Resistance Training Rules for 2026: New Guidelines Explained

Sticking with an exercise program of any kind can be really tough, especially if you’re worried about “doing it wrong”. Our clinicians at Origin encounter this concern all the time, especially in regards to muscle strengthening exercise: many people assume that resistance training is only worth it if they’re following the “exact right” program. They think they’re wasting their time if they don’t have the “perfect” equipment or plan in place.

For folks with pelvic floor conditions, there’s often another layer of consternation. They worry that resistance training, especially lifting heavy weights, may worsen their pelvic floor symptoms.

Well, readers, we have some good news. Both of these worries, while understandable, aren’t warranted. (We have the science to back it up!)

The American College of Sports Medicine (ACSM) recently published its first major update to resistance training guidelines since 2009. To write these guidelines, their researchers really dove deep, examining 137 systematic reviews covering data from more than 30,000 participants.

The findings challenge a lot of what the fitness world has been telling us about resistance training for longevity and health. They have real implications for how we think about strength training, longevity, and pelvic health, so let’s jump in.

The best exercise for longevity is consistent exercise

The ACSM's updated Position Stand makes a very straightforward recommendation: healthy adults should resistance train at least twice a week, put in high effort, and engage all major muscle groups.

In contrast to their previous guidelines, the current version does away with specific recommendations for sets, reps, or session lengths. The emphasis is now on consistency and effort, not a meticulously designed program.

The position stand found that many forms of resistance training produced real gains in strength, balance, endurance, and physical function. Home-based training worked. Exercising with elastic resistance bands worked. Non-traditional formats (read: not just the gym) worked.

It turns out that there’s no single best workout for longevity and health. The type of resistance exercise you do matters far less than doing it consistently.

Resistance training rules: what actually matters

The new ACSM Position Stand also debunked several popular beliefs about resistance training. Let’s break down common questions and the study’s key takeaways for each.

Do you have to train until muscle failure?

Nope! Many trainers advocate lifting to complete muscle “failure”, in which you couldn’t complete another rep with good form. However, this approach didn’t produce better results than stopping just short of failure. In short: failure is not required, but putting in high effort still is.

Do you have to lift heavy to build muscle?

Not necessarily. While there certainly are many benefits of lifting heavy, it isn’t the holy grail some fitness influencers would have you believe. In fact, if your goal is hypertrophy (building bigger muscles), moderate weight may be more helpful.

The ACSM guidelines identified that a higher volume of exercise (10 or more sets of exercise each week for a given muscle group) was best for increasing muscle volume. Additionally, exercises that emphasize the eccentric phase (think: the lowering down part of a squat) were best for hypertrophy.

To perform high-volume, mostly eccentric exercise, you simply can’t lift your heaviest weight: you have to go a little lighter, and that’s okay!

Are free weights or weight machines better for strength training?

Neither, as it turns out. Using machines versus free weights made no significant difference in strength outcomes, and there isn’t enough data to tell if it matters for increasing muscle bulk or power. In short, you can get benefits from either or both types of weights.

Is strength training on unstable surfaces better for my balance?

Maybe not. Lifting weights while standing or sitting on unstable surfaces such as foam pads or Swiss balls can make exercises feel more challenging and interesting. However, we don’t have enough data to prove that it improves balance outcomes.

Compared to training on stable ground, unstable surface training does not increase strength gains. The takeaway: you can add instability to your routine for an extra challenge, but it’s not required.

Do I have to keep muscles under tension for a long time and limit my rest breaks?

No and nope. Neither the time for which muscles were under tension (think: how long you take to actually perform one rep of a squat), nor the length of rest periods between sets, had meaningful impacts on outcomes.

What factors impact resistance training outcomes the most?

So glad you asked! The ACSM researchers concluded that the following three factors were most important for an effective resistance training routine:

• Resistance training at least twice a week
• Using sufficient load or resistance to make the exercises high effort
• Moving through the full range of motion during each exercise

It’s that simple! If you’ve been avoiding strength training until you have time to develop the perfect training plan, this is your evidence that you don’t need to wait.

Working hard or hardly working? Making sense of rep maximums

“But wait!” You may be thinking. “What does ‘high effort’ mean? How do I know I’m working hard enough?”

This is a fair question. Something that feels a little hard to you might be easy for your neighbor and nearly impossible for your best friend: everyone’s sense of effort is unique!

This is why the new ACSM guidelines support using individualized tools to assess effort during strength training. In resistance training, the “rep maximum” concept is a useful tool for quantifying the effort you’re exerting.

Your one-rep maximum (1RM) is simply the heaviest weight you can lift for one repetition with good form. It’s a reference point used in research and coaching to describe relative effort levels. However, most people don’t need to formally test their 1RM: In practice, you can use perceived effort to find your sweet spot.

The new guidelines support strength training to “near-failure” rather than complete muscle failure.

In practical terms, this means finishing a set when you have about two to three good-quality repetitions left in the tank. (For reference, this is about 80% of your 1RM).

The last few reps of a set should feel hard, but you shouldn’t reach the point of sacrificing good form or being unable to continue. However, each exercise should still feel like it requires “high effort”. To maintain this effort as you adapt and get stronger, you may need to do more reps or add more weight: this is called progressive overload.

Progressive overload for women, men, and everyone in between does not require pushing to failure. You don’t have to max out, but you do need to challenge yourself.

Strength training for longevity: the key to aging gracefully

There’s so much more to resistance training than increasing your muscle size and strength. Unless you’re a professional bodybuilder, you probably have other reasons to resistance train.

Perhaps you’re most interested in maintaining your bone density or avoiding muscle decline during intentional weight loss. Maybe you’re focused on improving your balance or preserving your independence as you age. Fortunately, resistance training can help with all of these goals!

Resistance training is a powerful tool for preserving bone health, particularly in postmenopausal people at risk for osteoporosis. It can also help people using GLP-1s for weight management to combat excessive loss of muscle.

The ACSM researchers also found that resistance training consistently improved several functional measures, including gait speed (how fast you walk), the Timed Up and Go test (TUG), and a chair stand test. These measures all assess lower extremity strength and function.

These tests are all strong indicators of your functional capacity and predictors of health outcomes in older adults. They are directly connected to longevity: multiple studies of measures such as the TUG and versions of the chair stand test show that poor scores predict increased risk of disability and even mortality in older adults.

These results remind us that lower extremity strength and function are some of the strongest indicators we have of how well and how long a person will live independently. Remember: you don’t need an expensive gym membership or fancy equipment to improve your lower body function. The Position Stand confirmed that home-based resistance training and elastic band training were sufficient to improve these functional outcomes.

The best workout for longevity is the one you will actually do, so choose an approach that works for you.

Is it safe to weight lift with pelvic floor dysfunction?

In short, yes!

One of the most persistent myths in pelvic health is that resistance training, especially heavy lifting, can be harmful for your pelvic floor. People who experience symptoms such as urinary leaking, pelvic pressure, or pelvic organ prolapse (POP) often think they must avoid any kind of weight lifting.

Research to the rescue! The scientific literature doesn’t support this idea.

A 2019 survey of nearly 4,000 AFAB* folks found something interesting: physically active people who lifted lighter weights (under ~30 lbs) were actually more likely to report POP symptoms than those who lifted heavier (over ~110 lbs). More evidence for the benefits of lifting heavy!

Other research supports the benefits of resistance training in combination with pelvic floor muscle training. A randomized controlled trial divided 26 older women with stress urinary incontinence into two groups. One group did pelvic floor muscle training alone; the other combined pelvic floor training with moderate-intensity weight training. The combination group reached symptom resolution faster: nearly 60% were leak-free at four weeks, compared to about 15% in the pelvic-floor-only group.

A small study of 17 older people with vaginas examined the impact of resistance training on bladder neck angle, an early indicator of prolapse and incontinence risk. Groups performed resistance training with simultaneous pelvic floor muscle contractions, resistance training alone, or neither. Compared to the other groups, the combination group showed improvement in bladder neck angle at 12 weeks.

Taken together, these findings suggest that resistance training can support pelvic floor rehabilitation rather than set it back.

For people with pelvic floor symptoms, the evidence does not support stepping back from resistance training. With the right guidance, heavy lifting for women with pelvic floor dysfunction is not only possible but may actively support recovery.

Remember: you don’t have to go super heavy to get the benefits of resistance training. If you want to lift heavy, though, you don’t have to let pelvic floor problems get in your way! Origin’s Director of Clinical Education, Liz Miracle, recently discussed this topic on the CNN podcast Chasing Life with Dr. Sanjay Gupta: give it a listen here to learn more!

*AFAB: assigned female at birth

How can I get stronger while maintaining a healthy pelvic floor?

Origin’s pelvic physical therapists are experts in movement and pelvic health: they’re here to help you learn how to strength train in a way that supports your pelvic floor.

During a visit with your pelvic PT, you’ll discuss any pelvic symptoms you have, from vaginal pressure to leaking to pain. Your physical therapist will teach you strategies to address these symptoms so you can train without exacerbating them.

One crowd favorite is the “exhale on exertion” technique. You exhale during the hardest part of a movement to reduce pressure inside the abdomen and pelvis. This also makes it easier to engage your pelvic floor muscles during the effort. In a squat, for example, you would inhale on the way down and exhale as you push back up to standing:

With the right guidance, you’ll be on your way to lifting symptom-free. Ready to get started? Schedule your first visit with an Origin Clinician here.

Sources Cited

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Forner, Lori B et al. “Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey.” International urogynecology journal vol. 31,8 (2020): 1551-1558. doi:10.1007/s00192-019-04163-w

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Makizako, Hyuma et al. “Predictive Cutoff Values of the Five-Times Sit-to-Stand Test and the Timed "Up & Go" Test for Disability Incidence in Older People Dwelling in the Community.” Physical therapy vol. 97,4 (2017): 417-424. doi:10.2522/ptj.20150665

Menezes, Enaiane Cristina et al. "Acute and Chronic Effect of Resistance Training on Pelvic Floor Muscle Morphology and Function in Older Women: A Clinical Trial." Movement & Sport Sciences - Science & Motricité, vol. 124, 2024, pp. 1–11. doi: https://doi.org/10.1051/sm/2024004

Virtuoso, Janeisa Franck et al. “Effect of Weight Training with Pelvic Floor Muscle Training in Elderly Women with Urinary Incontinence.” Research quarterly for exercise and sport vol. 90,2 (2019): 141-150. doi:10.1080/02701367.2019.1571674

Zhao, Fang et al. “Optimal resistance training parameters for improving bone mineral density in postmenopausal women: a systematic review and meta-analysis.” Journal of orthopaedic surgery and research vol. 20,1 523. 27 May. 2025, doi:10.1186/s13018-025-05890-1