Nur Dania Rosaini, Stuart R. Gray, Esther Oyebola, Gemma C. Ryde
8 min
This qualitative study, part of the WISH (Women in Strength) project, explored how 24 women aged 18 to 64 in the United Kingdom maintain muscle-strengthening exercise (MSE) habits. Unlike studies that focus on inactive populations, this research specifically interviewed women already meeting the recommended muscle-strengthening guidelines. Researchers used reflexive thematic analysis of semi-structured interviews to identify the barriers, facilitators, and practical strategies these women employ to sustain their activity levels.
Participants identified several significant hurdles, including perceived time constraints, low confidence in their ability to perform exercises, and a lack of access to affordable, inclusive equipment. A prominent barrier was the culture of gyms, which many perceived as male-dominated and intimidating. Conversely, internal and external motivators fueled their participation. Health concerns—such as managing injuries, addressing menopausal symptoms, and preventing age-related decline—were primary drivers for engagement. Once initiated, many women found that the positive mental and physical changes, along with social support and accountability, reinforced their long-term commitment.
To manage the challenges of MSE participation, the women reported using diverse strategies. On an individual level, many kept their workouts simple, used digital resources (like YouTube or fitness apps) for guidance, or prioritized home-based sessions to overcome logistical barriers. Socially, they leaned on partners or friends for accountability and encouragement. Participants also proposed systemic improvements, such as the creation of women-only gym spaces, the availability of kid-friendly sessions to accommodate caregivers, and better vetting of online fitness content to ensure it is credible and accessible.
This study highlights that sustaining muscle-strengthening exercise is a complex behavioral process influenced by interacting factors at individual, social, and physical levels. By focusing on women who successfully maintain their habits, the findings offer actionable insights for practitioners and policymakers. Effective interventions should go beyond mere information provision and instead adopt a multilevel approach that addresses the structural and environmental barriers, such as gym inclusivity, that currently prevent many women from engaging in these essential health-protective activities.
Background: While the benefits of muscle-strengthening activities are well established, national surveillance data suggest that women do fewer muscle-strengthening activities than men. The study aimed to understand the barriers and facilitators to participation in muscle-strengthening exercise among women aged 18 to 64 who are currently meeting the muscle-strengthening guidelines, and to identify strategies to improve involvement in these activities. Methods: 24 women, aged 18 to 64, from the United Kingdom who participated in muscle-strengthening exercises at least two days per week were invited to an online or in-person interview. A qualitative study using reflexive thematic analysis was used to identify key themes related to the barriers and facilitators of participation, as well as potential strategies to improve participation. Results: Qualitative findings revealed four overarching themes: (1) reason for participating in muscle-strengthening exercises (health concerns and sports performance), (2) barriers to muscle-strengthening exercise participation (perceived time constraint, low motivation, cultural stigma and societal perceptions, confidence in ability and accessibility), (3) facilitators to participating in muscle-strengthening exercises (resources or information, accountability, social support, ability to choose and positive changes) and (4) strategies to improve women’s participation in muscle-strengthening exercises (what an individual and others can do). Conclusion: This study enhances understanding of women’s engagement in muscle-strengthening exercises by highlighting how individual, social, and physical environments interact to influence participation. Findings suggest that strategies are needed that target all levels of influence to help increase participation in muscle-strengthening exercises.
Sam: And how did the team move from individual stories to claims about shared experiences?
Alex: They used reflexive thematic analysis: interpreting patterns across accounts while examining the researchers’ own assumptions. Researchers developed codes from the transcripts, discussed interpretations and refined broader themes. Those discussions aimed to deepen interpretation, rather than make every coder agree.
Sam: Give me an example where an account reveals something more useful than simply saying that confidence matters.
Alex: One participant described starting with organised classes to become comfortable with the location and exercises. She then worked with a personal trainer and eventually gained confidence using equipment independently. That account connects confidence with guidance and familiarity, rather than treating confidence as something she simply lacked.
Sam: So the same person’s participation depended on both learning skills and feeling comfortable in the setting. What initially brought women into these activities?
Alex: Health concerns featured strongly: injuries, ageing, menopause and watching family members’ health deteriorate. Some wanted to improve sports performance. One woman described beginning with a physiotherapy programme after a herniated disc, then moving into Pilates, motivated by not wanting another injury.
Sam: Those are reasons participants gave, not evidence that strength exercise prevents every condition they feared. What barriers remained once they were participating regularly?
Alex: Their accounts establish motivations, not disease prevention. Continuing barriers included work and study demands, cost, equipment access, uncertainty about technique and fluctuating motivation. Some also described gym environments as male-dominated and intimidating, alongside assumptions that strength exercise would make women bulky.
Sam: The equipment issue makes that concrete. Was access simply about having a gym nearby?
Alex: No. Women described limited suitable weights, insufficient exercise space and the cost of memberships or trainers. One participant had taken resistance bands on a trip but never used them because she lacked confidence with them. Having equipment available was not the same as feeling able to use it.
Sam: Home exercise might avoid some gym barriers. Did women describe it as a workable alternative?
Alex: Some found home exercise quicker and more convenient. Others valued nearby gyms or classes. The facilitating feature was choice: choosing a location and an activity that fitted their preferences and circumstances, rather than one setting being best for everyone.
Sam: What helped them continue on days when convenience and good intentions weren’t enough?
Alex: Routines, goals and accountability helped. Some said paying for classes or training encouraged attendance, while companions made exercise more motivating. One participant described being more likely to stop early alone, but lifting more and receiving encouragement when exercising with a friend.
Sam: Payment appears on both sides, then. It could support commitment for someone who could afford it, while excluding someone else.
Alex: The study reports both experiences. Social support also went beyond having a workout partner: one woman described her partner looking after their child so she could exercise. Participants also said perceived improvements in strength, pain, confidence and mental well-being reinforced participation.
Sam: How do the authors bring those overlapping influences together without just producing a longer checklist?
Alex: They use an ecological model, a framework linking personal, social, environmental and policy influences. Their example is someone motivated by injury but held back by low confidence. A training partner, professional guidance or a more welcoming exercise space could help address that barrier across different levels.
Sam: But an interview study can’t tell us whether introducing those supports would increase participation. Where does the evidence stop?
Alex: It identifies experiences and candidate strategies, not intervention effects. There was no comparison group of women who were not meeting guidelines. And although the framework includes policy, the findings did not capture policy-level influences.
Sam: Selection also seems central. These women had already found a way to participate, so whose experiences might be missing?
Alex: Half the sample were in the oldest age band studied. Roughly four in five had university degrees, and participants tended toward greater affluence. The authors also lacked information about cultural and ethnic diversity, limiting how confidently these accounts transfer to other groups.
Sam: That makes the proposed solutions useful leads, but not a universal recipe. What changes did participants actually suggest?
Alex: They suggested simple starting options at home, accessible guidance and help learning technique. For providers, suggestions included women-only spaces, child-friendly classes and trainers specialising in women’s fitness. They also wanted reliable online resources, because abundant information did not necessarily feel trustworthy.
Sam: Who should read the full document, and where should they start?
Alex: Researchers studying exercise maintenance and people designing exercise services should read it. Start with the results on facilitators and participation strategies, then the discussion integrating ecological levels. Read the limitations alongside those recommendations: the proposals come from a selected group, not a test of what works.
Sam: And what should everyone else remember when thinking about women’s participation?
Alex: The contribution is not a new list of barriers. It is an account of how women navigate familiar barriers through interacting supports. Regular participation does not mean the barriers are gone.
Sam: Thanks for listening.