how we want to do it. But I think that so often it's not because it was invented like, our bodies were not invented to be really difficult to fuel. I think it's difficult to fuel because we've bucked nature's systems so much. You know?
Mhmm. It's because we have boxes of Cheerios for cereal as a default that we have to work so hard to then find the proper way to fuel our body. Not because our bodies are difficult to fuel, but because our culture and our our ways, you know, the industrial revolution and all of those, you know, all of it has kind of made it so difficult to buck that system and go back to nature's way of fueling our body. So it's I I think it's annoying, but here we are. I it's important.
It's really, really important. It it's and it's worth spending some time and learning where you need to be at. You know, there there's all sorts of macro counters, calorie counters, all that kind of stuff out there. I think it's worth giving yourself a couple weeks at least of focused on that. Focused how much am I getting in during the day?
Count it. And if you're just counting macros, that's okay. You don't have to know like the calories or just count the protein. Just protein. Yeah.
And and just see how much you're getting in a day to day. Now there's a the aim of one gram per pound of body weight is is an easy metric to kinda keep in the back of your mind. But really the ideal is point seven to one gram per pound of body weight of the protein aspect. And, you know, ignoring carbs, ignoring fat, you know, for the time being until you're you feel like, hey, I wanna fine tune those a little bit more. If you have endurance goals, I would definitely start to fine tune those carbs because that is a very good way to under fuel your endurance activities is not eating enough of those.
Yeah. And you know, it again, we get into this, oh, we've got to eat less and lose weight. And we get into this vicious cycle where we just get so used to eating less that we're, we're completely undernourished. We're completely under fueled. We don't recognize how much it is that we actually have to eat.
Yeah. So that's an important aspect to keep in mind. But if you just start on focusing on how much protein you're in getting day to day and you're able to get in three large boluses of protein, you know, at breakfast, lunch, and dinner, fantastic. Yep. You don't have to eat every two hours.
And I don't actually recommend that Yep. To get in your protein amount rather these bigger boluses, fewer amount of times a day is is actually better for from muscle protein synthesis. And it's very clear that starting your day with a good sizable chunk of protein is better for your overall metabolic health. And it's gonna fuel those workouts whenever they do fall into your debt. Yeah.
So, yeah, it's it's an area that is essential to support this whole idea of of we're talking about strength and we're talking about building muscle and we're talking about having the capacity to do all these things. Really, if we don't have the fuel in on board, we're gonna lose all of those or or not be able to really optimize all of those. Yeah. Awesome. Well, anything else you wanna say as we wrap up?
Anything that you feel like we've missed or anything as a parting, just kinda shout it from the rooftops that you wish women knew about this this concept of building muscle and strength training? I mean, I think that we've hit a lot on all the different points. Just getting into the gym or just getting into a workout routine as a starting point is huge just to build up your consistency. But if you really wanna start to build progress and really hit those goals, that's where I think I do think you need to get into some of the nitty gritty that we've talked through today. And we really have only just kinda scratched the surface.
And I wouldn't recommend that anybody, do any of this without a little bit more help than the broad overview that we've talked about today. For sure. But, you know, don't be afraid to ask for that help. Don't be afraid to look into some of these other programs that are out there that can give you a lot, but be scrutinize them. You know?
Again, what are their goals? What are your goals? Make sure that they they definitely align. Make sure they're they're qualified to be able to be chatting with you and talking with you. And then in the background, keeping those foundational pillars is is always essential.
If we feel like we're getting into a stuck point, you know, we're plateauing, for example, there's a couple ways to kinda think through that. Are we actually pushing ourselves hard enough? You know, have we worked up to that failure point? Are we fueling enough? I can't we'll we'll keep coming back to the fuel.
Yeah. Are we sleeping enough? Are we taking enough rest days? Maybe we've been going hard for eight weeks and we haven't taken, you know, a quote unquote deload week or a reset week, where we just kind of cut back on the number of repetitions, the amount of weight, and give our body a little bit of break. Or maybe we walk out of the gym and we don't go to the gym at all for that entire week.
What I wanna emphasize on that point is that if you something comes up in your life and you can't go to the gym for two weeks, you can't go to the gym for a week, you're not gonna lose all of your gains. You truly aren't. And there's been some nice studies that have shown even taking a ten week break that the folks who took a ten week break were able to catch up to folks that hadn't taken a break due to a faster kickstart of the muscles they had already been built before that. So yeah, maybe you won't be able to go right into the gym and lift exactly where you were, but you'll be able to get up faster if you do have to take a break. So that's another nice thing about muscle is once you start to build that reserve of muscle, once it's there, it's gonna be there and you can reactivate it.
So say right now you're listening to this and you were previously quite athletic and did a lot of strength training, but then life got in the way and you haven't stepped in the gym in ten years, you you're actually gonna have faster gains than someone or you're you're you're gonna be able to reactivate that muscle a lot faster because those those little muscle cells are there. They're just a little bit more dormant, and you'll be able to get back into it fairly swiftly, presuming, of course, all the other fillers are there. So don't let that be a deterrent for you either. And if you are new to it, if you were totally new to it, don't be afraid to dive in because you you you will have you you actually get the newbie gains which are are kind of the fun the the fun gains to be able to have because you're gonna see some of the fastest progress. But don't don't be afraid.
Lean on other women in your in your community who are doing it. Reach out. Don't be afraid to chat with them about it and and, how they got started or how they're doing things. It's it's your life. It's your it's it's thinking about where you wanna get to in the long run.
So just dive in and go for it. I love that. Thanks so much for sharing all of your wisdom and your great tips, and I think this will be really helpful for people to know kind of taking their their workouts to the next level and figuring out how to troubleshoot if it feels like they've been just not seeing the the gains that they wanna see. So thanks so much for your time. Absolutely.
It was a lot of fun. Thank you so much for tuning in to today's episode. A huge thank you to our guest for sharing their insights and time with us. We are grateful for the incredible support from our sponsors and to all of you listening. We couldn't do this without you.
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