Having worked with hundreds of women over the past 16 years as a trainer, I have seen the constant struggles many females face when it comes to getting in great physical shape. While it is difficult for all of us to achieve great physical fitness it is fair to say the female population has a much more difficult road to take. From complex hormonal systems, to hyper-mobility, an anatomical structure that compromises stability, it can be difficult to enjoy exercise and fitness activities. When you add on top of this the constant body shaming, Instagram comparisons and belief that smaller is better, it is no wonder many women are turned off from trying to improve their health and fitness. I believe the community needs to understand just how important exercise and eating well is for women's health and not focusing solely on losing weight. For while women tend to live longer than men, their quality of life is often diminished significantly due to several health factors. In this article I discuss these factors in great detail and the reasons many women avoid exercise altogether.

The health and fitness industry has exploded over the past 15-20 years as more people have become aware of the incredible benefits to exercise and eating well. Only 20 years ago gyms were mainly seen as a place for guys interested in body building to lift big weights, and the girls to do aerobic classes. You very rarely saw people in their 40’s or older adults exercising as this was seen as mainly a younger person’s domain. It is great to see that times have changed and people have become more educated as to the value of strength training.

However, I am not convinced that many people are exercising truly for health reasons as there is still this constant push to lose weight and look good. Years ago it was about looking good in the mirror, now it is about looking good on Instagram or Facebook. Research shows that Instagram use is strongly linked to self –objectification. The more women view fitspiration images on Instagram, the more likely they are to base their self-worth and happiness on how they look.

This is where people take drastic measures that severely compromise their health. They are convinced that they will be happier when they lose weight and treat exercise as punishment and food as the enemy as they seek to lose as many calories as possible. Their choice of exercise is not based upon what their body needs, but what they think will make them skinny and look good.

Even the medical community, who should know better, along with the media focus too intently on losing weight in the belief that all health problems disappear once someone is skinny. I have met many skinny people with six-packs who were very unhealthy people. Always remember this.

“Being skinny is not a measurement of health.”

What Should Women Focus On?

I think it is important to understand what the greatest health risks and obstacles women face with regards to health and fitness. Take a look at the info-graphics below.

It is clear that women have several greater challenges than men, mostly due to their complex hormonal structure. What can you do about it?

Strength Training for Women Is ESSENTIAL

I cannot say this enough, along with eating quality nutrition the value of adding muscle to a women’s body is far and away the most important ingredient for optimal health. Several of the risk factors listed in the infographics above can be easily controlled, and even eliminated as a concern by adopting strength training 3 times per week.

Research shows that your muscles are more indicative of your overall health than your BMI is and that low strength with females dramatically increases health risks. Without regular exercise with resistance the process of strength and muscle loss can start in women as early as their late 20’s and early 30’s. When this is combined with endless dieting and finding ways to lose weight the consequence to their health is immense.

Let’s take a quick look at each of these factors in more detail so you are perfectly clear as the reason you need to lift weights and add muscle.

The Complex Female Hormonal System

I have mentioned this a few times already that women have a much more complex hormonal system than men. Hormones control much of what you feel such as being hungry, thirsty, tired, sick, energetic, hot or cold. On a basic level your hormones are like your body’s messengers, they are produced in one area of the body such as the thyroid, pass into your bloodstream where they can be sent to organs and tissues to modify structures and functions.

They act like traffic signals telling your body what to do and when to do it so it can run effectively. They are as much a part of your respiratory, cardiovascular, skeletal, immune and digestive system as they are a part of the reproductive system. Females obviously have a much more complicated reproductive system and the hormonal cycle dramatically changes things within their body on a regular basis.

If there is an imbalance left unchecked it can cause a lot of trouble to your health as all of the hormones are thrown out of balance.

It is important to understand that there is no good or bad hormones, there is only good balance or bad imbalances of them. Too little or too much of certain hormones can lead to obesity, and obesity can create changes to hormones and their levels. Too much estrogen for example leads to the development of breast cancer. The female reproductive system requires delicate care to maintain this hormonal balance and avoid throwing the body into chaos. A classic example of this would be menopause or PMT.

What is the best way to control these hormones?

Eating quality food, getting enough sleep, controlling your stress, and exercise.

The exercise of choice again is strength training. Why? Muscle is one of the best natural methods for balancing out your hormones as the extra muscle increases your body's production of human growth hormone (HGH). The muscles of people who regularly lift weights absorb blood sugar in response to insulin much more effectively helping the pancreas to secrete lower amounts of this hormone.

There is so much more to muscle than looking good on Instagram.

Osteoporosis & Bone Density

Decreased bone density occurs when bones lose minerals such as calcium faster than the body can replace them. The decrease in bone mineral density (BMD) and changes in bone quality make bones more fragile and more easily broken than bones of 'normal' density. Low bone density is known as osteopenia and is the range of bone density between normal bones and osteoporosis.

While osteoporosis is also common in people with malabsorption disorders such as coeliac disease and certain hormonal disorders, like type 2 diabetes it is often a disease created from lack of activity and poor lifestyle habits.

Women are more likely to develop osteoporosis than men due mainly to a lack of muscle mass to begin with. Women who have gone through menopause are at the highest risk of osteoporosis as their bodies can no longer absorb calcium as well as it did when they were younger.

When the thoracic vertebrae are affected like in the picture above, there can be a gradual collapse of the vertebrae. This results in kyphosis, an excessive curvature of the thoracic region. This causes what is known as a Dowagers Hump! Not very attractive, but even worse than how it looks is the damage it creates to rest of the body. Multiple injuries begin to surface when this poor posture is left untreated. It is a very long slow process to correct this condition, it is so much easier to prevent it from happening.

The good news is you can prevent this decline and even reverse it! By eating calcium, getting enough Vitamin D and using strength training exercises to improve your posture and bone density.

Below are some great videos to watch with detailed explanations of how to address this.

You will find a ton of information about this in the articles

• Everything you need to know about bone density and arthritis
• What causes a dowagers hump?
• How to correct Kyphosis and the dowagers hump

Headaches, Migraines, Neck pain More Common with Women

Statistics show the prevalence of headaches, migraines, and neck pain in women is significantly greater than men. Why is this? Well there is no definitive answer as to why but when you consider the rate of injury with neck and shoulders you can see how it is much more likely that women will suffer with chronic headaches and migraines. Winged scapula problems as seen in the picture below are much more common in females than males and this postural dysfunction is linked to many shoulder and neck injuries.

Take a look at the statistics below to see the prevalence of shoulder pain in women.

Following on from our last point with osteoporosis and bone density the postural problems combined with a lack of strength to support and stabilize the joints of the shoulder and neck it is no wonder many women suffer with neck stiffness and pain. Women tend to have longer hair than men which makes their head weigh more. This extra weight adds more strain to the muscles of the neck and shoulder region, and if weakness already exists they will inevitably experience problems.

Once you add mental stress to the mix you now have the perfect storm for a lifetime of chronic pain. This is where you also see the development of TMJD (temporomandibular joint disorder) also known as jaw pain. In the book “The TMJ Healing Plan” by Cynthia Paterson she quotes a study by the New England Journal of Medicine that 40-75% of adults in the US report at least one sign of TMJ disorder!

They also found TMJD is 3-9 times more common in females than males.

With the onset of jaw pain the chance of chronic migraines and headaches is extremely high.

Most of the time people respond to problems like TMJD and neck stiffness with stretching and massage. It makes sense right? Unfortunately, all you are really doing is treating the symptom and not addressing the underlying cause, which is usually weakness and poor movement strategies.

In the book "Fixing Neck Pain & Headaches" by Rick Olderman he states.

"Almost all neck pain and headaches I treat are primarily due to poor shoulder blade (scapula) function regardless of the structural diagnosis involved."

This is very important to understand for it helps to explain why people never seem to get rid of their stiffness no matter how many stretches or massages applied. In some cases this serves to make the neck even worse as the stiffness is the only thing holding them together. This does not mean stretching and massage is of no use, it means you need to follow up any mobility work instantly with the stability correction.

If mobility is improved a very small window of opportunity will appear in which the body cannot rely on stiffness as its method of stabilizing as you have just disabled the muscle/s responsible. In this window is where you can begin to strengthen muscles primarily responsible for stability and begin to involve them in the process of movement again. You have to be very careful with how much you do for too intense or excessive volume will turn the stiffening muscles back on. The exercises must challenge the stabilisers enough to retrain them but not so much that it fatigues them excessively.

For example the serratus anterior wall slides exercise is a perfect example of a stability exercise that follows a mobility release.

You can read more about how to address the jaw and neck in the following articles.

• How to get rid of a stiff neck
• What causes TMJ Disorder and how to correct it
• Why the body chooses stiffness over stability
• Why I love the serratus anterior wall slides exercise

And for more detailed help with neck, jaw and shoulder exercises download the report below.

Heart Disease, Cancer & Type 2 Diabetes

Since 1984, more women have died of heart disease than men each year and is more deadly than all forms of cancer combined. This is partly because women generally live longer than men. However, while women live longer they are more likely to suffer with chronic illness and disease much earlier compromising their quality of life.

Women tend to be older and have more health problems when they develop heart disease, and experts have long assumed those differences might in part explain the gender survival gap. Research also shows that women are less likely than men to take prescribed medications and a lack of understanding about heart disease with women is partly to blame. This lack of education sparked a campaign in the US called goredforwomen.org to bring greater awareness of the symptoms and treatment required for heart health in women.

Heart disease is not something that only affects older women as it can occur in women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. And while the risks do increase with age, things like overeating and a sedentary lifestyle can cause plaque to accumulate and lead to clogged arteries later in life.

With Type 2 diabetes the global statistics on the WHO (World Health Organisation) website paint a very bleak picture.

• The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014.
• The global prevalence of diabetes among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014.
• Between 2000 and 2016, there was a 5% increase in premature mortality from diabetes.

Those with type 2 diabetes are

• Two to three times more likely to develop pancreatic cancer – one of the most deadly cancers.
• Women are twice as likely to develop liver or endometrial cancer, have a 50 per cent higher chance of getting bowel cancer and a 20 per cent greater risk of breast cancer.

Lastly, we need to look at the statistics with cancer.

• Cancer is the second leading cause of death globally, and is responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer.
• Around one third of deaths from cancer are due to the 5 leading behavioural and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use.

Yet there is still a feeling among the community that cancer is due to genetics, or the inevitable price we have to pay for living longer as modern living has enabled us to increase our life expectancy. Yet, age is clearly NOT the only factor, as the incidence of some cancers has risen in ALL age groups.

Our modern way of life is conducive to the development of cancer, a bad diet with too much sugar and processed foods, being overweight, and a sedentary lifestyle creating the perfect breeding ground for precancerous cells to go rampant. These destructive modern lifestyle habits create inflammation, and this increases the production of nitrogen and oxygen free radicals that damage DNA and destabilize its structure.

The message is clear that all of these chronic diseases are linked to each other via our modern lifestyle. And the best way to combat this is via exercise and eating healthy foods.

There are as many as 20 other beneficial biochemical changes that occur during exercise, some that help you burn calories and lose body fat, while others help stabilize your blood sugar and maintain testosterone and cortisol levels. Basically, being a healthy weight and exercising regularly creates a good cycle that optimizes and helps maintain healthy glucose, insulin and leptin levels.

Insulin and leptin resistance is caused by excessive eating of sugars and grains in combination with a lack of exercise—and is the major cause of weight gain and is now known to be the underlying factors of nearly all chronic diseases that we see in today’s modern lifestyle.

Great articles to read on these subjects are below.

• Exercise is just as effective as medication for preventing heart disease
• Type 2 Diabetes prevention is better than a cure
• Cancer prevention is more important than ever

ACL Injuries in Women Sports

Over the past 5-10 years female participation in amateur and professional sports has exploded which is a great thing. Unfortunately the rise in sports injuries has also increased and one of the worst injuries seen in sports is the ACL rupture of the knee. This particular injury is a season-ending injury and even a career-ending injury for some!

With females, the chances of this injury occurring are a staggering 5-8 times higher than males!

As opposed to collision injuries that are being in the wrong place at the wrong time, up to 70% of these ACL injuries are non-contact injuries, meaning they were caused from a poor cutting move or pivot or landing poorly from a jump. ACL tears happen when you plant your foot on the ground and attempt to rotate your body in relation to the planted foot, placing your weight on it. This creates a twisting force through the knee joint, which the ACL must absorb. When the ACL cannot cope with the force it ruptures. This movement is the common movement seen in basketball when a player tries to change direction off the dribble or in football when evading an opponent from a tackle or landing from a jump.

But why are females more at risk?

In my detailed article I published in 2018 (Why females are more at risk of ACL injury) I listed 7 factors in great detail. These include:

1. Poor neuromuscular control
2. Anatomy
3. Quadriceps to hamstring ratio
4. Joint laxity
5. Poorly designed strength programs
6. Ignorance to moving well
7. Ignorance to running technique

The need to learn how to move correctly and strengthen the body is absolutely critical for females playing sports. This is not a luxury, it is something they must devote considerable time to for the risks are very high.

Watch the videos below where I assess a Women’s football team and explain the risk factors associated with several of these players.

If Strength Training Is So Important For Women Why Do So Many Still Avoid it?

With all this information I have just provided about the value of strength training for women why do so many still avoid it? I must admit this is something that really frustrates me as a trainer who specializes in injury and rehabilitation. I am constantly having to convince women that they should be doing weights and the benefits to their health is more than just looking good. Yet, what I regularly see is most women participating in Yoga, Pilates, and cardio exercises. While this type of exercise has some benefits, it will not address the problems we have discussed in great detail so far.

I am often told that Pilates and Yoga are great forms of strength training for women as it helps them to tone their muscles, making them long and lean. This is absolute rubbish. There is no form of exercise that can make a muscle stronger in this way. The word “toning” is just a marketing ploy to make the word hypertrophy (building muscle) sound more feminine and sexy to the girls and these exercise methods take advantage of this thought process. Muscle tone has nothing to do with muscle shape or size, it refers to the muscles level of resting tension.

Without doubt the most common reason women avoid strength training is the fear of getting big like a guy. To do this is near impossible for most women.

For starters women only have 1/10^th the testosterone levels of a male, and this hormone is the most important ingredient for “getting big”. Secondly you need a lot of time and you have to eat a massive amount of food to do this. Even guys struggle to gain muscle size for they cannot eat the extra surplus of food and lift weights every day to turn it into muscle.

Watch the video below of two female trainers who explain why strength training is so important to them.

With regards to Yoga I fully endorse this method of exercise for mental health and learning to breathe correctly. But, in terms of improving flexibility with females I am not as excited. Females have much greater flexibility and greater joint laxity and while this can be a good thing as it allows for full range of movement it can come at a cost if there is not enough stability and a lack of motor control as discussed earlier. The main reason females have this extra joint laxity is to allow for childbirth, if their body was as stiff as a male, they would be unable to give birth. During pregnancy, there is even a secretion of relaxant hormones to further enhance this.

Knee laxity is greater in females than males, and increased knee joint laxity has been found to be a great predictor of ACL injury.

Stretching, Yoga and various movements that encourage excessive mobility must be treated with caution for the female, for even though this may look impressive and may not cause any pain at the time, this extra mobility is potentially creating a severe loss of functional stability at other joints. Too much flexibility is just as bad as not enough, in fact, I would go further to say it is actually worse.

I my opinion most women need to tightened, not loosened. In my mobility assessments it is very rare to find a female who fails the tests. Yet, with the stability and strength tests there is a 90% failure rate with pelvic and shoulder stability assessments!

Another reason women do not participate in exercise and especially weight training is that they hate exercise. They simply do not enjoy it. I do not have the answer to this problem but I think much of this has to do with the way it is promoted in the media, TV, magazines, and of course social media like Instagram. So many women are put off exercise altogether for fear of being judged and unrealistic ideas of what healthy is. The images of taut and toned #FITSPO influencers does more harm than good in terms of inspiring women to get healthy. Where I live in Melbourne Australia the local state government Vic Health launched a new campaign in 2020 called This Girl Can which focuses on empowering women to believe in themselves and feel comfortable getting active.

On the flip side of this is the women who see exercise as a form of punishment and a way to burn calories. Excessive exercise and is not healthy in any way and over-training will quickly ruin any positive gains you may have made.

A great book to read about the danger of excessive exercise is “Fit Not Healthy” by Vanessa Alford. This is the story of how one woman's determination to be lean, fit and healthy took her to the brink of infertility and death and how she pulled back just in time to regain her health and perspective and start a family.

While not all women may go to this extreme I have worked with many young women in recent years injured from working out 5-6 days per week at F-45. All of these women suffered severe bulging disc injuries to their lower back that required over 12 months of rehabilitation. All of this could have been avoided if they were taught how to respect exercise and learn to build health in a positive way.

Don’t Forget About Nutrition

We cannot conclude this article if we do not discuss the importance of a healthy diet. One of the first lessons I learned early in my career is that calorie counting does not work. And even when it does work in terms of losing weight it is still not a good way to achieve optimal health. We must move beyond looking at weight loss as instantly being healthy. Someone can be a healthy weight range but extremely unhealthy as their body is deprived of essential vitamins and nutrients needed for optimal function of vital organs and bodily functions. We need our food to provide these essential vitamins and nutrients. We must look at our food as more than just fuel or energy to do exercise as it is so much more than that. 

The old saying you are what you eat is so true.

Cutting back and ideally eliminating processed foods as much as you can is a great start. This will ensure your nutrition is from fresh vegetables, fruits, meats, dairy and grains that are loaded with the essential vitamins and nutrients your body needs. If it is in a packet, bottle, or jar, don’t buy it. This means it is processed in some way so try to minimise as much of these foods as you can. By completing this step you are already half way there!

Secondly you need to find the foods that best fuel your body. What works for one person may be completely different for what you need to eat. You need to experiment to find your answer.

I find the Keto diet combined with intermittent fasting works really well with most people as it gets them off the constant sugar craving. You can read more about this in the articles below.

• What you need to know about intermittent fasting
• How to use the Keto diet to improve your health

Do You Need More Help?

For more help with the various things we have discussed in this article make sure you grab a copy of the detailed PDF reports below. Each of these contains a stack of detail about how to improve your strength and overall health. The heart health report includes a ton of information relating to nutrition.

Summary

The female body is a very complex system and maintaining great health can be very difficult at times. The need to apply strength training in combination with quality nutrition cannot be overstated to ensure the body’s hormonal system is maintained in perfect balance. The lack of muscle mass can contribute to so many problems and affect women across a wide section of ages. With ACL tears most prominent in teenage girls in sports to osteoporosis in older women the need to add muscle is vital. We must try to educate the women in the community as to the benefits of strength training and overcome this long held stigma and myths circulating that prevent them from taking part in this form of exercise.

For the risk of serious disease and injury is blatantly obvious.

If you live in Melbourne and would like to know more about our personal training or core strength programs click the image below to request a free consultation and I will get back to you within 24 hours to schedule time.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 16 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

• Give Yourself More - By Georgie Fear & K Aleisha Fetters
• Equal Not The Same - by Paul Chek
• Fit Not Healthy – Vanessa Alford
• Movement - By Gray Cook
• Corrective Exercise Solutions - by Evan Osar
• Athletic Body Balance by Gray Cook
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Back Pain Mechanic - by Stuart McGill
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• How To Eat, Move & Be Healthy by Paul Chek
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Advanced Program Design - By Paul Chek
• Twist Conditioning Sports Strength - By Peter Twist