Mental Health Performance - Exercise Prescription For Improving Athlete Psychological Outcomes
About the Author
Ben Foodman is a licensed psychotherapist & performance specialist. He owns his private practice located in Charlotte North Carolina where he specializes in working with athletes to help them overcome mental blocks (the yips), PTSD, ADD / ADHD and achieve flow states through the techniques of Brainspotting & Neurofeedback. If you are interested in services, use the link here! Enjoy the article below!
Mental Health And Strength & Conditioning
As a both a licensed psychotherapist and certified strength & conditioning specialist, I have had the unique opportunity of being able learn about the importance of overlap between exercise and mental health. Many individuals who are experiencing mental health concerns are oftentimes dealing with the following issues: sedentary lifestyle; experiencing significant declines in motivation; susceptible to poor sleep; undergo unpredictable bouts of anxiety; struggle with maintaining healthy body weight; and experience declines in self-confidence. In my private practice I am frequently asked if there are certain types of exercises that can help individuals improve their mental health concerns and what the proper exercise protocols would be for those issues.
Because I believe exercise is a critical component towards maintaining positive mental health, I wanted to take the time to address the most common questions that I receive surrounding this issue. For this Training Report I will cover three areas: first I will explore different types of weight training tactics that individuals can focus on to help with their mental health concerns while also explaining how specific exercise are more likely to help compared to others; second I will explore different cardiovascular exercises to utilize, the importance of cardio exercise for mental health, and which cardio exercises are best to use to avoid injury; and finally I will discuss rest & recovery for exercise. First, let’s explore weight training and how it can help with mental health.
Exercise & Mental Health Outcomes
When most people think of weight lifting, CrossFit and body building are some of the first things that come to mind. But these are specific training models and do not necessarily equate to positive health. In fact, there is substantial research that cites the high injury rates that are associated with the previously mentioned training models. For the purpose of this Training Report, we want to to discuss what types of weight training can actually translate to positive health outcomes especially when discussing how to help reduce negative mental health symptoms through exercise prescription. But there are a few terms we need to go into first before we explore specific training protocols. First, how do we define positive health outcomes for the population as a whole?
There are a variety of subjective definitions that could be ascribed to positive health outcomes. Having worked extensively within the field of mental health & strength training I would describe positive health outcomes as a sustainable state of physical and psychological well being. It’s not enough just to arrive at an ‘ideal’ state. You have to also be able to live in that subjective ideal state long term. For instance, when people go on a diet they will initially lose body fat and hit a body weight number that they were aiming for. However, some research suggests that many diets have approximately a 95% fail rate, meaning that individuals have a 95% chance of not only regaining the weight they lost during the diet but in some instances they can also put on more weight compared to what they weighed before.
Benefits Of Heavy Weightlifting On Mental Health Outcomes
When people begin exploring weight training protocols to help achieve positive health outcomes as well as improve their mental health symptoms, they need to create an exercise routine that is sustainable (something that one enjoys and consistently engages in) while also selecting exercises that are low risk in injury but also engaging the body in a specific way that reduces negative psychological symptoms. For this to happen, individuals need to be mindful of two different factors: specific exercises; and intensity of training. From my perspective as a licensed psychotherapist and strength & conditioning specialist, I believe that the majority of individuals will benefit from lifting heavier weights with lower quantity of reps, and choosing multi-joint exercises that target large muscle groups. Let’s explore the rationale for this.
First, when training large muscle groups through multi-joint movements, individuals are able to secrete larger amounts of serum testosterone which can both increase the development of other muscle groups and create an anabolic response in the body. This is a good thing for positive health outcomes because the larger and stronger our muscles are, then the more likely we are to be able to exhibit autonomy and control within our environment and reduce the likelihood of injury. But just as important is the fact that when we lift heavy, we are able to access Type II motor units which have a higher threshold of recruitment. This is important for improved mental health outcomes because activating these motor units essentially leads to increased central nervous system activity which can be beneficial for positive psychological homeostasis.
Some research suggests that when we have more control over our bodies through increased central nervous system activity this can provide not only a calming sensation to the body, but also improved focus, decreased levels of anxiety, decreased levels of depression, and increased levels of confidence. Interestingly healthcare professionals such as occupational therapists have seen successful patient outcomes with children exhibiting ADHD, by having them lift heavy objects in a repeated and measured approach. So with all of that being said, what would the ideal program look like and what are some exercises that can be selected that give patients the best outcomes to achieve these mental health outcomes and reduce the likelihood of injury? Let’s first look at a program outline example:
SAMPLE PROGRAM DESIGN
Superset 1
Multi-joint / large muscle group movement + Multi-joint / large muscle group movement
Superset 2
Multi-joint / large muscle group movement + Multi-joint / large muscle group movement
Superset 3
Unilateral movement + Unilateral movement
Accessory Work
Core isolation + Active Recovery
REP RANGES & PERCENTAGES
Superset 1
3-5 sets of 3 - 6 repetitions (combination of either push / pull or upper / lower body movement) @ 80-90% intensity or 8-9 / 10 SPE
Superset 2
3-5 sets of 3 - 6 repetitions (combination of either push / pull or upper / lower body movement) @ 80-90% intensity or 8-9 / 10 SPE
Superset 3
3-5 sets of 6 - 8 repetitions (combination of either push / pull or unilateral upper / unilateral lower body movement) @ 65-85% intensity or 7-8 / 10 SPE
Accessory Work
3-5 sets of 8 - 12 repetitions (combination of either push / pull or upper / lower body movement) @ 70-85% intensity or 7-8 / 10 SPE
EXERCISE SELECTION
Superset 1 Exercise Possibilities
barbell back squat, hex bar deadlift, Romanian deadlifts, power cleans, barbell front squats, barbell bench press, barbell military press, barbell rows
Superset 2 Exercise Possibilities
barbell dead lifts, incline barbell bench press, supinated pull ups, pronated pull ups, belt squat machine, V bar Lat pull machine, Lat pull down machine
Superset 3 Exercise Possibilities
single arm dumbbell rows, single arm dumbbell bench press, dumbbell incline bench press, single leg barbell step up, single leg kettlebell RDL
Accessory Work
planks, side planks, dead bug, side line leg raise, TRX band row, foam rolling, active stretching
Benefits Of Cardiovascular Training On Mental Health Outcomes
Making sure that your training incorporates cardiovascular exercise can have an incredibly positive impact on your mental health and overall wellbeing. With that being said improper training can also lead to undue stress which in turn can have a negative effect on your mental health. Proper exercise selection, careful implementation of rest, and rigorous self-monitoring will be a key component towards this type of training. It’s also important that individuals make sure that if they are going to run and lift on the same day, that they lift first. Before we begin reviewing actual exercise selection and programming tactics, lets explore what the actual benefits of cardiovascular training can have on your mental health status as well as providing strategies for enhancing your mental recovery.
First, there are many obvious benefits that actually indirectly have an effect on mental health. Cardiovascular training can improve ligament strength, tendon strength, stored glycogen, increase capillary density, increase aerobic power and decrease percent of body fat which in turn can improve psychological confidence in one’s own capabilities, improve self-esteem due to increased energy production, and increase one’s immune system which can have a significant overall effect on internal homeostasis. There is also a plethora of research that suggests increased cardiovascular training can help reduce anxiety, depression and improve overall mood. Combining cardiovascular training with weight training also appears to potentially create a positive synergistic training effect.
But like anything moderation and balance is key in order for individuals to truly achieve the benefits that can be accrued from this type of training. Individuals need to consider not only the stress load that will be absorbed from cardiovascular training, but they also need to evaluate if events in their personal life will require them to scale back their workload. We have to stop thinking of our lives in silos and start realizing that everything in some way affects multiple systems in our body. I recommend starting off your day by identifying on a scale of 1-10 (1 being negative, 10 being positive) how one feels overall. This number should be based on physical, psychological, social and existential health.
As individuals begin to incorporate cardiovascular training into their daily regimen, they should consistently assess whether this overall number is maintaining it’s current trajectory or if there is a negative linier response due to implementation of training and life stress. My recommendation is that individuals should try to maintain a consistent high number but if they start to notice a decrease in their overall number (along with decreased quality of sleep and increases in muscle soreness), then there is a good chance that it is time to implement a d-load recovery week. With that being said let’s look at some examples of cardiovascular exercise selection, training styles, and program design that someone could potentially follow.
EXERCISE SELECTION
Rowing machine, elliptical, treadmill, stationary bike, walking, hiking
HEART RATE ZONE TRAINING
Zone 1
104-114 Beats Per Minute
Zone 2
114-133 Beats Per Minute
Zone 3
133-152 Beats Per Minute
Zone 4
152-171 Beats Per Minute
Zone 5
171-190 Beats Per Minute
SAMPLE PROGRAM DESIGN
Long Distance, Slow Training Options
Week 1 - 15 minutes HR Zone 1, 20-40 minutes HR Zone 2, Cool Down 15 minutes HR Zone 1
Week 2 - 15 minutes HR Zone 1, 30-50 minutes HR Zone 2, Cool Down 15 minutes HR Zone 1
Week 3 - 15 minutes HR Zone 1, 40-60 minutes HR Zone 2, Cool Down 15 minutes HR Zone 1
Week 4 - 15 minutes HR Zone 1, 40-60 minutes HR Zone 3, Cool Down 15 minutes HR Zone 1
Interval Fartlek Training Options
Week 1 - 15 minutes HR Zone 1, 3 x 1 minute HR Zone 3 followed by 1 minute HR Zone 1, Cool Down 15 minutes HR Zone 1
Week 2 - 15 minutes HR Zone 1, 3 x 1:30 minute HR Zone 3 followed by 1 minute HR Zone 1, Cool Down 15 minutes HR Zone 1
Week 3 - 15 minutes HR Zone 1, 30 seconds Zone 4, 30 seconds zone 1, 45 seconds Zone 4, 45 seconds Zone 1, 60 seconds Zone 4, 60 seconds Zone 1, 45 seconds Zone 4, 45 seconds Zone 1, 30 seconds Zone 4, 30 seconds Zone 1, Cool Down 15 minutes HR Zone 1
Week 4 - 15 minutes HR Zone 1, incline or hill sprints 3 x 30 seconds sprints HR Zone 4, followed by HR Zone 1, Cool Down 15 minutes HR Zone 1
Connection Between Exercise, Sleep & Mental Health Outcomes
How one specifically designs their recovery performance program is just as important as the exercise and program design . Active recovery protocols are essentially the glue that holds positive physical health outcomes together. Without a thoughtful approach to how one improves their recovery, gaining improvements in mental health outcomes will be very difficult. There are several areas that individuals should focus on in order to maximize on both their psychological health and overall health performance: sleep performance; self-massage; and smart nutritional choices. Let’s first begin by exploring different tactics that can be employed to maximize on sleep performance.
Individuals looking to improve their mental health should start to view sleep as an individual performance. This means that there will need to be significant preparation that occurs before sleep commences. Shutting off electronics before entering the bedroom, setting the appropriate room temperature, and removing clocks from the bedroom are examples of the types of strategies that one will need to incorporate. But should individuals continue to experience psychological health concerns in addition to poor sleep outcomes despite these interventions, it may be necessary to consult with a psychiatrist and/or sleep specialist to rule out any medical health concerns.
There are also nutritional and supplementation choices that individuals can make that appear to help with recovery. In regards to sleep, some doctors and experts in the field of sleep have recommended a combination of Magnesium, L-Theanine, and Chamomile to help with sleep (assuming that individuals who have consulted with their doctors and received approval based on their subjective health factors). Other medical experts have also recommended that individuals increase their protein consumption along with Vitamin D and K. Some research seems to suggest that many individuals experiencing depression are also significantly depleted in Vitamin D.
Finally, individuals should regularly engage with massaging their muscles, frequently stretching and improving their balance through unilateral movements. Like a car, your body needs regular maintenance due to the extensive work that it undergoes. Some asymmetry between muscles is normal and does not need to be corrected, but this is assuming that individuals are consistently taking care of themselves. Regularly massaging muscles through foam rolling or using a percussion guns can improve the health of the muscle tissue, reduce muscle tension, and potentially help people maintain a healthy ROM which can reduce psychological stress for individuals.
Regardless of the severity of your mental health symptoms, incorporating physical activity and exercise will have a significant effect on your overall psychological health. The previously mentioned exercises are examples of strength training and cardiovascular exercises that in my opinion yield the highest return in terms of improving fitness, reducing the percentage of injury occurrence, and improving mental health. With that being said there are many different types of exercises that can be just as beneficial that were not listed in this article. Ultimately, individuals should take the time to invest in activities that they would both enjoy and honestly feel are sustainable activities (meaning that they will engage in them long-term). Exercise is NOT a cure for adverse mental health symptoms, and cannot provide deep processing in the same way advanced psychotherapy methods can (e.g. Brainspotting, EMDR, Psychodynamic Psychotherapy). Exercise is just one piece to the puzzle of overall health and wellbeing. But whatever you decide to do, make sure that you start slow and be patient with yourself, because like anything worth having in life, positive mental health takes time and effort to cultivate.
Note To Reader:
If you are an athlete reading this segment of the TRAINING REPORT, hopefully this content was helpful! I put the Training Report together because I felt like many of the discussions on issues such as the Yips/mental blocks, strength training & other subject matter on athlete performance concepts were really missing the mark on these ideas (e.g. how trauma is the direct cause of the Yips). If you are interested in learning more, make sure to subscribe below for when I put out new content on issues related to sport psychology & athlete performance! Also, if you are looking to work with a mental performance specialist, you are in the right place! USE THIS LINK to reach out to me to see if my services are the right fit for your goals!
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