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The Four Pillars of Exercise

Written by: Dr. Dan Fosselman

There is no perfect exercise or activity. If you’ve been involved in athletics for any duration of time, you’ve likely run into overuse or traumatic injuries. Cross training is imperative for our health and we should look at our programing to include each of the pillars of exercise. Exercise has four pillars - strength, cardiovascular fitness, mobility and coordination.


Mel Siff wrote about the different types of strength in his book Supertraining. We often correlate strength with how much we can lift in the power lifts - squat, bench and deadlift. This neglects strength endurance and power. In general, strength increases with neural adaption (efficiency of the nervous system) and hypertrophy (bigger muscles). Louie Simmons was a proponent of developing the different types of strength by training them at the same time, called conjugate training. The most efficient way to build strength is to lift, and the barbell is one of the most effective tools. Most people would benefit from at least 2 days per week of strength training.

Cardiovascular Fitness

Just like strength, this does not strictly mean how long can you run. The most common test used to evaluate cardiovascular fitness is the VO2 Max test. The VO2 Max is often performed on a treadmill or bike. This can be completed in Grandview Primary Care's exercise physiology lab. Currently, there is a lot of dialogue about Zone II cardio. This is often described as how hard you can train while holding an uncomfortable conversation. Phil Maffatone describes this as approximately 180-your age. Cardiovascular fitness can also be measured by how quickly you can return to your baseline heart rate after activity. The cardiovascular system should be trained 5-6x a week if performed moderately and 2-3x a week if performed at higher intensities.


The ability or capacity to move. For the purpose of this article, it’s defined as the ability to move through the full range of motion. Limitations are not always structural, limited by a joint, or tissue quality. There is also a nervous system component to this. Our body will not move into positions if our body does not feel stable in a certain position. This is why lifting and strength development in a full range of motion can also improve mobility. Static stretching is often one of the least efficient or effective ways to improve mobility.


Coordination is the harmonious functioning of parts for an effective result. Coordination in this context is the skill set required to move your body in space, which is also called proprioception. Hand-eye coordination is also vitality important and can improve function over time. As we age coordination becomes imperative as this reduces the risk of falls. Athletic activities that require contralateral movement or ball and stick sports can be one of the most efficient and fun ways to improve coordination.

Concurrent training can often lead to improved results in any endeavor, and more importantly, can help mitigate the risk of overtraining and injury. When programming for health, we should consider all four pillars if we want to improve function over time.


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