Expert Answers: Healthy Weight Gain, Avoiding Knee Pain During Exercise and More

By Andrew Heffernan |

Q1: Can workouts affect menstruation?

A. Yes, your regimen could be affecting your cycles. The good news, according to Rachel Cosgrove, CSCS, author of The Female Body Breakthrough (Rodale, 2009) and Drop Two Sizes (Rodale, 2013), is that the impact is usually a positive one.

“When my female clients start strength training, their periods become lighter and they don’t have as many PMS symptoms because their hormones are more stable.”

Long term, a new exercise routine can also help you lose fat and gain lean muscle — which in itself can alleviate PMS symptoms.

Granted, it can be particularly challenging to drag yourself to the gym when you’re menstruating, but you’ll probably do fine once you get there: Most research suggests that the phase of a woman’s monthly cycle does not influence strength or performance in high-intensity activities like sprinting.

Many women also find that strength training dispels fatigue, improves their mood and reduces cramping in the hours following a workout.

One caveat on cardio: It may be wise to avoid your longest, toughest runs or rides during the week before your period. In that phase of your cycle, body temperature rises slightly and your heart may work a little harder than normal. As a result, some women become exhausted sooner than usual — especially if the weather is hot or humid.

So stick with the weights to help alleviate PMS symptoms. And go easy on the extra-long, extra-tough cardio in the week before your period.

Q2: How do I gain weight the healthy way?

A. “Lean, lightly muscled types — ectomorphs, to fitness pros — have a tough time keeping weight on,” explains Angelo Poli, elite-level ISSA trainer and owner of Whole Body Fitness in Chico, Calif. While this may sound like an enviable problem to many of us, ectomorphs sometimes have to pay even closer attention to diet and exercise than people struggling to drop a few pounds. “Gaining lean muscle mass can be every bit as difficult as losing fat is for people with different body types,” Poli says.

If you are trying to bulk up efficiently and safely, Poli suggests sitting down to eat five or six times a day, with an emphasis on high-quality protein (such as eggs and organic meats), plenty of healthy carbohydrates (whole-wheat pasta, multigrain bread, potatoes), and healthy fats from sources such as olive oil, avocados and almond butter.

And while you shouldn’t give up on fruit and veggies, Poli cautions against filling up on them, since they’re bulky but low in calories. He also encourages healthy snacks, especially nuts and dried fruits, which are an excellent source of protein, carbs and calories. So keep a bag or two of trail mix within reach.

When you’re at the gym, perform three or four strength-training workouts a week, consisting of multi-joint exercises like squats, deadlifts, lunges, presses and rows. On each exercise, choose the heaviest weight you can handle for eight to 12 reps (or eight to 12 reps per side, depending on the exercise), and strive to get stronger each workout.

When doing cardio, avoid long, slow running or cycling workouts, which can work against your weight-gaining efforts. “Circuit strength training, sprint intervals or swimming intervals are the best cardio choices for ectomorphs,” Poli says, because you’ll maintain your cardiovascular health without burning off muscle mass.

Q3: How do I avoid hurting my knees when I do cardio?

A: Knee pain doesn’t have to mean the end of your cardio career, says Dean Somerset, medical and rehabilitation coordinator for World Health gyms in Canada and coauthor of the DVD series Muscle Imbalances Revealed. It might mean you have to take a few extra precautions to keep your joints healthy while you’re running, rowing or riding, however. Follow these steps to find a pain-free cardio regimen that won’t damage your joints:

Not all forms of cardio stress your joints in the same way, so hunt around for a modality that keeps your knees happy. “Ellipticals and bikes are usually easier on your knees than running on a treadmill,” Somerset says. And for low impact, nothing beats swimming. “But it comes down to what works best for you. So you might have to try out a few different forms of cardio” to find the right one.

If you’re a runner, keep most of your weight on the balls of your feet as you run, and avoid “heel striking” (coming down hard on your heel on each stride). If you cycle, make sure your seat is high enough so that your leg is almost straight — but not quite — in the down position of each pedal stroke. Any doubts on form? Grab a qualified trainer and get some tips.

Even before you start your workout of choice, lay the groundwork for proper form with a thorough warm-up. Start with a few minutes on a foam roller, focusing on tender areas in your glutes, quadriceps, calves, hamstrings, and the insides and outsides of both thighs. Follow that with dynamic warm-up drills, which lengthen tight muscles and establish healthy movement patterns: Ankle rolls and high knee walks are good pre-cardio choices. Conclude with body-weight squats, lunges and planks. Together, these moves ensure that your cardio workout — or any workout you do afterward — targets the appropriate muscles while keeping the strain on your joints to a minimum. (For another great dynamic warm-up, see The Perfect Warm-Up.)

Fitness Fix: Easing Shoulder Pain

Shoulders have more moving parts than you probably realize, says Stacy Barrows, PT, GCFP, CPI. That’s part of why they’re so prone to injury. “The ball-and-socket joint, the shoulder blades and the collarbones all require a refined coordination of the muscles that control them,” she explains. Because traumatic injury, overuse and habitual slouching can all upset this delicate muscular balance, shoulder pain is a common ailment among active people.

If one or both of your shoulders hurt, avoid any upper-body exercise for a few days, icing the area periodically. If the joint still feels tender to the touch, or so sensitive that you can’t lie comfortably on your injured side, Barrows advises you seek out a sports-medicine physician or a physical therapist for a customized therapeutic program.

Once the discomfort subsides, work these two movements into your daily routine several times a week to help prevent additional problems. Perform two sets of 10 reps of each.

1. Scapular Rotation


  1. Finish the exercise by rotating your shoulder in a clockwise circle, and reversing the entire sequence for one rep.

2. Wall-Facing Shoulder Mobilizations

  1. Complete 10 reps to the left, then repeat the movement on the other side.

Finding Your Fitness Edge