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A case for Powerlifting in increasing healthspan

There are many fundamental interests in life that most people generally share, such as staying healthy, finding love, and doing good for the society. These qualities are innate in us in varying degrees and may manifest in different shape and form along these pursuits.


These interests are means for us to live a meaningful life. Today, I am here to write about healthspan and strength, the former being our pursuit for living longer and healthier, and the latter of paramount importance for various aspects of human life, including physical health, daily functioning, and overall well-being. I find the association between muscle strength and living longer and healthier a captivating discovery in modern Medicine, as it unites my two big interests of mine as a medical student who competes in the sport of Powerlifting. While some find the idea of a doctor going to the gym contrary to stereotype, I believe that strength training and healthspan are more inter-related than commonly being given credit for.


Healthspan refers to the length of time in one’s life during which they are enjoy good health, free from significant illness, disability, or chronic disease.

First of all, let us define the foundational concepts upon which this article is based. Healthspan refers to the length of time in one’s life during which they are enjoy good health, free from significant illness, disability, or chronic disease. It represents the period of life when an individual enjoys a high quality of life and functional independence. Strength training is a type of physical exercise with the end of increasing muscular strength and endurance. Strength training involves performing specific exercises or movements against resistance, which can be provided by various means, such as free weights (dumbbells, barbells), resistance bands, weight machines, or even body weight (calisthenics).


Powerlifting are movements that best correlate with overall muscular strength.

Powerlifting is one form of strength training (and my favourite!) that involves three primary lifts: the squat, bench press, and deadlift, which are movements with high strength carry over to other sports, and are the best correlates of overall muscular strength. In competition, powerlifters compete to lift the maximum amount of weight in each of these three exercises within their respective weight classes. Whether one has competing in mind, it is undeniable that training for powerlifting is an excellent form of increasing overall muscular strength.



There is a growing body of literature suggesting a correlation between strength and healthspan. See the previous deep-dive article on articles supporting an association between muscle strength and healthspan, especially Ruiz et al (2008) [1], Newman et al (2006) [2]. Further to those articles, in a recent review published in 2019, Bohannon evaluated evidence that suggest grip strength can be used to consistently predict all-cause and disease-specific mortality [3]. In addition, correlational studies have found that grip strength accounts for bone health, upper limb function, cognitive performance and general quality of life. Therefore, the author suggests the routine use of grip strength as a possible measurement for evaluating health status of adults.


Muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases.

In the context of powerlifting, the bench press and especially the deadlift are good developers and indicators of grip strength. Furthermore, in a meta-analysis of prospective cohort studies published in the BMJ published by Momma et al [4], it was found that muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including cardiovascular disease, total cancer, diabetes and lung cancer. Muscle-strengthening activities of ~30 to 60 minutes per week were associated with a 10–17% lower risk of all-cause mortality, cardiovascular disease (CVD), total cancer, diabetes and lung cancer. However, the inverse relationship does not keep increasing with time spent on strength training. Beyond two hours, more weight training each week was actually associated with an increased chance of dying young.


Besides, we can reason to the fruits of powerlifting from what the sport does not involve. Powerlifting does not involve high-risk movements and scenarios, e.g., collisions, high-velocity impacts, fast and explosive movements. These might be characteristics of other sports, like mixed martial arts, football and rugby, that involve more than one person. Collisions and high-velocity impacts lead to extremely high risks of injury, whether concussions, bone fractures or joint dislocation, which may be irreversible. Moreover, sports that involve fast and explosive movements further increase risk of irreversible damage when these involve sudden changes in direction or speed, which contribute to a higher likelihood of tearing or rupturing tendons. On the other hand, powerlifting does not involve body tackles or collisions, unless, of course, one drops the weight on oneself purposely or through negligence. Rather, powerlifting involves lifting progressively heavier weights over time, in a gradual, deliberate and technical manner. Seldom outside of competition, do powerlifters actually train by lifting maximum weight on their lifts - as it is very fatigue-inducing without much strength benefit. Instead, it is more common for powerlifters to train with sub-maximal weight and lifting it for more repetitions (e.g. commonly from 3-8), thereby lowering the risk of injury caused by loading excess weight. Obviously, improper technique and form easily leads to injury, especially at a weight close to one’s limits. But there are risks associated with every form of physical exercise.


A final word in the context of Powerlifting movements. The “big 3” movements not only increase grip strength, seemingly an indicator of health status, but also contribute to the preservation of health. The squat and deadlift are hip-heavy movements that build a strong lower back and hips, in addition to increasing and preserving bone density. Strengthening one’s hips and lower back are crucial to long-term health, with increasing research backing the connection between hip fracture and mortality. More mature adults with hip fractures are ~3-4 times more likely to die within one-year after surgery than the general population. [5,6] This could be explained by the fatal consequences of a hip fracture, which lead to a pandora’s box of health issues such as loss of mobility and muscle tightening. Besides preventing hip fracture, the big 3 combined engage every major muscle group, training the muscles to work synchronously with coordination. Strength training prepares the person for daily functioning and helps prevent the ease of accidents, such as falling, tripping or losing balance. Even in these circumstances, increased bone density from lifting lowers the risk of bone fractures significantly.


All in all, powerlifting is one form of strength training. Its movements and training style is the fruit of decades of biomechanical and physiological research, effective to safely and steadily increasing overall muscular strength. With proper technique and adequate knowledge of programme design, you too can reap the fruits of this exciting sport!


References:

  1. Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjöström, M., & Blair, S. N. Publication: BMJ, 337, a439 (2008) DOI: https://doi.org/10.1136/bmj.a439

  2. Newman, A. B., Kupelian, V., Visser, M., Simonsick, E., Goodpaster, B., Nevitt, M., ... & Harris, T. B. Publication: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61(1), 72-77 (2006) DOI: https://doi.org/10.1093/gerona/61.1.72

  3. Bohannon R. W. (2019). Grip Strength: An Indispensable Biomarker For Older Adults. Clinical interventions in aging, 14, 1681–1691. https://doi.org/10.2147/CIA.S194543

  4. Momma H, Kawakami R, Honda T, et alMuscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studiesBritish Journal of Sports Medicine 2022;56:755-763. https://bjsm.bmj.com/content/56/13/755

  5. Mariconda, M. et al. The determinants of mortality and morbidity during the year following fracture of the hip: a prospective study. Bone Joint J. 97-B(3), 383–390 (2015).

  6. Lee, T. C. et al. One-Year Readmission Risk and Mortality after Hip Fracture Surgery: A National Population-Based Study in Taiwan. Aging Dis. 8(4), 402–409 (2017).


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