Episode 27 | Ask the Expert | Guest: Samantha Williams BSc, HCPC, MSCP, AACP – Specialist MSK Physiotherapist & Founder, Form 360 Physiotherapy
Samantha Williams knows what strength looks like. A competitive Olympic weightlifter who represented her country at the Rio 2016 Olympics, she has since built Form 360 Physiotherapy into a specialist MSK practice – and made strength training for women a central part of her clinical mission.
In this episode of the London Bridge Sports Medicine podcast, Samantha joins Lucie to discuss why weight training matters far beyond aesthetics, what stops most women from starting, and how to build a safe and effective strength training practice at any age.
The case for strength training: it’s not about ‘toning’
When women ask about the benefits of weight training, the conversation often gravitates quickly towards aesthetics – toning, body composition, appearance. Samantha is happy to discuss all of that, but she wants to establish the bigger picture first.
The headline benefit is bone density. After menopause, women can lose up to 20% of their bone density. Strength training – by placing stress on bones through loaded movement – is one of the most effective ways to slow that process and build the reserves to draw on later. Women as young as their 40s are presenting in clinic with osteopenia (the early stage of bone density loss), often unaware the process had started.
But bone density is just the start. Samantha’s summary of the key benefits:
- Functional strength for everyday life – picking up children, carrying bags, hiking, maintaining posture at a desk. “Strength training is just to handle the impacts of everyday life,” says Samantha.
- Mood and mental health – even 20 minutes of strength training increases dopamine output and reduces cortisol. Studies show manageable strength sessions can have antidepressant effects.
- Body composition and metabolism – muscle is more metabolically active than fat, meaning more muscle supports a healthier metabolic rate. High cortisol – reduced by regular exercise – also directly affects how and where the body stores fat.
- Injury prevention – strength training reduces the risk of sports injuries by approximately 60% (Lauersen et al). Strong muscles take load off joints, tendons, and bones.
- Future-proofing – “the more we have now as a good base, the less we have to lose later on.” Building strength earlier in life is an investment in the decades ahead.
Busting the ‘getting bulky’ myth
The most persistent barrier Samantha encounters is the fear of becoming too muscular. “It’s a very iconic myth but not really grounded in reality,” she says.
The biology is straightforward: women have between 10 and 30 times less testosterone than men. Building significant muscle bulk requires not just regular heavy training but also the right nutrition, recovery, and multiple dedicated strength training cycles over a sustained period. Picking up a dumbbell twice a week will not produce a bodybuilder physique – it will produce the “toned” look most women are actually seeking, which comes from a foundation of muscle giving shape beneath the skin.
“Toning only actually comes from having a good underlying muscle mass that holds shape,” Samantha explains. The aesthetic goal and the health goal are one and the same.
Strength training and your other sports: a foundation, not a replacement
Many women who run, cycle, play team sports, or do yoga do so exclusively – without any dedicated strength work. Samantha sees the consequences of this regularly in clinic.
“You wouldn’t build a house without putting a foundation first,” she says. Running is accessible – you just put on your trainers and go – but without adequate strength in the supporting muscles, there is a ceiling to how far or how fast you can progress before injury intervenes. The same applies to tennis, netball, hockey, and most other sports.
Yoga presents an interesting counterpoint. Hypermobility – the ability to move through a wide range of motion – is not the same as strength. Samantha notes that she sees more back injuries from yoga than from strength training, because yogis are often moving into ranges of motion where they have no muscular strength to support the position. Pilates sits in useful middle ground: it builds control and isometric strength through the same ranges of motion that yoga explores.
The goal Samantha trains her clients towards is what she calls being in omnia paratus – ready for anything. “Once you start training for those things, you will quite often see that your body adapts in many other ways.” A woman who can do a barbell squat finds a snowboard easier. A woman who can do walking lunges with weight finds an off-road ultramarathon more manageable. The strength transfers.
The most common injuries – and what actually causes them
Contrary to popular assumption, backs are not the most common injury Samantha sees in women who weight train. The more frequent presentations are knees and hips – specifically knee tendinitis and hip impingement.
The root cause, more often than not, is a “break in the chain”: restricted mobility in one area causes the body to compensate elsewhere. The body is clever – it will always find a way to produce the movement you’re asking for, even if the pattern is inefficient or loading the wrong tissues. Over time, that compensation accumulates.
Hip impingement in particular is often linked to poor pelvic health awareness and insufficient core control, which alters movement patterns and creates compression at the hip joint during loaded movements like squats and lunges.
Technique matters more than load. Samantha’s example: someone doing a squat who only feels it in their quads and shins is not recruiting their glutes, adductors, or hamstrings effectively – meaning the movement is both less productive and less safe. Understanding what you should feel during an exercise, and where, is a foundational skill.
How to start: practical advice
Start with body weight control
Before adding external load, Samantha wants to know one thing: can you control your own body weight? A single leg squat with good control, a side plank held steadily, a slow step-down from a box. These movements reveal the muscular foundation – and they reveal it quickly. Many regular runners and team sports players are surprised to find they can’t manage them.
Pilates or Reformer Pilates is Samantha’s recommended entry point for developing this body awareness. Movement analysis with a physiotherapist is another useful starting point.
Frequency and timeline
Two to three strength sessions per week is the realistic minimum to see meaningful progress. One session a week is better than nothing, but results will be limited. Equally important: don’t expect visible change in four weeks. Six to eight weeks is a more realistic timeframe to begin noticing adaptation – and the bigger picture is a long-term commitment, not a short programme.
Find good guidance
Samantha is emphatic on this point: find a qualified trainer or coach, because good technique from the outset saves time, money, and injury. The personal training industry is not tightly regulated – a strong Instagram presence is not evidence of qualification. She recommends even a small number of one-to-one sessions initially (in person or online) to establish correct movement patterns, then checking in periodically as training progresses.
For those in London, she highlights Stable and Strong and Strong Her as female-only strength training environments that offer a lower-intimidation entry point with good technique coaching.
If none of the above is accessible, the advice is: start with machine-based training (safer for beginners than free weights), supplement with Pilates-based warm-ups, and use resistance bands at home to practise technique before loading.
The bottom line
Strength training is, in Samantha’s view, the foundation of physical health for women at every stage of life – not just those navigating perimenopause or osteoporosis risk. The earlier you build that foundation, the more resilient the body you take into the decades ahead.
The fear of getting bulky is unfounded. The fear of injury is manageable with good guidance. And the benefits – to bone density, mood, metabolism, injury resilience, and functional capacity – make a compelling case that is hard to argue with.
“My fear of not doing strength training – the risk later on in life – is so much more scary to me,” says Samantha. “I will happily go and do gym workouts for the rest of my life.”
Samantha Williams (BSc, HCPC, MSCP, AACP) is a Specialist MSK Physiotherapist and founder of Form 360 Physiotherapy, with clinics in Spitalfields and Victoria, London. A competitive Olympic weightlifter and Rio 2016 Olympian, she specialises in musculoskeletal rehabilitation, movement analysis, and strength training for women. Find her at form360.co.uk or on Instagram as @physio_rio.
To book an appointment with the LBSM team, visit lbsm.co.uk/booking
Listen to the full episode below ↓
