The Perils of Muscle Beach

Just three months ago, the Journal of the A.M.A. had reassuring words for a reader who was concerned because his 22-year-old son with high blood pressure had taken up weight lifting. Two Journal consultants suggested that there was nothing to worry about if proper precautions were taken to avoid injuries to the muscles or joints. That reassurance may well have been ill considered. The Journal and Circulation, an American Heart Association publication, have now raised warning signals about both weight lifting and isometrics, exercises that increase the tone of muscles without changing their length. Such activity, they say, can cause far more harm than muscle or joint injury.

Natural Posers. "As a former weight lifter and as a specialist in cardiovascular disorders," Dr. William S. Breall of San Francisco writes to the Journal editors: "I would like to note a few other possible dangers." First of all, Breall says, a weight lifter should learn to breathe properly, or he may fall in a faint, damage his lungs or suffer a hernia in the groin or the diaphragm. Taking issue with those who dismiss high blood pressure as a hazard, Breall draws attention to the danger of "weight lifter's hypertension." A man performing "severe isometrics," he explains, markedly increases his blood pressure because he tenses his arm or leg muscles and cuts down the flow of blood through them.

Breall urges that doctors make sure a weight lifter's blood pressure is not continuously at an abnormally high level. If it is, he says, the patient should be forbidden to do any weight lifting. Other physicians agree with Breall and suggest that anyone with a tendency to high blood pressure should refrain from any form of isometrics, or static exercise, and consider instead such rhythmic exercises as swimming or jogging, which are preferable for the heart and circulatory system.

Writing in Circulation, Physiologist Alexander R. Lind of St. Louis University School of Medicine notes that while isometrics may increase the strength of one or more muscle groups, they do little or nothing to improve breathing efficiency or the workings of the heart. Tensing the muscles invariably raises blood pressure, Lind says, and the rise may be dramatic if the muscles are strained to half their maximum tension. He points out that the size of the muscles involved is of little importance: a 30% contraction of the small forearm muscles in a hand grip will have the same effect on the blood pressure as a 30% contraction of the much larger leg muscles exerting 31 times as much force.

Lind says that such increases of blood pressure might be dangerous for people with defects in the walls of the heart or great vessels or for certain patients with damaged heart valves. He adds that the deleterious effects for those with some degree of heart failure are probably illustrated by the occasional patient who suffers an attack of angina pectoris that is dramatically precipitated by working with arms extended or elevated. Physicians. Lind goes on to suggest, should study the possible blood pressure changes in their heart patients.

Infirm and Flabby. Dr. Lind takes a dim view of physicians and others who recommend isometrics instead of jogging, and "write in the open press urging the waddlers to turn instead to press-ups (pushups) and pull-ups." The risks are particularly great, he says, for the elderly, who are likely to be somewhat infirm and also flabby. "There is an ironic twist," he writes, "in that most of the recent popular articles urge the use of isometrics mainly in these groups of people, known to be more likely to have actual or potential weaknesses in their cardiovascular systems." If there is one kind of exercise in which such people should not indulge, Lind concludes, it is isometrics.

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