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I'm just getting back to an exercise program after months of being laid up with back pain. What's a good way to return to strength-training without reinjuring myself?

First, if you are under the care of a physician, you may want to make sure it's the right time to begin this type of program. This may depend on your age, general health, and status as a smoker (or tobacco user), etc.

Most experts agree that in order to build muscular strength and endurance and achieve a training effect, you must challenge the muscles. This means to perform the right amount of intensity and volume of exercise. The muscles must be loaded long enough to increase muscle fibers formed within the muscle.

Start with an easy amount of exercise and see how your respond. If there is no increased pain or other problems, then you can gradually increase the load enough to result in changes in the soft tissue.

In weight training, one repetition maximum (1-RM) is the maximum amount of weight you can lift in a single repetition for a given exercise. The 1-RM guideline can be used to determine the desired load for an exercise (as a percentage of the 1RM).

For example, exercise performed at 50 to 70 per cent of 1-RM is a good place to begin to build muscle endurance. This is especially true if you are performing multiple sets of repetitions. Gradually increase this to 60 to 80 per cent of 1-RM to improve muscle strength.

You can also include a program of upper extremity exercises that will affect abdominal and trunk muscles strength needed for core stability. Shoulder extension pull downs and horizontal shoulder extension (pull back elbow with arm at eye level) work quite well to strengthen core trunk muscles needed for a stable spine.

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