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Within the upper extremity, men have broader shoulders to support more muscle mass, which in turn provides advantages to the muscles acting at the shoulders. This difference helps explain why woman only exhibit 52% of the strength of a man in the upper extremity versus 66% of the strength of a man in the lower extremity (7). So, how do these knee and shoulder disparities impact training? Given the popularity of higher-intensity, whole-body exercise-type programs (e.g., jumping exercises, squat-presses, cleans, etc.), it certainly justifies the need to first examine, then establish or improve knee and shoulder stability, before progressing to strengthen both regions, regardless of goals or training experience. Herein lies the value of a fitness professional well versed in assessing levels of stability and mobility within the lower extremity (ankle, knee and hip) and upper extremity (lumber/thoracic spine, scapula-thoracic region and glenohumeral joint) and throughout the entire kinetic chain. Keep in mind however, that these assessments also hold great value in men. Figure 1-2 provides a simplified overview of the stability-mobility relationship throughout the kinetic chain that the body follows during basic movement patterns (e.g., walking, bend-and-lift, push, pull, and rotation) (8). This illustration provides a template for professionals to follow when aiming to re-establish stability and mobility throughout the entire kinetic chain. Once assessed, any designed programs, whether corrective or active/functional in nature, should emphasize:

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Table 1-1 provides the top reasons cited for participation in exercise by women of different age classifications (13). Whether reasons are to look better, lose weight, stay healthy or preserve functional strength, participation in resistance training is critical to the success of each. Effective strategies for weight loss should include resistance training as it minimizes potential losses of lean body mass as illustrated in Figure 1-3 (14).

As part of the 2008 Physical Activity Guidelines for Americans issued by the U.S. Department of Health and Human Services (HHS), adults should participate in moderate or high-intensity muscle-strengthening activities on two or more days a week (15). Unfortunately, participation by females in resistance-type activity appears to fall very short of that guideline as illustrated in Figure 1-4 (16). Social physique anxiety (i.e., fear of bulking up) is a common reason cited by women for not participating weight training, but so too are lack of knowledge and understanding on programming and technique. Social physique anxiety tends to be higher in women who exercised in a mixed-sex facility and results in shortened workouts. In this case, consider training these female clients in more secluded areas or during low-traffic times. Emphasize the development of skill and competence (self-efficacy) initially using selectorized machines which are generally a good fit. 041b061a72