Resistance training may be the single most important type of exercise a person can do — and the scientific literature increasingly supports that claim. Not just for athletes. Not just for people recovering from injury. For everyone, at every age, regardless of fitness history. Yet when most people picture physical therapy in El Paso, they think of ice packs and resistance bands. When they picture a weight room, they think of bodybuilders. Both mental images are missing the point — and both are costing people their long-term health.
The importance of building and maintaining skeletal muscle has been extensively documented in recent literature, and the scope of its role goes well beyond moving your joints. Skeletal muscle is a metabolic organ. The more functional muscle mass you carry, the more effectively your body regulates blood glucose, manages lipid metabolism, and maintains hormonal balance. The clinical consequences of inadequate skeletal muscle mass are significant — it is directly linked to metabolic syndrome, obesity, type 2 diabetes, hypertension, and a range of endocrine-specific dysfunctions.
Loss of muscle mass — sarcopenia — accelerates with age and is now recognized as an independent risk factor for chronic disease, hospitalization, and mortality. Improvements in body composition through resistance training are not cosmetic achievements. They are physiological ones, with measurable downstream effects on disease risk, hormonal regulation, and long-term quality of life. The research on this is not ambiguous.
The popularity of GLP-1 receptor agonists — semaglutide and related medications — has exploded in recent years, and for good reason. These medications are effective at reducing appetite and driving meaningful weight loss. But something I have observed consistently with patients on GLP medications is that they are also losing skeletal muscle mass, not just fat.
When caloric intake is significantly reduced without a concurrent resistance training program and adequate protein intake, the body does not preferentially burn fat. It catabolizes muscle alongside fat. The result is a lower number on the scale that masks a worsening body composition — less fat, but also substantially less functional, metabolically active muscle. For anyone currently on a GLP-1 medication, resistance training is not optional. It is the mechanism by which you preserve the lean tissue that drives long-term metabolic health. Without it, the weight loss may be real, but the health benefit is incomplete.
When someone is in pain, strength deficits develop rapidly. Pain inhibits muscle activation through a neurological mechanism — the nervous system suppresses motor output to protect the painful area. Even a few weeks of altered movement patterns or reduced loading is enough to cause measurable muscle atrophy and motor control deficits in the surrounding musculature.
This is why returning fully to resistance training after an injury is not just about athletic performance — it is about restoring the tissue's capacity to do its job. An undertrained muscle cannot protect a joint. An undertrained body cannot prevent the next injury. Getting back to loaded activity is as clinically urgent as any manual therapy or hands-on treatment a PT provides.
One of the most common reasons people avoid resistance training — particularly women and older adults — is the fear of getting too big. This concern reflects a fundamental misunderstanding of how hypertrophy actually works. Building the kind of muscle mass associated with competitive bodybuilding requires years of dedicated, high-volume training with very specific nutritional strategies designed to drive muscle growth above all else. It does not happen accidentally. It does not happen from a well-designed therapeutic or general fitness program.
What does happen from a properly prescribed resistance program: improved joint stability, better movement efficiency, increased bone density, reduced injury risk, and improved metabolic health across every system. Research in long-distance runners specifically has documented that athletes who incorporate resistance training experience reduced injury rates and improved running economy — without meaningful increases in body mass. The adaptations that come from strength work make people more resilient, not bulkier. This finding holds across athletic populations and across ages.
Whether you're recovering from injury, on a GLP-1 medication, or just want to train more intelligently — Dr. Cisneros will build a program grounded in exercise science, not a generic handout.
Walk into most insurance-based physical therapy clinics in El Paso and you will hear the same prescription regardless of the patient, the injury, or the goal: three sets of ten. Every exercise. Every person. Every session. This is not clinical programming. It is a placeholder — a default rep scheme that requires no understanding of exercise science to prescribe and no clinical reasoning to maintain.
The actual science of resistance training is built around understanding the relationship between loading parameters and physiological adaptations. Lower rep ranges with higher loads develop maximal strength through neural recruitment and motor unit synchronization. Moderate rep ranges in the six-to-twelve range with moderate loads drive hypertrophy. Higher rep ranges with lighter loads develop muscular endurance. Explosive, velocity-based work develops power and fast-twitch fiber recruitment. These are not interchangeable. Each rep scheme targets different muscle fiber types, drives different neurological adaptations, and stresses different energy systems.
This connects directly to understanding aerobic and anaerobic energy systems. A runner whose rehabilitation program consists only of slow, controlled movements is never training the fast-twitch fibers that fire during race pace and acceleration. A CrossFit athlete whose program lacks explosive velocity work returns to competition without the power characteristics their sport demands. A powerlifter whose program uses only high-rep, low-load exercises will not recover the neural adaptations they need to return to the platform.
The overload principle — the requirement that training stress progressively exceed what the system has previously adapted to — and the specificity principle — that the body adapts specifically to the type of demand placed on it — are foundational concepts in strength and conditioning science. They are largely absent from the template-based programming that high-volume insurance clinics use because individualized programming takes time and expertise that the insurance billing model does not support.
My background in strength and conditioning and previous experience as a CrossFit coach is not incidental to the clinical work at Solas PT — it is embedded in how programs are designed from day one. I have worked with high-level and collegiate athletes, CrossFit athletes, competitive weightlifters and powerlifters, long-distance runners, and triathlon athletes. The programming principles that apply to those populations apply — adapted appropriately — to every patient who comes through the door, regardless of whether they are a competitive athlete or someone who simply wants to move through their life without pain.
Every rep scheme has a reason. Every loading parameter is tied to a physiological goal. Every progression is grounded in both the tissue's healing timeline and the demands the patient will eventually need to meet. This is what the overload principle and specificity principle look like in actual clinical practice — not a laminated sheet with three sets of ten on it.
This is not a message only for athletes. Resistance training is one of the most evidence-supported interventions available for healthy aging, and it is appropriate — and encouraged — for all age groups. In older adults, preserving skeletal muscle through progressive resistance training is one of the most powerful tools available for preventing falls, maintaining independence, and reducing chronic disease burden. In younger populations, it builds the structural and metabolic foundation that will shape health outcomes for decades. In patients recovering from injury or illness, it is the most direct path to restoring function and preventing recurrence.
There is no population for whom well-prescribed resistance training is not appropriate. There are only populations that require different prescription parameters. Getting those parameters right — the load, the rep scheme, the energy system emphasis, the progression rate — is what clinical expertise in exercise science actually looks like. It is not something a cookie-cutter clinic with fifteen patients per therapist per day can deliver. It is exactly what Solas PT was built to provide.
Whether you're managing an injury, on a GLP-1 medication, or want a program built around actual exercise science — book your evaluation at Solas PT in El Paso.
No. Building significant muscle mass requires years of high-volume training with very specific caloric surplus strategies — it does not happen from a standard strength or rehabilitation program. What does happen: improved joint stability, better movement efficiency, increased bone density, reduced injury risk, and improved metabolic health. Research in long-distance runners specifically documents that resistance training reduces injury rates and improves performance without unwanted size gains.
Yes — this is especially important. GLP-1 medications reduce appetite and drive weight loss, but when caloric intake drops significantly without a concurrent resistance training program and adequate protein intake, the body catabolizes skeletal muscle alongside fat. The scale goes down, but body composition worsens. Resistance training is the mechanism by which you preserve lean mass and ensure the weight lost is primarily fat, not metabolically active muscle tissue.
These are distinct physiological adaptations driven by different loading parameters. Strength is developed through lower rep ranges (1–5) with high loads, targeting maximal neural recruitment. Hypertrophy occurs in the moderate range (6–12 reps) with moderate loads. Power is developed through explosive, velocity-based work. Muscular endurance is trained with higher reps and lighter loads. Most insurance-based clinic programs default to a single moderate rep scheme regardless of the patient's actual goals or sport demands — and that is a significant clinical shortcoming.
The overload principle states that the body adapts only when training stress progressively exceeds what it has previously handled — load, volume, or complexity must increase over time for adaptation to continue. The specificity principle states that the body adapts specifically to the type of stress placed on it — training slow movements improves slow performance, training explosive movements develops power, training aerobic systems improves aerobic capacity. Effective resistance programming applies both principles and tailors them to the individual's activity and goals.
Yes — for all ages. In older adults, preserving skeletal muscle through resistance training is one of the most evidence-supported interventions for preventing falls, maintaining independence, and reducing chronic disease burden including diabetes, hypertension, and metabolic syndrome. The prescription parameters differ by population, but the physiological need for progressive resistance stimulus does not diminish with age — it becomes more critical.
Dr. Cisneros has an extensive background in strength and conditioning, including experience as a CrossFit coach and working with collegiate athletes, powerlifters, runners, and triathletes. Program design at Solas PT reflects actual exercise science — appropriate rep schemes for each adaptive goal, training across aerobic and anaerobic energy systems, application of overload and specificity principles, and individualized weekly progression. This is distinct from the three-sets-of-ten default used at most insurance-based clinics regardless of the patient's presentation or goals.