What is the recommended resistance training regimen for a generally healthy adult with no significant medical contraindications?

Resistance Training for Healthy Adults

For generally healthy adults without significant medical contraindications, perform resistance training 2-3 days per week using 1 set of 8-12 repetitions per exercise, targeting all major muscle groups with 8-10 different exercises per session. 1, 2

Core Training Parameters

Frequency and Volume

• Train 2-3 non-consecutive days per week to allow adequate recovery between sessions 1, 2, 3
• Perform a minimum of 1 set per exercise, though single-set programs produce most health and fitness benefits while improving compliance due to time efficiency 2, 3
• Include 8-10 different exercises per session covering major muscle groups: chest press, shoulder press, triceps extension, biceps curl, pull-down (upper back), lower-back extension, abdominal crunch, quadriceps extension or leg press, leg curls (hamstrings), and calf raise 1

Repetition Ranges by Age

• Adults under 50-60 years: 8-12 repetitions per set at moderate intensity 1
• Adults 50-60 years and older: 10-15 repetitions per set at reduced resistance levels (40-60% of 1-RM) to minimize injury risk 1

The higher repetition range at lower intensity for older adults specifically addresses injury prevention, as previous injury is the single greatest predictor of future musculoskeletal injury during resistance training 1

Proper Exercise Technique

Movement Execution

• Perform all exercises in a rhythmical manner at moderate to slow controlled speed through full range of motion 1
• Breathing pattern: Exhale during the contraction/exertion phase and inhale during the relaxation phase to avoid Valsalva maneuver and excessive blood pressure elevation 1
• Alternate between upper- and lower-body exercises to allow adequate rest between muscle groups 1

Initial Resistance Selection

• Set initial weight at a moderate level that permits completion of the prescribed repetition range with proper form 1
• The early training phase emphasizes musculoskeletal adaptation and technique mastery to reduce excessive muscle soreness and injury 1

Training Goals Based on Desired Adaptations

The American College of Cardiology and American Heart Association guidelines provide a foundation, but specific adaptations require different approaches 4:

For Maximal Strength Development

• Use 3-5 repetitions with heavier weights (≥80% of 1-RM) 4
• Allow 2-3 minutes rest between sets 4
• This recruits more high-threshold motor units and optimizes neural adaptations essential for maximal strength 4

For Muscle Hypertrophy

• Use moderate repetition ranges (8-12 reps at 60-80% of 1-RM) 4
• Apply progressive overload: increase resistance when you can perform 1-2 repetitions over the target range for two consecutive sessions 4

For Muscular Endurance

• Use 10-15 repetitions at lower resistance (40-60% of 1-RM) 1, 4

Complementary Training Components

Flexibility Training

• Stretch major muscle groups 2-3 days per week 1
• Hold static stretches for 15-30 seconds, performing 2-4 repetitions per stretch 1
• Focus particularly on lower back and posterior thigh regions to reduce chronic lower back pain risk 1

Critical Safety Considerations

Pre-Exercise Screening

• Screen carefully for cardiovascular limitations and preexisting orthopedic/musculoskeletal problems before initiating resistance training 1
• Individuals with low functional capacity (<4 METs) may warrant additional risk stratification and monitoring early in their program 1

When to Stop Exercise

• Stop immediately and seek medical consultation if chest discomfort or undue shortness of breath develops during training 1
• Do not exercise when experiencing cold or flu symptoms; wait until symptoms have been absent for 2 days 1

Environmental Adjustments

• Avoid vigorous exercise within 2 hours of eating to prevent gastrointestinal distress 1
• Drink water before, during, and after moderate-to-vigorous intensity exercise lasting ≥30 minutes 1
• Adjust exercise intensity to environmental conditions, particularly in hot weather 1

Common Pitfalls to Avoid

• Using exclusively one repetition range limits overall development; combining different loading schemes provides optimal results 4
• Neglecting progressive overload will stall adaptations regardless of repetition range 4
• Prioritizing weight over form at heavy loads increases injury risk significantly 4
• Higher intensity efforts (fewer repetitions with heavier weights) can adversely affect the knee during leg extension and shoulder rotator cuff 1

Progression Strategy

For beginners, the emphasis is on proper technique with moderate loads (8-12 repetitions) before progressing to more specialized protocols targeting specific adaptations 4. Machines are generally safer than free weights for those with musculoskeletal limitations, and guidance from a clinical exercise physiologist or physical therapist is recommended for appropriate machine adjustment and exercise selection 1.