ICSC08 Transcripts

FICS have not loaded transcripts as PDFs as this restricts students where English is their second language from seeing the transcript in their language. To print the transcript in a different language, follow the steps below. 

1. Select your preferred language first. This will change the transcript into your chosen language.
2. Copy the text
3. Open a word document on your computer
4. Paste the text into your word document and save it to your computer.

If you have any suggestions on how FICS can improve this service, please email us at admin@ficsport.org

If you want the direct download for the English version of the transcript, you can do that from each of the unit modules, which gives you an option at the top of the module to download the PDF.

 

English Direct Download PDF –ICSC08 _01_ExPhy TRANCRIPT

ICSC Lower Extremity Module 8
Part 1 – ICSC08
Instructor Andy Klein
Video Lesson: 01:45:46

Welcome to the first session of Exercise Physiology. Today, in this session, we will be focusing on muscle physiology review, basics of muscle physiology, and our focus, in terms of the practical application, will be strength and conditioning. We will focus more on the strength with this session. On the muscle physiology, if you remember, the basic muscle structure, we talked about the muscle fiber, we talked about the motor unit, the anterior thigh remote neuron in the muscle fibers that it innovates, and we are going to focus a little bit more, primarily on the sarcomere, which is the smallest contractile unit of the skeletal muscle.

Basically, this is the fundamental unit of contraction, when we talk about the muscle. Now, the actin and myosin fibers that we are talking about, we reviewed that. That is taught well in most Physiology classes, but in your Basic Physiology, they often leave out intermediate fibers and some of the larger proteins that are involved in the muscle, which are very important to us, and then we are going to discuss z-disc streaming.

We can see our basic muscle in here. There is nothing new. Now, keep in mind, the myofibril is really where everything takes place when we talk about increasing the cross-sectional area of the muscle, when we look at the myofibril. This is where we are going to incorporate the protein where the satellite cells get activated.

Keep in mind, in the human, when we talk about increasing muscle size and muscle strength, it is about increasing the size of the fibers, hypertrophy and not hyperplasia, no indication of any hyperplasia at all. Some animals do, I believe the cat and the quail, they can get stronger with hyperplasia, but not humans.

The basic Sliding Filament Theory, this started in the 50s and it is still going strong. There has been some talk about changing the paradigm, and one of the reasons why is when we look at the contractions between the myosin-actin, you can stretch past it where you can, pretty much, it looks you are gapping some of these filaments, but you are not because some of the intermediate fibers are going to be there. We are going to focus on some of the release of calcium in the sarcoplasmic reticulum, and how that affects us, our treatment of the athletes.

Our basic sarcomere and muscle length, if we look in the middle here, this is the muscle resting length. Technically, you would be able to see that this is where you would think you would have the most potential for your greatest contraction because this is where you have the most potential cross bridging between the actin and myosin. When you are contracted, at this point, what you will notice is that you have already used some of the active cross bridging, so at that point you are really not going to lose some of your ability to contract.

Here, you would think in a lengthened position, “Well, I am going to lose some of my ability to contract, too, because some of the cross bridges have pretty much been separated.” The thing about that is when you are doing this Type of separation, now, you are going to start being able to take advantage of some of the elastic components of the muscle and connective tissue.

Here is when we talk about z-disc streaming. Here is your z-disc to z-disc. This is the basic fundamental unit. This is your sarcomere. Now, remember, a lot of basic physiology teach about the actin, and the myosin, but you also have a lot of the intermediate fibers. You have nebulin, which often goes with the the actin, and then you have the titin, which often is tracking with the myosin. We will discuss the titin in a little more detail, but this is where when we talk about, “Okay. Let us build a muscle,” this is where the initial damage takes place when we talk about exercise and strengthening. It is this damage which now allows us to incorporate more protein into the myofibril, and this is how we start to get hypertrophy. The process of building muscle is a process of first, tearing down, and then building up stronger.

A lot of our patients, do not understand that the primary goal of exercise is to damage the muscle in a controlled manner. If you go too far, then it becomes an injury, but if you can do it in a controlled manner, then you can build up the muscle. When we damage this z-disc, that is where the inflammation comes in. People often make a judgment, “Oh, inflammation is bad.” Not correct. Controlled inflammation is not only necessary; it is a good thing. It is when the inflammation is uncontrolled that we run into problems with the injuries with the athletes, and this process is called z-disc streaming. It is not labelled here, but usually, one of the main fibers that is damaged or the main proteins is desmond, but you also have other proteins like the menin and Simon.

Calpain is one of the enzymes that is activated. Calpain is residing within the myofibrils itself, but when the calcium is released, you will have some calpain activation which helps stimulate some of this inflammation, and this is what will start the repair process. One of the things we have to look, is that when calcium is released, this triggers the muscle contraction, then the calcium is resorbed back into the sarcoplasmic reticulum. If you are fatigued or with injury, this calcium is not all resorbed back and you will have a greater activation.  There is a phenomenon that happens that in effect, to try and protect the entire muscle so that you do not have too much damage, you will have some of these contractile filaments contract in order to try and sequester some of this calcium and some of the calpain activation so it does not spread up the entire muscle. Sometimes, you will see this as an inflammatory process. You will see this, called ultrastructural capping. I have seen that term used in some of the literature. Once again, ultrastructural capping. It has not been used a lot, but that will create a cap so that you do not get soreness throughout the entire muscle.

If those filaments are contracting for any period of time, they will start to shorten up. I do not think there is any effect when you talk about one exercise session, but if you talk about repeated exercise sessions, you can start to get some hyperactivity, some contraction of these fibers, and they have to be broken up. When we talk about soft tissue work and myofascial release, and things like that, we still do not have a clear physiological explanation for exactly what we do. We know our athletes will feel better when we do a Type of myofascial release, but we are not sure exactly what is going on. I think the concept of breaking up adhesions has pretty much been shown that we are not sure if that is going on.

If you look at some of Stecco’s work on densification of soft tissue, maybe we are doing that. When we do the soft tissue, maybe we are able to loosen up some of the contractions in the muscle which allows better resorption, which allows better recovery time, either that, or maybe it is just the heat that is produced when we do some of what we call myofascial release, or it is the actual pressure, mechanical transduction, which is affecting the cell, but we do not really know. Nevertheless, we do know that soft tissue work is very important for athletes.

I want to bring up this concept, when we talk about titin in here, one of the things we can see is that titin has different forms. I think one of the things that is overlooked is when we talk about some of these proteins, we talk about in relation to, “Okay, this is myosin this is titin,” but in fact, there are a number of different isoforms, and titin, which has been studied a lot more in the last five years or so, one of the things we will see is that the titin has different isoforms. You can have different isoforms in the cardiac and skeletal muscle.

If you look at this, this is in the same study, not only can you have a difference in the cardiac and skeletal muscle, but skeletal muscles, themselves, can have different isoforms of titin. When we look at some of this, for example, you can see in the psoas versus the soleus, you will have different contractile abilities in here. Some of our athletes may have different isoforms than other athletes, and what happens is clinically, when an athlete comes into your office and says, “Well, I have always been tight,” well, you can probably trust them that, “Yes, they always have been tight and we do not need to over stretch them.” We listen to our athletes, but this might be the physiological reason why we see some of the changes. It is not just the muscle, but we can also see difference in the connective tissue structure in a lot of our athletes also.

When we look at the muscle fiber Types, this is a review, the slow twitch versus the fast twitch, Type I versus Type II, if you do not remember this, the classic physiological model that I was taught when I was doing my Masters was just think of the chicken. The chicken is walking around all day so their legs or the dark meat of the chicken, that is because the higher concentrations of myoglobin because they are not doing anything explosive. They are just walking around all day, versus the fast twitch or the white meat, the light meat from the chicken, which they do not really use it every once in a while. They will convulsively flap their wings, and that does not need as much myoglobin. It is just a quick explosion power. Fast twitch Type II would be the white meat or the wings of the chicken.

We look at the slow oxidative Type I versus the fast oxidative/glycolytic Type II. Remember, Type II is Type IIA and Type IIX, which is a change from the last 15, 20 years ago when everybody was talking about Type IIB. Why the change from Type IIB to Type IIX? A lot of it has to do with technology where we are able to identify more myosin-heavy chains and we end up calling it Type IIX. Type IIC is the undifferentiated fiber Type. As you can see, the Type I versus Type II, and this is pretty straightforward, that myosin ATPase would be low in Type I, high in Type II, energy utilization, mitochondria, the color, I think this is pretty straightforward, and the duration, prolonged and short. Just keep in mind, Type IIA has some ability to maintain as contractions for a longer period of time, whereas Type IIX is easily fatigable. This comes into play when we talk about eccentric actions and damage to the muscle fiber, that Type IIX seems to be the vulnerable fiber.

Type IIA fibers, six times greater power and 26% greater cross-sectional area than the Type I fibers. Type IIX fibers have 10 times greater power and 39% greater cross-sectional area than Type I fibers. Once again, you can see it is the Type IIX fibers where we get a lot more of our power, but you still have significant strength and power that are developing in the Type IIA fibers.

The question you will often get is, can you change these fibers? What is the genetic potential? Is there a genetic tendency? This was one of the studies and this has been looked at a lot. I just like this study that was done. When they looked at the effects of endurance, strength, and power training, what they found is you can see the shift from Type IIX to Type IIA and back at about five weeks, depending on your training. If you are doing more of, let us say, Type IIA fibers maybe more speed and endurance, whereas Type IIX, which you would do in just intense sets of one or two repetitions, that would be the difference in training, there is a very limited body of evidence that suggests that you may be able to shift between fast and slow fibers.

In terms of your athletes, when we talk about genetic potential, if we talk about a muscle, we sometimes say, “Oh, that is a Type I muscle. It is more of a slower muscle or postural muscle,” that does not mean it is all Type I fibers. It might be 70% Type I and 30% Type 2. That will be different in certain people. What we are seeing is some of our elite endurance athletes, some of these muscles are 90% Type I and 10% Type II, so they are built for endurance. They are built for these extreme-type of events where you will see some strength people when we talk about Type I and Type II, in Type 2 muscle, let us talk about, maybe, a gluteal muscle, Type 2 muscle, well, that will be different in some athletes. That might be a 60/40 split, 60% Type II, 40% Type I. In some athletes, that could be a 70% to 80% Type II and 20% Type I, so you can see, they have a greater potential, then, for increased strength and increased hypertrophy.

When we talk about repairing the muscle and we are talking about strength conditioning, satellite cell activation is necessary for hypertrophy. This is just a simple chart. What will happen is the muscle will be damaged. There is going to be a difference between whether it is damaged from exercise or whether it is more of a serious injury. One of the things that we are looking at is the satellite cells, which are in the basal lamina of the fiber, they will start going but they will also split and reproduce so that you have a continuous, steady pool of satellite cells in the basal lamina, and then they will go in here. Now, one of the things that is interesting, this occurs with exercise when we talk about strength and conditioning, you will damage the fibers a little bit, but the satellite cells are not designed just to patch the area. The satellite cells are designed to patch the area, but also incorporate more protein, and that is how we get stronger.

I saw at least one study at the University of Utah where they talked about the satellite cells and how it coordinates with the fibroblast in the cells to help produce, repair the muscle, incorporate more protein, but at the same time, the fibroblast, producing more collagen to help with the synthesis and the healing and the increase of connective tissue. Remember, you will get an increase in collagen weight with strength conditioning in your ligaments. They did animal studies, but what they did is they ablated the supply of fibroblast in the area to see what the effect was on the satellite cells. What happens is the satellite cells ended up reproducing what they were activated prematurely, so the muscle fibers that they produced, in effect, were damaged, they were random, and much weaker. They also did the opposite where they ablated the satellite cell pool. What they found is the fibroblast then ended up having to work harder, but they produced a connective tissue that was weaker, so it appears as some sort of signaling in the cell between the satellite cells and the fibroblast so that we get an increase in the repair of the muscle fibers and the connective tissue, at the same time.

Keep in mind, in this area, you will see some bleeding. This initial framework or matrix so the cells can lay down more protein, initially, is a fibrin clot, fibrin threads. They are somewhat fragile for the first 24 to 48 hours so you have to be careful about applying too much stress to these areas on a consistent basis, that we have to make sure that what we are doing when we do this is we are still protecting the area. That is why, sometimes, heavy-light day or even on the heavy days is not damaging the muscle too much.

Here is an example of some of the changes you will see. This is what we have, a young athlete with a great supply of the stem and satellite cells. You will get the activation; the athlete does their work out; they will do some strength training and they will get the injury in here. Then the stem cells just come and do their job, but as we get older, our supply of stem and satellite cells are not as good. When we are talking with our older athletes, especially when we have an older recreational athletes or our masters athletes, they may need a little more time to heal, whereas in the younger athletes, they can go heavy day, heavy day, heavy day, then maybe a light day, so that can vary. Our older athletes now become, maybe, instead of heavy day, light day, heavy day light day, becomes heavy day light day, light day, heavy day, or maybe you need more, like three or four days of lighter activity to help with the recovery.

You also can see that the environment of the satellite, themselves, the local microenvironment can be damaged or at least not satisfactory for the rehab process. We are talking about, dehydration, poor nutrition, all which can also affect the stem cells/satellite cells.

Looking at some of the studies that we have seen on the satellite cell, Sir Mac looked at a single bout of high force eccentric exercise, it increased the muscle fiber satellite cell content and activation status in Type II, but not Type I muscle fibers. We can see that the type of exercise session that you do will have an effect on different muscle types and different areas of the muscle. This change that we saw occurred within 24 hours post-exercise recovery. A single session will automatically start having an effect on the satellite cells. Usually, a lot of the satellite cell activation appears to occur maybe within 2 hours or so.

High-intensity resistance training at a normal speed resulted in significant fiber type-specific adaptations, that is the increased MMD. MMD is myonuclear domain. This is the cytoplasmic volume within the myonucleus, and this is an indication of a better response to training. It gives you an idea that high intensity is always better than the low intensity, no matter what the speed is. I think we will see this in a several different situations and a several different studies, how important high intensity is.

If you are really talking about strain conditioning you have to go heavy. You must go higher intensity.

A high-intensity resistance training protocol, about 85% of your one rep max, will yield the greatest overall adaptive response within the skeletal muscle fiber. This study by Herman-Montemayor, shows you just how important the intensity is.

It says “about 85%”, and that is going to vary depending on your athletes. When we talk about the strength power curve and how do you get the most of it, the most out of your workouts, you will see that it will vary from athlete to athlete and you will almost have to keep track. It could take you six months to a year to sometimes figure out what is the best exercise training session for that particular athlete.

Eccentric overload during leg extension exercise, once again, a single bout, induced significant satellite cell Activation and content increases. Satellite cell numbers related to Type II myofibers occurred within 24 hours post-exercise recovery. This is a confirmation with what we have seen. This research has came out this past year.

Interestingly, there were no signs of increased satellite cell differentiation or formation of new myofibers within the first 24 hours. The formation of new myofibers and the satellite cell differentiation probably occurs at a later time period. We have to look at, this is a single bout of exercise which shows you the change we have, but it is a cumulative effect that seems to give us the changes in satellite cell differentiation and the formation of the new fibers.

Satellite cell number activation and myogenic potential are modulated in different physiological and pathophysiological context. What that means is when we talk about the continuum, the spectrum of exercise, with exercise, we are trying to create an injury, we are trying to create damage but in a controlled fashion, but if you go too far along this continuum, that becomes injury, and then the body responds differently.

When we look at the injury, one of the things we see is a local transient fibronectin secretion by satellite cells, very important step in the cascade of satellite cell activation, and an increase in the fibronectin in the muscle. It is necessary for successful regeneration. Remember, fibronectin is an acute phase protein. It is almost like a natural-type glue for the cell, so very important, but if you have too much of the fibronectin in the basal lamina in the under injured state, this is correlated with a reduced ability of satellite cells to respond to injury. Who would have an excess fibronectin in the basal lamina? People who are untrained, who are sedentary, or overweight. We can see that the body has a homeostasis that it has to try and maintain, and a lot of the increases we see in terms of fibronectin interleukin-6 and things like that, these are transient increases. If you have higher levels of this because you are centered on untrained state, this will actually interfere with your ability to get stronger with your ability to repair the muscle when you try and do training. People who are first starting out, if they have been sedentary for a while and they just, they want to get back into it, let us say you have a patient who is once an athlete and they have not worked out for 10 years, they have not done any training, they get back in, they are not going to have the same response to training as an athlete who has maintained that training over a period of time. It is going to take a little bit longer and they must be a little more careful. This is where we talk about recovery, where they are getting to need a little more recovery maybe than they did if they had been training the entire time.

Delayed onset muscle soreness, very important. DOMS, we see this often. Exercise-related muscle pain that develops after excessive and unaccustomed exercise, it more commonly occurs with eccentric exercise. What we will see in a lot of cases, a lot of the damage in our athletes are eccentric-type mechanisms of injury. For example, if you have someone who is throwing overhand, a baseball pitcher, a bowler in cricket, when they talk about the rotator cuff, the rotator cuff damage is due to through an eccentric type of action, trying to slow down the forward motion, the forward acceleration of that arm as it comes forward, eccentric exercise may damage Desmond predominantly and cause an increase in intracellular fibronectin. Once again, we get back to the Desmond, which is at the z-disc. We see that the Desmond, that is the damage, but that is a good damage, that is, kind of, a controlled damage that we are looking for. I will sometimes see this, especially my cross-country runners, who have not been staying in shape because hill running, especially running downhill, there is a strong eccentric component to that so you will see them damage themselves at the beginning of the season if they have not been staying in shape.

It suggested that Type IIX fibers are more vulnerable to glycogen depletion and endurance training may help limit exercise-induced muscle damage, only because it may give them a little bit more resistance to fatigue as you work out. Keep in mind, when we are talking about these big muscles that are primarily Type II fibers, Type IIA, Type IIX fibers, there are still Type I fibers within the muscle, so if you want to develop the whole muscle, you still have to do, maybe, a little bit of endurance, but you do not want to do so much that you take away from the effect of the Type II fibers.

We are going to look at some of the muscle physiology, the types of muscle action. When I look at the types of muscle action, this is straightforward: concentric, isometric, eccentric.

Presentation Video Placement: 25:16 – Video Playing within presentation

This video is a volleyball player. I want you to watch her do the simple squat. Holding it there, she is in an isometric position. As she drops down, you are going to see that eccentric axes so her core will stay isometrically stable, her quads will go down and control eccentrically. As she goes down, she is going to hit that bottom position, and she must get that hip extension, then the glutes are going to have to fire, but they going to fire more in a concentric manner.

At any point, depending on the type of training, you can accentuate what you want. For example, there is someone at the University of Minnesota, Cal Dietz, who coined the phrase, “triphasic training”, and you can work on it. For example, let us say you want to work more on the eccentric component, you can go down very slowly to a count of six to eight but you would explode out of it, or you can go down at a normal pace, but at the bottom, hold in an isometric position and then explode out of that, or you can just go very quick and try and accentuate the concentric.

They are all very important motions. For example, if you look at someone like a soccer player who has to make a cut, well, when they make the cut, their first response when they plant that foot, it becomes an eccentric action to slow down and decelerate the body, then there is a moment before they push off that is all isometric, then they push off, and that is concentric.

You can practice, for example, just practicing your eccentric where you just practice landings and things like that in high speed, just trying to absorb and you can work eccentrically, or you can work more strength in an isometric, or you can practice concentrically, which is what most people do when you talk about pushing off and triple extension motions.

When we look at the muscle physiology and force production, we can look at the fascicle length or the muscle penation. The penation angle is the angle of the fascicles in relation to the line at the tendon. Basically, we draw a line from origin to insertion. That will give us the penation angle. Fascicle length, usually, if you can increase your fascicle length, which is what you do a little bit with strength training, that tends to increase velocity or speed, whereas muscle penation, if you increase muscle penation, the angle, generally, you increase your ability to produce strength, but that will be a cost to velocity. I have seen baseball pitchers before who get very enamored with weightlifting and really develop those arms and they get very strong, but they lose speed off their fastball because they have diminished their ability to contract at a higher velocity. Some of the physiological factors you can see is there is a neural factor in your ability to contract. When we talk about overriding the Golgi tendon response to try and inhibit tension, that is usually done in the motor cortex and pre-loading factors which we will talk about, but ultimately, when we talk about the ability to contract, it comes down to increasing the cross-sectional area of the muscle. You increase the cross-sectional area of the muscle, you increase the ability to contract the muscle, it does not mean you will get all that contraction out of there, then that becomes training and neural factors.

Once again, you can see the different penation, you can have parallel. The smaller cross-sectional, smaller force, longer length, you can get a little bit better, more mobility, the more flexibility, a little bit of a quicker contraction versus the penate. The short length, you get a small length change, but you are going to increase your ability to create a contraction.

When we look at the muscle physiology, high force, low-velocity training, this will increase the cross-sectional area of the muscle, the fascicle length, and the angle of penation, but what you will end up doing with high force, low-velocity training is that is what you are going to develop. Think of someone who might be doing deadlifting, very high force but low velocity, they are going to get very strong, but it does not mean that they are going to get very fast, it is totally different, versus doing a low force, high-velocity training, where you do not get as much change in cross sectional area.

I will not say no change, but not as much change, and increase in fascicle length and a decrease in angle penation. This leads you more to a higher rate of contraction or high velocity, greater speed. What would the ideal be? The ideal thing to train would be high force with high velocity training. There is a trade of the higher the force, the lower the velocity, but if you can hit that sweet spot between the high force and the high velocity training, that is what we are really trying to do for our athletes.

Here is our force-velocity curve. This is what I was talking about. This is the increase in force right here. As you increase the velocity, you are going to find that you have the amount of force you can use goes down, but you can see the continuum. If I want maximal strength, I am going to do high force, maybe it will lower speed. If I want to get a little more in that strength speed continuum where I am still doing strength but maybe add a little bit of speed, now, I am dropping the weight down again until I go totally into the speed. This is our force-velocity curve. Generally, if we want to develop for athletes’ power, remember, this is force-velocity, it is not power, we want to develop power, we are generally going to be somewhere in this area in here.

Here is our power-force curve, right in here. What we will find is the greatest power output is right about here, and this will vary from athlete to athlete. You will see it might be working. It is anywhere from 30& to 70%, which is a very large range, so that is why a lot of times, it is determined by observation. It is determined by the history of the athlete where they can develop the most power. If we talk about powerlifting, and this is a term, for example, powerlifting that really is not power because powerlifting, if you ask most people, and in competition, powerlifting is the bench press, the deadlift, and the squat, those are the three powerlifts, but if you are moving the bar, it is a good lift, even if you are moving it slowly. You are using that high force, but a very slow velocity. On this force, velocity curve is changed in here. As we increase the force, you can see the velocity of shortening has dropped down, so you are not going to get as much power as you would like.

Once again, we are looking at the cross-sectional area of the muscle in here, so we are going to increase. Remember, the number of fibers does not increase. That is hyperplasia. We do not have that. What we have is an increase in the volume or hypertrophy of the myofibers, which leads to an increase in the cross-sectional area of the muscle. The number of force generating sarcomeres arranged in parallel predict the maximum force-generating capability. Sometimes, you will see this term is PCSA, physiological cross-sectional area, these are the same things.

Your fundamental principles of muscle contraction: The peak rate of contraction, it is dependent on the myosin ATPase activity and the size of the motoneuron. We will get into the size principle. Maximal force is dependent on the actin-myosin action, the ability to make that contraction repeatedly. Continuation of the contraction is dependent on the ability to recycle ATP, so then, you are getting into your bioenergetics. How good is your ATP-creatine phosphate reservoir? How good are your enzymes, which allow this metabolic action to occur? Muscle fatigue is the decrease in the ability of a muscle to generate force. Now, this can take place at the muscle itself or this can be more of a neural change. You can have peripheral fatigue in the muscle, you can have central fatigue in the nervous system.

Let us look at our velocity of shortening, our force-velocity curve for eccentric and concentric actions.This point here, joint angular velocity is 0. That is our isometric hold right in there. As we start to contract, as the muscle shortens, that is our concentric action, you can see you have more strength in the flexors than you do in the extensors. As you increase the velocity, the ability to create strength goes down. Now in the eccentric mode, you can see, once again, flexors a little stronger at the knee than the extensors, but if you look in here, you can see eccentrically at a small level, if you are not going too fast, you can actually increase the most force in that eccentric manner. That is when we talk about possibly doing what we call negatives or eccentric work to get some strength. If they are having trouble lifting and they have hit maybe a sticking point where they cannot go heavier, it is a good idea to develop more force in the muscle to develop more capability of muscle to start doing some eccentric training.

This is, in the gym, what is it called, using negatives and weight training. Let us say this is 100 kilos or approximately 220 pounds. They cannot go any further so you can put more weight on, and then they can control it going down, and then their training partner helps them bring it back up. That is a way of breaking through that platform. Keep in mind, eccentric training is tough to do. It will create more soreness, especially for someone who is not used to it. In most training sessions, there is an eccentric component if you are controlling the weight, but if you want to take advantage of that peak in strength, then you have to go to an eccentric level that you cannot lift concentrically, and that is why you need a training partner or you need some sort of adaptation.

Where can we get the most strength in the sarcomere? If I review, it looks like it should take place in the natural, the resting length in here, because that is where you have the most potential for cross bridging. As you contract, you have already used the potential, so in a short muscle, you will not have as much ability. In the length and muscle, yes, this is the area where you have the most contractile ability. Even though you lose some of the contractile ability of the cross bridging, you will get that back as the muscle starts to shorten. You are getting a greater boost from the elasticity of the connective tissue in the muscle. Remember, even though it looks like this is separating, you still have titin, which has a huge elastic component. That titin is going to help bring that muscle into a shortened position to help improve the contractile ability.

This is the length and position, and that is this part of the curve right in here. That is where you get that eccentric component. Here is your resting length of the isometric, and here is your shortened position, so you can see, once again, this is where you have that decrease in your ability to contract.

With muscle proprioceptors, when we talk about training stimulation, stretch reflex is a muscle contraction response to stretching the muscle. That is pretty basic. When a muscle lengthens, the muscle spindle is stretched, and its nerve activity increases. When we talk about the stretch reflex, about plyometrics, about jumping, this is what we must keep in mind.

The Golgi tendon organs that you are familiar with, they connect extra fuel fibers and detect tension, not length changes. When you are training, the Golgi tendon organs are trying to inhibit your ability to produce this tension as protective device. This is going to be over in training. It will override the Golgi tendon organ so you can produce greater tension. That override is going to take place in the motor cortex. The central nervous system is going to override what is happening at the local level so that you can increase. This is what some of the training changes that we talked about with strength and conditioning, and we talked about nervous system changes, also.

The Pacinian corpuscles, located close to Golgi tendon organs, this is sensitive to quick movement and deep pressure. When I talk to students, I always tell them, “This is one of the reasons why when you are doing soft tissue type of techniques, go light and gradually increase the pressure”. “If you go too deep, too quickly, or apply too much pressure too quickly, the body is going to fight that. The body is going to respond by tightening up. If you give the corpuscles a chance to adapt to feel the pressure, you can actually start going deeper into the tissue without getting a reactive rigidity from the patient.”

Looking at the elasticity of the muscle and connective tissue, we look at the stretch reflex, so we drop down. If we look at a countermovement jump, this is what we are talking about. You drop down, you stretch the muscles to get a good connective tissue stretch and a muscle stretch and you can use that elasticity to help with the muscle contraction. This is a countermovement jump. In this case, if you want to, this is how you can measure vertical jump in an athlete. If you do not have any fancy equipment, you could just do this on a wall. You put a little bit of chalk on their fingertips and have them just right there and measure that, then you have them jump, and you can measure from chalk line to chalk line from their fingertips and that gives you a vertical jump. Very important to get the vertical jump. Jump mats can work, but there is an equation that you need to make sure that you get a valid and reliable reading.

A lot of sports, when they talk about combines and pre-season training, they will use different type of jumps to measure vertical jumps. You must make sure if someone is talking about what their vertical jump is, you have to find out, “What type of vertical jump did you use?” In the NBA, this is a countermovement jump, they also do what they call a maximal jump, where an athlete is allowed to take two or three steps and then a jump.

Some of our neuromuscular adaptations, we talk about the all-or-none law, twitch versus tetanus. We are trying to get that increase, and this is almost a post-activation potentiation where you are going to get a little bit of a jump and then if you do a quick relation, then do the next contraction, you can start increasing the amount of tension that you have. If you apply too much, if you keep going, it can become like a tetanus or a cramping-type situation.

When we talk about the muscle contracts, we talk about the gradation of force. If you want to increase the contraction of the muscle, you can either do it by rate coding, which is frequency of activation, so the motor units activate at a faster rate, or you can talk about recruitment, which is the number of motor units that are actually activated. Now, what is interesting is if we look at gradation of force, we can see the different types of muscle fiber. In the Type I fibers, which is more of an endurance fiber, when you start increasing the intensity of the exercise in Type I, you are going to get increased recruitment to 50% of your maximum voluntary contraction, and then it becomes rate coding. When we talk about Type I fiber, let us talk about, maybe, the small muscles in the in the low back, for example, if you want to do some stabilization exercises. At a little lighter intensity, you can get every one of these motor units to fire at 50% of your maximum voluntary contraction.

If you want to just have them start increasing their frequency, then you can go and increase the intensity, and then it becomes rate coding. You do not need heavy weights or heavy loads to get all the Type I fibers to fire. However, in Type II fibers, what you will notice is that at the initial contraction, what you will have been that with the lower weight, you will have a pool of fibers that will fire to 10% of your maximum voluntary contraction. As you start increasing the load, you will start increasing your recruitment. As you increase your load up to 90% of maximum voluntary contraction, that is how you will get the recruitment. You cannot get full recruitment of Type II fibers until you get into heavy loads, almost 100%. Basically, 90%, if you want to get all those fibers to fire, you must lift heavy, you have to increase the load. The last 10%, you will get great coding.

That tells you, in terms of training for the athletes, once again, it is all about intensity. Most athletes know this, that they need to go 80% to 90% of their maximum voluntary contraction if they really want to get improvement of their strength.

Once again, what type of strength are we even talking about? What kind of strength do you want? We are talking about endurance. Here is, I believe, a 50K runner, or do you want to be able to lift tires? The ability to lift this tire, I am not sure how applicable that is to everyday situations. I am not sure how many athletes we have who do this, but it is a great strength training. A lot of people say, “Well, is this even applicable? What are you doing?” Well, it is a great triple extension, but sometimes, more than that, for the athletes, it is fun. If it is fun, you are going to get a psychological stimulation in there, which really is quite important also.

Our firing pattern is based on the Size principle. This used to be known as the Henneman’s size principle, but I know there has been a move in scientific circles to try and get rid of names as much and just work with the physiological principles. As muscle force increases, motor neurons with progressively larger motor axons fire. Neuromuscular fatigue. There is a decrease in muscle tension with repeated stimulation of the muscle fiber. Once again, depending on your training, if you are training more, then you are going to help decrease this fatigue factor.

Here is your firing pattern. Force production, low versus high, recruitment threshold. Here is the interesting thing. In some of these exercises, you can have to determine, for example, if you are doing a deadlift, if you are a working at light weights too much before you get to the heavy weights to get the strength and power, you might end up almost fatiguing out your grip muscles, your forearm muscles before you really get into the type of strength and load you need to stimulate low back and legs. For example, a squat works very well because you are really not going to fatigue the small muscles, and the squat works very well if you can handle the compressive forces.

Once again, we want to talk about some of the neurological responses. Neural plasticity can occur within the primary cortex in response to motor training. There is a greater number of synapses per pyramidal neuron in the motor cortex when complicated movements are practiced compared to simple tasks. Now, this was an animal study, a rat study. I was always fascinated by the fact of exactly what is a simple test compared to a complicated test to a rat. I was not sure. I was introduced to a PhD in Neurophysiology at a bar one night. She explained to me, that it is just based on the test, so the question becomes, “If I complicate the test, I can get a better response to training, but what is too complicated?” For example, if I am on a balance board and I am trying to juggle different medicine balls, maybe different weights, is that too complicated? Will that end up complicating the process? No one really knows, but I will say that this probably is one of the reasons why when we combine some of these balance with catch exercise or balance with strength training, why we might get a better response.

In terms of neuroplasticity, new exercises, in general, will increase your response in the primary motor cortex. That is why we constantly want to introduce new exercise, which may not seem like they have a lot of sport specificity but can still be very helpful. In general, when we talk about our athletes, remember, most of the environment that they are dealing with, if we talk about a soccer player, basketball player, or a hockey player, they must respond to unpredictable situations. The perfect motor pattern is not always going to be available to them, and that is why the more different exercises they can do, the more different angles, that neural stimulation is only going to be helpful in the long run.

If we look at this chart, for example, what are the training adaptations, we see them with resistance and endurance exercise, the fiber size and resistance will increase endurance, not so much the number of fibers. Remember, number fibers do not change whether you are doing resistance or endurance training. Your movement speed will increase with resistance, not necessarily with endurance. Your endurance, obviously, straightforward, will increase, but what is interesting is you can get some increased endurance with resistance training. You can get some increase in maximum VO2 with interval-type training. Your strength will increase with resistance, not so much with endurance. Your aerobic capacity, obviously, will increase more with endurance training than it with resistance training.

We want to look at strength and a lot of people have different definitions. Do not think that everybody agrees with exactly what strength is. I like the idea of the ability to transfer strength to sports performance is what is important. Now, this principle of dynamic correspondence, and this is from Siff and Verkhoshansky, the ability to use the means of special strength preparation that corresponds to the functioning of the neuromuscular system in any given sport. Not everyone agrees with this, some people will say, “Just get as strong as possible and then with your regular training sessions, you will be able to incorporate that into your training.” Siff and Verkhoshansky believe that you can do things that are a little more specific to you sport, which will help at a greater rate. I think one of the things to keep in mind is if you are one of those people, “Let me just do the strength,” and then incorporate into their sport, you have to be careful because a lot of these sports are specific motor skills.

If you are talking about throwing a ball, for example, it is a skill. If you got too strong, you could interfere with that motor skill. I think one of the things you can do is you can get stronger during the offseason, for example, make sure you still incorporate that into the sport. For example, our basketball players, when we used to do during the offseason, we would want to increase their vertical jump, have them get stronger, we would still make sure that they practiced during this strength conditioning period so as they were getting stronger, they were able to incorporate this strength in a gradual level into the motor skill, so that we did not end up interfering with the motor skill.

You can be sport specific. For example, if you are doing plyometrics for a basketball player and you want to increase the jump, keep in mind, you can actually do plyometrics with a ball in the hand, where maybe they are doing box jumps, but when they jump off the box with a basketball in their hand and then they jump up, there is a big difference between jumping to touch a rim versus jumping with the ball in your hands to reach the rim. There are different things you can do. I am not going to tell you there is one way of doing it. If there was one specific way of doing it, everyone would do it. The fact that there are so many different systems tells you that, we do not really know.

Rate of force development is a term that you must be familiar with, and this is basically “explosive muscle strength”. If you have strength how quickly can you use it to develop the force so you can push off or you can jump? Power is the amount of force exerted through a certain distance per unit of time. This is what we really want. I do want strength, but we want power. Peak power is defined as the highest power value achieved during the task being performed. Power equals force times velocity, and we already talked about the inverse relationship between force and velocity.

This is the curve that we looked at, the force-velocity curve, and there, you can see the inverse relationship which is an interesting chart because this gives you an idea of, for example, what percentage of your one rep max should you be working at? Maximal strength you absolutely must go up to 90% to 100%. Maximum speed is less than 30% of one rep max. Here is your peak power range, 30% to 80%, this is what I was talking about is it is going to vary. Some people are using something called velocity training and they will put an accelerometer on the bar, for example, when they train. They will try and determine; at what speed can they lift the most weight and where they get the best power equation when they do this? This will vary. What you must do, though, is you just must follow an athlete, because athletes will fall somewhere in this range, but they are not all going to fall in the same position.

If you look, this is a chart of sprinters, Ben Johnson, Carl Lewis, Maurice Greene, Tim Montgomery, Asafa Powell, and Usain Bolt. What you are seeing is their ground contact time. Remember, at the very start, that ground contact time is larger. Why? Because they must overcome inertia so that they would produce more force, but once they get going, whoever can hit the ground and get off quicker, that is going to be the fastest runner. You can see in here; you can see the difference between Bolt and the other runners. At 50 meters, he was hitting the ground and pushing off.

You lose a little bit of force production in here because you are not on the ground as long, but this was his sweet spot right here, where he combined that combination of production and speed. That is the power zone for him and look how much quicker he was from 50 to 90 than all the other runners. Also, in here, he slowed down a little bit but that is because he is usually winning in the last 10 meters anyway, but he was still getting great force production, but this is where he was winning his races, especially in that 50 to 90-meter range.

This is the sprint that is coming up. I want to show you this because in here, when we talk about exercise and strength in sports, this position here is that triple extension position where they are pushing off. It is extension of the ankle, the knee, and the hip, triple extension. In a lot of our weightlifting, this is what it is focused on. What is very important, though, in this position here is the triple flexion position, which is just as important, a little bit harder to train. The triple flexion position is flexion of the hip, flexion of the knee, and flexion of the ankle, or dorsiflexion, basically. A lot of people forget about this part of the training in here. Very important to develop this strength also, as well as the triple extension strength for pushing off.

When you are training athletes, keep this in mind. With untrained athlete, strength training will result in significant improvements in power. It really does not matter what you do. As long as you give them some training, they will improve. Athletes with established strength levels are higher level or elite athletes. They are the ones who really will benefit the most from specific training, dynamic lifts, snatch, clean, and jerk, and plyometrics. That is how you are going to optimize their power development.

Let us look at another exercise here. We go back to our volleyball player and using cleans. You would think, “Cleans for a volleyball player?” Well, clearly, you can see there is the triple extension coming up. What is interesting is this is a setter. This is a Setter who can clean her own body weight easily, very strong, and it improves performance. When you talk about jump sets, when you are talking about the set, in general, a lot of it is coming from the legs, your ability to get to a ball and do a cross court set, or if you get a bad receive, the ability to overcome that. That all comes from strength and conditioning.

Your basic concepts of strength training. First, overload, this is one of the key things. You have your stimulating loads, especially during the offseason when you are trying to get strong, and then you have your retaining loads, when you are just trying to maintain your strength. There are detraining loads, where you will just try and almost go a little bit lighter. Maybe this is where you decrease your force and maybe increase your speed a little bit, your accommodation to loads. This is very important, the SAID principle, A specific Adaptation to Imposed Demands. You must go as specific as possible. If you really want someone to run faster, the best strength training you can do is have them run faster. I know that sounds simplistic, but how do you get someone to run faster? That is the whole goal. Well, you can have them run downhill at maybe a three or four degree angles, so that will force them to actually go run a little faster. You have your basic concept of individualization, that people are going to respond differently to training and that they will respond differently to different exercises.

Our assignments based on the goal. This is the number of repetitions. There will be some overlap in here, but if you want to develop power, you are looking at one to three repetitions, three to five sets, but you need the three to five minute-period of rest. You must make sure that you have full ATP re-synthesis. You want to make sure that you are not stressing the metabolic pathways, that you are just stressing the structure of the muscle. Now, with strength training, you are talking about six repetitions or less for three to five sets, but you still need that increased rest period. This is where we fall off because this does not become valuable. A lot of coaches say, “I only have this much time, I cannot afford this amount of rest.” This is the amount of rest you need in between sets if you want to get the most benefit out of this training goal. For hypertrophy or just trying to get a little bit more volume, this will almost be a basic conditioning concept, six to twelve repetitions, three to six sets, 30 to 90 seconds. Endurance training, 12 or greater reps, two to three sets, 30 seconds or less rest.

I would tell you that when it comes to the hypertrophy or basic conditioning, generally, you really do not need six sets. The amount of improvement you will get from three to six sets may not be worth the amount of time that you put in with the athlete. That is something that must be decided with the athlete in terms of efficiency of training. For power and strength, I really find that the four and five sets will make a difference. I am not sure for your general conditioning where the six sets are going to be that great of an improvement that will affirm that you should be doing it. It is almost you will probably get as much benefit for three to four sets in terms of time and that putting in that extra time, really, is not an efficient way of training.

Before we get into some of the lifting, let us make sure we review our biomechanics resistance exercise. We have a first-class lever where the muscle force in the resistive force act on opposite sides of the fulcrum. We will call this the moment arm, moment of gravity, gravity is pulling the head down. Here is your moment arm of the muscle. Just keep in mind, when we talk about someone with the forward head posture, the head is moving forward so your moment arm of gravity will get increased. The moment arm of the muscle will not change, and that is where we talked about how the head will impart more force. You will have to work harder in the cervical muscles with a forward head posture.

The second class lever, this is where the muscle force and the resistive force act on the same side of the fulcrum, where the moment arm in the muscle being greater than the moment arm in the resistance. When we are going up on our toes, here is our fulcrum, center of gravity is coming here. The moment arm of the resistance or gravity is shorter than the moment arm where the muscle is in relation to the fulcrum. Therefore with a relatively small cross-sectional area of a muscle in the calf muscles, we have no problem lifting or exploding and creating a lot of force even though we are not talking about a huge amount of cross-sectional area of the muscle.

The third-class lever. This is how a lot of the muscles in our body work. The muscle force and the resistive force are on the same side of the fulcrum, but now, the moment arm on the resistance is greater than the moment arm in the muscle. Here is our bicep, we are doing a bicep curl. You can see here the great biomechanical disadvantage in the moment arm of the muscle compared to the moment arm of the resistance.

One of the things we do is we try and affect this so we can get a smoother action. This is a cam system. What you see with the cam system is in this position here, you can see the moment arm here, we have no trouble lifting, but right here, this is our greatest biomechanical disadvantage. Often, a lot of people refer to this as the sticking point. If you can get past this point, now, the moment arm decreases so now, you can complete the contraction of the muscle. In effect, to try and get this to be a smoother action, some people will use different levers and different cams. You can see if you are using a cam here, that the moment arm does not change as drastically in this way, so you can probably get a more consistent contraction of the muscle and not have to cheat in here. Look at the difference in moment arm from here to here versus here to here. That is what a lot of these machines try and do. That is what we try and do, even with some of the free weights.

The sticking point is the weakest point in the range of motion of an exercise, which probably occurs where the external resistance has the greatest mechanical advantage. If we go back here for a second, you can see if we use too heavy a weight, we cannot get a complete contraction. If we use too light of a weight, we would not get full stimulation of the muscle.

Let us look at a squat, for example. On times, this bottom position of coming out of the squat is where we are going to be weakest. What you can do is you can alter this with chains, and elastic bands can also be used. What will happen is as he starts dropping down, the change will start dropping down to the ground so you will have less resistance in here. As you start lifting into that stronger position, you will get more chain links, which would now have to be supported. This is how you can use chains or elastic bands to give you a better contraction throughout the movement.

This is a study by Bret Contreras, looking at, are all actions the same when we talk about back extension? Here is a back extension from the good morning position. Here is a back extension from the 45-degree position, and here is the back extension from a horizontal. You can see that it is the same movement, but you are going to get different amounts of force. When you look at what is happening in the good morning, the most force will be at the 90-degree position, but at 180 degrees, basically, you are just resting on the osteoligamentous system. Forty-five-degree back extension, you are producing force throughout the entire range of motion, whereas in the horizontal back extension, you are really getting most of the 180 degrees, but when you are just relaxing, you are not producing any force.

We look at the good morning, and develop the back extension, but you could be developing the most force with the fibers in the longest position relative to the other exercises. This is an excellent exercise for developing back strength, especially if you are trying to supplement deadlifts or any kind of cleaning-type movement in here.

Here, you going to be producing the most force, almost as this 45-degree position, going to here. This is actually a very good exercise when you think of sprinters coming out of a slower position and coming up into an upright position. This might be the exercise that you want to use for sprinters, or just think, for example, anybody coming out of the position, maybe even rugby players who are coming out of this position, you can see, they want to stay very low in there, versus the position where you get the most strength with the muscles in a shortened position. Anybody, for example, patients who have low back pain when they are standing, this might be the position you want to strengthen them in because they are getting the most development with the muscles in a shortened position.

The specific exercises, snatch, clean and jerk, power clean, hang clean, push press, and push jerk, we will go over these so you can see exactly what we are talking about. When we talk about Olympic weightlifting, that is a redundancy. Weightlifting is just weightlifting. To say “Olympic”, that really is something that is not making a lot of sense. We look at these exercises burst, looking at something like these specific size, what we call the powerlifting exercise, the deadlift, the squat, and the bench press. If you are weightlifting, that means you are doing either the clean and jerk or the snatch. It is that simple.

Let us take a look at some of these exercises. First of all, we will look at the snatch and the power snatch. Here is an example of the snatch. You can see just how quick that is. This is how you develop the power, versus you know just doing something slower like a deadlift or a squat. I want to show you, let us just look at this for a second. We will review this is. You can see him getting that, so you need a good amount of flexibility in there. You see where he is catching? He is catching down low. A lot of athletes would catch even lower than that. Catching down low, and he makes it a snatch. If you catch in a higher position, that makes it a power snatch. That would go the same for clean or a power clean. This is where our weightlifters are dropping down to. This is where some of our athletes go to. For example, if you have CrossFit athletes, you will see a lot of what they do is power snatch and power clean. Which is better?

I am not sure if you have to go down this low for most sports. I would tell you, if you can develop your power using power snatch and power clean, that would be excellent for the athlete. I still think you want to work range of motion, but maybe for your athletes, let us say we are talking about a basketball player, I use basketball players a lot because they are taller, they are ganglier, and this could be a very tough lift for them to do, but they could do power snatches or power cleans, and then you can work range of motion in an unloaded position so you can still maintain their mobility and their flexibility.

This is going to be the clean and jerk. This is Dr. Dennis Matos, one of my residents. There is the clean part, and now comes the jerk. You can see on that lift just how much power is developed. I think that was 110 kilos that he lifted, at a body weight of about 83 kilos. That is very good. When we look at it, here, there is the catch, the eccentric strength, and there is triple extension. Now comes the real triple extension and watch the power you have got to do, and then stabilize. This is just a great exercise. If you can do a snatch or clean and jerk, which one do you want athletes to do? The problem is these takes so much time to develop. For example, we look at the snatch, this is a lot of technique. You can see that if someone does not do this right, they can get hurt.

When we talk about basketball players or soccer players, we are going to have them doing something like this, do you really have the time to spend on a technical lift like this? Probably not. You start talking about that risk benefit ratio, and there is a good chance that you are starting to lean more towards the risk than the benefit. I know in this area of Minnesota where I am, a lot of football players, they start doing these lists in middle school and high school. By the time they get to their end year, for example, the volleyball player I showed you, she is doing clean, and jerks and she was doing some snatches, but she started about 9th grade, learning this with a lighter weight. That is how they develop it. I am going to tell you, for most of your athletes, you are probably better off doing just power cleans or power snatches.

Let us look at the clean now. This is a great exercise. I am going to show you the clean, the high pull from a power position, and the power clean from a power position. There is the power position and there is the high pull, and there is the power clean from a power position. These are tremendous exercises. I have read a lot of research recently which says that you are going to get the most benefit out of the clean high pull. Let us look at that again. They drop down into the power position and they just pull. You can see the triple extension and you can even jump off the floor a little bit. Now, the reason why they suggest you might be able to do the high pull better than the power clean is with a power clean, you still must catch in here, and for some athletes, they may not be able to pull as much weight if they also have to do the catch. You can probably get more weight and more production if you just do the high pull more than the power clean itself, but once again, just a great exercise in here.

We are talking about a progression. What we are doing is we did the clean, we drop down from the power position, we go more to the knee position. They can do the knee position, you can go all the way to the floor. If we watch this progression in here, she lifts up, there is the clean from the knee in there.

If you can do that pretty well, now, you can do a clean from the floor. There is your power clean from the floor. You can go from a power clean into your front squat. That is how you can develop. If you want to teach athletes do the full clean, like we saw in the earlier slide, that would be the way to do it. Once again, now you are going from the knee position, then you drop down to the floor. Some people, you can almost use this as a great warm-up. If you want to develop some mobility in here, start from here, and you drop down. Go a little bit more hip mobility, dropping from the floor. To get a little more stretch, now, you do your power clean and now onto your front squat. This is an excellent progression you can use for athletes.

As I go back in the video, I want to show you the difference between the push press and the push jerk, because they are very similar. The first two repetitions will be the push press. You can see, he is jumping off the ground in here. Here is the push jerk. They are similar, but what is the difference? What are you looking at? If we go through the push press, what you are going to see is you are going to see just a complete extension, really pushing up and driving up. A wonderful exercise. You see him drive up, pushing off the ground, and driving all the way up.

The difference in the push jerk is you are going to push up but you are going to dive. The athlete dives under the bar, so it is more of an eccentric catch in the athletic position. It is more of an eccentric catch, so the bar, instead of just driving up and holding it, you are driving, but getting under and catching. Let me pull that video back. Now, you can see, he is catching that, and he is in the athletic position, catching in there. Great for strengthening the shoulders and stabilizing in here.  This is an excellent exercise.

What would I choose for my athletes? Generally, I am probably going to choose more of the push press, especially for my athletes who do not have a lot of experience lifting. I think it is an easier lift for them to do and still develop power. The whole concept is developing power from the ground up.

Let us talk about the deadlift, a great exercise, engages a lot of muscles in the body. In a deadlift, you lift the weight from the ground to thigh level, primarily your leg and hip muscles, but you are using all the muscles. This is a great core exercise. When we talk about strengthening the core, as long as the muscles are firing, they do not have an injury, you are not going to strengthen the core much better than by lifting heavy weight, whether it is a deadlift or just the core engagement you get from doing a squat.

Here, we are going to do a deadlift. From there, you are going to see, the whole idea is getting that hip extension in here and down. The back is staying straight. Here’s that straight back, so we are not rounding at all. It is not considered as a technical lift as, let us say, a clean or clean and jerk, but it is still a wonderful exercise. I think when we talk about risk benefit, I think the benefit is a lot greater. You are not risking, as long as they are keeping their position, not lifting too much. I love the deadlift. I am 63 right now, and my motto is deadlift till I die. Just lifting the heavy strength, I think, makes a just a huge difference.

This is a modification. This is what we call a hex bar or a trap bar. Because of these grips, you are raising in a way you grip 8 inches higher the way you grip the bar from the floor. What this allows you to do is if you do not have as a greater mobility, this works very well. We use this with a lot of our high school baseball players. The reason why is they do not have the mobility, they might be a little bit taller, especially pitchers, but the amount of strength you can develop, we have had some pictures, who, their weight training in the offseason has been almost primarily just doing hex bar deadlift, and we have seen an increase in their fastball, for example, 3 to 5 mph. We had one pitcher who was drafted by Major League Baseball, and that difference from his sophomore to junior year, going from 92 to 95 mph, made a big difference in his signing bonus. This is a wonderful modification that you can use.

This is an interesting concept because you will hear people talk about, “proper posture. Do not round the back in here.” I think the key in here is not so much, because a lot of your athletes, one of the things you will see is because he does not have good hip mobility, he cannot drop down. look how far his shoulders are in front of his arms. Your shoulders, when you are lifting, should be in line with the arms. This should be straight down in here. The shoulder should be here and arms straight down over the knees. This is because he is leaning too far forward because he does not have the mobility he needs. This is someone who would really benefit from the hexagonal bar, the hex bar lift, if they want to lift heavy weights. The key here is he is not going to hurt himself as long as he does not round the back during the movement. If he can stabilize in here and make this stable movements so he is still just getting hip extension, he is going to be okay. This is something we looked at. If you look at the Strongman competition and they are lifting this boulder, some people, “this is going to be terrible for their back. Look how rounded the back is.” No, it is really not going to be terrible as long as you are still getting the hip extension and you are locking this in. You are not letting that spine move it. That spine is locked in, they should be safe.

The squat, fundamental human movement pattern that involves nearly every muscle in the body, very important for mobility, for everyday life, activities of daily living. It is a fundamental movement that we need to have.

I have already shown you the front squat. What I want to show you is some of the progressions you can use and the different squats that could be used, because some people will have trouble. Remember, you put a bar in your back, you are going to get a compressive force, something you must consider. The first thing we will look at is assisted squats, where you can use an elastic band or a trainer. You can drop down into the squat and still maintain good motion.

Looking at body weight squats, one of the things you will notice is you see how the knees are coming past the toes? There is no problem with that. The whole concept of knees do not let the knees go past the toes, as far as I can tell, I heard this at a strength conditioning conference, it all comes from one paper that was published in the 70s that seems to have caught like wildfire, so that became the macho. “do not let the knees go past the toes.” I will tell you. In fact, you cannot lift heavy without the knees going past the toes. It is almost a requirement. The other thing you will see is she drops down. You see that rounded back? Sometimes, they will call this the butt wink. In an unloaded position, this is not a problem. If someone wants to round that back in a full squat relaxed, look at babies. They are always in that position.

Whenever we talk about is something a good position, we must talk in context. Are we talking about a loaded position or an unloaded position? This is just body weight. This is unloaded position, so if she drops all the way down, that is not an issue. If she were to have a bar on her back and she got in this position, that would be an issue. Right about here, she is keeping a straight back. Make sure you go down to around 100 degrees, maybe the 90 degrees, but not past that, because when she goes past 90, she rounds the back in here so she may not need the hip mobility she needs. What is also interesting is she might not round her back if she had a bar in her back. Some people will squat differently with a lower on the back because if you have a lower on your back, your center of gravity changes. Your center of gravity would shift forward, and you might end up standing a little bit straighter.

This is one of my students, a former football player. He had a knee issue so he does a different form of assisted squats, and he uses the box there. He is going to drop down slowly but explode up. He is using the box at this point. This is that eccentric component, isometric, and pop right there. You can use rings, you can use elastic bands, you can use a TRX trainer. These are all excellent supplemental tools.

We go to what we call a landmine squat. Someone who wants to start to lift weight, but they might have trouble with compressing the back or may have trouble maintaining that load, you can do a landmine squat. This is just an attachment. You can see, now, as she drops down, you can see she keeping a pretty good position. She can drive straight up and she can start increasing her weight. This would be a landmine squat.

We can go to goblet squats. She is not compressing the spine. She still has a little bit, so I might want to stop a little bit higher than going all the way down because of that start of rounding of the back at the very bottom of the squat.

I have already showed you the back but let us look at the front squat. With the front squat, you need a little more mobility because you are really resting it right on the clavicles, almost, in there. You need a little more elbow flexibility to do the front squat, but once again, just a wonderful exercise. He is practicing the hold that the bottom. Let us look at that again. If you can hold in there, this is a wonderful exercise. Once you drop down to 90, you are really potentiating what is going on in the glute muscles because you are getting that stretch in the glute. It has got to maintain and then it is got to explode out of that. This is just a great exercise. That is a whole progression of squats that you can use.

Squats. Compared to the deadlift, the squat is more of a knee-dominant pattern. The deadlift and hip-based exercises place more emphasis on the posterior chain development. They both will give an effect for the knee-dominant, the knee pattern, and the posterior chain pattern. I do not want you to think that you are not getting any of these muscles involved; you are. It is just that relatively speaking, the deadlift is more of a hip hinge, whereas you are going to get more extension in the squat. If you are having trouble with compression of the squat because it applies a compressive force, that is when you may want to switch your athletes to more of kettlebell swings.

The reason I say that is a kettlebell swing, you can still develop some good power, but it will be more of a shearing force on the lumbar spine as opposed to a compressive force, whereas the squat will be more of a compressive force with some shearing. You may find some of your athletes just cannot squat, but they could develop some excellent power if they did kettlebell swings.

The bench press. If you are a power lift, you must bench press. We do not use the bench press as much with a lot of our athletes. We still use it with our football players because when they press up, for a lot of our linemen, it is the ability to extend and push off that becomes very important. I would have to tell you for the most part, although a lot of athletes like doing it, the bench press is not as vital to a lifting program as the other exercises that we are dealing with L squat, deadlift, clean and jerk, snatch.

Some of the other training concepts we can look at is we look at combination training where you combine strength and power training. Traditionally, combination training, often referred to adding aerobic training for anaerobic athletes or cross training. The first time I saw the term “cross training” was back, I think, in the late 70s, early 80s, with Sebastian Coe, from the United Kingdom, a great 800, 1500-meter runner. His father had him do circuit training for strength, and they felt that that was what gave him the edge, because distance runners were not doing any strength training at that time. That is where I first saw cross training. When they talk about cross training, they usually talk about much heavier weights, much heavier loads.

There are different concepts and there are different ways of doing it. Complex training, this is where you do several sets of heavy strain training repetitions and follow it by lighter power movements, or contrast training, where you alternate the strength exercise with the power movements.

Here is what that would look like. This is complex training where you would do your back squats, you would warm up a little bit, and now, you are getting to 85% of your one rep max, heavy loads for three reps, so you are really in that strength power continuum, rest of 180 seconds, making sure you get your rest, but as soon as you do, you do tuck jumps, which is body weight.  You are trying to explode, trying to jump up as high as you can for five reps and then 30 seconds, and then five more reps and 30 seconds. This would be one example of complex training.

The thing I do not like about this is five repetitions, if I am really trying to develop power, I am just going to do maybe three repetitions, and I would probably give myself more rest because now, we are really dumping into the metabolic pathways in there. It is still an excellent program, but you are taking a little bit of the benefit you get from power training away with the decreased amount of time. Once again, an excellent workout. This is, if you want to almost potentiate, the ability to explode your jump, works very well.

Instead of complex training, you can also do contrast training. We are doing the back squat, so now, once again, we work up to 85% for three reps and then you do 60 seconds, but you do not rest as much and you go into, maybe, a split squat jump. Once again, I think when you are doing complex and contrast training, you are really working more in this speed strength continuum as opposed to the pure power range, but for a lot of our athletes, this would work very well. If you are talking about soccer players, if you are talking about basketball players, I think this is an excellent way of working, especially if they do not have a lot of experience lifting. This is an excellent way of combining your strength training with power training. One of the keys to this is making sure that whatever you use in terms of your power jumps is similar to the motion you were using in your strength training.

The training concept is your increased excitability of the central nervous system due to post activation potentiation. This is the phenomena we see. We are going to increase the variety of training. If you are going to do this, one is the athletes must work at high intensities. The exercises should be biomechanically similar, and your volume will be low. Once again, it is just a great way of doing some of this training.

If I am doing exercise order within a session, generally, I want to go for power first, maybe a power clean or push press. If you are dealing with Olympic lifters, they are going to be doing whatever their lift is for the day. They may be focusing on the clean and jerk or the snatch. This is where I am dealing with maybe more of just my regular team sport athletes. I will go to the strength, either squat or deadlift, then I will do my supplemental lifts, hamstring curls. Nordic leg curls or Russian leg curls, depending on which part of the world you are in, basically, you are doing eccentric hamstring curls in there. Do I want to work more on my hip flexors in there? Do I have to do maybe some strength, upper body strength, shoulder, rotator cuff-type strength? Generally, within a workout, I have seen some workouts where they are using 12, 14 different exercises, but I want to keep my workouts within a 45 to 60-minute session, if possible.

Just think, if I am doing power, or doing the power clean, do my warm up and my power clean, and I want to do, five sets. If I am doing five sets of two or three repetitions, the actual lifting will only take about 10, 12 seconds, then I am resting three to five minutes. Let us go with the three-minute rest. Basically, every set you do is going to take about three minutes. If I am doing five sets, that is 15 minutes in there. Then, I am going to my strength. Let us say I want to do five sets of squat or dead, whatever you want to do.

I am looking same thing, same concept, where I am looking at maybe three minutes per set with rest, maybe it goes a little bit longer. The 10 sets, this, already, I do my power and strength, is going to be maybe 30 minutes of the session right in there, and then I am doing my supplementals. Let us say you do supplementals and let us say I am doing my hamstring curls and I am going to do maybe three sets of eight repetitions. Eight repetitions, each repetition takes approximately four to six seconds, that is average, after five. That is going to be about 40 seconds of lifting and maybe 90 seconds, so about 130. We are looking about two minutes per set. If I am doing, let us say, four sets of this at two minutes, that is going to be eight minutes. I am at 38 minutes. If I throw in, maybe, two or three more exercises, that is going to give me one hour.

You can see, if you really want to do an exercise session where you are doing some power, you are doing some strength and supplemental work, you are not doing 12 different exercises. You can choose maybe a power exercise, a strength exercise, and then three to four supplemental exercises, and that is going to give you a high-quality workout. If you are going more than 60 minutes, most people start to lose their focus at 45 to 50 minutes. Athletes can go longer, so maybe you can get them into that 60 to 80-minute range, but you are definitely not going to be doing an exercise session where you are going to be throwing 12 different exercises at them. You are not going to get as much benefit from that as to keeping it almost compact. Keep it simple. You can vary it from week to week when we talk about periodization.

Perfect segue, periodization. Periodization, it is a strategy designed to prevent overtraining and optimize peak performance. Training is often organized into cycles: macro, meso, and microcycles. This is arbitrary. What I mean by that is it depends on the athlete. For example, if you are looking at an Olympic athlete who is training for one Olympics to the next, that four-year period would be their macrocycle, then they may divide their macrocycle up into the mesocycles, which might be one-year cycles, where they are going for the World Championships every year.

That one-year cycle, you divide that up into your microcycles, which could be three-month periods where you are accentuating certain things. For example, if we look at a 12-month period of microcycle for an athlete, maybe they do one to two months of hypertrophy training volume, then one to two months of strength, and one to two months of power, and they repeat that three or four times, and that would make up the entire mesocycle.

For a soccer player, what are they peaking for? That is going to be much tougher. If you take someone in the EPL, they start in the Fall, but do they really want to peak for the Fall? Yeah, they want to be in their greatest shape as possible, but can they maintain that, then, throughout the season, with all the different matches and contests that they are doing? They might have UEFA games along with their regular season games. What exactly do you want to peak for? Much tougher to do in a seasonal sport like that.

A lot of what we talk about is the General Adaptation Syndrome. This is Hans Selye, who was a Hungarian-Canadian endocrinologist, and these were rats studies the did. He subject the rats to drugs and different stimuli, physical activity, and he would notice first that you have the alarm reaction and then they develop resistance to the alarm, but if you go too far, then they end up exhaustion, and possibly, death. Well, this was adapted for strength training by Mike Stone in 1982. The Theoretical Model of Strength Training is that you start putting resistance load on the athlete, the body, and that is the alarm, then if they adapt and go quickly, that is the resistance. The body develops a resistance, and this is where they start getting stronger, but you can get into overtraining. If you go in too much into overtraining, that is where injuries will start occurring, but you can also have almost a mental injury or fatigue when we talk about overtraining. Overtraining can be physical, it can be mental, and we talked about overtraining, it can be local and it can be central nervous system fatigue also.

When we look at periodization, the whole concept in here, this is, I believe, a Klavora chart, you have your preparatory period for the athlete. This is where they develop, do a lot of volume, they get prepared for the higher intensity activity. You can see, intensity is lower. Their technique is lower, they are taking it easy, but they are doing a lot more volume. The transition period, this is where they want to start getting stronger. Your volume decreases, your intensity increases, you start to increase your training technique, then you have your competition period. You are hoping that this is where you have your greatest strength in here. Are you peaking, here is your technique, at the most important time?

I often talk about, for example, in the United States, the college players let you know, some of the soccer players, what are they peaking for. Well, for incoming freshmen who are trying to make the team, they are trying to peak for tryouts so they can put their best foot forward to make the team, whereas if you are a returning player, you are really peaking for the first game of the season. You may not be coming into your greatest shape at the beginning of training camp; you are trying to peak for the first game.

Here is Klavora’s study. Your biological state, we talk about supercompensation, but this is kind of a vague concept because the only time we have actually tested and seen actual changes in supercompensation occurs with glycogen. We really have not seen it with the other system, so this is all theoretical in here. Here is where you start, and what you will do is if you do not work out hard enough, you do not get much change in here. This is that nice spot where you work out, you have fatigue, but then the body starts adapting, and then you get what they call the supercompensation. If you train too hard, you enter fatigue and you never really recover. You may not even get back to your baseline performance.

This supercompensation that we are talking about may not be supercompensation at all. What it might be is the concept of that when you come in here and you start tapering, it is just the fatigue goes away. When we look at the different paradigms, the paradigm we are looking at is the fitness fatigue paradigm, where when you are working out, you are getting in better fitness, but you are also increasing your fatigue, and this occurs concurrently. What will happen is as you work out harder, you adapt more and the fatigue starts to dissipate, so your fitness becomes more apparent even though it may have been not much different than here. The after effect in fitness and fatigue are exercise-specific. If you are training one exercise, let us say you are training the squat, that does not mean you are going to get that same benefit in the clean and jerk or in the snatch.

The key to periodization is your taper in reducing training to enhance performance. You can have a reduction in volume intensity and/or frequency, fatigue dissipates, and that is where your fitness becomes really apparent. What is interesting is when we talk about tapering, we do not know how much you should taper. For example, I have football players, American football players, high schools, who may have a Friday night game, but they will lift intense on Friday morning.

When I say intense, I mean 90% of the max lift, but maybe one to two reps with increase so their volume is very low, but they try and get that stimulus for the game and they seem to have some effect. If you look at weightlifters who are competing on a Saturday, for example, some weightlifters will tell you they do not want to lift one or two days before the competition. Some lifters will tell you, “No, I am going to continue to lift at an intense stimulus, but very low volume, very high rest periods,” and they feel that is what prepares them best to peak on their competition. It is very athlete-specific.

There are differences. Linear periodization, which is designed for peak performance at a specific time, for example, your Olympic athletes, and undulating periodization, designed to maintain high performance for longer periods of time. This would be your seasonal athletes, your soccer players who have to compete for the entire season.

Here is an example of a 12-month football training program. You can see, I am going to go to September because this is when the college or high school football starts in the United States. You can see in season. It is all about maintaining power and maximal strength throughout the season, and you will find a lot of athletes, once the season starts, do not want to lift this much. They will end up suffering from a decrease in strength and power as the season continues. It is very important, especially with professional sports. You will see them training, which can be tough. For example, a professional football team in the United States, if they have a game on Sunday, they are beat up on Monday. Monday is just a recovery day. Tuesday might be a strength day, where they will do some strength work, but they will not go too intense because they are still recovering. In fact, a lot of times Tuesday, in the National Football League, Tuesday mornings is what they call Community Day where they do community outreach, go to local hospitals, local schools, and then they have practice in the afternoon. Wednesday or Thursday will become their main lifting day.

A lot of the football players will lift heavy on Wednesday and maybe on Friday. This is where they have Saturday to recover, and they play on Sunday. You can see, especially with the scheduling, what happens if they have a Monday night game or a Thursday night game, which may happen two or three times in the season? It can really throw up their lifting. This is the problem that the athletes deal with.

Getting back into our periodization in season, January is transition rest. Generally, when we talk about rest, we talk about active rest, where they are still doing some sort of activity, maybe they are just not lifting. They go into February, their strength training is more of their functional strength training in here, and then they are going to do very little speed and agility training. As you go further into the offseason in here, now, we talked about our hypertrophy training, now, it is volume, but it is still low speed agility training. As you start getting into more strength training, maximal strength training, it is intense, but lower volume, so you start going into more speed and agility training, more technique, then you get into your power training, and then you do even more speed and agility training technique. Then you repeat the whole thing, where you go hypertrophy, more strength, and then into power, and once again, your speed and agility training.

You can see, speed and agility training are as high as when we combine that with power training. You can see how we will do this. This is a linear periodization, a year of linear periodization. This is the entire macrocycle versus an Olympic lifter, whose macrocycle might be four years.

The concept of undulating periodization is where, instead of doing periodization by month, you do periodization during the week. If we look at a weekly undulating period in here, Day 1, Day 2, Day 3, Day 4, and so forth, maybe on that first day, let us say we are talking about a Monday, they may do maximal strength in here, where they are doing lower body and they are doing a lot of pushing. On Day 2, they are doing maximal strength, but now, they are doing more upper body and pushing. Day 3, they will drop down in intensity and do more hypertrophy, so more volume, but lower intensity, then they will come into their power workout, once again, high intensity but a lower volume, and then maybe Day 5, they will go into a maximum strength again and they will focus on lower body but more of a pulling-type motion, and then they will do some strength endurance. This is just one example of undulating periodization.

I would say something that is more active in the athletes I train. For example, let us talk about the high school level, where maybe they are training weights Monday, Wednesday, Friday. Monday, maybe they had the weekend to rest, so Monday may be their power day. Wednesday would be their volume day, and then maybe Friday would be a strength day because they have a game on Saturday or game on Friday night. There are different ways of varying it. Once again, this will be more athlete-specific.

Very important if you read this. The Basics of Training for Muscle Size and Strength: A Brief Review on the Theory of Periodization. Periodization, as presented in the available literature, does not appear necessary for achieving optimal increases in muscle size and strength within a training program. In the context of sports performance, no evidence exists outside of anecdotal reports that longer-term periodization strategies and variations used actually support enhanced sports performance over merely repeated deliberate practice of that specific task.

Here, I am talking about periodization. It is a very important concept in strengthening and conditioning, but it is theoretical in nature, and that is why I say how important it is to work with your athletes in terms of how they feel and what they can do. I would tell you that periodization, anecdotally, is very important because they need these rest periods. They need the recovery, which is what helps them gain their strength. Just on a physiological basis, if you are not doing some sort of periodization in terms of lifting and recovery, you are not going to get the effects, you are not going to get the strength adaptations that you are looking for.

Here are some of the organizations that I like. FICS and ACASC, the American Chiropractic Association Sports Council are organization that I like to follow. For a lot of information, the American College of Sports Medicine, just a wonderful group, and this is good because you can follow epidemiological studies, you can follow studies on a cellular level.

For my national organization, National Strength Conditioning Association, I feel, is a great organization which puts out great information. I also follow United Kingdom Strength and Conditioning Association, excellent organization. www.Strengthandconditioning.org  is the Australian organization.

Some of the research that comes out of the UK and Australia is just wonderful. www.Allthingsgym.com  is a great site if you are interested in weightlifting, if you want to see a great technique, see great lifts, this is just weightlifting. You are going to see the clean and jerk, see the snatch, and it follows all the different international lifters. I just think that is a great source of information,

If you want to reach me, email: aklein@nwhealth.edu  I am the Director of Northwestern Health Science in the Human Performance Center.

I am not a big social media person, but I will sometimes post on @andyklein33 on Instagram if I find an interesting research concept, or sometimes.

[END Session 1 of Exercise Physiology]

English Direct Download PDF – ICSC08 _02_ExPhy TRANCRIPT

ICSC Lower Extremity Module 8
Part 2 – ICSC08
Instructor Andy Klein
Video Lesson: 01:50:34

Welcome to the second section of the Exercise Physiology for Fédération Internationale de Chiropratique du Sport. One of the things that we will be looking at for this session is the metabolic pathways of energy production. Then we will investigate aerobic conditioning.

We will begin with an introduction to energy transfer. When we are talking about energy transfer, we are talking about either a quick type of energy or something that is long-lasting. For our immediate energy needs, we talk about phosphate bond energy which is ATP. We have about 100 grams of ATP in our body, there is not a lot, which is a good thing because that means if you have a decrease, the percentage automatically kicks the body into higher energy production. You can see the ATP broken down to ADP and phosphate, so the high-energy phosphate bond is broken. That is where we get our energy. The enzyme will be ATPase. One of the things about metabolic pathways is that enzymes are very important. The environment that they operate in is very important. These are some of the training adaptations you will get with conditioning. 

There is a reserve, the phosphocreatine is in reserve, and phosphocreatine when you combine it with the ATP that was broken off will give you more ATP and creatine. The enzyme here is creatine kinase. This is an enzyme that is important. You will see this in blood reports. This is an enzyme that is at very high levels after heart attacks because of the damage to the muscle.

That is a very important enzyme, and we will talk about the environment that the creatine kinase has to work. Then we look at the adenylate kinase reaction, whereas you take two of these ADPs, and you can get one ATP and one AMP. AMP, adenosine monophosphate, activates the initial stage of glycogenolysis and glycolysis. Basically, your AMP is a messenger-type molecule. If you are latency, we use ATP.

We are using ATP right now as we sit here. As we need more energy, we can dip into the phosphocreatine stores. After you dip into the phosphocreatine stores, you are going to start getting some production of ATP through the ADP, the adenylate kinase reaction, that is where the cyclic messenger will tell the body, “Hey, it is time to ramp up. We are going to need more energy.”

One of the things we want to look at in terms of metabolic pathways is, “what are some of the nutritional supplements that fit into this area that people are trying to use or trying to sell us?” The first one we will talk about is creatine monohydrate which the theory is it enhances anaerobic power, enhances strength, and speeds recovery from interval work. We will want to look at dosage. We will want to look at the effect of caffeine on creatine. One of the first things we should ask ourselves if we are looking at the supplement is “is this something that is even legal to use?” In fact, I know the International Olympic Committee (IO)C allows it. You must check with your individual organizations, whether it is government or sports federation.

For example, here in the United States, one of the strange rules is it is legal at the college level but the National Collegiate Athletic Association (NCAA), says that trainers and strength conditioning coaches cannot provide it for the athletes or cannot supply it, which I think is an odd request. I think in the Minnesota High School Athletic League where I live, the High School Federation here, they say, “No, you cannot use it, but no one tests for it.” But they do not say it is legal, they just say do not use it. T

here are some grey areas in there. But in terms of research, it is one of the supplements that have gotten some of the best research in terms of usage and beneficial effects.

Let us just look at daily activity. You need about two grams of creatine daily just to perform your normal activities in terms of supplementing the ATP. A typical diet that includes meat provides one to two grams of creatine each day, so you are almost getting what you need for activities of daily living. If you supplement but you are not working out, it does nothing. For women, that means getting 46 grams of protein daily, while men need 56 grams of creatine each day. Which, once again, if you are a meat eater you are going to get on a normal day.

Here are some of the theories behind creatine supplementation. We were pretty sure it works but we are not quite sure how it works. Here are some of the theories that we are looking at. It increases high-energy phosphate metabolism. That is true. I should not say we do not know what it does, but we are not sure what the percentages are and if it is the same for everyone.

It does seem to increase satellite cell activity, which we have discussed how important satellite cell activity is for the repair process of the muscle. It seems to improve cellular hydration status, and hormonal proliferation, especially the IGF. The effect of training intensity, what training intensity do you have to do? How about the actual intake effects? If you take in, what are some of the things we need to look for in the athlete?

A couple of things, creatine will not help if a person does not work at significant intensity. If they are not working 75%, 80%, or 85% of their max, in terms of intensity, it is not going to help anyway. It does not even matter.

Now the actual intake. Some athletes will have GI distress with it. I have worked with some athletes, and some athletes cannot take it unless they mix it in some sort of shake. They might make a shake with some protein in it like bananas or peanut butter ice cream. Something that seems to ease the GI distress.

Before or after, that is another question. It seems to help whether they do it before or after. It is just some athletes handle the creatine better before a workout, some handle it after, and some will try both. Keep in mind when you are putting creatine monohydrate, most of the supplements are somewhat volatile. Let us say you mix it into chocolate milk or something and you mix it up and you drink it, if you do not drink the whole thing right away, some of that creatine will come out of the solution and just end up at the bottom. You may not get all the creatine supplementation that you were hoping for.

Creatine and hypertension, this is a side effects seen in a small percentage of the population. It might have to do with the increase in water retention where they will have a hypertensive effect. It is not something that is seen commonly but it is seen in some athletes.

Let us look at the effect of creatine supplementation on explosive performance and optimal individual post-activation potentiation. The two principal mechanisms for the development of fatigue are the rephosphorylation of adenosine diphosphate, and an increase in the concentration of hydrogen or lactic acid. This will start to increase your fatigue. Additionally, creatine supplementation may facilitate the reuptake of calcium into the sarcoplasmic reticulum via calcium pumps. Now we talked about how important it is.

Creatine supplementation can augment the resorption of calcium. There is less soreness in the muscle. We talked about what happens if calcium with fatigue is just hanging out in the myofibril. You activate the calpains, you activate some contractile hyperactivity, and this is where some of the soreness occurs. What they demonstrate in this study was that creatine supplementation improved maximal muscle strength and optimal individual post-activation potentiation time for complex training, but it had no effect on explosive performance.

They were not getting strength changes but, in the squat, you can see the improvement, but it did not seem to transfer over to the vertical jump. This might mean that you must be more specific in the type of activities you are doing when you are using the creatine if you want to get the benefits of it.

I am just going to go back here for a second. I realized one of the things we did not talk about was the actual dosage. I just mentioned it briefly. But if you look at some of Hultman’s original studies, most of the creatine original studies which showed benefits were based on percent body weight. For example, if you wanted to load the body with creatine, if you felt there was efficiency, it would be 0.3 grams per kilogram of body weight. In a 70-kilogram athlete, you are talking about 20 to 25 grams of creatine to load. But if you are talking about your daily intake, it was 0.03 grams per kilogram of body weight.

Basically, maybe three grams of creatine every day just to help maintain the creatine you have. At this point, most people feel you do not really need to load the body. If you just take a normal amount of creatine every day, you will get the benefits. I would recommend if you were just taking three to five grams per day in a shake, this would give you the benefit of the creatine and help with recovery.

There have been some studies, that have said that creatine might help in terms of brain function and cognitive function especially as we get older when we start going into our 50s and 60s, that the creatine, because of the energy and supplies, might help with cognitive function. They did some animal studies that showed if the animal, the rat studies if they were on creatine and then had a concussive force applied, they did not suffer from concussions as much if they had creatine in their system. This might all be because it probably delays the cascade effect that leads to a lack of energy for the brain. Remember, the brain does require primarily glucose to function.

If we look at cellular oxidation, we are talking about the removal of electrons from hydrogen which is oxidation and passed to oxygen, we are talking about biological burning and oxygen is the final acceptor. If you wonder why we need oxygen, it is to accept the electrons so we can just have enough energy. There are some organisms where nitrogen is the final acceptor. These are few and far between, usually, they are deep under the ocean or possibly in outer space. We use oxygen and that is how we accept the electrons now. You will find out when we do not have enough oxygen you will see what happens, we produce lactic acid.

Here is our electron transport system. This is catalyzed by the dehydrogenase enzyme. You can see nicotinamide, adenine, dinucleotide, and flavin adenine dinucleotide. These are the B vitamins that we need which help us with the electronic transport system. So, yes, if there is a deficiency in these vitamins, then there would be a deficiency in the energy systems and what we can get out of the metabolic pathways. Oxidative phosphorylation is the transfer of electrons from NADH2 and FADH2 to oxygen. When we look at energy production like if we look at glycolysis and immediate, that is taking place in the cell but outside the mitochondria.

When we look at glycolysis in terms of respiration and oxidative phosphorylation, that is going to take place within the mitochondria. Some of the adaptations are the enzymes needed for these reactions where they increase with strength and conditioning, and we will see that as we get into the cell membrane because we will talk about beta-oxidation and fatty acids, which fatty acids can get in, which fatty acids cannot get in.

Cellular oxidation. Exercise and oxidative stress. If you exercise, you are creating oxidative stress. Our reactive oxygen species are going to be created. This is when we start talking about free radicals. This is performed from an imprecise coupling. Oxygen is very volatile. During the reduction of oxygen to water in the final stage of electron transport, free radicals will be formed. Now, this will react with the cell membrane, and it can create changes in the cell membrane and let things in. This is where if you have enough free radicals, instead of being part of the normal process, the normal balance, and homeostasis of the cell, can lead to damage. It can lead to DNA damage in the long run. But in general, oxidative stress is a normal part of the exercise, it is a normal part of living. Five percent of the oxygen used during exercise will create free radicals. This is not a problem. In fact, this increase in free radicals will lead to an increase in the antioxidants that we need for normal functioning and for improved performance.

Here are the three primary antioxidants. Keep in mind these are inherent in our bodies. You do not really need to supplement them. Probably, the best way of supplementing them is just to exercise more. We have superoxide dismutase (SOD), we have catalase, and we have glutathione peroxidase. One of the things you will notice is under each one of these, I listed certain minerals because these are the cofactors. If you do not have these cofactors, the antioxidant will not work properly if at all.

In the cytoplasm, you can see superoxide dismutase needs copper and zinc. In the mitochondria in the muscle in myocardial tissue, it needs manganese. Now, catalase needs manganese and iron. Glutathione peroxidase needs selenium. The reason why I mentioned these minerals is because you can have athletes who have very good diets with lots of fruits and vegetables but if they do not know where their fruits and vegetables are grown, it is possible they are mineral deficient. Even if they think they have a healthy diet, they could be mineral deficient. When you talk about supplements, if we must take them, we talked about creatine monohydrate as a supplement, how about minerals and multi mineral as a supplement might be even more beneficial for the normal performance and improve performance of the athlete. Now interesting enough, catalase also requires iron, so we must be a little bit more conscientious when we talk about our female athletes who sometimes tend to be iron deficient. Once again, therefore I propose that supplementing minerals can be an excellent idea.

Now, superoxide dismutase triggers the dismutation of oxygen to hydrogen peroxide and oxygen. Dismutation, all that means is oxidation and reduction are occurring at the same time. That is because of the volatility of oxygen. Catalase converts peroxide to water and oxygen, and then the glutathione peroxidase uses reduced glutathione to reduce the hydrogen peroxide to oxidize glutathione and water. This is what it looks like. This is the enzymatic pathway for detoxification of the reactive oxygen species. Remember, reactive oxygen species, these free radicals also trigger inflammation in a healthy manner when we talk about neutrophil activation and monocyte activation.

Reactive oxygen species act as a signal to the muscle as part of the adaptation of the muscle. Exercise is an antioxidant. What factors appear to have the most antioxidant activity? Well, in terms of vitamins, vitamin C has high antioxidant activity. In fact, there were studies a while ago with HIV patients where massive doses of vitamin C were very beneficial. Vitamin C works but too much vitamin C and now you run into the problem possibly of dehydration. If you were not doing a lot of vitamin C, please make sure you are hydrating properly.

What is interesting is the number one factor that appears to have the most antioxidant activity is calorie restriction. Just do not eat too much. Eating and the breakdown of the macronutrients really will produce a lot of reactive oxygen species. If you just eat in a healthier manner, you are going to have better antioxidant activity.

The second major factor after calorie restriction for increasing antioxidant activity is exercise. Even though exercise is creating more free radicals and reactive oxygen species, it also triggers the increase in our natural supply of antioxidants.

Let us look at glycolysis or the breakdown of carbohydrates. Fast glycolysis, we need energy quickly. Maybe we use some of our ATP, we are going into high intensity. Not our highest intensity but high-intensity activity, so you need to break down carbohydrates a little quicker and the result is lactic acid which will be converted to lactate in the blood. Now, I want you to keep that in mind, this is not a waste product, this is an intermediate product because the lactate in the blood can then be converted back into ATP and converted back into energy if you start to get oxygen back into the system. This is occurring in the cell, but it is not occurring in the mitochondria. It is not as efficient in terms of producing energy, but it is a much quicker way of producing energy.

Then we have slow glycolysis, where the pyruvate that is broken down is now transported across the membrane into the mitochondria. This becomes the electron transport system. Glycolysis is controlled by the rate-limiting step of conversion of fructose-6-phosphate to fructose-1, 6-biphosphate, which is catalyzed by phosphofructokinase. That is a lot of syllables. What does that mean? Well, you will find this enzyme in the liver. You can break down glucose and get it into the bloodstream very quickly. We really do not have this in the muscle so once the glycogen gets into the muscle, it really cannot be transported to other muscles as far as we know.

The energy from the nutrient breakdown. Carbohydrates. Carbohydrates are our only anaerobic energy source. The brain needs carbohydrates and glucose. Glycogenolysis is where you break down the glucose molecule. Glycolysis is the first stage of glucose degradation, consider that maybe fast glycolysis. Then the pyruvate enters the membrane and goes into the citric acid cycle. This is where we release the remaining energy from the glucose.

With carbohydrates, some people say, “Well, let me get more carbohydrates into my system.” We talked about the concept of carbohydrate loading. First, let us talk about the classical loading procedures. Let us first describe why you must go into a depletion stage first. Let us say you have a race in seven days. On the first day of that week, exhausting exercise, 80-90% of the VO2max. You are trying to get rid of all your carbohydrates.

Remember you must go intense otherwise you will burn fats and you will not be getting rid of all your carbohydrates. Day 2 to 4, you have a low carbohydrate intake, so you really do not let the body resupply itself. Then you get into the carbohydrate loading stage, Days 5 and 6, with high carbohydrate intake, 2 to 3 sessions of very low-intensity exercise. Then competition day, this is where you get that super-compensation.

In the previous session, session one of exercise physiology, we talked about the only place we really have seen super compensation take place on a physiological level has been with glycogen. This is the procedure. This is a tough thing to do though if you are doing classical loading procedures, let me tell you, you are going to be very cranky, you are going to be very stiff, and you are going to be very sore these first couple of days.

A lot of people do not do it, I am not sure it is worth it. Unless maybe you are at that elite level. I would suggest to you that if you are going to try this, obviously, you try it in the practice, and you would never try this for a race when you have not used it before. We know how disastrous it is to try something new for competition. But you can do a modified loading procedure. Your basic modified loading procedure is where you really eliminate the exhausting exercise.

You just do some moderate exercise which obviously does not burn as much glycogen or low carbohydrate intake. Then you just try and increase carbohydrates the last couple of days. I think the modified loading procedure becomes more of social activity. This is the classic old pasta dinner the night before the race. I think that is almost more of a social activity now at this point than it is an actual physiological benefit.

The other thing is if you do the classical loading procedure. These last couple of days when you get super compensation if you are going to increase glycogen to that extent, you are also going to increase the water uptake. You almost might feel a little swollen, a little stiff because you are going to have more water resorption because of this high carbohydrate intake.

Keep in mind a couple of things. Carbohydrate from a bar is effectively oxidized during exercise. Carbohydrate ingestion can be effective with a gel as well as a drink. Although we do not really want to have any carbohydrates just before the race for 15 to 20 minutes because we are worried about insulin spikes, once you are exercising the metabolic pathways are going, then there is no problem in taking carbohydrates during the race. But do you really need them? Well, not if your event is under 60 minutes. You really want to be in that 60 to 120, or even 180 minutes to have any effect from taking the carbohydrates in during this competition.

Now, we are going to look at the macronutrient lipids and the energy that we can get from these lipids. This is almost freeze-dried energy. This is where we get most of our energy. The number of calories we have in our body in terms of fat is about 60 to almost I think 100,000 kilocalories within our body obviously, we cannot use all of this. A lot of this fat would be in the cell membranes, and we do not want to use our cell membranes for energy. Adipogenesis is the maturation of the fat cells. Now, lipolysis provides 30-80% of the body’s energy.

It liberates the free fatty acids. This is really where we want to be in terms of creating energy. This is where we can go long-term. This is our endurance. This is the energy that we need. The better trained you are and the increase in lipases that you have so that you can mobilize these free fatty acids a little bit quicker, that will let your spare glycogen. That is the glycogen-sparing effect that we talk about.

Then we want to also talk about – how lipid intake in general, and how much fat should be taken in? Well, there are all many different types of concepts and diets about how much lipid you should take in. Generally, I am going to speak in generalizations because people do not agree with everything but less than 30% of your total calories should be fat. Then you have the ratios, polyunsaturated to saturated fat ratios, 1:1 minimal, 2:1 preferable.

Then if you want to talk about your polyunsaturated to monounsaturated to saturated fat ratios, we are talking about a 1:1:1 if you can do that. Some people obviously will say, “Well, that is too many lipids.” Other people will say, “Well, I will take in more. I need to take in more liquid for energy.” A lot of it would be your activity level. If you are looking at a cross country skier or a long-distance runner, the number of calories they burn, you will have no accumulation of fat.

When I was in college when I was running track for a while, I was running 70-90 miles a week. The number of calories I was burning really did not matter what I had in my diet as much because it was all being burned anyway. I could easily go 5,000 calories a day and still have trouble maintaining weight. In that sense, the amount of fat I was using was all being used for energy, and none was being used for accumulation. I can never maintain that type of diet these days without ending up with severe coronary artery disease.

When we look at the entire circuit in here. Here, when we break down carbohydrates, you can see this is pyruvate. This is what enters the mitochondria. Then you can also have some protein oxidation, the amino acids which will come in the Tricarboxylic Acid Cycle sometimes also known as the Citric Acid Cycle, then fatty acids. The fatty acids are going to enter the membrane. Now, short-chain and medium-chain fatty acids can enter right into the mitochondria through the membrane. Long-chain fatty acids cannot enter.

They must be transported in. They will be transported in by carnitine. We will talk about that in a little bit also, the benefits of carnitine. But you can see this is where we are going to get most of our energy and the electronic transport chain right through here.

 One of the things we have had to deal with is, and this is more with my regular patients than my athletes, they will come in because of some of the social media exercising at a lower percentage of your VO2 max will burn more fat. What that should say is it burns fatter percentagewise.

I did a chart to show you what that exactly means. We look at a 77-kilogram person, 170 pounds. Let us have them do 30 minutes of exercise. If they do a 20-minute mile, that is easy. You can see they are burning 5.7 kilocalories per minute. Under that condition, a lower percentage, yes, is 80% of the energy used is fat use.

Those are the calories you are burning but you are burning 80% of a much lower calorie total, so if you look at total fat calories if you are on a 20-minute mile or 11-minute and 32-second mile, you are burning more calories if you run faster. Yes, you are only burning 50% of your fat but when you are done because your temperature will be up, you will still be breathing, you will continue to burn calories. Overall, you are going to end up burning more fat. This is the ideal situation.

If you are talking about a seven-minute mile and you are doing 30 minutes per session you can see you are burning a lot more per minute, it comes out to about the total fat calories for the exercise session but once again, post-exercise, you are going to end up burning more calories. That because you add a rest period will be more fat calories. I mean, ideally, if you are sitting here just watching this session, the calories you are burning is probably about 95% of fat. Unfortunately, it is 95% of almost no calories expended so it is not very helpful.

We will talk about proteins; this is one of the things which annoy me. I really think that most people, or athletes get enough protein. I mean, the question we asked is “do athletes need more protein? Does excess protein stimulate strength and development? Do supplemental protein powders work? Does excess protein intake have medical risks?”

When we look at the breakdown of protein, the metabolism of protein requires the deamination process before it can enter the pathway for energy release. This is where for a while, people were advocating high protein diets for weight loss because of the number of calories you would burn just breaking down the proteins. But that still does not take the place if you are just using the diet, it is not going to be very beneficial.

In the United States, the RDA is 0.8 grams per kilogram of body weight. That is the recommended daily allowance. They say that 1.5 grams per kilogram of body weight would be considered a high protein diet. I mean, we will look at these numbers but let me just say, this is ridiculous, so let us look at some of the evidence that supports it.

Here are some of the recommendations. I already talked about the USA-RDA recommended daily allowance. The American College of Sports Medicine, for endurance and strength they are recommending at least 1.2 to 1.7 grams per kilogram of body weight. This is for endurance, too. I don’t think most people realize even though you are not getting a lot of hypertrophy with muscles, there is still a high protein turnover in the muscles when you are doing a lot of endurance exercise.

Drogon was a Bulgarian strength coach, and he was looking at 3.5-4 grams per kilogram of body weight. He was working with weightlifters which is a different population but that is a lot of protein. If you consider that maybe a 5–6-ounce steak might have 80 grams of protein, well, let us figure it out. Let us say you have about a 90-kilogram lifter.

If you are looking at 4 grams, that is 360 grams of protein that you would need for that lifter. If they had an 8-ounce steak, maybe you are looking at 100 grams. You are looking at maybe 4 steaks a day for 8-ounce steaks a day, that is a lot of meat to take in.

Luke Bucci had an interesting text on injuries and rehab. His recommendation based on the evidence, he was looking at is that if you are recovering from an injury or rehabbing from an injury, you would want at least 2 grams per kilogram of body weight to help you during that recovery and rehabilitation process.

This was an interesting study by Luetkemeier and Bradburn. This was a four-week study. Twenty-three college seniors who lifted weights three times a week – these were not beginners; these were seniors who had lifted for a while. They gave them different protein levels. The levels were either 0.4, 0.8, 1.2, or 1.6 grams per kilogram of body weight. The seniors at 1.2 gram, remember that is the lower level of what the ACSM recommendation was, had a negative nitrogen balance. If you have a negative nitrogen balance, you are not going to build muscle.

In fact, you might even lose some muscle mass. Seniors at 1.6 grams barely maintained a positive nitrogen balance, so, 1.6 grams did make it so especially if you were trying to maintain weight, that would be good. I think at least looking at this evidence, this is where you start thinking about 1.5 to 2 grams per kilogram of body weight seems to be a pretty accurate recommendation.

Protein requirements are elevated in endurance athletes after exercise. They reported that after their studies, they recommend a protein intake for endurance athletes of 1.65 to 1.83 grams per protein. Once again, much greater than the RDA. If you look at the current recommendation for endurance athletes as reported by the ACSM, also 1.2 to 1.4. Once again, I think we must look at and discuss the concept of protein intake and an increased protein intake for athletes who are not getting enough.

The energy from nutrient breakdown. Whey protein is a protein supplement. It is something I use, too, I try and avoid red meats. I will have some, but I try and avoid them. I will get my protein from a plant-based diet, but I also am taking in chicken and turkey and fish. But you can see the different types of supplements you have. The concentrates of whey protein, low levels of fat and cholesterol, and high levels of bioactive compounds. The isolates were processed to remove lactose and fat, slightly lower in bioactive compounds but if you are lactose intolerant, this would be a good supplement to use. The hydrolysates pre-digested and partially hydrolyzed more easily absorbed, and most effective, but they are also more expensive.

 If you try this, when you mix it in with liquid it has a bit of a chalky taste. Most of the supplements that you are going to buy in the market are a combination of concentrates and isolates. This seems to work best for me at least. Once again, you are always talking about how people will react, it is an individual thing but there are some generalizations we can make. But I think this is a wonderful way of getting some protein supplementation.

One of the things we have seen is carbohydrate and protein ingestion after a workout. This is the ratio that they found: 1.06 grams of carbohydrate to 0.41 grams of protein per kilogram of body weight, 0 to 2 hours post-exercise, this increases plasma insulin and appears to increase growth hormone. If you have this combination after a workout within that two-hour window, you may improve the benefits of your strength training.

Interestingly enough, this ratio is what you will often find in chocolate milk. How many people can drink chocolate milk after a workout? Not a lot of people can do that. I can, I love it and sometimes I will have the chocolate milk and then I will put in my protein powder with that. I also may add my creatine at that point. It will be an all-encompassing shake for me. 

This was an interesting study: Resistance Exercise Augments Postprandial Overnight Muscle Protein Synthesis Rates. Is there a way of increasing your protein synthesis while you are sleeping? Here is what they did, they used an exercise protocol, which consisted of 60 minutes of lower body resistance exercise. A lot of leg extensions, leg presses, and leg curls. They completed the exercise two and a half hours before the person was going to sleep. At the end of the exercise, they gave them 20 grams of protein but just before sleep, they gave him 30 grams of protein.

They measured protein synthesis rates that were increased in that 30-40% range so they did get a very good increase. Now, you always talk when you look at the research, look at the evidence, how feasible is this? It is for someone who does not mind exercising later in the evening.

This would not be a problem for me. Exercising early in the morning is more of a problem. If you get athletes to do this and some competitive athletes especially younger athletes will do this, but it is also a question of, two and a half hours before sleep, what is your fatigue factor at that point in the day?

I thought this was an interesting one to also add: Leucine supplementation enhances integrative myofibrillar protein synthesis in free-living older men consuming lower- and higher-protein diets. The intake of protein and the ability to absorb protein is not equal across the board. As we get older, we lose some of our ability to absorb and use protein. If anything, we need a higher protein intake. They found that when they did the supplementation of leucine, which is a branched-chain amino acid, and they mix it with regular meals they actually had an increase in myofibrillar protein synthesis. When they say free-living older men, we are talking about 70-year-old men who are living on their own as opposed to being in a nursing home. I mean, that is an entirely different subject that needs to be addressed but if you consumed high protein, you had an improvement in your resistance exercise and your strength.

Leucine co-ingestion with daily meals enhances integrated myofibrillar protein synthesis in rested and in training conditions. It was equally effective in all men who consumed daily protein and takes greater than or equal to the RDA. Even if they were taking the accepted protein intake, this still helped absorb and helped use the protein in a greater fashion.

When we go back to these questions, “Do athletes need more protein?” Everyone needs protein, especially your athletes. That is something you should consider if they want to get the greatest benefit out of their conditioning. “Does excess protein stimulate strength and development?” Not unless you are working out. I mean, you cannot just take increased protein and think it will help although, there are some people who may not be getting enough protein for their normal daily intake. If they are just getting maybe a gram of protein per kilogram of body weight? No. I would say that the excess protein might stimulate strength only in terms of performing their activities of daily living.

“Do supplemental protein powders work?” Absolutely. They absolutely work then it becomes a question of price. You would rather get it from food, but a lot of the foods are going to be high in protein. Unless you are talking about a plant-based diet. If you are talking about fish, and you are talking about some of the meats. Yes, that could get a little expensive.

I think one of the things you must look at with some of the younger athletes that I was working with is they will have these protein shakes and they will be quite filling, and they need to be supplemental, and they will almost use it in place of a meal instead which is not what you want. If they are getting breakfast, lunch, and dinner, the idea is not to have a protein shake at lunch which will eliminate the protein that you would normally get from your lunch.

Where the supplemental protein powders work especially with my younger athletes is before bedtime. I know some athletes who are a little bit more extreme in their approach, they will get up at 3:00 or 4:00 in the morning and have a protein shake and go back to bed so they can get that increase in protein. That has provided some benefits.

The next question is, “Does excess protein intake have medical risks?” The medical risks that have been associated with excess protein, I think when I am looking at the evidence seems to be more dietary in nature, that people who are getting two and a half three grams and tend to be centred, they are getting it from a lot of red meat which I think is more of the issue. I think if you are in those two grams per kilogram of body weight, I have not seen anything that suggests that you are going to have any medical risks. So, yes, if not getting extreme, the people who have more medical risks are usually sedentary people whose diet is just too high in processed foods and red meat.

We are going to start taking a look at aerobic and anaerobic exercise, and some of the differences in conditioning. Aerobic exercise is brisk exercise that promotes the circulation of oxygen through the blood and is associated with an increased rate of breathing, running, swimming, and bicycling.

There are so many things you can do cross country, skiing, rowing, and kayaking. Anaerobic exercise is exercise intense enough to cause lactic acid to form. It should be anaerobic exercise is exercise intense enough to cause an increase in the formation of lactic acid because, in fact, even as we sit here, we are producing lactic acid but we are taking in enough oxygen where we are able to metabolize that lactic acid so we do not get an increase of lactate in the blood.

Our oxidative system. What are our substrates? That is one of the things we are looking at. It is all of them. It is the carbohydrates, it is the lipids, and it is the proteins. But what do we want to do primarily? Lipids. Then we want to get most of our energy for the oxidative system, the aerobic system, through the citric acid cycle also known as the tricarboxylic acid cycle.

When we look at substrate relationships, we can see immediate energy, we want ATP phosphocreatine stores as the stored phosphagens. Our glycolysis system will be glycogen and glucose. Aerobic metabolism — glycogen and glucose, fats, and proteins.

The greatest rate of energy production. All right, the fastest you can get it is through ATP and creatine phosphate. Then fast glycolysis, slow glycolysis, and carbohydrate oxidation. Then kicking in with fat and protein oxidation. Remember, it is primarily fat. If you want to talk about the total amount of ATP production, well, then we reverse that order because we did not get most. The greatest amount of ATP production is from fat and some protein carbohydrates, and then the glycolytic system, and the ATP phosphocreatine system.

The effective event duration. If you are looking for very short period, 0 to 6 seconds of very intense energy, all phosphagen. Then you will start kicking the creatine phosphate in about six seconds, six to thirty seconds is intense. That is phosphagen, ATP phosphocreatine, and fast glycolysis. Thirty seconds to two minutes, heavy, fast glycolysis. Two to three minutes, moderate, which is fast glycolysis and start oxidation to kick in. Greater than three minutes is considered more of light intensity. That is where we talk about just oxidative phosphorylation or oxidation.

This is out of the book on exercise physiology from McArdle, Katch, and Katch. One of the things you will notice is it is not that one is on and then the others are off. It is almost like dimmer switches where if you turn it on just a few seconds, yes, it is primarily ATP but the other systems are already kicking in. Remember, when we talked about ATP, how it is broken down, and the adenylate kinase reaction, which will give you an ATP and an AMP, which is a cyclic messenger.

Well, here is the messenger triggering everything right away. Even when you talk about aerobic metabolism, there is still some ATP and phosphocreatine being used from that system as you increase in time.

 Substrate depletion and repletion. These are going to be general levels. ATP doesn’t usually decrease greater than 6% from its base level. It does not have to because you are going to get feedback right away and start creating these feedback loops to the body to increase glycogen breakdown. Complete ATP resynthesis in 3 to 5 minutes, once again, this is the same rest period we need for power and strength conditioning.

The reason why is we get ATP resynthesis so when you do your next set of one to two repetitions, you will not be involved in the metabolic system, you will just be talking about stimulation of the muscle structure. Complete glycogen resynthesis in about 8 minutes and then if you want to get glycogen repletion say after a game, 0.7 to 3 grams per kilogram of body weight every 2 hours. This is what is going to help you get your full glycogen repletion.

Keep in mind, for someone who is untrained or if it is an extreme event, you are not going to get complete glycogen resynthesis in eight minutes. This is for like a set of exercises or something like that. If you are talking about an event or a game, it could take 24 hours and maybe 48 hours before you get full glycogen repletion.

Once again, our immediate energy system, the ATP-PCr system. What this will tell you, by the way, is like in a 100-meter race, a lot of times, we have talked about it is not the one who is running fastest at the end, it is the one who slows down the least because you are going to get your top max speed. Most people are maxing out at 60 to 80 meters – that is a 6 to 8-second range, then it is a question of, “Can they decrease the rate of deceleration to actually hold on?” If you see someone kicking the last 20 meters, it is just a relative perception that they are slowing down less than the other runners around them.

When we talk about short-term energy, we talk about glycolysis which is in that 60 to180-second range. Maybe even fast glycolysis will be in that 30 to 45-second range. There are two terms that are sometimes used interchangeably, and they are not. One is the blood lactate threshold, and this is the threshold at the point at which during exercise, lactate starts to build up in the bloodstream higher than your resting value.

Usually, a lactate threshold gives you a good predictor of submaximal fitness. The onset of blood lactate accumulation is a little bit different. This is the point where lactate accumulates, and you are looking at its highest level. It almost forces your exercise intensity to decrease. This implies maximum exercise intensity that a person can sustain.

If we look, for example, the blue rating here is the untrained person, and red is the trained person. If you look, this is our resting lactate production. Millimoles per litre of blood are just under two in most cases. As you start to increase your running speed, at a certain point, it is not aerobic. You are going to have to start using a little bit more glycolysis and that becomes your lactate threshold. In this case, your lactate threshold in the untrained person is about 10 kilometres per hour. If you start training, you are going up to almost 12 kilometres per hour. That gives you an idea of your lactate threshold.

You are going to keep increasing your build-up. There is a certain point, the onset of blood lactate accumulation where it could be here, it could be here where your ability to maintain your size, intensity, and start levels off or decreases, that is where we consider the onset of blood lactate accumulation because it is decreasing your ability to perform. You can look at some of these values. You are talking about in the untrained person, maybe 9 millimoles per litre.

The trained person, they are going up to 10. But they have done studies, especially on hockey players. Some of these shifts, these 30-40 second shifts, where I have seen levels as high as maybe 18 to 20. Their onset of blood lactate accumulation might be lower. They get up to a blood lactate reading of 20 millimoles but the onset of blood lactate accumulation, where they can skate at that high intensity and that high speed might be at 15 or 16.

When we look at the onset of blood lactate accumulation, what can we do about this? Is there anything we can do? Any supplements that we might be able to take which will allow us to perform at higher levels so that we do not build up lactate as quickly? One of the things we have seen as a possible supplement is sodium bicarbonate used for athletic performance. This is a nice meta-analysis from 2012.

I became familiar with sodium bicarbonate. Some of the studies at the University of Pittsburgh in the early 80s and were getting some good results but at that time, one of the things they found is they were putting runners on treadmills, and they were getting better performance except for the fact that sodium bicarbonate made them nauseous. They were all vomiting on the treadmill. That is where the work started. Obviously, we have come a long way since then.

One of the things we saw in this meta-analysis when they looked at these different studies is sodium bicarbonate has an overall moderate effect size. In some of these studies, it was not statistically significant but there was a moderate effect size. It appeared to be more effective in recreationally trained athletes. It did not help as much in the elite athletes in terms of values but one of the things is the effect size and elite athletes do not have to be very great. Although only minor benefits were seen in these trained individuals, this can be significant at an elite level. Remember, you have athletes in the 100 meter who trained for years to drop, maybe three-tenths of a second or like three-hundredths of a second even. Even though it is not statistically significant, can still have a major difference.

One of the things they looked at is recommended starting dose – 0.2 to 0.4 grams per kilogram of body weight, 60 to 120 minutes pre-exercise in flavored water or capsules. A couple of important points here. Some of the original studies I have seen. This fits in very well that 0.2 to 0.4 grams in a lot of studies. Sixty to 120 minutes pre-exercise, I would suggest to you that even a little bit earlier, more like 120 to 180 minutes pre-exercise, I think athletes from what I have seen, anecdotally handle that a little bit better.

If we are talking about supplements, how about the effects of combined creatine and sodium bicarbonate supplementation on repeated sprint performance? Get the creatine for recovery but the sodium bicarbonate so you can perform at a higher level.

Thirteen male participants, VO2 max greater than 55. We are going to talk about that but that is a nice aerobic intensity. These were male participants with greater than five hours per week of aerobic exercise, high intensity greater than two hours a week. This was not your basic untrained person or just a simple recreational athlete.

These were trained athletes. They use supplements of creatine and sodium bicarbonate, 20 grams of creatine which is almost a loading dose, and 0.5 grams per kilogram of body weight. At the higher end of what allowed the evidence says but still within the normal amounts of most of the evidence.

Two days of supplementation before the test but no supplement the day of the test which gets rid of the possibility of nausea from the sodium bicarbonate in the athlete. The test was 6 by 10 second Wingate sprints. If you are not familiar with a Wingate sprint, a Wingate sprint sometimes is 30 seconds long, but it is a bicycle ergometer and you are pedalling as hard as you can. A very tough thing to do. If you have ever had to do a Wingate sprint, 10 seconds is an eternity, and 20 to 30 seconds is pure hell.

 A 60-second active recovery was performed between sprints. Based on the supplementation for the previous two days, there was a significant increase in peak and mean power and less of a decline in relative peak power over the six sprints in the combined supplementation condition. By using the supplements, you can work at a higher intensity which obviously is going to help with training and help with performance.

One of the things it is doing is that sodium bicarbonate is influencing the pH. This is an interesting thing. If we look at a normal blood pH value of 7.35 to 7.45, maybe you want to talk about an average of 7.4. When we are talking about athletes who are training hard, especially in the anaerobic state, they will get their pH down. They will get down to 7.0 blood which if you walked into a hospital emergency room with a pH of 7.0 in your blood, they would consider an emergency, put you on oxygen or everything like that but an athlete can compete and get to that level.

Although there will be side effects. If you are trying to train, if you are doing repeat intervals, high and anaerobic intervals, and your blood pH is 7.0 – 7.1, you are probably going to get some nausea. You are probably going to have some headaches. But what we read in the blood is not the same as what we are going to see in some of the cells and tissue.

If we look at the pH in some of the muscles compared to the blood, a pH of 6.6 can be attained. We are starting to talk about changes in the viscosity of the connective tissue, Hyaluronic acid which is an important part of the extracellular matrix and connective tissue, if you are working anaerobically and it is 7.0 – 7.1 in the blood, well, you might be at 6.6 within the muscle cell and within the connective tissue. This is where you are starting to get that stiffness in there.

There is an old term I do not know if they are still using it, we used it in track and field where you are in such bad shape. You were “rigging” which was short for rigor mortis because that is what it looked like. That may lead to additional stiffness seen in athletes after prolonged activity. This can be heightened or exacerbated by being in a state of dehydration. Once again, if you are talking about the extracellular matrix of the connective tissue, hydration is a very important factor.

If we look at oxygen uptake, and we look at aerobic exercise, some of the terms I want you to know — maximum VO2. The amount of VO2 you can use, and this are measured in millilitres per kilogram per minute. Then we are going to talk about oxygen deficit, oxygen debt, and excess post-exercise consumption (EPOC). Maximum VO2 is the point at which oxygen consumption plateaus and shows no further increase in your workload.

You are sitting here right now, and then I asked you to get up and you start getting up and you start doing a steady state exercise. You start gradually increasing the intensity, and as you increase the intensity, you increase your oxygen consumption. There is going to become a point where you will start to keep increasing the intensity, but you cannot take in any more oxygen, and you plateau there. That is your maximum VO2. If you keep exercising, increasing your activity, and your intensity, now you are going to start getting into your glycolysis. It is your anaerobic state.

What are some good max VO2 values? Here are some of the top values for men and you can note the different sports: Oskar Svendsen cycling, cross-country skiing, and cycling. Look at the Max VO2 on these milliliters per minute per kilogram. This is high. I would suggest to you based on what I have read, that a lot of the evidence is if you are an elite endurance athlete, you are going to be in that 70 to 90 milliliters per minute per kilogram. That does not mean you get a win do not equate maximum VO2 with performance because you can have an elite athlete who might be at 80, who still might be the one who is winning.

But this is in terms of just your maximum aerobic capacity, of course, there are other factors involved in performance besides just maximum VO2.

Here are some of the values for women, running cycling, cross country skiing. One of the things that you will notice is that at least just in terms of max VO2 that the top women really enter into the realm of elite performance in male competitors because as I mentioned before, in the male competitors, the elite level is in that 70 to 90 plus max VO2 while your top women are still in that range. In that bottom range. They would all qualify as elite when compared to the male participants.

Your oxygen deficit. This is a difference between the total oxygen consumed and the total oxygen that should have been consumed had you reached a steady state of aerobic metabolism at the start of the exercise. That is oxygen deficit. This will make a little more sense in a minute or two.

Your oxygen debt is the oxygen consumed during recovery that exceeds the amount of oxygen that would be consumed at resting levels. Also known as excess post-exercise oxygen consumption (EPOC). Here is what it looks like. You are sitting, you are resting, and you get up to start running. Well, most of you know that your body does not kick in right away, the aerobic metabolism so you are going to supplement this part under the line.

We go right into a steady state. There will be some anaerobic energy process going on here. You are going to have to make this up. This is the oxygen deficit. Now, when you stop your exercise and you just sit, you will notice you are still breathing hard. Your blood is still pumping a little bit, your heart rate is still elevated. That is because you still going to be taking in oxygen in here, that is your debt. You should think of this, like when you check into a hotel and you give them your credit card, well, that is a deficit. At the end of the month, the bill comes in, you got to pay that off. That is your oxygen debt. That is what you have to pay off.

The excess, the oxygen you take in this excess post-exercise oxygen consumption, is what we are talking about. This is how you pay your oxygen debt. This will be different. If you are trained, you are going to get down and you are going to get down very quickly because if you are a trained person, you will get to that steady state much quicker, and you will have less of a deficit so then you will have less of a debt.

But if you are training very hard, even if you are a trained person, let us say you are training for 45 minutes at 75 to 85% of your maximum intensity, when you stop, that will keep going and there will be a 24-hour period where you are going to burn more calories.

This excess post-exercise oxygen consumption can stay at an elevated rate for at least a 24-hour period where you can burn. These are some of the studies they have done where you can burn up to anywhere between 20 and 40% greater calories than would be expected from the exercise just performed. This concept of excess post-exercise oxygen consumption is the basic theory behind the fitness chain, Orangetheory Fitness. Or I think that is Orangetheory Fitness or Orange Fitness Theory. I forget, I am not even sure what they do but I know it is a global chain. That is the whole concept where you are going to train at such a high level that when you are done, that metabolism is going to go at an increased rate for the next 24 hours and there is a lot of evidence that backs this up.

We will talk about some of the cardiovascular anatomies at this point.  We want to look at cardiovascular anatomy and physiology and how this plays a part in training, especially for the athlete. This is just a quick review. You have the structural anatomy, and then you have the conduction, the ECG, the P wave, atrial contractions, QRS complex, ventricular contractions, the T wave, and ventricular repolarization.

That is just a quick review. Just keep in mind when we talk about measuring heart rate and heart rate variants, we are going to talk about different intervals. You can measure R to R, or S to S. It is your choice.

 Some of the cardiovascular responses to exercise. We talked about cardiac output, which is your stroke volume times your heart rate. The stroke volume is going to be regulated by end-diastolic volume and sympathetic hormones. You will see the difference, for example, in swimmers because when a swimmer’s end-diastolic volume fills up easier than if you are running upright. Because in swimming, you are horizontal so the circulatory system isn’t fighting gravity, so it is easier to fill up in diastolic volume, so you will get the same cardiac output, but your heart rate may not go up as high as your maximum heart rate.

You will see this a lot more in recreational athletes as opposed to your elite athletes. Blood pressure obviously goes up. Systolic blood pressure is going up with your response to exercise and then the oxygen extraction going to get more oxygen out of the blood. How much oxygen do you get out of the blood? Well, once again it will be based on your training because you will start an increase in enzymes which will allow you to take more oxygen out of the blood as you train.

Your cardiac output, heart rate times stroke volume. Heart rate, and stroke volume, are all simple definitions. Stroke volume is the amount of blood pumped out of the left ventricle in each cardiac cycle.

Let us look at two different people. The first person here, 70 beats per minute is the untrained person, and the 50 beats per minute are your athlete. Well, what will happen is and this is at rest. The untrained person, they have a normal stroke volume is 70 millilitres. But your trained athlete, your trained cardio athlete, this stroke volume, remember the heart is a muscle and that is what they are training. Their stroke volume is much stronger and much more efficient, a hundred millilitres per beat. If you look at 70 times 70, so your untrained person at rest is getting almost five litres per minute, five litres of blood per minute circulating. Your trained person, even though it is only 50 beats per minute is still getting that same five litres per minute but that is at rest.

Let us see what happens when we look at exercise now. First, the untrained person then the trained person. Well, one of the things we know is that the untrained person can still get their heart rate up just as high as a trained person, but they cannot increase their stroke volume as much. In the untrained person, maybe with an increase in intensity in exercise, they will get up to 100 millilitres per beat. But the trained person can get up to 160 millilitres per beat. Now, look at the difference in cardiac output during activity – 20 litres versus 32 litres, that is a lot more oxygen. That is a lot more blood being pumped and a lot more oxygen being carried to the muscles in the trained person.

When we look at the distribution of cardiac output during rest, we can see there is going to be a difference. At rest, muscles get 20% but in exercise, 84% of the cardiac output is going to the muscles. The heart gets its share no matter what. I feel like the heart is like a bookie taking bets. The heart is going to get a share no matter what you are doing. You can see through the shunting of the blood to the muscles from the organ. Both the liver and the kidney, all of this decrease.

There is also some decrease in the blood to the brain. Sometimes I think about, as a fan of sports, you are watching near the end of the game and you say, “Oh, I cannot believe what a boneheaded play. How can he do that?” I think of the athlete though who you take a combination – there is some decreased blood flow to the brain, and he now combines fatigue with it. If they are not in the best shape, there also might be a decrease in circulating glucose because of their fatigue and deconditioned state.

It becomes much more understandable how someone can make a mistake which to the untrained person sitting in an easy chair at home watching a big screen TV seems inexcusable.

You have the oxygen exchange in the blood, that is what you need. The purpose of the circulatory system is to get oxygen to the muscle. Why do we need oxygen in the muscle? Because it is the final acceptor for the electron transport chain.

Once again, that is how we are going to end up getting our energy. Some of the potential limiting factors: it could be at respiration, it could be at lung ventilation, it could be not enough mobility through the ribs and thoracic spine but respiration general, central circulation, your cardiac output, your blood pressure, hemoglobin concentration, then your peripheral circulation, your ability to shunt blood to the muscles, your capillary density, your ability to extract oxygen from the blood.

But this all can be trained. You are going to increase your peripheral circulation. All this will be part of your training adaptations towards aerobic exercise. Then the muscle metabolism itself. Your enzyme potential, your substrate availability, mitochondrial muscle mass, and type.

Interestingly enough, with exercise, aerobic exercise, and cardio exercise, you will get an increase in the number of mitochondria. You will also see some translocation of mitochondria, where the mitochondria will get closer to the cell membrane so you can get the energy out quicker. You can get an increase in mitochondrial number and an increase in mitochondrial density in certain parts of the cell.

When we are talking about getting benefits from cardio exercise, we talked about the training sensitive zone. To try and figure out the training-sensitive zone, we have an equation. We start with the maximum predicted heart rate, which is 220 minus your age. Then you look at 70 to 90% of the maximum heart rate for fitness. That is your fitness level.

If you are talking about really training for performance and exercise, now you are talking about 85 to 90, 95% of your maximum heart rate, even going up to 100%. But for fitness 70, 90%. Swimming is only 208 minus your age. It is for the reason I talked about before is because the end-diastolic volume is easier to get to in the horizontal position.

This heart rate max came from a fax out of Ohio State University, and this came in 1971. One of the things we have seen with this equation is it can significantly overestimate the heart rate maximum in younger adults and underestimate the value in older adults. This is the predicted maximum heart rate that the American Heart Association is still using. This is Gelish.

A lot of people have been using different equations trying to make it a little more accurate. What I used is for a 60-year-old person, if they were using the standard predicted maximum heart rate, they would use 160. Now with these equations, you can see you would have a slightly higher rate for the older adult, 165 and 166. These are not huge changes in terms of significance. If you talk about 90% of 160, that would be about 144. Here, maybe it would be 145 or 146. Even with all these differences, if you want to get highly technical with the equations, they do not really change that much.

We are going to look at using the standard heart rate evaluation. Let us look at the 30-year-old athlete versus the 50-year-old athlete. Remember 70-90% of your heart rate. If you look at the 30-year-old person, 220 minus their heart rate. This is the predicted maximum heart rate of 190. Their target heart range is going to be 133 to 171. Whereas the 50-year-old, it will be 119 to 153. But I will tell you for a lot of 50-year-olds if they are in shape, this is too low.

This will not be enough to really get that really good performance for the training sessions. It might be enough for fitness but 153 really would almost be like 70 or 80% of what their zone should be. You can see this is where the underestimation takes place. Ninety percent for 30-year-olds in shape 171, even that is going to be a little light in terms of your standard training session.

What we want to do to make up for this is use the Karvonen method. The Karvonen method takes into account that you are in good shape, you have a higher heart rate reserve, and a lower resting heart rate. Now what you do is figure out what your training is going to be, you take your heart rate at rest, plus your training interval. In this case, we are going to use 70%, we are going to use the lower value of the training fitness.

Your heart rate max is still the same, 220 minus your age, so it is still going to be 190. Here, you are going to take your heart rate max minus your heart rate at rest, so it is 190 minus 60, so you have 130. You take 60, your heart rate at rest, plus 0.7 times the 130. You end up with a target heart rate of 151 for your 70% training zone.

Let us review the Karvonen method for this 30-year-old athlete who is in good shape. If we just use that general estimation, we can see that the target heart rate would be 133 to 171. At 133, you are not going to get much benefit. But if you consider that they are in shape with their resting heart rate and their heart rate reserve, using the Karvonen formula, their target heart rate is now 151 to 177. You get a much more accurate range of where they should be for fitness.

Maximum VO2. When we talk about maximum heart rate, it does not equate to maximum VO2. It is somewhat of a linear relationship, but it is not a perfect linear relationship. You can see, if we look at our maximum heart rate, our 70 to 90% range, we are only getting into the 58 to 83% of our maximum VO2. This is great for fitness but not great for performance. For performance, we are really going to have to get up to that 80 to 95% of your maximum heart rate.

The other way that we can gauge is what we call the rating of perceived exertion, and we look at the Borg scale. If you look at the rating of perceived exertion, you will sometimes see charts and we will have someone pick out, “Okay, I feel like this is what it is.” Now what is interesting about the Borg scale is they have done a couple of studies that I am familiar with, probably more than I am familiar with. But what they found is that this was a very valid way of figuring out where they were in their VO2 max.

That when someone picked out light, they were in that 31 to 50% VO2 max and it did not matter if they were an untrained or trained person, it is all relative. If they were at, for example, if this was hard, yes, that equated to 85%, the VO2 max or 92%. They were really at the top end of their training zone in terms of fitness. You can see that this could be something very good to use.

I know a lot of people, I have had students say, “Well, I do not like the scale, it makes no sense.” The scale makes a lot more sense if you add a zero and consider this heart rate. Let us say instead of 68, we would say this is like 60 to 80. Or let us go back in here to the heart, if we looked at this is 150 to 160, let us see at a heart rate of 150 to 160, this starts to make more sense.

I know some people have tried to make a modified board scale, which is 0 to 10. This makes a lot more sense to me. This is a valid tool that you can use for having people just point out on a chart where they feel like they are.

Some of the adaptations we see with exercise. We see resting heart rate decrease, we see blood pressure decrease. Then we talked about the athlete’s heart. This is a model that we have had for several years, which talks about moderate cardiac hypertrophy with training. In the original studies, it is shown that left ventricular volume increases with aerobic fitness but ventricular wall thickness increases with strength training.

The feeling behind this was that you are increasing the blood pressure so much this is what creates that adaptation of wall thickness. Now, something to keep in mind – this concept was based on Modern World Studies in the ’70s at the University of Wisconsin. Since then, technology has gotten much better. We can see the heart a lot better than the basic echocardiograms that they were using. The concept is changing. Adaptations in increases in ventricular mass are not “true” when you normalize it to changes in lean body mass.

What we are seeing is, that whereas the model still focuses on left ventricle adaptation, now it is focusing a little bit more on right ventricle adaptation. That is because the end-systolic wall stress is relatively greater than the left ventricle due to the increases in pulmonary artery pressures. Ventricular arrhythmias and elite endurance athletes are associated with the right ventricle. Relative right ventricle enlargement and reduced right ventricle, ejection fraction is expected in athletes and should not be considered pathological.

Sometimes that is one of the things we must look at is some of these changes, physiological changes are viewed if someone’s going to a primary care physician and they do not know enough about the adaptation sports, they may see some of these physiological adaptations. It is pathophysiological. I ran into this trouble in college, as someone who ran track when I went from my pre-participation physical. I went to my primary care physician and my resting heart rate was 48 to 54 and he ran all these tests on me. I tried to explain that it was a normal adaptation. He did not realize it. This would become a factor when we talked about our ECGs in a few minutes.

Cardiovascular drift is a phenomenon I want you to be familiar with. It is a progressive increase in heart rate and decrease in stroke volume that begins approximately 10 minutes into prolonged moderate-intensity exercise. Drift is greater during hotter temperatures. What we see is we think that when it starts to get hotter, we are going to have a shunting of blood. Remember, before we talked about how the blood is shunted to the muscles.

We are going to see how the blood is shifted to the periphery to help with heat stress and to help release some of this heat. What will happen is some of his blood is now shunted to the periphery, so your stroke by him decreases, so your heart rate will increase to make sure you are getting the same amount of blood. Let us say you are working, and your heart rate is at 160, after 10-15 minutes, especially in the heat, you may see this go up to 180, and this is just a sign of metabolic stress. You may just have to lower it down a little bit. I want you to be aware that we are not quite sure exactly why the drift is occurring. We have these theories, but it has not really been proven yet.

When we look at heart rate variability, a lot of people are using this now as a way of helping athletes with their training sessions, and how hard they should be working out. You will see GPS systems, catapult systems, and several different things to try and figure out. It is all based on recovery, making sure that athletes have enough recovery after their training sessions. The heart rate variability and objective physiological measurement of the interval between consecutive beats. Keep in mind, that if we talk about it, someone will say, “Oh, yeah, my heart rate is 60 beats per minute.” Well, that is the average, but it does not mean that they are having one beat, every second one beat could be at 1.1 seconds, and one beat could be at 0.7 seconds.

What happens is this variability is normal and is a sign of good health. If you look at healthy biological systems exhibit complex patterns of variability that can best be described as mathematical chaos. Your ability to variable someone who is one beat per second on the dot would indicate that they probably are not responding to the instantaneous changes that are always occurring in our body.

Measurement of heart rate variability. The next couple of slides will be a little bit technical and may not make a lot of sense but I will tie it all into what I think is something that is understandable and easy to use. When we look at the measurement of heart rate variability, we can look at the time domain which is the interval between successive complexes.

Remember, we talked about, do you want the Q? The R? The frequency domain measures. This is plotting the frequency at which the interval changes. Then we talked about low-frequency to high-frequency ratios. When we are talking about frequency ratios, a lot of it also depends on how long you are taking your heart rate when you do this. This is what I mean, which interval are you measuring? The R-to-R interval is the easiest one to pick out. That is usually what is measured when we look at a lot of these algorithms.

You can do ultra-short-term and short-term heart rate variability. You can look at the dynamic relationship. When we talk about what is variability, and what is occurring. Well, in the short term, we are looking at the relationship between the sympathetic and parasympathetic branches and the regulatory mechanisms that control the heart rate via respiratory sinus arrhythmia. If you investigate 24-hour heart rate variability, you are looking more at circadian rhythms and core body temperature metabolism.

This is the gold standard 24-hour heart rate variability which athletes do not use. This is what is used in hospitals. They can almost predict if someone is about to have a heart attack based on this heart rate variability. But this is a hospital situation. What we are seeing in athletics is, in fact, for the most part, we are using short-term heart rate variability. If you are looking at some people who are using the rings and the Fitbits, and things like that, where they are using two minutes. Two minutes really is not enough to get good feedback as to what is going on with heart rate variability. I would suggest to you a minimum of 4 to 5 minutes if you use it.

Also consider the equipment that is used. If you are looking at high-level teams, like in the EPL, the different academies, they are using their systems where they are almost wearing a training vest. In fact, you will sometimes see it in the game, where that vest has a GPS system which is giving them speed, it is giving them feedback, heart rate feedback, and things like that. When I use it, what I use is just use a heart rate monitor, but I use a chest monitor that I can strap on. You are going to get much better reliability in the information and the data that you get from something like that as opposed to a ring or a wrist bracelet.

This is a study where they looked at cardiac electrical conduction, autonomic activity, and biomarker release during recovery from prolonged strenuous exercise in trained male cyclists. They looked at the ECG intervals obtained from eight highly trained athletes before, during recovery, and 24 hours after a prolonged bout. Now, this is the root mean square of the standard deviation. All right, that is the domain that they were measuring. It was significantly reduced during recovery. That suggested a suppressed parasympathetic, and/or a sustained sympathetic modulation during recovery. If by looking at this domain, this root means a square of the standard deviation, if you wait and you just monitor when it starts to increase, that is when you know the athlete is recovering from that training session.

This was a session on individual heart rate variability responses to pre-season training in high-level female soccer players. When we looked at this, they were looking at training loads, as you can see, and it showed very large relationships with the weekly changes. Once again, the root means the square of the standard deviation, the averages. The increased training load was associated with a decreased mean, the decreased training load was associated with an increased mean. If it was unchanged, you can see no substantial changes. By using this, using looking at the reduced mean, along with the reduced mean in the variance that was related to non-functional overreaching. Non-functional overreaching is the training response that we want. As opposed to functional overreaching, which means they were overtraining.

The increased values indicated that there was an upward and downward change throughout the week. You can have a coach who has a whole training session laid out. When we are going to do this, this, and this. But if using heart rate variance, you may say, “You know what, they do not have enough recovery to train this hard the next day.” That is basically all this is saying.

Here is something I use, a lead heart rate variability and this is the app that I use. I use a Polar H10 heart rate monitor, and I strap it on every morning. I just sit quietly for 10 minutes after I wake up. This will give me based on the algorithm that will tell me what my relative balance is between my sympathetic system and my parasympathetic system. On this day, my heart rate variability was 41, and I was in perfect balance.

To really use this as an effective training tool for how you want to do your training sessions, you must monitor this over a period of time. It took me about six to eight months to realize, so, even though I am doing the heart rate variance at the same time, you keep a training log. What your training session was, how much sleep you got, any other factors that you want to do, if it was an extremely stressful day, things like that. That all feed into the equation, it gives me an idea.

For example, let us say, I woke up one day, and after my training session, and I was maybe like a four or five on parasympathetic, indicating I was more into parasympathetic influence so I would get a recommendation of maybe some rest or recovery day or something very easy. What I found out is by monitoring myself, if I was at four or five parasympathetic, maybe for that day I had scheduled 10 intervals on the treadmill sprints.

Instead, I would not want that much volume instead, to try and come under the more sympathetic influence, I would do a high-intensity, low-volume day. Maybe I might do a deadlift day or a power clean day, where I might just do four sets of one to two repetitions. Something intense but low volume to see if I can come more into sympathetic influence.

The opposite is also true. Let us say that day I was scheduled, I want to do a 45-minute run on the treadmill at about 70 to 80% of my max heart rate. But that day, I came in and turned out I was a little more sympathetic, well, then maybe I would go slightly more parasympathetic instead of a 78%, maybe I would just go maybe 50 to 70% of my heart rate to make it a little bit easier to get my workout in but try and come on to more of a parasympathetic range.

These are things that you must play with. It is not one size fits all, but it can be very useful. A lot of athletes are using this to help with their recovery so they can prepare. This way they do not go into an intense training session at a deficit so that they can take advantage of a high-intensity training session.

The cardiovascular function. We are looking at hypertension, which is one of the most common medical disorders. Even though this is not sports-related, it is more patient-oriented. Exercise will lower blood pressure. I mean, the World Health Organization will tell you one of the primary ways of treating should not be pharmaceutical unless really needed in their comorbidities. You should try for a few months just doing some basic exercise.

The effects of exercise are most noticeable when it comes to blood pressure during a meal or after a workout. Lowered blood pressure can be most significant right after your workout in a session. But if you want that cumulative effect of lower blood pressure at rest during the day, you are going to have to basically train for two to three months to try and get this effect.

KAATSU training, which really means it is the forerunner of blood flow restriction, but KAATSU training started its origins in the 1960s. Dr. Yoshiaki Sato found out about it almost by mistake. He was kneeling, in the kneeling position, he felt when he kneels for long periods of time, he got the same swelling in his calves that he was getting from his weight training when he was doing it. He was just trying to figure out if there was a way of maybe occluding the blood flow, so you get the same workout without training as hard. That is really the origin of it. He worked with it now. 

We will talk about some of the side effects. When we talk about 13% of subjects report small red spots that disappear after a few days, well, if you are not careful, you can have more side effects. He ended up at one point with a thrombosis because he had too much pressure on with the bands. He kept experimenting on himself but where it really came very valuable for him, even though he was hospitalized at one point or got out but then he had a serious ski injury. He ended up using these KAATSU training techniques, these blood flow restriction techniques to help him get back and regain his strength and help prevent muscle atrophy. Basically, you are trying to create metabolic stress. Let the body get metabolic stress without having to use its higher load by restricting the blood flow in the first place.

The risk for more serious conditions such as venous blood clots and severe muscle breakdown where has been minimal, but it can happen. I am surprised it has not happened more because when you have something like this, you have a lot of people in the gyms working with it and trying to figure out what they can do and they do not want to spend money on decent equipment, so they start using everything from tape to just weightlifting bands, which are not designed to occlude blood flow.

You also get numbness and feelings of cold due to compression. They would be temporary, and they do resolve after the release of pressure. When we talk about this, we talk about the use of this for conditioning and training, I really think this is more a technique that would be used for rehabilitation.

When we looked at blood flow restriction exercises and sprinters and endurance runners, what was interesting is blood flow restriction protocol using 20% of one rep max appeared to benefit endurance runners more than sprinters. The reason why was because sprinters operate at such a high intensity, they were already getting incredible metabolic stress. They do not need anything more than what they are getting. Whereas endurance runners, you are not getting as high blood pressure. The blood flow restriction protocol uses 20% of one rep max. That appears to be what I have seen in most of the research. What was interesting is I did try blood flow restriction on myself after knee surgery, I had a replacement of my right knee. They tried that protocol, and I was fascinated. I got a good effect, but I was very sore.

This is not a comfortable technique by any means. This is very uncomfortable because you are trying to create that metabolic stress. The reason to become so good at rehabilitation is you do not have to use an intense load by occluding the blood flow. You can use a lighter load that will not damage the structure, the muscular or the bony or the connective tissue structure. But I felt it was quite intense.

I just want to go back here for a second. I did not want to show a lot of different studies on this but my recommendation to you is I do not think it is beneficial for athletes. I think it is more of a gimmick for athletes. They just need to train hard, and I feel it is much more useful for rehabilitation. I know in the United States, the FDA has only approved the Owen System. I don’t know much about it or what it is, but you will see a lot of fake products like tourniquet type devices sprouting up in the gyms, where a lot of people, healthy athletes are using this method. I do not see why they need to do this and if they just lift heavy, you are going to get the same effect without as much risk.

Just a brief talk about exercise and coronary heart disease, looking at the risk factors and making sure that we focus on the modifiable and not the non-modifiable exercises. As you can see, diet, exercise, smoking, and stress. This is what we should be focusing on.

When we talk about getting patients ready, a pre-exercise evaluation can be very helpful. We have our PARQ, the Physical Activity Readiness Questionnaire, which was developed in Canada. Some of the modifications were physical activity readiness, medical examination for pregnancy, and PARmed-X. You can also use stress tests for evaluation. You are not going to use a maximum stress test on people unless they are a well-trained athlete or in really good shape. Generally, you will use something submaximal. You can get the protocols like a bulky treadmill protocol. A lot of these, there is a publishing company called Human Kinetics, where they will have a book on all the different protocols, I have used high school athletes to get a whole team and I have used a step test using bleachers, the bleacher steps.

When we look at cardiac hypertrophy, once again, this function versus pathological. We talked about increasing right ventricular volume, and about the changes in arrhythmias, which are functional, not pathological but the number one cause of sudden death in older athletes is coronary artery disease. These are our master’s athletes or older athletes. Young athletes are the ones who are at risk for cardiac myopathies. This can be very hard to pick up on our pre-participation physical unless you are using ECGs.

Talking about ECGs, for a second, the primary screening tool is the pre-participation history and physical exam. But just doing the history and physical exam appears to lack the sensitivity to reliably detect the causes of sudden coronary death. These were the Bethesda guidelines from 2005 that shows the ECGs will reliably diagnose up to 75 to 95% of athletes with hypertrophic cardiomyopathy. Why do not we use this more? If people are worried, at least in the United States, they are worried about the cost because of a number of false positives that are sometimes attained with the ECG.

Electrocardiograph evaluation in athletes and use of the Seattle criteria to improve specificity. This is an international consortium that was designed to try and weed out these false positives that you are going to see in athletes who are in really good shape. The whole idea was to figure out, “Okay, we need the cardiologist to know what physiological change is, and what is pathological.”

This is the international criteria, if you want to look this up, there might be a recent one, I think every two or three years, but with COVID, we have had a bit of a problem, in terms of getting this group together. This was 2017, British Journal of Sports Medicine. I don’t know if there is an updated one yet.

But basically, what they are looking at is, they say, “Here are your normal ECG findings. Here are your abnormal ECG findings. Will you go straight to further evaluation?” But there are several borderline ECG findings, which will give you a false positive, which do not necessarily have to lead to further evaluation.

If we look, for example, at a completely right bundle branch block, and if that is all they have, and they do not have any other comorbidities, and they do not have a family history, then that would be a normal positive finding and you do not have to do anything more about it.

But it just gives you a better idea as it will weed out, for people worried about the expense, it will weed out some of this. It is a shame we are talking about expenses when we are talking about sudden-death situations. We have seen some of these situations arise on the pitches in some of the different leagues. It is a good idea to have it. I always have the automatic external defibrillator and when we look at the ECG, if you are talking about international competition, certain federations require the ECG.

A lot of the federation requires this including the IOC. In the United States, although not everyone requires it, it is recommended. When we do our high school pre-participation exams, we do a standard 12 lead ECG screen. We are doing that but not everyone is. Recommendation. I am pretty sure FIFA, and all international competitions are requiring it, which is a good thing.

Let us look at possibly designing an aerobic endurance program. When we are looking at the different factors that we want to see and based on what we know now about cardiovascular anatomy and heart rate variance, first, you want to choose an exercise mode, whatever it might be. Then you are looking at training frequency, training intensity, exercise duration, and exercise progression.

What type of exercise do you want to look at? Keep in mind – swimming, cycling, running, cross country skiing, and rowing, when you are doing these, these physiological adaptations are specific. If you get a cardio benefit from swimming, it does not mean it is going to transfer over to cycling or to running. The reason I listed swimming, cycling, and running is because these are our triathletes. If they want to get the physiological adaptations, they must make sure that they are training intensely in all three. That is why it can be so tough, sometimes when we are talking about preparation for the triathlete. But will they get some crossover? Minimal. Not enough to compete at the elite level. That is the mode that we are talking about.

The training frequency, and number of sessions per day or per week. Once again, it depends on how intense you can be. You can train every day, but you cannot train intensely every day unless you are keeping the volume down low. For example, there are some weightlifters who are training intensely maybe 6 or 7 sessions a week, but their intensity is based on load, not on volume. That is why they might be able to get away with it, but they still need some lighter days.

Training intensity must be high enough to overload the body to get the desired adaptation. Regulation of intensities monitors in different ways. Once again, we can do it by VO2, we can do blood lactate, we can do heart rate variance, or we can do ratings of perceived exertion. But you want to have some way of monitoring this. VO2, unless you have a gas card or something like that, VO2, you are probably monitoring heart rate. You are looking at that relationship even though it is not linear. Blood lactate is a fairly easy way to do it and I know several teams will do blood lactate to try and get an idea of how intense the session is. My favorited really is heart rate. When I say heart rate, I am talking about heart rate variance and monitors.

Your exercise duration – length of time of the session which is usually related to the intensity of the session. If you are going very intense, you are looking at a 20 to 30-minute session. If you are talking about max VO2, maybe you are going 120 to 180 minutes, depending on what you are training for. I would tell you that in a session where you train 85 to 90%, let us say you are doing intervals, maybe you are doing 400-meter intervals in terms of exercise. Obviously, that is not aerobic that is anaerobic, but the actual amount will be different. If we are just talking about aerobic training, then yes, then 20 to 30 minutes is more than enough at a 5% max VO2.

Then your exercise progression. How do you manipulate the frequency intensity and duration values? There comes a point where it is very tough to increase some of these values for high-level athletes. They are already training almost every day. They are already training at maximum duration. The only thing you do is maybe increase the intensity at that point.

With elite-level athletes, a lot of times it is more a question of decreasing some of these variables and increasing them. They are already trying to go max and sometimes you must rein them in a little bit to get better performance. If you do not remember some of this, there is an acronym, FITT, Frequency, Intensity, Time, and Type. If you keep all that in mind, time obviously is the duration. Type is the mode up in here number one. But if you keep this in mind, you will always remember the different factors that you have to consider when you are designing a program or monitoring a program, or you are just talking to the athlete about it. The one that is not here is obviously exercising progression.

What are the different types of aerobic training that you can do? Well, there is a long slow distance, there is pace/tempo, there is interval, high-intensity interval training, and fartlek training.

Long slow distance. Some people confuse this because, in the ’70s, there was a concept in the United States, I do not know if it was in other countries by Joe Henderson, long slow distance. Long, long miles at a slow pace. That is not what long slow distance training should be. Slow just means slower than your race pace. You are training at about 70% of the VO2 max, which is still a nice pace, it is just not race pace but allows you to go for a longer period. Then you can get improved cardiovascular function, you can start improving your thermoregulatory function, and you increase your utilization of fat as an energy source. The enzymes increase so you can mobilize your free fatty acids easier. This type of training does not stimulate neurological adaptation of muscle patterns used during a race. You will use this to some extent, this might be something you use off-season or almost as a recovery type of pattern.

Pace/Tempo training. You are using an increased intensity, or you go slightly faster than the race pace that the athlete uses. This will correspond to the lactate threshold. You really want to get a little bit like you are crossing that line into the anaerobic range. This is sometimes known as Threshold Training. Generally, these sessions are 20 to 30 minutes of Pace training.

Interval training. You are exercising intensely close to your VO2 max. Intervals that last 3 to 5 minutes. Then you gradually increase the workout to rest ratio to 1:1. You may start the intervals, 3 to 5-minute intervals where you are doing a 2:1 rest to work ratio, or 3:1 rest to work ratio, and gradually get to 1:1. These are very stressful, they really need a good endurance base if they are going to do this type of training.

High-intensity interval training. Using short high-intensity intervals with brief recovery periods. Athletes need to go above 90% of their VO2 max for several minutes. The rest periods are usually a little less than the work interval when you are doing this because you are really trying to put yourself under metabolic stress when you are doing this type of thing. Something to consider when you are doing this type of thing, let us say you are a 10k runner and you want to get your mile pace, it may be 5-15. Then you might be doing high-intensity, half-mile training at maybe 2 minutes, 20 seconds, and you do a couple of these and that is how you do your high-intensity interval training.

Fartlek training. The Swedish word for speed play. I hope I got that right. An exercise session of easy intensity interspersed with brief intervals of higher intensity. This might be, let us say you have a team of runners like eight runners. Well, they would run paired up two in a row and what you will do is run at a certain pace, and then the two runners in the back must sprint up to the front.

Then you run this way for 10-20 seconds. Then the two runners in the back now sprint up to the front. You have a nice easy pace, but you have to sprint, maybe you are getting a sprint every 60 to 120 seconds. Now you are combining your VO2 max and now you are getting into a little bit of lactate threshold. This really helps with your ability to use your substrate metabolism. It really starts increasing enzymes for those metabolic pathways.

After discussing this, this is out of Runner’s World where someone who might just be starting, let us say you have someone who is starting or an athlete who is recovering, a very simple way of looking at this on a seven-day basis for a seven-week program. Okay? So, 15 minutes, 25 minutes, then on Wednesday, this could be rest or a 15-minute interval. If you are an older athlete or someone who is starting at an older age, take the rest and maybe use it as a stretch day or do some yoga. This will go for seven weeks, but I want to show you how you manipulate some of the variables.

Here is Week 7 of the chart I just showed you. Let just say now you want to start increasing intensity for an athlete. What you can see in Week 8, is you go from 20 minutes on Monday to 20 minutes on Fartlek. Let us say start doing some speed play. Then on Tuesday, you go to what was 45 minutes now you go to 60 minutes of long slow distance. Then Wednesday, which was a rest for 20 minutes — I just say rest, just rest it up. Make sure you are ready for the next couple of workouts. Thursday you go from a 40-minute session to now a 30-minute with interval session. Friday was a rest day in Week 7.

Friday is a 30-minute-long slow distance. Saturday, which was a 60-minute easy run now becomes a 40-minute Fartlek. Sunday is rest. You can see it went from a total of 165 to 185 minutes for that week. Now, in Week 8, it is only 180 minutes, but you have increased the intensity on a couple of days. That is how you can manipulate some of your variables for aerobic or endurance training. These are general guidelines. Obviously, this would apply to some of your high-level athletes.

Looking at recovery, when we talked about recovery, there is immediate recovery, and that would be what occurs between rapid movements. Short-term recovery, which is really what we see more during exercise sessions between sets of an exercise, or between intervals. Then your training recovery, what are you doing between successive sessions or competitions?

It depends on whether you are doing a non-steady versus steady state. If you are talking about going out for a 10k run at a steady state, well, then you are going to end up with a different metabolic pathway versus a non-steady state, like a soccer player who is sprinting, resting, sprinting, resting. In the non-steady state, for example, they might build up some lactate. For them, you are going to look more at active recovery when they are done with a game. Maybe a basketball player when they are done with the game, they have gone into that lactate threshold. It is not a bad idea now to metabolize some of that lactate with an active recovery, which could be on a stationary bike. It could be an easy run, but you are talking about, 40 to 50% of your VO2, so you are basically now just using the lactate as an energy source versus having run a 10k where now you want passive because you want to make sure that you have just been replenishing your energy stores.

If you have, especially younger athletes who sometimes have tournaments, the recovery recommendation is, first to make sure you rehydrate. You replace your energy stores. But after the game, once you get to metabolize lactate, you will use an active recovery system.

There are several different ways of recovering. Heat is a good recovery tool. Massage is a good recovery tool. It seems to help the athlete. We have not seen a lot of evidence on it. A lot of this is anecdotal, although I have seen some nice recovery studies on using heat after exercise sessions. But when they talk about heat, when you talk about actual changes, you are talking about getting into maybe 43-44 degrees centigrade, or maybe 107 degrees Fahrenheit, to really get some of these benefits. I do not know how many of the athletes are getting into that range, but foam rolling is something I see a lot of my athletes use and can be used as a recovery tool after an intense battle of physical activity.

Like a lot of different things, we see. We are going to see contradicting reports. We are going to see some evidence that foam rolling is good, and some that say it is not. This is the nature of the scientific process. A lot of times what you want to look at is you want to see, well, on the studies that say it is helpful, what is their methodology? On the studies that say it is not helpful, what is their methodology? Who were the subjects involved in these studies?

This was an interesting study. Twenty physically active resistance-trained males, the average age of 25.1 years, did 10 sets of 10 squats. They really worked the muscles, and there was a control group in a foam rolling group and the foam rolling group rolled at the end of the exercise session 24 hours after, and then 48 hours after. They did five exercises. They worked all different sides of the thigh, and they did the gluteal muscles. Each exercise was done for one minute twice on each side. The total time of this foam rolling session was 20 minutes.

What they found out is the foam rolling group had substantially less perceived pain. The foam rolling group performed better in the vertical jump than the control group. This was a result of maintaining pretesting values better than the control group. They still had a decrease, but they had less of a decrease. I would tell you that I think foam rolling is a nice recovery tool.

Let me just go back to this for a second. Now when we talk about foam rolling, where I see the relationships between these studies that say it does not seem to help and the studies that say it does seem to help. The studies where it seemed to help usually, or post exercise and they usually spent 10 to 20 minutes during the recovery session. If they are just doing it for two or three minutes, they are probably not getting the benefits. That is where the evidence goes.

How about foam rolling before the workout to see if you can potentiate the workout? Not a lot of evidence about this. But for people I have seen who have said, “Hey, foam rolling is a waste of time, it does not really work. There is no evidence that suggests that it works.” You know, that might be true, but there is also no evidence that suggests that it is causing any damage.

If I have an athlete who tells me, “You know what? I really feel great. I think it really helps me and I have no evidence that says it is going to hurt”,

Why would I tell them not to do it? Why would I say, “Well, the evidence does not support it?” They will probably tell me where to stick my evidence.

There becomes a point where, well, they feel better with the foam rolling, and if we really look at the psychosocial model of health and of exercise, well, if psychologically, they feel better, that is going to be a benefit to their exercise even though we may not have evidence that it helps them on a physiological level.

That is my take on that. I think some people get too carried away with evidence, but I have something that I think helps psychologically, and there is no evidence that shows it is going to be a risk, I think it is a good idea to continue with that type of technique.

That completes this second session.

[END]

English Direct Download PDF – ICSC08 _03_ExPhy TRANCRIPT

ICSC Lower Extremity Module 8
Part 3 – ICSC08
Instructor Andy Klein
Video Lesson: 01:27:39

This is the third module of exercise physiology for FICS. We will be covering a couple of different topics in this final lesson. This is the agenda where we will talk about speed and agility, plyometrics, program design. At the end, I will talk on environmental stresses.

Let us talk a little bit about some of the different definitions that we have, so we are on the same page. We will be talking about speed which is the ability to achieve high-velocity movement, about change of direction, and that is the ability to explosively change direction and velocity. Then we want to talk about agility which is sometimes I think misconstrued. It is the ability to change direction and velocity in response to a stimulus. It is one thing to do all your drills for speed and everything, but how does that translate into a playing situation when we go onto the field or onto the pitch?

When we talk about speed, how fast are you moving? The velocity, how fast are you moving in a specific direction? Acceleration, the rate at which that velocity changes, and deceleration which is negative acceleration. From a practical point of view, I spend a lot of time on deceleration. I think people overlook this concept because let us say you are on the pitch and you have to change direction, well, you have to first decelerate. If you do not have good deceleration ability, which is a function of strength, it is very easy to hurt yourself or it is very easy to slow down where you can really lose your pace as you are playing. This is where you will see a lot of people, for example, when we are on the field, where you see one player out jukes another (Juke meaning: that awkward moment in the halls when you and some other person are trying to go different ways but you can’t get around each other) or just really lose them, it is because one of the players can decelerate a lot quicker than the other player.

Let us look at rate of force development as a function of time. Rate of force development is comparable to strength and power when we talk about it, but if you look at the difference, let us say you are untrained. You can see they can eventually get to the maximum strength in 500 milliseconds. Versus the person who is in resistance training, someone who is in the weight room and doing a lot of heavy weight training, you can see they also get there about 500 milliseconds, but you can see how much more strength they have. The important thing is the athlete who trains explosively or ballistically, they can almost get to their point, their maximum strength at about 200, 250 milliseconds.

Why is this important? Well, it is important because when we look at different aspects of sport, you can see that the movement will be rather quick. Let me go back here for a second, at 250 milliseconds. If you look, for example, at a runner, a runner when they hit their contact time on the ground, a sprinter, it is about 80 milliseconds. They are very quick, but they are not using their maximum strength at that point. What you are doing is it is a function of velocity, it is a function of power, and that is what we will look at in further detail.

Speed is a neural quality. Boo Schexnayder is a well-respected track coach in the States. He was with Louisiana State University, LSU, and his team basically won the NCAA, the college championships for 5 years in a row. One of the reasons is his training, is he understood that it is a neural quality that you must improve your neuromuscular integration which includes recruitment, rate coding, synchronization. When we talk about recruitment, it is an interesting thing because recruitment, if you want to recruit the larger muscles, your type 2 muscle fibers, if you want full recruitment, you must get to 90% of your maximum voluntary contraction. You are not going to recruit all the fibers if you are working at 60, 70%.

When he talked about training the nervous system, it is quality of work, long risk, low volume. If you are training for speed, that is all you train for in that training session, which means if he has a sprinter, he may have them, maybe he will be doing 100 meter runs.

Well, he does 100 meter run at top speed and then they will rest 4, 5, 6 minutes and they will do another one. If they start decreasing by 10% or more of their top speed, the workout is over, training session is over. Like he says, I am not training you to be slow, I am training to be top speed. They are trying to build up that neuro quality, try and create those engrams, that cortical facilitation, and that is on just strictly with speed. Afterwards, they may rest, maybe go to the weight room, but if it is a speed workout, that is all they do. If you are slowing down, you no longer train to be fast, you are training to be slow.

Sprinting, it involves the relationship ship between stride frequency and stride length. Your stride frequency is dependent on metabolic system, so that is what we talked about previously when we talked about ATP. When we talk about ATP and creatine phosphate, these are your metabolic pathways for very fast explosive movements. You can see your stride frequency that when you get up to about 3.8, maybe 4 strides per second, you can see how fast you are going. That is when you are starting to hit top speed.

You can see there is a certain point at the stride length where your stride length will increase with stride frequency to a certain point and then you really are not going to increase your stride frequency anymore. That is, it, your stride length, it is going to max out. The stride length will typically max out about 2.2 meters, and that would be for someone who is about 6 feet tall, or I think that would be about maybe 180 centimeters, 1.8 or 1.9 meters tall, and that is going to max out 2.2. If you start increasing your stride length too much, you will start slowing down.

Here is a typical example, Usain Bolt and all the other sprinters. His stride length based on his height was 2.46 meters. His stride frequency is much greater, too. He only needed 40 strides where all the other sprinters needed 44 to 45 strides in the 100 meter dash.

When we talk about sprinting technique, we talk about the start, and that is coming out of the blocks from a standstill position. Your acceleration, those initial steps are vital, and this is producing your ground reaction forces. Hopefully, it is more vertical reaction forces into a horizontal position. That is what we are looking at. Top speed, also known as maximum velocity. Here is the thing, this is starting out of the blocks, but we deal with so many athletes and this is their starting position, from an athletic position or from a rolling position, where they are just moving slowly and then they have to all of a sudden explode out of it. You are not getting that maximal, what we call, triple extension movement. Your triple extension is coming from a standing position.

When we talk about starting with your out of the blocks or just in an athletic position, the whole idea is aggressive extension with both legs, although one leg will be a little more dominant. Even when we talk about leg dominance, when you say, “Well, what is your dominant leg?” It is often defined as well, what leg do you kick with? If you kick with your right leg, we really should define that more specifically as your flexion dominant leg because when you are kicking with that leg, what is your other leg doing, it is planting and creating whip-like motion. Your plant leg becomes your extension dominant leg. A lot of times, from a standing position, athletic position, you will have one leg which is going to be a little more aggressive in terms of extending out.

The vertical forces, they overcome the static position in the stance phase, but those vertical forces are at an angle because you are trying to initiate a horizontal force. You are not looking to just jump in the air although sometimes, with some athletes, that is exactly what you are doing, a basketball player or even for a soccer player who is going for the header.

The current literature suggests that the biggest difference between elite speed and average speed is the amount of vertical force applied to the ground. How would you increase this? You would increase that with training.

Looking at the phases of stride. Let us look at that stance phase right in here. When he lands, what is going to happen is, it is going to be an eccentric breaking. You want as little as possible because you want to transfer your speed from one strike to the next as quickly as possible. You are going to have an eccentric landing, and this is what we call our amortization, and then he will have concentric propulsion and then he will go into his triple extension. You can see this leg just finished a triple extension which is extending the ankle, knee, and hip.

Then we get into our flight phase. Here is our flight phase with the recovery, you have a leg swing for ground preparation. You can see that triple flexion position right in here on all three of the athletes, you can see it, where you are flexing the ankle into dorsiflexion and you are flexing the hip to drive that leg forward. On this athlete trailing the play, you can see that this is that triple extension that we are talking about and this is the triple flexion as he prepares for his next stride.

If we want to improve performance, we want to improve strength during the support phase, we want to have strength against gravity and we want to create those propulsive forces. We want to improve swinging actions, which is the speed of circular movements, the speed of reversal. How quickly can we bring the legs around?

When we look to improve performance, one is, for strength, we can do weight training, we can do plyometrics, we can do contrast training. Contrast training is going to be different. People use this term differently and they are not wrong. You can do contrast or complex training where maybe you are doing, for example, in a previous session, we talked about, maybe you will do squats and then go into vertical jump, but you can also do contrast training in terms of applying resistance or assistance.

Let us look at sled pulls. I have 2 different diagrams of sled poles. You can see he is pulling a lot of weight, but one of the things is, if you are pulling too much weight, are you in the position that you want to be in? I mean, this is not a very athletic position. You can look at the flexion of the lumbar spine, this is not a good position. He is probably carrying too much weight; this is not a great position. If you are going to do sled pulls, shoulder harnesses or waist harnesses work much better because you can see this athlete is in a good sprint position. That is one of the things we look for sled pull.

When you are doing sled pulls, the whole concept, are you doing sled poles for strength and power, or are you doing it for speed? If you are doing it for speed, it is going to be a lightweight. For athletes who might be doing sled pulls more to just provide a little bit of resistance but at the same time still keep in with the motor pattern of sprinting, one of the things you can do is time them. When we are working with football players here in the States, what we will do is, let us say they can run a 4.5, 40, 40-yard dash, they can do in 4.5 seconds.

Well, when we put weight on the sled, we will time them. If they go slower than 10%, if they run a 4.8, that is good. They are developing the speed that we want, just stimulating a little bit more. Let us say they run greater than that, 10% of 4.5 would be a 0.45 seconds, so if they run a 5 second or 5.1 second, that is too much weight. We are interfering with the actual concept of training for speed.

You can do sled pushes, as well. What angle do you want to work at? Here, we have a football player, this is a more athletic angle, but what if you want to go lower? You can use a sled push and you can go with a higher grip. I mean, this is perfect, if you want your rugby players to maybe work a little bit more in that position like when they are getting into the scrum or getting into the rock, you might want more of a low sled type push, and this is where you develop.

How do you want to work? Let us say we are talking about a rugby player now and you want them strong in their work. Well, a lot of times, the rock and the scrum are not velocity-based, it is more strength-based. In that case, it might be good to really load up the sled, so they get used to pushing a lot of weight in that strength and explode out of it. There is a certain power component in there, this would be more appropriate for, let us say, a bobsled athlete because they are going to push as hard as they can. They want to develop speed. A rugby player, not as much. They want to develop more power, so we can load up the sled at that point.

We can also use bands. We are talking about resistance. I have been dealing more with resistance, you do resistance. This is an example where this athlete would start running and this athlete would run behind them. You would have movement in there or you can do assistants. With assistance, you can use a bungee cord, this is almost after the release. What would happen is you can have a bungee cord and create a lot of resistance so the athlete would almost have to fight against being pulled at the very start.

Then when they start their sprint, not only are they sprinting, but they are getting the elasticity, the bungee cord pulling them. With that, they can have an increased speed. Then the athlete who is over here will release it and then they will just run through for a 20 or 30 meter sprint, something like that.

A lot of the resistance and assistance exercise, we have seen resistance with parachutes. I have worked with parachutes before. I am not crazy about working with the parachutes. I think, for a lot of athletes, I see they change their motion and then on a windy day, you might be dependent on when and you might be getting different vector. I am not as big a fan of parachutes, I have not been using them in the last few years.

Some of the interesting research when we are looking at the muscles in terms of sprinting mechanics in sprinters? One of the things we see is compared with untrained men, sprinters had significantly greater thigh muscle volumes of the hip flexors and extensors, adductors, gracilis and psoas major. I am not sure this is going to be a surprise to you. I think that the big surprise is, how do we work the hip flexors because most of the exercise we are doing is that triple extension mode?

Working with the hip flexors can be a little more difficult. We do not have as many machines. You are going to end up using bands. You are going to end up maybe using weights attached to the legs, to the feet. If we will look at monoarticular knee extensor and flexor thigh muscle volumes, they were similar between the two groups. Hip flexion training appears to be much more appropriate for sprinters. Some of that, you will get help just by sprinting fast. How do you run fast? Run fast.

It sounds almost ridiculous to say that, but that is what you are going to do. How can you maybe increase some of the hip flexor strength? Well, you can do things like maybe running up a hill. Running up a hill or running a treadmill at maybe a 3% or 4% grade is very similar to the mechanics that we see with acceleration in sprinting.

Trunk and lower limb muscularity in sprinters. What are the specific muscles for superior sprint performance? This was last year. Absolute relative cross-sectional areas of most trunk and lower limb muscles, including psoas major and gluteus maximus, were significantly larger in sprinters than in non-sprinters. The absolute and relative cross-sectional areas of the psoas major and the gluteus maximus correlate significantly with personal best 100-meter sprint time in sprinters. I think with our patients and our recreational athletes, a lot of times when we look at the hip flexors, we talk more about stretching than we do about actual strengthening when I think we must change our focus and really emphasize more the hip flexor training.

The muscle morphology of elite sprint running. We investigated the differences in muscle volumes and strength between male elite sprinters, sub-elite, and untrained controls. Once again, what were the three hip muscles consistently larger in the elite? Tensor fasciae latae, sartorius and gluteus maximus. I think this is straightforward, most of us understand the importance of the gluteus maximus, but looking at these hip flexors, we see how important they are.

What surprised me in this study was the plantarflexors showed no difference between sprint groups. That was surprising to me. Because we talk about the push-off, we talked about the importance of proper dorsiflexion and then during the ground contact, really go into a plantarflexion. I was surprised with that. Greater hip extensors and gluteus maximus volumes, they discriminate between the elite and sub-elite sprinters.

What can we do to possibly improve our performance a little bit? You know, technique? Well, leg drills, are looking at triple extension. We are looking at triple flexion drills. Just think for a second, the triple extension we can do that with clean and jerk, hang cleans, deadlifts. You can do some squat jumps. The triple flexion, once again, a little more difficult. I am working right now on some exercise protocols for triple flexion. I am not introducing it here because I am still playing with it.

I am a little bit like the mad scientist in there. Arm drills, very important, standing and seated, elbows locked, movement at the shoulders, the classical chin to pocket. When we talk about stride frequency, we see, a lot of times, stride frequency is dictated by arm swing frequency. Arms have got to stay relaxed.

Talking about speed. The acceleration, 10 to 40 meters, that is our acceleration point. Speed, you are going to hit top end speed at 40 to 70 meters. Even in soccer, let us say you have a back doing an overlap, all right? They are going to cover that 40 or 50 meters and then they have to cover the 40 or 50 meters to get back on defense. Then at speed endurance, that is where we are getting it to 80 to 150 meters. If I am working this as a session, if I am working just acceleration for a training session, I am going to go in that total volume range for a training session of 200 to 400 meters, no more than that. There is a lot of times I might just do 200 meters. I might just do 5, 40 meter sprints, and that could be the work out, maybe with a 4 or 5 minute gap in between, have them do a little bit of easy dynamic or ballistic stretching and timing them.

Let us say I have a football player who runs a 4.4. I want them to run a 4.4 for that first sprint and then I will let them rest 3 or 4 minutes. Let us say they are fourth sprint, they run a 4.9. No, that is too slow. I will just stop the work out there. Even though I had planned for 5 sprints, the fourth sprint was too slow, I will just end it. Or what if I find by their third sprint, maybe they are nursing an injury, I might end the workout with 3 sprints. For a top-end speed, I am probably going to be in that 400 to 600 meter range for total volume. I will not go more than that.

Let us say I am working 60 meters, I will do maybe 6 or 7 sprints tops for that training session. Speed endurance, I will probably go maybe as high as 600, 800 meters tops. Maybe I would do like 150 meters, I would do 550 meter sprints tops. In here, if we recap in the acceleration phase, I will do total training volume sessions of 200 to 400 for speed, 400 to 600 meter total volume. Then for speed endurance, a total volume of 600 to 800 meters.

Here is some of the breakdowns of where you are expanding your muscle energy. You can see almost 60% just to accelerate the body segments, and this would be the triple extension. A lot of that is a triple extension and then the recovery triple flexion. Twenty-two percent to decelerate body segments. We are talking about deceleration, how quickly can I go from deceleration to acceleration? The stronger I am in that amortization phase where I can- and that is where you do almost some of your eccentric work. The stronger I am there, the quicker I can get to the acceleration.

Three percent just to balance gravitational forces. This is interesting. If you are working with your athletes, you want to test single-leg balance, you want to see how they are in single-leg balance. A lot of times, I will have them standing. I will just have them drive up and see if they have a good balance with an explosive-type movement. You might have to put some time into single leg balance just so that when they land, they are not spending too much energy just balancing and taking away from the energy and their work to accelerate the body segment. Then there is 18% against air resistance and friction. Friction, we also mean ground friction.

The interaction of stride frequency and stride length. What is interesting is we want explosive horizontal push-off, but this is measured in vertical ground reaction forces. Even though we want as much ground reaction force vertically as possible, we want minimal vertical displacement. This is that horizontal where we want to work in that angle of maybe 45 to 60 degrees.

Your stance phase. As your leg touches down, the knees should be slightly flexed at approximately 170 degrees and your angle of alignment between your toe hip line, and horizontal line is approximately 60 to 70 degrees. This will vary from athlete to athlete, but this is what we are looking at. First of all, if we look at the toe hip line in here, follow that toe hip line, versus the horizontal line, you can see 60 to 70 degrees is where we want to be. When they are landing, we want to be at about 170 degrees of flexion.

What will happen is if this foot comes too far out and you are landing at 180 degrees, well, at that point, you are probably going to have to pull a little bit more. You are not getting as much push as you want. If you over-stride, what happens with a lot of people who over-stride, this hip will be further back in here, so they are landing and they are actually decelerating. They are losing too much energy during the deceleration phase, and that is sometimes, you will see people will talk about an athlete who is sitting down in their sprint. A lot of times, that is because they are over-striding.

Your flight phase. After you take off, the backward moving leg reaches maximal extension while your front leg is in an optimal flex position. When the back leg starts moving forward, the knee flexors should hold the leg folded at approximately 30 degrees. Through the propulsion phase, the athlete should bring the foot of the folded leg through the cycle at the same level of the supporting knee. What does that look like?

We can see 2 runners basically in here. You can see as that landing, about 170 degrees, he is landing in here, but this back leg, you can see it having almost a maximal extension, the back leg. Then we want to fold the knee. When you fold the knee and bring it in because the radius is smaller here, this is just physics, you can bring this recovery leg through quicker. Imagine someone who is jogging, going slowly, this recovery leg will be down here, which slows down the ability to swing that leg forward. If you look, you are doing a video analysis, look as to where this knee is coming through. It is coming through right about the height of the stance leg in there and then you are doing this. You will bring this leg through, and end up recovering and then go into your triple extension.

On that recovery phase almost maximal extension, you start bringing it through about 30 degrees of knee flexion in there to bring it through. The knee comes through at the height of the other knee, so it is not lagging, and that is almost perfect mechanics in there.

When you are talking about speed, define what you need to develop? You need to improve strength and power. Do you need more triple extension? Do you need more triple flexion? Your beginning athletes, you are going to need both, it does not matter. You want to improve your technique and then you want to emphasize the neural quality of that speed. That is what we talked about, you are training speed that session, that is all your training. If they slow down too much, forget it.

Boo Schexnayder once, he had an instance where a coach flew over from, I forget what country he flew over to watch a workout, he wants to see what Boo is doing. Boo had planned for 6 sprints, but his sprinters were pretty much maxed out at 3 and they were just too tired, and he ended the workout. The coach looked at him and says, “That is it?” He goes, “That is it for today. I apologize, but we cannot go any further.” I think the visitor was a little disappointed. That is when we talk about, the emphasize of neural quality.

We are going to talk about agility a little bit. This is the ability to change direction rapidly. You can have anticipated movements and you can have unanticipated movements in response to an opponent, all right? Anticipated movements are during practice where, I throw the ball to you, you know it is coming and that is great and that is what you are reacting to your next move, but it is the unanticipated movements in response to an opponent that really become very important and training in an unpredictable manner. I think this is what a lot of athletes talk about when they say I am in shape, but I am not in game shape because they are not used to getting back into those unanticipated movements.

More terminology. Flexibility, the ability of a muscle or muscle group to lengthen passively through a range of motion. Mobility is the ability of a joint to move actively through a range of motion. Stiffness is a measure of how much load a tissue can take before it deforms. When we talk about stiffness, we are not talking about the everyday term, oh, I feel stiff today, the layman’s term. No, we are not talking about that. We are talking about the ability of the muscle to stiffen and then react. Stiffness is good. When we talk about running, the athlete’s ability, their ability to handle increased stiffness will increase their ability to produce force. That is what we are looking at.

I am going to show you a drill. Let us watch. This is a soccer player I remember as a child but let us watch his agility in here and let us watch this kick. The agility is his reaction to the ball. That is a nice kick, I want to break this down a little bit while we are doing it. I am going to stop the video right there. We think in terms of mobility and flexibility, look at his hips, there is nothing outrageous about the range of motion here. He is in a normal amount of flexion, he is in a normal amount of extension.

One of the things you notice is you are getting a lot of the leg movement, the hip movement. Why is he able to do this? Where does he get this great agility? From his core. His core is not moving, so his core is the anchor. His core is moving in space, but his core is acting as a stabilizing force so his hips can come through. Look at these hips, we are not talking about any excessive range of motion here.

On his follow through, the kicking leg, you can see once again, look at the flexion of the hip, it is not that extensive. What he is getting is he is getting great eccentric action here of the hamstrings, of the glutes so he does not go too far. Look at the core. We have some rotation, but we do not have any range of motion that you would say excessive. I mean, do you need to work flexibility in a lot of these cases? No, you need to work some mobility. He has the strength to maintain to follow through, but you can see that flexibility sometimes.

Look at the range of motion in here. Core is staying stable for his landing and the hips, nothing excessive about that. That is what we really want to work when we think in terms of agility.

This chart, is Young’s work out of Australia where he broke down agility, and you can see it is based on perceptual and decision-making and then change of direction speed. With the change of direction speed, a lot of these things we can train, but perceptual and decision-making, a lot of that is a mental aspect. That is experience, that is some of our older athletes who are a little slower, they have lost a step, but they recognize events much quicker. They can react a little quicker even though they may not have the same muscular strength or the same speed.

When we look at change of direction, if you are looking at a shallow cutting angle or very quick, that is less than 250 milliseconds. That is what we would consider a plyometric. Sometimes, when someone is running full speed and it is aggressive cutting angle, they must drop down lower and that is going to be a bit longer and that is going to require more strength. We look at the orientation of the body. They must decelerate to a stop, leading into reacceleration. Increased muscle mass in combination with decreased percent body fat is regarded as the best predictor of change of direction ability.

If we look at the centre of mass here and we look at our centre of force application, if someone is cutting, all right, they are landing and planting, one of the things about is you want to keep this centre of mass. You want to make sure that it is just posterior to the centre of force application and then we want to rotate drive. One of the things about this is when we talk about core stability, if they were weak in the core in here, as they drop down, their centre of mass is going to keep going laterally, and that is when you become vulnerable to injury to the knee. That is where we see some of our non-contact injuries. They need great strength in here as well as strength in the leg.

The other thing is, if they are running at a very high speed, you need more knee bend. They must drop down lower, otherwise once again, their centre of mass is going to end up going lateral and that is where you are going to end up with an injury in there. We are looking at strength in the legs, we are looking at strength in the core muscles also.

Looking at this chart, we are working with agility. Here are some of the things that I can work with in terms of strength conditioning. When I talk about change of direction of speed, we can work on technique, we can work on straight sprinting speed, we can work on strength leg muscle qualities. Anthropometric, that is no change. We can do some technique, foot placement. We can do adjustments. You can see the things that you can do in terms of strength and conditioning. These others, you can also work with if you change some of the technique. This is playing as much as you can, but there are certain things you can do in terms of having them make decisions during their training sessions.

When we look at reaction time? We have pre-motor time, the time between stimulus identification and the onset of muscle activity. Then we have the actual motor time, the time between initial muscle activity and initiation of movement. This would include electromechanical delay. Pre-motor time, that is when you make the decision. The more experience you have, the more you have played, the pre-motor time goes down. If you do not have great strength or if you are aging, your motor time will increase. The pre-motor time can offset some of the decreases in motor time that we see with athletes as they get older.

In this slide we are looking at the central nervous system needing time to identify and implement appropriate postural and movement strategies to make decisions even before we move. Then the muscular system needs the strength necessary for executing these strategies as quickly and efficiently as possible.

Here are your stages of motor learning. First of all, the acquisition, what skills do the athletes need to know? The application, can the athlete successfully complete the skill? Assimilation, can the athlete do the skills and routines automatically? Adaptation, can the athlete do the skills and routines automatically in a unique situation?

I do not know if you have heard these terms before, but acquisition, a skill that the athlete needs to know. This could be at the beginning level. Sometimes, this is known as unconscious incompetence. They do not know what they do not know. Then you can teach them the skill, you are trying to apply it. They are not good at it, but they know what to do, so that would be a conscious incompetence. Then you want to see if they can assimilate. Did they get better at it? At that point, it becomes conscious competence. We want to get to the adaptation where it is unconscious competence where they do not even have to think about what they are doing.

Here we have a W drill. He just goes back and forth in there. These are BlazePods which I got from the United Kingdom. This athlete has to make a decision. He must go to the light that goes off. I set up an easy one as a random type of drill, for filming purposes. I set up three, but you can set up six of these so that he has to make a lot more decisions. The whole idea is to really explode out of this.

This is a plank drill, which is an upper body reactive drill. She gets in a plank position; her shoulders stabilize as she has to react. Sometimes, the shoulder stabilizes and must react to the movement. Sometimes, the shoulder must move itself. It is constantly going back and forth between a stabilizing and a dynamic function. It is tough. That is the concept behind the agility.

We are going to get into plyometrics, and I am sure most of you are familiar with plyometrics to some extent. These are the exercises that enable a muscle to reach maximal strength in as short a time as possible. These exercises use the force of gravity to store energy in the elastic components of the muscle and then combine with the energy of the muscular contraction to exert maximal power. Plyometrics has also been called jump training and stretch-shortening exercises. You will hear the term of using the stretch-shortening cycle. Often, you will see the abbreviation SSC.

Depth jump versus drop jump. When we talk about plyometrics, there is a lot of confusion about what terms we are using. Not everybody agrees on the same terms. Some of this stems from the original research by Yuri Verkhoshansky because some of the people interpreted, they had to go to the original Russian manuscript. His daughter who has done some webinar, some seminars, she says that some of his work was misinterpreted, and she is trying to clarify some of the things that were done, depth jump versus the drop jump. Paavo Komi, he did a lot, once again, with the stretch-shortening cycle and the drop jump. Then Bosco did a lot with the drop jump test.

If you look at the initial depth jumps that Verkhoshansky talked about, this was with elite athletes, to increase explosive strength, very high drop heights and you had a pre-landing muscle activation. In the Russian translation, it was almost like he was calling these shock jumps. These would not to be used with beginning athletes. These were athletes who had a good amount of strength to begin with. A drop of 1.10 meters, that is a high drop. The drop jumps that Bosco worked with to improve elastic energy recoil, that drop height was 20 to 60 centimeters. You can see the difference in there.

If ground contact exceeds 0.25 seconds, then the power production can be significantly reduced. You may actually get more strength, but the power of value will go down. Let us look at some of the ground contact times. For sprinting, I mentioned this earlier, 80 to 90 milliseconds for ground contact time, which is a fast stretch-shortening cycle classification. With race walking, 270 to 300 milliseconds, which is slow. Some of the plyometrics, you might work, you can work slow in plyometrics. You can see, if you are working the depth jump, depending on how high it is and what the athlete’s strength is, it could be anywhere from 130 to 300 milliseconds and then have multiple hurdle jumps.

What is interesting, when we talk about speed and contact time, we talked about 250 milliseconds. I work with some golfers, and when you look at their swing, the amount of time that they swing down, depending on how good they are, will be in that 200 to 300 millisecond range.

We do have what we call the reactive strength index, which is something you should be familiar with. It has been developed as a measure of explosive strength and it is derived by evaluating your jump height, divided by your ground contact time during the depth jump. You are going to use either a force platform or a jump mat. I use a jump mat for this and get some good values. Once again, your flight time divided by your ground contact time.

Your reactive strength index will give you a good idea of what level of plyometric you can work with when you are dealing with an athlete. When we look at a low reactive strength, you want to do just build up their strength, low-level plyometrics, moderate strength plyometrics, 1.5 to 2.0. You can see the values go up. When you get to world-class reactive strength ability, if that is greater than 3.0, you are probably working a lot of technique in just trying to maintain their strength.

We always talk about, well, how much strength do you need? There is a certain point where you probably do not need any more strength in certain athletes. For example, when you talk about doing a squat, for most athletes, for elite type strength, you want to get to two times body weight for this squat. If you start going more than two times body weight, we do not see much difference in performance or power development if you go much more than two times body weight. There is no need to keep packing on the pounds for your squat. We are doing that with other athletes too.

If you are looking at the reactive strength index test, you are jumping from a specific height. Here is what this shows. Here is a low drop height. You can see from 12 centimeters to 36 centimeters, the reactive strength index goes up. You can still work at this height, but look at this, the second athlete. When you go to 51 centimeters, their reactor strength index goes down and that is because they do not have the strength they need to handle this jump.

What is happening in this situation is when they jump down, they are spending a lot more time just taking the landing and they do not have as much energy to use the elasticity to increase and go for a higher vertical jump. Athlete 1, you can work them and still increase their power at a 51 centimeters drop. Athlete 2, no, you want to stay in this 36 centimeters range until they can develop enough strength and power where they can go up to the next level.

For the muscle spindle reflex to fire, you need a fast rate of eccentric muscle stretching. If you are doing low plyometrics, you are not really getting the benefit of the muscle spindle reflex, you are getting the benefit of elasticity of the connective tissue and you are getting the benefit of the elasticity of the tightening in the muscle and the elasticity of the tendon. For elastic energy, there must be a short transition period between eccentric and concentric phases.

For enhanced motor unit recruitment, there must be a fast eccentric phase and a short transition period between the eccentric and concentric phases. For increased force development, the eccentric phase must be slow. If you are looking at motor unit recruitment, if you are looking at elastic energy, it has got to be fast. If you are trying to develop a little more strength, then you are going to be a little bit slower in your eccentric phase.

Some of the program factors, we are looking at strength based. We will talk about this because these are some standards, but a lot of people do not go by this. For example, for strength base, you should not do plyometrics unless you can squat 1.5 times your body weight. We do not go by this. I would tell you, reactive strength index is just using a vertical jump, more importantly, because we have a lot of athletes who have never trained so they cannot even do a squat. Or you can have a tall or like your athlete who has great power, but they cannot squat.

I have had basketball players who cannot even squat half their body weight, but they have a 40-inch vertical jump. Well, if you have a 40-inch vertical jump, you have incredible power and you can do plyometrics. In fact, they developed this power because they are constantly jumping, so I don’t use this. Upper body, they are talking about bench press 1 times body weight or if you can do 5 clap push-ups. This is interesting because it is very hard to do upper body plyometrics. The main reason being is with the upper body, the contact time is so slow.

I talked to you about 250 milliseconds as being the cutoff. Well, if you do a clap push-up, that contact time is going to be maybe 750 milliseconds, 800, almost close to a second of contact time. That is not really a plyometric at that point. It is not that you are not going to get benefit from it, but the elasticity you are getting from it is not from the stretch-shortening cycle. I think this is probably the best way of doing it. At least if you want to talk about plyometrics, talking about drop height, you select a drop height as low as 20 centimeters, you have them jump down, so I would do a vertical.

If you do not have any fancy equipment, you put some chalk on the athlete’s fingers, you have them stand next to a wall and bring their arm up, have them raise their arm as high as possible and touch the wall and you can see what their height is. Then you have them do a vertical jump and you can measure the difference between chalk marks and you now know what their vertical jump is. Then you have them stand on a platform, 20 centimeters, and once again have them jump again with a little bit of chalk on their finger and you see what their vertical jump is. Their vertical jump should be higher than it is from just a standing counter-movement jump.

You can go to the next jump. From 20 centimeters, you can go to 30 centimeters, all right? At 30 centimeters, the vertical jump should still be higher. If you go to 40 centimeters and now, the vertical jump is lower, you know that is too high of a jumping height to go from and you bring it back down to 30 centimeters. That would be the easiest way of doing it.

If the drop height is too high for the athlete’s strength, ground contact time will increase. They are going to be bilateral differences in peak force and average force based on drop jump height. We will see these bilateral differences in 20 and 40 centimeters, and this is done off a force plate, but once you start going to the real high starting heights, you will not see a bilateral difference but you will see a decrease in power.

Keep in mind, and I will talk about inches, is when we talk about vertical jump, there is a certain inhibition when we talk about a bilateral jump. If I am working with an athlete, I might find that if I do a single leg vertical jump on that left leg, it might be 17 inches. Then if I do the right leg, it might be 16 inches. Well, if I do a bilateral jump, countermove jump, I do not add up the 17 and 16 to figure out what their height will be. It will not be 33. In fact, it will probably be about 26 or 27 inches. When you do a bilateral jump, there is a certain inhibition that one leg crosses in the other leg as opposed to a single leg vertical jump.

When we look at plyometrics, what equipment are we using? Footwear, surface, facilities. You want good footwear, although some people will do this barefoot, but make sure the athlete is used to working barefoot before you do it. The surface has some give but not too much. If there is too much give, you cannot get a jump because the surface is absorbing all the force and the contact time becomes too long. If the surface is too hard, you can start getting injuries. Then just proper facilities. Do they have enough space to do some of these jumps, some of these sprints? Is this a safe facility? Just your basic precautions.

When I talk about some of the movements, if you go to different seminars, different instructors will talk about different type of movements. Your jumps are basically triple extension type movements. When we talk about hops and this could be single leg or double leg, this is the paw mechanics and this is more about pushing off. Hitting the ground clawing the ground and pushing off, whereas your bounds are more about push mechanics. That could be more of in a horizontal manner or more of a vertical manner.

What do I want to do in terms of intensity, this is a system I use. Level 1 plyometrics is eccentrics. This is all about the landing mechanics. Remember, I talked to you about deceleration. A lot of this is landing. I want to see first, I just emphasize, can the athlete land? Just have them stop, minimal flexion of knees and hips and then stick it. As I increase the amount of force, then I want to increase the amount of flexion at the knees and the hips for the whole concept is stick the landing quietly as they are developing their strength. The more they develop their strength, the more I know they can now convert that eccentric into a concentric action in terms of acceleration. The level 1 plyometrics is all about developing deceleration.

Your level 2 plyometrics, low-intensity. You are minimizing ground contact. The jump height is unimportant. Ankling, skipping, this is all about creating just quick motion, creating stiffness in the leg, staying on the balls of the feet. Jumping rope, jumping rope for 20 seconds is an excellent low level plyometric.

Then your level 3. This is where you start increasing intensity. This is where you are minimizing your ground contact, maximizing your force. You are talking about your horizontal and/or your vertical jumps. This is where we start getting these are your depth jumps, these are your drop jumps. Going from lower intensity to higher intensity, your jumps in place, just easy jumps then you are standing jumps now. You can start doing broad jumps, you can just start doing vertical jumps. Then you start combining them. Multiple hops, multiple jumps. Then you go into your bound exercises and then you start your box drills.

You can now stand on a box and jump down, or you can stand and jump onto a box. Out of the two jumps on a box, jumping onto a box or jumping off a box, which is the lower intensity one, you are safer if you jump onto a box. The reason is when you jump onto a box, gravity is trying to pull you down as you land, so you are just starting to decelerate so your contact forces are not as high as if you are jumping off a box and you are getting all your gravity acceleration involved. If I am just starting with an athlete, I might have them for explosive jumps, just jump onto a low box. Then you start getting to your depth jumps where you are jumping off the box and then trying to explode out of that.

If we look at program design, let us look at the frequency. Well, you know what, this is a high intensity type exercise, so you really do not do much more than two days a week. Here is your volume. When we talk about volume, this is foot contacts. Your beginner foot contacts, not more than 80 to 100 contacts for a session. If you are doing an exercise, let us say you are doing some bounding exercise, some skips and you are doing 8 repetitions, that would be one rep. Well, if you do six of those, you are really at low almost like 48-foot context at that point, so you are only doing two drills.

Your intermediate, 100 to 120, although I have seen ranges of 100-to-150-foot contacts. Then your advanced, 120 to 140 and you are going up to 150 to 250 contacts. When I say a foot contact, if you are doing a single leg hop, that is a foot contact. If you are doing a double leg hop, that is still only one considered one foot contact. Where I find it interesting, this is where I have worked with some volleyball teams is sometimes, in their warm-ups, I watch them during warm-ups before they get into their plyometrics. Their warm-ups, they might be doing almost 50 to 100 jumps even before the warm-up, same thing with the game. I am amazed at how many jumps a volleyball player will take in warm-ups before a game. They are almost taking 150 to 200 jumps even before the game starts. I have spoken to some volleyball players where I really think that needs to be downplayed that we need to decrease the amount of jumps they are doing in their warm-ups.

Then we look at the intensity. Once again, we went over the different intensity. Recovery progressive overload. When you are talking about that progressive overload, how much recovery are they getting? You want one or two days. Also, if they are playing a game, what do you do next the next day? Do you want them doing plyometrics or you want that recovery? That is how we deal with, when do you want to do these types of workouts? A lot of this is done more preseason than in season, but then it becomes a case.

Let us say you are dealing with a soccer team; do you want to do these plyometrics sprint? It really depends on who that player is. When we work with basketball teams, a lot of times, basketball teams have an 8-man rotation or 8-woman rotation, so the 9th, 10th, 11th player, they are not getting as much work. Whereas, your starters, those players are doing a lot of jumps, a lot of sprints, so they need more recovery. You may almost need 2 different workouts depending on how much playing time that player got in season. Then we like to combine our plyometrics and weight training.

This is interesting for children should children do plyometrics. First, if you look at child, you do not have an option. Children are always playing around with jumps and so they are doing it anyway. In fact, for most children, they are safer if there are no adults involved when they just can jump and play on their own. This was an interesting workout. This was done at a soccer academy, aged 8 to 14. The current evidence suggests that a program of twice per week at 50 to 60 jump sessions for 8 to 10 weeks results in the largest changes in running and jumping performance. That you actually can get some benefits if you do a little bit more of a guided program.

The plyometric training had a large effect on improving the ability to jump. The effects on running velocity were not as consistent across the studies. Looking at the studies, I think a lot of that had to do with the type of plyometrics they were doing. They were doing plyometrics that emphasize the vertical and not so much the horizontal. An example of this would be if you are doing a lot of vertical jumps as opposed to broad jumps, if you want to develop more horizontal type of ability, then you are going to do bounds and emphasize more of the horizontal length as opposed to the vertical length. There was some improvement in their agility and their kicking distance in the soccer players, and each study did address safety in a satisfactory manner.

The focus of the exercise should be specific to your desired outcome. Progression should be to 90 to 100 jumps by the end of the 10 weeks. That is what they found. They were starting at 20 to 30 and progressing to 90 to 100. Sessions were 10 to 25 minutes in duration. They had warm up, they had cool down. The drills last approximately 10 seconds. No matter what drill you are doing, it should only last 10 seconds. It was a 90 second rest between drills.

They also found that when you are doing these drills, there should be a low instructor-to-student ratio, 1:4-5. This is where the assistant coach has become very important and the assistant coaches who know what they are doing. In the States, we have a lot of these soccer programs. We may have one coach and maybe an assistant coach who knows what they are doing. Then you have 2 or 3 parent volunteers who probably do not have much of a concept. They think they do, but they really do not have much of a concept.

This was interesting is, how can you sequence the effects of balance and plyometric training? I talked about balance and how important it is that they have good balance strength so they do not waste too much time or energy when they land so that they can start converting that into a concentric action and increase power. This was an interesting study that they did.

They want to see what the effect of sequencing balance and plyometric training on the performance of 12- to 13-year-old athletes would be like. Twenty-four young elite soccer players train twice per week for 8 weeks, and they changed it. One group for the first 4 weeks did balance training followed by plyometric training. One group did 4 weeks of plyometric training followed by 4 weeks of balance training. I included the workout in case you want to see that. I thought it was a fascinating study. I thought it was well laid out.

You can see what jumps they were doing, and you can see what their workouts were. You can see some of the higher intensity type of plyometrics single leg maximal rebounding, drop jumping from low platform, performing ballistic type push-ups. You can see that was included later in the training session. They work out 6 workouts, 7 workouts, 8.

What they found was that sequencing the 4 weeks of balance plyometric training in the 12 to 13 elite soccer players resulted in either similar or superior performance enhancements compared with plyometric before balance training. If you are not sure about what level your athletes are, I emphasize, get them started on balance training first, develop their strength in a balanced position. This would be doing stick it, just maybe some simple hops and then go into more of your plyometric training the following 4 weeks. If you are working preseason, you start your drills, you start your team drills, you start all your individual skills, work your balance training into those sessions before you start your team sessions, and then 4 weeks after that, then you can start going into more of your plyometric training.

When we are designing a program for athletes, we have all these concepts: speed, agility, strength training. What do we do with it? Well, let us look at a needs analysis. Before you do any program design, what is a needs analysis? This helps determine the current state of the athlete and what level that athlete wants to achieve, that is their need. You look at the task analysis and this involves the sport. For example, from a metabolic stay point of view, what do they need? Do they need more speed, more endurance?

From a skill point of view, what strength do they need? What do they need in terms of the game itself? Then you look at your athlete analysis. Well, the athlete you are dealing with. If you look at that, you can see you might have a team, but your athletes are in a different position. We often train teams all in the same manner. Sometimes, we do not have time to do individual programs, but it is individual programs that we need. What are your goals and priorities? Not only of you but of that athlete.

I worked with a golfer in the PGA, and clearly, when you talk about his goals, what are his goals, well, he wants to be able to finish the season without being hurt and he wants to be a top ten golfer. He wants to be one of the top 10 golfers in the world. What are your resources and your constraints? What do you have available? What are some of the constraints of the training?

If I am working with a PGA golfer, I may want them to train, but if he has a term and he is doing well, he is playing Thursday, Friday, Saturday, Sunday, Monday is a travel day, maybe we can do some strength training there. Tuesday, he is already starting to practice. Wednesday, if I gave him too much strength, it could mess him up for Thursday’s first round. How do you work around that? In this case, Monday usually a travel day. He usually gets in and he can do a strength workout. Then Tuesday, he can practice, he can do some flexibility. Then Wednesday, he will do strength, but what we do is it is high-intensity low-volume so we do not tire him out the Thursday. That is what I mean when we talk about resources and constraints.

Let us look at soccer for a second. Let us look at some of the task analysis. Less than 2% of the total distance is with the ball, which means when you do have the ball, you have got to be very good with it. I notice when I watch EPL versus watching college soccer in the States, that is the big difference. You see a lot of the American college players, they are in great shape. You will hear the announcers like, “What a motor on that athlete. Look at him go after the ball.” Well, the reason he is going after the ball working so hard is because his first touch is so poor. You work on the EPL, they make it look effortless, like that first touch is so good. They are doing a lot of action, but they can really focus more, when do they need that burst of speed? When do they need that follow-up or when they have to chase someone down?

One to two thousand bouts of different action. Activity transitions every 5 to 6 seconds, 3-second rest every 2 minutes. Their sprints have a 15-meter average. About once every 90 seconds, they might break into a sprint. But once again, that could be clusters too. We talked about clusters of time. I can tell you, well, every 90 seconds, they must do a sprint. Does that mean I have them sprint for 15 seconds and then their rest period is 90 seconds when I train them?

But we also see clusters and we see different time where they may have a cluster where the team is attacking, and they may sprint and only have a 10-second rest in sprint and 10-second rest in… They may have 3 or 4 sprints in a row and then they may not sprint. Maybe the other team takes over them more in a defensive shell and maybe they have a 15, 20 minutes where they are not hardly doing any sprint. We must be careful. We just talked about averages that sometimes does not consider the actual run of play of a game.

Standing, 17%, walking, 40%, easy running, 35% of the time, easy running backwards, only about 2% of the time, and then hard running, 8% of the time. Typically, in a soccer game, in an EPL game, maybe they are going a total of 10 kilometers per game. That is a pretty good distance, but how much of that is sprint? You want to break up. That is what we mean about needs analysis. How do you break up a sport? If I am dealing with American football, a play only takes 5 seconds, a lineman, the most they are going to do, they are basically going to explode out of a stance. Maybe the play lasts 5 or 6 seconds and they are going to have a 35-second rest, assuming they are not being subbed out of the game for another lineman.

When you look in this analysis, a lot of it is design test protocol, so we know where the athlete is. We look at our administration of tests. What is this? We must supervise these tests. We must make sure they are warmed up. Then what is the motivation? Are you truly getting excellent results in terms of motivation and are you safely administering the test? The last thing you want to do is hurt an athlete during a test. You do not want to be the coach or the health care provider who hurts an athlete during a test.

I have run into some things with motivation. I have seen great players and you time them on the 40-yard dash, and you know what, their time is like 4.6 or 4.7. It is not even very good, but if you watch game, no one can catch them. The difference is motivation. They just do not care that much during a testing procedure unless they are a rookie coming in and must worry about their spot on the team. That is great motivation.

These are the different categories when we are looking at test selection. If you just look at these quickly, you must decide which of these you want to test. For example, local muscular endurance, do you really need that for your team? How many tests do you want to do? When do you want to do them? Are they being done preseason? Are you doing this to select the team? There are several different choices you must make.

Here are some things for local muscular endurance. You can do curl-ups, you can do push-ups, abdominal endurance, back extensor endurance, lateral trunk endurance. I am not sure how vital these are. For example, a lot of the sports I deal will… Even a soccer player, they are resting. They need more explosive movements, so their core strength is more about exploding-relaxing, exploding-relaxing. It is not about keeping the abdominals tight. Let us say you had a fighter like an ultimate fighter where they were going 4 or 5 rounds or a wrestler where they must keep a certain amount of stiffness for extended periods of time, then you might want to know this type of thing. This is a category that is there that I generally am not using.

Strength and power. You can do one rep max bench press, squat, one rep max power clean. This can be useful for an athlete who is lifting, but do you want to do this in a rookie camp or someone who is not used to lifting or a sport that is not used to lifting? No, I do not think you need that. You are not really going to get a good determination. However, for lower body, you can get great determination with a vertical jump. You can get a great idea of what their power is with the standing long jump. If I am working with a sport that is traditionally not weightlifting or athletes who have not been weightlifting, this is what I want to do. If you want to measure upper body power, there is several different medicine ball throws that you can use.

I am waiting for it to come out on the market right now, but there is a company that is developing a medicine ball with an accelerometer built into the medicine ball, so you can do a horizontal throw. I like the chest throw where I have them lean against the wall and just throw for horizontal power. I know some coaches who like where they are standing, and they are doing a rotational throw for power. You decide, but then you just want to standardize how you are going to do it for the athletes.

Aerobic capacity, a 1.5 mile run or a 12-minute run. You can go by distance. There is some correlation with aerobic capacity and how well they do. I would do this more for a non-steady state. It might be good for a basketball player or soccer player. I think this is a measure you would probably want more, anaerobic capacity, because they are non-steady state, the ability to sprint-relax, sprint-relax. I think in a basketball player, the anaerobic capacity becomes more important and then the soccer play, the aerobic capacity might be a little more important.

I would tell you when I am training soccer players and want to develop this capacity more where I might have them do a total of a mile and a half or two miles or even go three miles, but it would be based on a 50-meter sprint, 150 meter jog, a 50 meter sprint, a 150 meter jog to get up to 3 miles. I think this is a staple. I like to keep it in there, but I am not sure how I feel about it.

Agility, I think this is great. We use a T-test, we use a pro agility test which I think is great. These are short tests. I want to know what their agility is because if they do not have great agility, I have an idea of where I need to build up their strength. Then the speed, the 40-yard sprint or the 40-meter sprint. I think this is a good evaluation. I think speed is just so necessary. I think speed is what divides one level of player from the next level of player.

In the United States, we really work on the 40-yard sprint. There are cams just for the 40-yard sprint. You have a lot of college players who go to these combines and in their position on a team where their draft position will be based on how fast they can do a 40-yard sprint. A lot of this is the drive. The initial segment lasts 7 steps, explode. I mentioned this before, stay low at 45 degrees. If you want to train them for speed and you want to add a little bit of power, what would you do? This is where you can do the sled push, but it has got to be a weight where one, they are staying at 45 degrees and two, they are not slowing by more than 10% of their actual time.

Transition, that is where you are going from that 45 degree into a more upright position that takes about 2 seconds and then finish running through the finish. The best is John Ross. In 2017, he ran a 4.22. Is John Ross playing in the NFL? He ran this in 2017. As a matter of fact, he has had some injuries. If you do follow American football, you are not thinking of John Ross when you think of great receivers. That is what we must look at with players. No matter what your sport, it is not the person who is the fastest player, it is not the person who is the strongest player, who is going to be at the top, but they do need minimums.

If you look at your top soccer and you look at your top rugby players, there may be other players faster, but they are still fast. It is just their skill level is higher. Same thing if you look at your locks, your props. If you look at during rugby, well, they need a certain amount of strength. They may not be the strongest man in the world, but they certainly have a certain amount of strength combined with their skill.

Then you can look at body composition. This is just to get a basic idea. You can see I put a star next to some of these, when we talk about hydrostatic weighing which is the gold standard. I do not know what you are using, what you have available to you. Hydrostatic weighing measures the mass per unit of volume. Percentage of body fat is estimated based on the density of the body. You must account for residual volume in the lungs, how much air there is. You can use the Siri and Brozek equation.

So much of what we do with body composition is based on equations, and these equations come out of books. humankinetics.com, if you are looking for specific values, let us say you want to use a treadmill protocol for aerobic capacity, go to humankinetics.com and get their book. I know they have a European office also, I think, in the UK. humakinetics.com would give you a lot of information on that. I have no association with humankinetics.com. One of those conflicts of interest, just the fact that I like a lot of their publications.

Here is what you must do. One, you must make sure the athlete is comfortable being underwater. This is not a very feasible type of testing situation. First, these tanks cost a lot of money. This is something that you are going to find more on a university setting for research.

Hydrostatic weighing may overestimate body fat percent in elderly patients. There may be an underestimation of body fat percent in athletes due to denser bones and muscles. I have seen 1 or 2 athletes in hydrostatic weighing tested as negative percent body fat, meaning they did not have any body fat, which we know is impossible. That is based on certain assumptions.

Most body fat estimation techniques are based on a two-compartment model. You either have fat or you have fat-free mass, but the fat-free mass includes organs, muscle, bone, and body water. The fat-free mass does not necessarily equate to muscle. It is possible, based on their bone, how much water they are carrying in their body. It could be read as fat-free mass and give you an inadequate or it actually- and inefficient measure of how much muscle they have.

Skin fold measurements. I think this is a great basic concept. Based on the relationship between subcutaneous fat and total body fat. You can use a combination of 7 different sites. Once again, this is based on equations measured against normal. For example, Jackson and Pollock. Where do you get these equations? Once again, you get them right out of a book. I use a book that I got from humankinetics.com. This can be up to 98% accurate, but the accuracy is based on the tests or who is using it, someone who has done a lot of testing who is used to it.

If you are going to do subcutaneous fat skin fold measurements on your team, the person who does initial measurements should also be the person who does follow-up measurements because you are going to lose some reliability if you change the tester. I use a lung caliper, very accurate. I have used it for years and not very expensive, a few hundred dollars and you can get some very good readings.

This is the Bod Pod which is something you will see more of in some high-end corporate fitness centres or in academic settings for research. It is the same concept as the hydrostatic weighing where you are displacing air instead of water. That is how they are doing it. This is a very expensive piece of equipment. I think this in US dollars is maybe USD 31,000, USD 32,000. I just want you to be aware that it is out there. I have tried it. I have been to at the conference where I have tried it. It is interesting to use, but a lot of money for something you can get pretty accurately with skin calipers.

Body composition. The body mass index which they are using also just based on your body mass and your stature and it will give you different levels. You can see the limitations of body mass index. I would not use it, especially with athletes, athletes are just off the curve. What is interesting is body mass index is basically a rehash of some of the actuarial tables used by insurance companies in the 60s and 70s. When I did my master’s program and exercised physiology in the early 80s, the body mass index has actually been eliminated. I do not know who decided to bring it back.

What really bothers me the most about body mass index is it is in a lot of the electronic health records in the States. It almost gives you an official value, so you can have someone in great shape and they may end up with a high body mass index as overweight or even obese, which is not an indication of their actual fitness levels.

Test selection. Body composition, hydrostatic weighing, skinfold. I would go with skinfold measurements. Flexibility. This is one of those things. I do not even test for flexibility, to be honest with you. I do certain motions like I will do a lunge to see if it looks like they have good hip flexibility in there.

I might do a Thomas test, but I do not actually test. I almost feel like flexibility, how do you define it? What is a good flexibility? What is not? It is almost like jazz, you either know it looks good or it does not look good. I do not use flexibility test when I am doing any preseason with athletes, pre-season testing.

In the United States, this was a Division 3 college soccer team and how they did their test selection. This was a good school, it is not great, it is not Division 1, which is the highest level in the United States, at the University level. This is good competition soccer, and I worked with this team. When they do their test selection, it is a 3-day, so they are in preseason camp. This is before the semester is starting, they are getting ready for the season. They have their returning players and then they have the new players who are trying to make the team.

On Day 1, they expect their players to do a 2-mile run under 12 minutes under a 6-minute mile. Then Day 1, this is done, they warm up, they do this in the morning and then they will have a team session, so after the 2-mile run, they will have 2 or 3 team sessions. A lot of times, test selection is included in their camp in terms of team training.

Day 2, they will do a shuttle sprint, which is more for agility and more a little bit of anaerobic testing. They do a 60-second sit-up test and a 60 second push-up test.  am not crazy about it, they like it because it is safer than doing any strength testings.

Let us go back to Day 1 for a second, 2-mile run the players have to do under 12 minutes. I asked a player, “Well, what if you do not do it under 12 minutes?” he says it depends on who you are. If you are a starter returning from last year and you are a great strike, it does not matter. If you are trying to make the team and you are not in shape, that is usually an indication that they are not going to take you. Day 3, they do a vertical jump. This is what I talked about for power and they do a bench press. They only do lifting, but they did a squat test as well, but only for returning players because they know their returning players have been trained how to lift correctly. It also gives them an indication of which of their players kept training offseason. They will not do this for first-year players who are coming out of high school because they are not sure how they were trained.

So you have an idea of how you might do some of your program design. I want to throw in just something on environmental stresses. This will be brief. Hypothermia, defined as a condition where the core temperature is 95 Fahrenheit or 35 Centigrade. Muscular coordination becomes affected, judgment is impaired as core temperature decreases.

This is something we have here living in the United States in Minnesota. The temperature is about 5 degrees Fahrenheit, almost zero degrees. We can see, so we play outside. People are skiing. Hypothermia, sometimes, you build up your core temperature, so you are not really being affected by hypothermia. If you get tired, if you get fatigued, your muscular coordination will become impaired, but even more importantly, your cognitive ability.

Your judgment will also become impaired, which is when people run into trouble. Whether we talk about people who are going on Mount Everest climbs and things like that, they start making poor decisions. I remember reading one of the tragedies, I wish I could remember what year it was, with Mount Everest, where one of the things they found is one of the climbers died near an oxygen tank that had oxygen, and they think that he misread what the gauge said so he did not even bother with the oxygen tank.

We have our wind chill index. This is wind constantly replaces the insulating air around the body with cooler ambient air. For example, once again, in your cold weather. For example, we are at 5 degrees Fahrenheit today, where the wind chill, it is about minus 6. It is a little misleading because a lot of times, the wind chill index is almost based on well, what would it be if you were not wearing any clothes? Since I do not know anyone who really goes out without clothes in this type of weather, it is a little misleading.

Respiratory check when we are talking about environmental stresses. In extreme cold, incoming air is warmed between 26.5 and 32.2 Centigrade by the time it reaches the bronchi. In a very cold weather, if you wear some sort of scarf or mask, you can also warm the air a little bit more so that this is not as big an issue. You are still getting the air at the proper temperature as you inhale and it gets into the body.

Altitude stress, is a little more interesting. High altitude decreased barometric pressure reduces the ambient pressure of O2. Acclimatization, dealing with reduced loading of hemoglobin. Immediate changes, you get hyperventilation, increased blood flow from increased submaximal heart rate. It takes about 2 weeks to acclimatize at 10,000 feet. What I find interesting about that is I have patients who go on ski weekends, so we are pretty sea level. They will go, and you need 2 weeks for acclimatization, and they are not getting it. They do everything possibly. They will ski all day and they are not used to working at that height. Then they will drink all night, so they get dehydrated. They almost do everything that you could possibly do to be wrong and to hurt the body for a ski trip.

Here are some of the hematological changes you will see: decreased plasma volume, increased hematocrit, increased hemoglobin, and increased number of red blood cells. This is where the acclimatization, some of the things that we will see. Decreased plasma volume, you must make sure you hydrate under these conditions. I think that is one of the biggest mistakes athletes make.

This is a concept that is being used, live high-train low model. The training method is the athletes live at high altitude, but they train at low altitude. Their goal is to improve performance at sea level and they are trying to get these modifications living in a high level. You are trying to get that high altitude acclimatization, but you maintain the intensity of low altitude training. If you go at high level and you are not used to training at a high altitude, you cannot train as intensely, so you can lose some of your training ability. That is why they live high, but they train at a low level to maintain the intensity of their training.

You see an increased erythropoietin activity. This has not been observed in simulated live high-train low models. For example, hypoxic tents, and I have seen different research on it. It varies. It is a little contradictory, but I would have to say most of the research tells me that these hypoxic tents are not working, that you may have some changes if you have a hyperbaric chamber, but most of our athletes do not have access to that.

Here are some of the related medical problems: acute mountain sickness. You can see a lot of people; this is something that is not that uncommon. You are not used to being at high altitudes, headaches, dizziness, nausea, constipation, vomiting, some visual problems, general weakness. It can occur within 4 to 12 hours of 10,000 feet. Appetite suppression can be severe, symptoms are gone within one week, so this would not be uncommon for some people. A lot of people do not have this. I do not want to give you a specific percentage. Ten percent would not surprise me.

Some people can suffer from high altitude pulmonary edema. General fatigue, coughing, headaches, nausea, this will occur in 2% of the population within 12 to 96 hours after they go to a high altitude. This is life-threatening. If someone has these symptoms, they must get down right away, they cannot play with this. They cannot wait to acclimatize, this is life-threatening, and you want to get them down there. I also would recommend at this point that they just do not go down on their own. I think someone must go down with them because once again, with these types of symptoms, you do not know when it can all of a sudden escalate.

You can have high-altitude cerebral edema, more severe than a pulmonary edema. This is cerebral vasodilation occurring with increasing edema that distorts the brain structures, occurs in 1% of the population. They must be taken down immediately. The symptoms would be just more severe type symptoms than pulmonary edema, severe headaches. Get them down immediately, not on their own, as they have to be able to be transported right away.

When we look at some of the related medical problems, at 1,500 feet, 457 meters, you will start getting a decrease in light sensitivity. At 3,000 feet, you get a decrease in light sensitivity, you get a decrease in visual acuity, you do not see things as well. I put in Denver. In the States, this is known as the mile-high city, 1,610 meters. We have several professional teams who go to play there. For example, we have basketball, we have football, we have hockey, so visiting teams who might be sea-level teams have to go to Denver. With this type of altitude, a 33% decrease in postural stability, a 15% decrease in cognitive ability, and a 20% decrease in recall ability.

Typically, a lot of football teams, if they have a Sunday game, will fly in on Friday. You know what, that is not enough time to acclimatize, but it is enough time to start feeling some of these deficiencies. That is why you will find a lot of teams where they will go in and they will go in as late as possible. They have a Sunday game; they are going in maybe Saturday afternoon. They are doing all their pregame workouts at their home field and then going to Denver. If they have a Monday night game, they are not flying into Denver till maybe late Sunday or early Monday. They are trying to offset these effects that they would feel from acclimatization. Where you run into trouble, let us say you are a hockey team in the playoffs who are going to play the Denver Avalanche, well, you have 2 games in a 4-day period which means you can fly in as late as you want for that first game, but you are going to get hit by that second game.

[END]