Why Muscle Is Medicine: The History, Science, and Future of Strength

The landmark study by Maria Fiarroni Singh, published in JAMA in 1990, recruited 9-10 residents of a Hebrew Rehabilitation Center (many Holocaust survivors). They performed high-intensity knee extensions. Results: some participants went from wheelchairs to walking unassisted. This overturned a century of medical orthodoxy that said muscle was lost forever after middle age. Later, the Singhs opened the Center for Strong Medicine in Australia, where every patient receives a prescription for strength training as treatment for their specific chronic disease. This protocol is now the evidence base for geriatric strength training.

At the Center for Strong Medicine, a patient who had experienced severe muscle atrophy from a statin side effect was prescribed triceps training. When asked why he persevered, he replied, 'Get off the bloody toilet.' This anecdote underscores that the intrinsic motivation for functional strength is often rooted in dignity and autonomy. The Singhs' clinic emphasizes 'little muscles get big attention' because they are leverage points for maintaining quality of life. A simple cable push-down can be the difference between living at home and requiring full-time care.

The only surviving ancient athletic manual, the Gymnasticus, argues that prescription-based training is inferior to training improvised for the right time (kairos). It tells of an Olympic champion wrestler who went on a bender, then was forced by his coach to complete his workout; he died. This story isn't just hyperbole—it warns against the modern blind adherence to periodized plans. The host, Gabrielle Lyon, recognized that her own messaging ('don't break rule number one, let's go') may need softening after hearing this, especially given her history of re-tearing hamstrings from pushing too hard for fun.

Gabrielle Lyon shared that when her parents visit, the deal is they will train. Her father, a former college wrestling captain, has an aggressive mindset and will eagerly jump into cold plunges and sled pushes. She has to remind him to 'chill a little.' This models intergenerational strength culture, echoing the goal of making strength as habitual as brushing teeth. The host's personal practice serves as its own protocol, demonstrating how to weave the book's philosophy into real family life.

Ancient Greek athletes ran Olympic races for centuries without knowing muscles had anything to do with movement. They attributed motion to a trapped portion of hot air called pneuma, which inflated and deflated muscles like a balloon. It wasn't until the 17th century that the contractile tissue was recognized as the engine of movement, and not until the late 19th/early 20th century that the brain-muscle partnership was understood. This blindness persisted through the Roman Empire; Galen acknowledged muscle's role but maintained a hierarchical, brain-in-charge view, calling mass-building athletes 'incapable of rational thought' and claiming they 'smothered their souls with the slime of this muscle.' The result was a cultural prejudice that equated muscle growth with mental dullness—a bias that still echoes today.

Classicist and strength coach Charles Stocking argues that the supercompensation effect—the rebound in capacity after a periodized training block and a tapering rest—mirrors Greek accounts of battlefield or athletic excellence being a gift. The Greeks saw the winner not just as the strongest trainer, but as someone who received divine strength. The metaphor remains relevant: an athlete can do everything right and still find that on some days, strength exceeds what ought to be possible, a phenomenon that athletes often describe as feeling 'touched' or 'blessed.' This perspective challenges the purely mechanistic view of strength and reintroduces the role of recovery and timing as gifts one must accept.

Winship promoted heavy partial deadlifts for women, advertised as making pregnancy and labor easier. Chain gyms called health lift parlors flourished, with photos showing women in bustles and corsets training. But Winship died young from a stroke, and the public, interpreting his death as a sign that lifting was dangerous, abandoned the practice. Within a few years, all health lift parlors closed. It wasn't until the late 20th century that women's lifting began a slow resurgence. This historical erasure explains why Jan Todd, upon discovering these 'athletic foremothers,' felt connected to a lineage that could validate her own pioneering role in powerlifting. The takeaway: women's absence from the weight room is not because their bodies are unsuited, but because a cultural amnesia was imposed after a medical tragedy.

Later, with elderly patients, trainer Evelyn O'Neal had to adapt language again: no 'pain' but 'soreness'; not 'hard' but 'challenging'; acknowledging ups and downs mirroring cycical training. This approach allowed 90-year-olds to engage with high-intensity strength training without fear. The broader lesson: to mainstream strength, we need a vocabulary that is invitational and granular—prescribing 'dose' and 'timing' for specific conditions like depression or diabetes, just as the Center for Strong Medicine does. The goal is to make strength training sound as normal and tailored as dental hygiene, not an extreme sport.