The concept of sport-specific training has continually gained popularity over the years. It’s a growing market and business-minded individuals are taking notice. Similar to trends in functional exercise, you have a growing number of trainers stating they offer the “latest in sports training”. Frankly, anybody online can say their method or approach is the best. In a competitive market, people enjoy using words to attract your business. There are plenty of gimmicks that exist, namely in the world of speed training. Often times, athletes acknowledge such methods did little or nothing to improve on-field performance. If these gimmicks worked, it's simply because the athlete was a novice or of low qualification. Novices have the unique ability to respond to almost any form of training. But does this mean what was done is most appropriate? Does it mean training was efficient or effective? Not necessarily. When it comes to the training of higher level athletes, previously used methods and/or exercises will eventually fail to produce continual improvements in sport performance. There is a point of diminishing returns and training must adapt accordingly.

For any athlete, sport-specific training must ensure maximal transfer of the training program to on-field results. If exercise selection or organization has little carry over to making athletes better, you are wasting valuable time and money. Transfer of training can be summed up with the SAID Principle (Specific-Adaptations to Imposed-Demands). The SAID Principle has been proven time and time again in both research and training. This principle implies that training is most effective when resistance exercises prescribed are similar to the target activity or primary sport form/movement. Furthermore, every training method will elicit a specific (and different) adaptation response in the body. There must be compatibility between training and sport. This becomes of increasing importance as an athlete reaches higher and higher levels of athletic competition.

As mentioned before, research has demonstrated how exercises that once worked to improve sport performance for an athlete at a lower qualification level, will eventually lose training effect as the athlete gains mastery. For instance, indicators of maximal strength (squat 1RM) often have a direct correlation in low-level athletes, but lose significant correlation with enhancing sport performance in higher-level athletes. Similarly, movement abilities such as sprinting and change-of-direction (agility) are each separate motor tasks, characterized by specific motor abilities. Improvements in linear sprint speed and change-of-direction ability have limited transfer to each other and the degree of transfer decreases as an athlete progresses.

Thus, in order to enhance the sporting ability of high-level athletes, there comes a time when we must get more detailed than simply chasing increased strength and 'quick feet'. It’s inevitable. There is no way to avoid it. The world’s greatest Sport Scientists understood this and proved the need to go beyond traditional training approaches to see continual improvements in performance as athletes reached higher levels of competition. This is where the concept of Special Strength Training (SST) becomes of importance in the training plan.

Introduction to Special Strength Training
Pioneered by Dr. Anatoli Bondarchuk, SST has been incorporated for decades by coaches in other countries, mostly in the Olympic sports. Dr. Bondarchuk is most noted for his involvement in the throwing sports, particularly the hammer, and his results speak for themselves. It was Bondarchuk’s identification and implementation of special exercises with the highest degree of dynamic correspondence to the sporting movement that became the focus of his athletes' training plan. His organization of training allowed athletes to set world records and win numerous international and Olympic medals despite the fact that they did not possess the greatest strength in movements such as the clean, squat, or bench press.

Exercise Classification System
Bondarchuk classifies exercises into 4 categories:

1. GENERAL PREPARATORY EXERCISES are exercises that do not imitate the competitive event and do not train the specific systems.
2. SPECIAL PREPARATORY EXERCISES are exercises that do not imitate the competitive event, but train the major muscle groups and same physiological energy systems as your sport. However, movement patterns are different.
3. SPECIAL DEVELOPMENTAL EXERCISES are exercise that replicate the competitive event in training but in its separate parts. These exercises are similar to the competitive event, not identical.
4. COMPETITIVE EXERCISES are exercises that are identical or almost identical to the competition event.

“General exercises have little relevance to the sporting action. Specialized preparatory exercises use the same muscles that are involved in a particular sporting action. Specialized developmental exercises include single joint actions that duplicate one portion of the sporting action. They also mirror the velocity and range of motion seen in the competitive movement. Competitive exercises are those that fully mimic the competitive movement in more difficult conditions and easier ones.”

When my brother and I envisioned Gallagher Performance, one of our primary objectives was to provide a system that truly identified the structural and functional limitations of athletes, thus addressing these issues properly before they became implicated in serious injury or potential surgery. We knew the perspectives and coordinated efforts of a strength coach, massage therapist, nutritionist, and chiropractor with advanced training in manual and rehabilitative techniques could provide athletes with the avenues needed for improving sport performance and health. After all, achieving high-end sport performance is a multi-faceted and complex process.

Among the approaches and individualized considerations that are made for each of our athletes and clients, a fundamental concept within our programming is the emphasis on proper breathing patterns through focused exercises to optimize breathing and its impact on sport-specific movements.

Breathing Correctly
When we breathe, proper function of the diaphragm is the key and it should drive respiration. The question is, are you using it correctly when you breathe? To find out, simply place the web space in between your thumb and index finger firmly on each side of your abdomen in the area between your lowest ribs and your hip bones (or iliac crests). Now take a few normal breaths.  What is happening? If you're using your diaphragm correctly, you should feel a "bulge" outward into your hands. Why? As you breathe in, the diaphragm pulls the lungs down and creates compression within your abdominal cavity. It is this compression that creates the bulge outward into your hands. You can also think out it as breathing into your waistband or belt. You should feel your abdomen expand in all directions with proper breathing and this should occur normally, not only with deep breathing.

Another area of focus is how much your shoulders elevate during inhalation. Commonly, when someone wants to take a deep breathe, they have the tendency to lift their shoulders up to get more air in. But this is the exact opposite of what we want. Lifting the shoulders during breathing pulls the lungs up, which prevents the diaphragm from pulling the lungs down and will reduce the amount of air we can breathe in. It's important to note that shoulder elevation is normal with intense physical exercise; however, during normal breathing and even moderate exercise, there should be no shoulder elevation.

Don't sweat it if you didn't pass the test? Breathing has more to do with poor habits than anything else, which opens to door to retraining. The retraining of proper breathing patterns is something we spend a lot of time focusing on at GP with our clients and athletes.

Breathing and Its Influence on Athletic Performance
Previously, the role breathing has in the promotion of a healthy spine, prevention of neck and back pain, and enhancement of muscular coordination was underappreciated by many in the world of sport performance and physical medicine. Nowadays, breathing patterns have gradually gained more and more attention for the critical role they play in spinal stabilization, movement efficiency and athletic performance. Now it’s time for us to get in on sharing the knowledge. Below are three simple ways that breathing can affect your performance as an athlete.

1. Improve Joint Mechanics There is no question that movement and range of motion needed from specific joints throughout the body is always activity dependent. For example, hip internal rotation (IR) deficits have gained a lot of attention in regards to faulty lower extremity mechanics during movement, such as the squat. To address the deficit, the idea of performing internal rotation stretches has been popular to help improve the restriction. But it is interesting to observe that simply teaching an athlete proper breathing, abdominal and hip extension/external rotation activation through exercise can improve hip IR tremendously without the application of any static stretching. This raises the question of stretching and we addressed that in the article, Why Stretching Won't Solve Your Tight Muscles. Essentially, if range of motion was improved through breathing and stabilization techniques, the limitation was due to position of the spine, pelvis, and surrounding musculature, NOT because of a limitation in the hip. The same can be said of any joint in the body. Using specific breathing exercises can restore balance to the key joints of the body (i.e. spine, shoulders, and hips) by promoting normal expression of movement and range of motion.
2. Optimize Movement Patterns If an athlete attempts to execute a sport or skill-specific movement from a non-neutral position, they are already set-up to be inefficient and will limit their performance to some degree. The result is compensatory movement patterns and athletes may or may not be aware of how they are compensating for poor movement quality. If you consider rotational sports such as baseball, hockey, golf, and throwing sports (i.e. shot put, hammer throw), it’s easy to see that spinal rotation is a key component to the execution of movements specific to each sport. If an athlete cannot rotate adequately through their spine, the first compensation becomes lateral bend. This will limit power and efficiency and predispose the athlete to overuse syndromes. Using breathing exercises to help restore a neutral spine will potentially help restore rotation to the spine. As spinal rotation improves, this new range of motion is then re-integrated into sport-specific movements with emphasis on quality and control. The outcome of focused breathing exercises becomes improved joint mechanics, more efficient technique, more power, and less risk of overuse injury. This is just one of the reasons we want coaches to understand that our job is to make their life easier.
3. Decrease Injury Risk, Improve Recovery Injury prevention is a challenging task. There are several factors that play into specific athletic injuries, each carrying their own unique considerations and strategies to decreased risk. There are many factors that predispose athletes to injury and with targeted approaches, appropriate steps can be taken to reduce the risk of injury by focusing on improving joint/muscle function, reducing the impact of fatigue, and ensuring adequate recovery. We already discussed how breathing can improve joint and muscle function. Utilizing optimal breathing patterns can delay fatigue by assisting in maximum air/oxygen exchange, therefore delaying the point at which aerobic metabolism ceases and anaerobic processes kick in. This is especially important during high-intensity activity, when the demand for oxygen is critical to prevent accumulation of metabolic byproducts responsible for lowering pH levels and inducing fatigue. Ideal breathing will also accelerate the recovery process between intense bouts of exercise, therefore promoting recovery of the body’s energy systems. Following training and competition, the use of proper breathing patterns will help the body shift into more of a parasympathetic state. Returning to parasympathetic dominance is the essence of recovery and breathing is one tool that can be used to enhance recovery. More detail on the importance of recovery can be read in our article, Understanding The Role of Recovery in Health and Performance.

Chronic back and joint pain is a health problem which affects a relatively small number of people within the US, but has profound impacts on society and our healthcare system. This article looks to explain why the current medical model is failing the chronic back pain patient. The goal is to provide an understanding of why a greater focus on psychosocial factors and patient empowerment through education and progressive reactivation through physical activity, rather than imaging and exam findings, may result in improved management and outcomes for the chronic pain patient.

The Problem with the Traditional Medical Model
Back pain was believed to be a self limiting condition for the majority of individuals, meaning that the nature of back pain is that it would "run its course" and eventually pain would go away on its own.  Current research has demonstrated that this understanding of back pain is flawed, yet many clinicians still hold this belief. In fact, 85% of people with a single episode of low back pain will likely experience future recurrences and 2-8% of those individuals will develop chronic  back pain. How is chronic pain defined? Chronic pain is considered to be pain lasting longer than 12 weeks. Even though the percentage of chronic back pain patients remains relatively low, the impact on healthcare cost is significant. Chronic pain accounts for 75% of all healthcare costs related to low back pain, is second only to the common cold in missed days from work, and is the number one reason for workmen compensation claims.

Considering the burden chronic back pain places on healthcare resources, effective patient management appears to be an issue in need of addressing appropriately.

When dealing with the chronic back pain patient, the primary goal within the traditional medical model is to identify the structure responsible for generating pain by means of diagnostic imaging. This could mean the use of x-ray, ultrasound, MRI, CT or a combination of these procedures to determine what specific structure is the responsible for your pain. In his text, Rehabilitation of the Spine: A Practitioner's Manual, Liebenson states this is done for two main reasons:

1. The belief that structural pathologies seen with imaging are strongly correlated with pain symptoms.
2. Fear of missing serious disease, such as cancer, infection, or fracture.

Let’s start off with illustrating a scenario that may sound familiar to many of you:

As an athlete or someone who simply enjoys being active, you put in plenty of hours working out, training, practicing and competing.  Whether it’s running, jumping, throwing, swimming, skating, shooting, or swinging, you slowly begin to notice some minor irritation in a joint or muscle. It could be a knee, a shoulder, back, quad muscle, groin, foot, wrist, or your rotator cuff. You sense things don’t feel right, but you convince yourself it’s nothing serious. After all, it may be a little painful during activity and goes away quickly when you are done. Plus, you got an important game, match, or race coming up and you can’t afford to take any down time.

You decide to put conventional wisdom into practice and take it easy, resting as much as possible. You ice the area. After all, it’s what we have been told to do for years. You may even take it a step further and do some stretches to bring some relief to the area. If the pain is bad enough, you may reach for medication to help take the edge off.

However, over the course of weeks or months, you begin to notice this pattern occurring more frequency as your pain persists. It’s got you puzzled. Now your pain is not just present during training or sport, but you notice it with everyday tasks such as walking or opening doors. You could shrug off the pain before, but now pain during simple tasks has your attention. You may now be getting concerned since it’s not only taking less to cause pain, but your pain may be getting more intense. You may even start to avoid certain activities.

What you are learning and beginning to realize is that despite the efforts to ease your pain, your symptoms persist and are getting worse. Despite rest, ice, and medication, your symptoms are not improving.

Change the Approach
Contrary to what has been preached for years, it is now known that interventions such as rest, ice, anti-inflammatory medications and electrical stimulation will not solve your problem. The application of these interventions was based upon the assumption that inflammation within connective tissue or joints was created by repetitive motions and sustained postures associated with labor, sport, or other forms of activity. However, this assumption has been proven to be wrong. New understanding of overuse injury is providing the foundation for treatment that truly addresses the root cause of your symptoms, not merely alleviating them.

New Understanding
We all know someone who has been told they have tendinitis, or inflammation of a tendon. Tendinitis is commonly referred to as an “overuse” injury.

Tendons are the structures that connect muscle to bone. They are critical in transmitting the force produced by muscles during movement. It was believed that tendons, when injured or over-stressed, became inflamed and painful. Inflammation is the body's natural response to injury. Inflammation begins the healing process. Applications such as rest, ice, and anti-inflammatory medication are prescribed to minimize the effects of inflammation.

Interesting thing is, research has demonstrated that inflammation is rarely present within tendons, thus providing a new understanding of how overuse injuries develop.

Back in 1979, a couple surgeons by the name of Robert P. Nirschl and Frank A. Pettrone examined sections of injured elbow tendons under a microscope. What they found was no presence of inflammation. None. What they did notice was how the tendons had degenerated. Their color and texture had changed. The tendons were grayish and swollen rather than white and soft.

No inflammation? No tendinitis. Tendinosis is the correct name for this condition. Tendinosis is the result of repeated or sustained muscular contraction associated with poor movement or posture, which decreases blood supply. The body begins to react in similar ways as if you had injured muscular tissue and scar tissue development is triggered. This would be a normal response if there were actual damage, but the body has been tricked. There is no injury, but scar tissue accumulates in healthy tissue due to compromised circulation. Accumulated scar tissue increases mechanical stress on tendons, limiting normal function of muscle contraction. Limited function means reduced strength, range of motion, and can lead to pain during activity.

Now that we understand the mechanism behind scar tissue production, the deeper question is, "What is the underlying reason for poor movement or poor posture that is responsible for the overload?" Because if the reason was simply just sustained postures or repetitive movements, wouldn’t we see more of the population coming down with overuse injuries?

Mobility vs Stability: Stabilizing the Confusion
Mobility seems to be the buzzword of the fitness industry and it’s certainly popular among certain camps within the physical medicine profession. There are plenty of products, assessments, and even entire workouts that are devoted to mobility. Some define mobility as the ability to achieve a certain posture or position, while others define it as the ability to achieve a certain range of motion specific to a movement (i.e. squat, push-up).

Advocates of mobility claim that mobility should be achieved first. We need mobility and lack of mobility is implicated as a predisposing factor for overuse injury. But is mobility the secret to preventing overuse injuries and unlocking athletic performance?

While mobility is important, if we consider the developmental model, stability should be the primary focus.

Enter the Developmental Model
Developmental kinesiology, or essentially understanding how we develop motor function through early childhood, emphasizes the existence of central movement patterns that are “hard-wired” from birth. For example, an infant does not need to be taught when and how to lift its head, roll over, reach, crawl, or walk. Each and every one of these movement patterns occurs automatically as the CNS matures. During this process of CNS maturation, the brain influences the development of stability before purposeful movement can occur.

The process begins with the coordination of spinal stabilization and breathing through what is known as the integrated spinal stabilizing system (ISSS). This constitutes the “deep core” and it is activated subconsciously before any purposeful movement. The musculature of the ISSS  contracts automatically under the control of the nervous system. The role of the ISSS is critical because it provides a fixed, stable base from which muscles can generate movement. The ISSS is essential to maintaining joints in a neutral position, thus maximizing muscular forces with minimal stress to structures such as ligaments, capsules, and cartilage.

Bottom line: Inadequate activation and stabilizing function of muscles may place greater stress within the body, compromising posture and movement. Mobility is DEPENDENT upon stability. You need stability first before you can achieve purposeful, efficient motion. A deficient stabilizing system is likely to lead to strain or overuse injury due to compensatory movements.

Managing Overuse Injury
Now that we have a better understanding of why scar tissue develops in the body and factors that contribute to poor movement and posture, its time to discuss what can be done in the treatment and prevention of overuse injuries.

#1 - Myofascial Release Techniques. Understanding that overuse injuries are most often degenerative scar tissue problems rather than inflammatory conditions, treatment strategies should change accordingly. Rest, ice, anti-inflammatory medication, and electrical stimulation are no longer ideal treatments. Treatment that involves myofascial release or soft-tissue manipulation becomes the focus in order to breakdown scar tissue and allow for normalized muscle/tendon function. Clinicians or therapists are able to locate scar tissue by touch. The hand is a powerful tool.  Characteristics they evaluate for may include abnormal texture, movement restriction, or increased tension. Treatment is often delivered by the hand or with the use of an instrument and is non-invasive in nature.

#2 - Improve the stabilization function of muscle. To ensure quality movement during functional activities or sport skill execution, it is critical that all stabilizers of the body are adequately activated. Insufficiency within certain muscles in the kinetic chain will result in muscular imbalances that can contribute to chronic pain or poor performance. Corrective stabilization strategies thus should always be the foundational concept of any training or rehabilitation program. Clinicians are beginning to recognize the importance of “training the brain” since the majority of motor dysfunctions may be more related to altered CNS function than local joint or muscle issues. The CNS is the “driver” and attention must be given to how it coordinates muscular patterns during movement in order to provide stability.

For example, if someone has difficulty performing a squat, rather than focusing on local “tight” or “weak” muscles or restricted movement in a specific joint, one may need to realize that the insufficiency is due to a dysfunctional ISSS pattern at the brain level.

Rather than focusing on mobilizing a tight glenohumeral capsule/joint and strengthening the rotator cuff musculature in the treatment of shoulder impingement in a baseball pitcher, should you focus on an inadequate ISSS and the "weak" link in the kinetic chain, such as poor dynamic scapular stability, proprioceptive deficits, or impaired lower extremity mobility.

The body functions as a single unit during complex movement, not in segments. The key is to maintain control, joint stability, and quality of movement. Every joint position depends on the coordination of stabilizing muscle function throughout the entire body. Through repetition, ideal stabilization patterns are achieved and then integrated in with sport-specific movements.

Conclusion

New information has provided a deeper understanding of how overuse injuries develop and led to improved treatment. These concepts are foundational to the patient-care and sports performance training clients receive at Gallagher Performance. Myofascial release techniques can help offset the build-up of scar tissue within tendons or muscles, promoting normal function of those tissues. Ultimately, the ability to coordinate and control precise movement will minimize stress on the body and the trigger for scar tissue development. Developmental kinesiology provides a method for both assessment and the training or rehabilitation of muscular stabilization as it relates to efficient movement. The combination of these approaches not only reduces the risk of injury and pain syndromes resulting from overuse, but impacts sport performance.

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Janda V. Muscles and motor control in cervicogenic disorders. In: Grant R (ed). Physical therapy of the cervical and thoracic spine. 1^st edition. Churchill Livingstone, Edinburgh. 1994, pp 195-215.
Kibler WB. The role of the scapula in athletic shoulder function. AM J Sports Med. 1998;26(2):325-336.
Kolar P, Sulc J, Kyncl M, Sanda J, et al. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012;42(4):352-62.
Kolar P. Facilitation of Agonist-Antagonist Co-activation by Reflex Stimulation Methods. In: Craig Liebenson: Rehabiliation of the Spine – A Practioner’s Manual. Lippincott Williams & Wilkins, 2^nd edition 2006, 531-565.
McGill SM, Grenier S, Kavcic N, et al. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13(4):353-359.
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Panjabi MM. The stabilizing function of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-9.
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Schlottz-Christensen B, Mooney V, Azad S, et al. The Role of Active Release Manual Therapy for Upper Extremity Overuse Syndromes: A Preliminary Report. J of Occup Rehab. 1999;9(3).
 
 

An interesting dynamic has been developing in youth sports. The dynamic has been generated by the current nature of greater focus placed upon competition rather than athlete development. This is evident by the increasing number of games played at the youth level, commonly seen within travel or club organizations. Now, while this trend is not a favorable one and can actually be detrimental to youth athletic development, it has seemed to be the driving force for another trend.

The trend being the greater awareness and proactive nature some parents and young athletes are taking to become more educated on proper nutrition and training. The reality is, at the youth, club, and high school levels of sport, there is a competitive advantage to athletes who not only improve their athletic qualities (strength, speed, power, stamina, etc.), but also become healthier by making better food choices or finding ways to improve recovery.

When it comes to athletic development and preparation, there is no such thing as a “one size fits all” approach. There are far too many individual differences to account for. However, there are some basic principles or guidelines that most any aspiring athlete can implement and see results.

That said, here are five tips that can put you on track to experience better health and more consistent sport performance:

1. STRATEGIC FOOD SHOPPING
 When shopping for food, stay on the perimeter of the store. This is where you’ll find the best in whole food selection such as beef, chicken, fresh produce, and other food that should be the foundation of quality nutrition. The middle aisles mostly consist of processed foods. Sure they may taste awesome, but they do little to support the nutritional demands of young athletes.

2. READ FOOD LABELS
 The importance of reading food or ingredient lists cannot be stated enough. It's important that you know what you are consuming. Food labels can be misleading. For example, items can read “Low Fat” or “Non Fat” in an attempt to appear as a ‘healthier’ choice. However, if you read the label closely, you will find that these foods often have added sugar and/or artificial flavors. As we discussed in this article, fats, such as saturated fat are not the bad guy. Sure, you should avoid foods with trans fat, but the over-consumption of sugar and other processed foods will do more harm to your body than quality, healthy fat ever will.

Focus on selecting foods with a short ingredient list. Food manufactures appear to be taking notice, as they are producing a greater selection of foods with few and familiar ingredients to appeal to the consumer demand for healthier, natural foods.

3. EAT RIGHT, ALL DAY LONG
 When it comes to meals, you can find plenty of people who will advocate breakfast as the most important meal of the day. Others will say dinner. Some may even say lunch. Regardless of opinion, it’s more important to be consistent with your nutritional intake during the ENTIRE day. As a growing and developing athlete, simply focusing on nailing one meal won’t cut it.

It’s important to consume food at adequate levels throughout the day to replenish energy stores and promote an environment within your body that is essential for growth and repair.

4. IN-SEASON MAINTENANCE
 Strength and weight gains occur during the offseason. During the season, athletes need to focus on maintaining what they have built during their offseason.

Why?

With the abundance of practices and games during the season, athletes do not have the energy reserves and time to make strength or weight gains and recover in time for competition. Plus, many athletes can be banged up during the year, thus limiting what you can do with their training. This makes having a trainer or coach who understands how to work around minor injuries of tremendous value.

Establishing an in-season maintenance program can keep athletes healthier and performing at more consistent levels during the season. It also allows them to step into offseason training with greater ease and ahead of the game.

5. TRAIN SMARTER, NOT HARDER
 This is contrary to what almost every athlete hears at some point in their career. Athletes are told to train hard, work hard, etc. While hard work is necessary and valuable, there comes a point when being smart about your training is even more valuable.

Training should produce results. You should be getting something out of it rather than just being exhausted. It’s not difficult to make someone tired. Anyone can make you tired. Those trainers and coaches are a dime-a-dozen. What athletes need is someone that will produce results. There should be measurable gains in strength, speed, and power. If you are not seeing gains and simply becoming more and more tired, you need to start training smarter.

For additional reading on the difference between training smart vs. training hard, check out this article.

For those of you familiar with GP, you know we take the balance between training and recovery very seriously. It's a subject we feel we cannot educate our clients on enough. Recovery is too often a poorly understood or ignore aspect of training and the organization of sport (i.e. practice, competition). Many coaches and trainers push their athletes to the brink, attempting to build physical stamina and mental resilience. This is a part of sport and a necessary component to improving physical attributes such as strength, speed, and power. However, if you miss the boat on recovery, you could be sabotaging your efforts.

Why is recovery so important?
How much time do you spend training on a weekly basis, working towards physical or athletic goals? Probably not much, at least when compared to the amount of time spent between those sessions.

Training, regardless if you run, lift, swim, or skate, is a stimulus to the body. It's a stimulus for change and that stimulus will only generate results if you recover adequately between training sessions.

When recovery is poor, health and performance begin to suffer. This is the point at which many people describe themselves as "feeling flat" or “hitting a wall.” What they are communicating is low energy levels and an overall sensation of not feeling right. Fatigue has built-up because recovery has not been adequate. This state of fatigue can be referred to as “over-reaching" and in more serious cases it is known as "over-training."

Over-training can involve signs/symptoms such as:

• significant decreases in power or capacity of physical attributes such as strength, speed, or power
• significant and chronic joint and muscle pain
• significant changes in mood, such as depression
• significant sleep disruption
• major immune problems — frequent illness (i.e. bacterial/viral infections)
• hormonal suppression (i.e. low thyroid, low sex hormones, amenorrhea or irregular periods in women)

• low energy
• lack of motivation to train
• feeling "run-down"
• persistent sore and achey joints or muscles
• mild mood changes such as feeling more irritable, moody, or anxious

1. Central (CNS) - The central nervous system (CNS) serves the purpose of monitoring the body, similar to the function of a car engine regulator. If you "redline" the engine of your car too long, the engine shuts down. Your brain attempts to protect your body in the same fashion by reducing the ability of your body to "fire muscles" through nerve impulses.
2. Peripheral (muscular) - The other form of fatigue, peripheral, is related to energy system depletion and/or metabolic byproduct accumulation. Sticking with the car analogy, this is similar to running out of gas.

• Sympathetic activities – often referred to as “fight or flight”
• Parasympathetic activities – often referred to as “rest and digest”

• Low-intensity, aerobic-based exercise (cycling, walking, hiking)
• Massage
• Yoga
• Meditation
• Hot tub or sauna
• Relaxing hobbies such as reading or listening to music
• Meaningful relationships
• Drinking tea

• Sedentary individuals are at moderate risk for infection. Their immune system isn’t running as well as it could be.
• Individuals who are regularly active, using moderate intensity and variety in their training, demonstrate the most resistant immune systems.
• Individuals who are active, but consistently pushing the limits in workout frequency, duration, intensity, or loading without proper recovery put themselves at increased risk for becoming sick.

• Make a point of including 20-30 minutes of parasympathetic activity each day (i.e. meditation, massage, warm bath, good conversation, laughing, etc.)
• Consume nutrient dense foods at regular intervals, use herbs and spices, and drink adequate amounts of water and tea
• Consider using a carbohydrate, protein, BCAA, and/or creatine supplement as part of your peri-workout nutrition
• Incorporate variety into your training program
• Utilize low-intensity exercise on days between high-intensity training sessions to promote recovery (i.e. walking, cycling, swimming, flexibility work)
• Avoid the regular use of anti-inflammatory medications
• Make rest a priority and aim for 7-9 hours of sleep per night

There is no question that knee injuries are a common occurrence among athletes. The incident of devasting knee injury, such as ACL tears, has been on the rise for years. Once considered an adult injury, ACL tears are occurring more often in children as reported by orthopedic specialists, estimating that thousands of children and teens suffer an ACL injury each year. According to statistics presented at the American Academy of Pediatrics 2011 annual meeting, over the past decade youth ACL injuries have increased 400% and girls are at eight times the risk of an ACL tear as compared to boys. Clearly, there is a problem with knee injuries among youth athletes. But where is the solution?

Mechanism of Injury and Risk Factors
To identify a solution, we must first identify the problem. In this case, the problem is the mechanism(s) of injury most commonly associated with ACL injury. Keep in mind that about 2/3 of all ACL injuries are non-contacted related. Meaning, the athlete didn’t have someone tackle them or have a player roll-up on their leg, resulting in injury. Non-contact injury opens the door to the possibility that a large percentage of ACL injuries can be reduced or prevented. Here are the most common mechanisms of injury associated with ACL injury:

• Jumping/landing improperly
• Planting followed by cutting or pivoting
• Straight-knee landing
• Stopping or landing with the knee hyperextended (too straight)
• Sudden deceleration of movement

• Weak hamstring and gluteal (hip) muscles
• Poor neuromuscular control and balance
• Poor dynamic biomechanics (Jumping, landing, cutting, etc.)
• Fatigue
• Female Gender

1. Improve hamstring strength. The hamstring muscles have a critical role in maintaining healthy knees. Proper hamstring training and strengthening must take into consideration how the hamstrings function during the primary sporting movement(s). For example, land-based sports with an emphasis on jumping and sprinting ability will place a high demand on the hip extension action of the hamstring. The hamstrings must be trained accordingly to be able to meet and accommodate the forces generated during sport.
2. Improve hip and core strength. The musculature of the core and hips have a tremendous amount of control on the pelvis and femur, and thus the knee. Poor hip control puts the knee in compromising positions, increasing the risk of injury. When the core and hips are weak, they needs to be a focus of treatment/exercises. This will serve to improve the stability of the knee.
3. Improve Proprioception (Balance) and Neuromuscular Control. Sufficient proprioception and neuromuscular control is the difference between being able to ride a bike and falling on your butt every time you get on a bike. Understand that altered proprioception and neuromuscular control contribute to abnormal motion during dynamic sporting activities, such as cutting and jumping/landing. One study revealed, “Improved joint mechanics during landing were achieved regardless of the individual’s muscle strength, suggesting that strength may not always be a prerequisite for movement re-education.”  This should demonstrate the importance that mental focus and repetitive use of proper movement has on correcting mechanics.
4. Decrease fatigue. There are 2 types of fatigue, peripheral (muscles) and central (brain).  Peripheral refers to exercise induced processes leading to decreased force production (typical muscle fatigue).  Central fatigue relates to a gradual exercise-induced reduction in voluntary muscle activation. Essentially meaning the brain gets fatigued. It is plausible to say injury comes from both, however from an injury prevention stand point; peripheral fatigue is difficult to manage because your muscles will get fatigued.  But targeted training of central fatigue might be the way to go in preventing injury. How does one train central control. As one study put it, “Exposure to more complex or cognitively demanding movement tasks may facilitate improved perception and decision making within the random sports environment.” This is were mental focus and developing an athlete's awareness of their body during drills becomes important. Mental imagery may prove beneficial in developing central control by utilizing “mental reps” to help engrain proper movement and ideal mechanics.

1. Powers  CM, Souza RB. Differences in Hip Kinematics, Muscle Strength, and Muscle Activation Between Subjects With and Without Patellofemoral Pain. J Ortho Sports Physical Thearpy. 2009;39(1):12-19.
2. Powers CM. The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51. http://www.jospt.org/issues/articleID.2396,type.2/article_detail.asp.
3. Heiderscheit B. Lower Extremity Injuries: Is It Just About Hip Strength? J Ortho Sports Phys Ther. 2010;40(2):39-41. http://www.jospt.org/issues/articleID.2404,type.2/article_detail.asp.
4. Mizner R, Kawaguchi J, Chmielewski T. Muscle Strength in the Lower Extremity Does Not Predict Postinstruction Improvements in the Landing Patterns of Female Athletes. J Orthop Sports Phys Ther. 2008;38(6):353-361. http://www.jospt.org/issues/articleID.1408,type.2/article_detail.asp.
5. McLean SG, et al. Impact of Fatigue on Gender-Based High-Risk Landing Strategies. Medicine & Science in Sports & Exercise. October 2006.
6. McLean SG. Fatigue-Induced ACL Injury Risk Stems from a Degradation in Central Control. Medicine & Science in Sports & Exercise. January 2009.
7. Hilgefort M, Winchester B. Preventing ACL Injuries in Female Athletes.

Today's post takes on a bit of a different focus. It's more thought provoking than informational, but let's just say I had some inspiration to write this.
When I was young, you could say I was considered a decent artist.  I enjoyed drawing. So did my brothers. We preferred drawing mostly comic book characters and athletes. Our parents took notice of this artistic side and being the good parents they are, they signed us up for art classes to help us develop our artistic ability.

Outside of playing hockey, drawing was my main hobby. I did lots of drawings and many of them I still have to this day. It’s interesting to look back and see the progress in the quality of those drawings over the years. How I started out very unimpressive. Many of those early drawings are very amusing. But steadily, I developed my drawing abilities to replicate very detailed, very life-like objects or people.

I recall getting compliments such as, “You’re really talented” or “You have a gift.” I also remember hearing people saying, “I wish I could draw like that.” It was if people assumed I was naturally talented at drawing, that drawing somehow came “easy” to me.

Looking back though, I’m not so sure I was naturally talented when it came to drawing.

Yes, I produced some very realistic drawings. I did great work. But what fails to meet the eye is the understanding of how many hours and years it took for me to produce that very same artwork. Often times, hours were spent just to get a small feature to look the way I wanted it to. I wasn’t churning drawings out with effortless ease by any means. I would sit and study my subject matter. I would study each feature, the shading, the line angles, the negative space – anything and everything that made the object what it was. Then with my pencil and paper, I would work at replicating it until I got every last detail right.

Is that talent? To some, maybe it is. To me, it was not so much about talent as it was my willingness to spend more time at it than most. I wanted to get it right. I wanted my drawing to look just like what I was studying. In my opinion, the end result was the “appearance” of being good at it.

Now let’s fast-forward several years. I was considered a talented hockey player. I was pretty good. I accomplished a lot, but there are several other athletes that accomplished more that I ever did. The same can be said of my time competing as an amateur Strongman. I've won some contests and placed high in others. Yada yada yada.

What does art and all this talk about drawing have to do with my athletic accomplishments?

You see, it’s the exact same effect. I have never consider myself naturally talented as an athlete. It’s simply the attention to detail in the pursuit of my goals. It was spending countless hours skating and developing my puck skills, running sprints and lifting weights, and taking my rest and nutrition seriously.

Perhaps my only real talent is being driven and disciplined enough to achieve my goals, regardless of how long it takes me to realize them.

To sum up, I learned that if I want to be good at something, to be great at something, I needed to immerse myself in it. I learned that I need a high degree of focus and attention to detail. That I can’t waver in my pursuit. That if it takes me five hours to get a single detail right, that’s what I do. Anything less and I won’t improve. I won’t realize my potential.

Maybe you have learned the same lesson about yourself.

After all, who knows how many truly “naturally talented” people exist.

 
 

Lack of progress or results in any training or fitness program is a common frustration for many athletes and individuals. Let's take a look at two of the more common reasons why people fail to see results from their training efforts.

#1 – You Aren’t Training Correctly

“I don’t get it. I workout hard. I eat right. I follow advice. I feel like I’m doing everything right, but I just can’t seem to (plug your goal in here)”

• Was an assessment performed to understand if my body is prepared for the training ahead?
• Is my injury history accounted for and understood?
• Is this training program tailored to reach my goals?
• Am I going to learn proper lifting technique to minimize my injury risk?

What you need to know:

• For athletes, reaction time is highly important to success as many athletic events can be determined by tenths of a second.
• Outside of practice and training, chiropractic adjustments appear to improve reaction time.

"As a professional athlete, I am highly competitive - only accept the best. When it comes to healthcare, chiropractic is an essential service. It keeps on-field performance at its highest level and contributes to the success of the entire team!"

What you need to know:

• Training for speed is not the same as conditioning. Speed is an entirely separate physical trait than being "in shape".
• Sport-specific speed requires an understanding of the sport and the individual athlete to help maximize their speed potential.

# 1 - Train Powerful Legs NOT Quick Feet

# 3 - Speed Work and Conditioning Are Not the Same

# 4 - Make Lateral Starts and Transition Drills a Priority

The Problem
Youth, high school, college, and professional sports continue to rack up thousands of injuries each year. Despite advances in areas of sport such as equipment, coaching, and player safety guidelines, injury rates are not decreasing. In fact, many sport-related injuries have increased dramatically over the last decade, with a sharp rise in youth sport injuries as evident by some alarming statistics:

• High school athletes account for an estimated 2 million injuries and 500,000 doctor visits and 30,000 hospitalizations each year.
• Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students.
• Since 2000, there has been a fivefold increase in the number of serious shoulder and elbow injuries among youth baseball and softball players.
• According to the CDC (Centers for Disease Control and Prevention), more than half of all sports injuries in children are preventable.

I have been lifting ever since high school and have been all over the fitness spectrum since then.  In high school it was a simple program 3 sets of 10 for everything.  The programming didn't change much in college.  My results with this left me bulky and with stagnant numbers.  My bench, squat, deadlift max outs never changed no matter how hard I pushed myself with this programming.  So then I decided to leave the strength world and try high intensity interval training or HIIT. I read tons of articles, Internet blogs, etc. for workout ideas.

Fast forward after 5 years of HIIT, 6 days a week, an average workout time of 50 minutes, and the result was a 6’2”, 160 pound weakling with 3% body fat (measured by 7 point pinch test).  I found myself having to force myself to go to the gym. Every workout left me gasping for air and not enjoying it. I was extremely fatigued throughout the day and had difficulty concentrating. When you’re in a Doctorate program, you need all the concentration you can get. I didn't know where to turn because I had scoured the Internet and couldn't figure out how to program. I kept operating on the idea that "more training with higher intensity is better and who needs a deload week".

One day I had enough and set my goal: to get as strong as I possibly can. I heard about GP's training approach, so I went to talk to them to see what they had to offer. If you have read as much as I have on fitness blogs and articles, it is easy to separate those who know what they are talking about from those who don't. After talking with them and even seeing their own performance in the gym, I knew that GP was absolutely the place to turn to.

For the reader who wants to know the results I gained in 2 cycles (24 weeks):

• Deadlift -  went from 425 to 530
• Push Press - went from 165 to 270
• Front squat - went from 175 to 350 (and yes I sat on my heels)

What you need to know:

• Many endurance athletes have exhausted their means of improvement with traditional training.
• Training deficiencies, such as strength, can take your endurance capacity to new levels.

• Maintain and/or promote the building of muscle mass. This is a huge benefit because endurance training negatively impacts muscle mass, meaning many athletes lose precious muscle.
• Strengthen the endocrine and immune systems. Yet another big plus since chronic endurance training has a negative impact on both these systems.
• Promote adequate bone density. The importance of this should speak for itself, but this will be of special importance to runners when you consider the risk of stress fracture.

• Triathlete trained is one of the head researchers for PowerBar, has a PhD in nutrition.
• 8-10 lifts were performed per month in the 90-95% range of her 1RM (rep max)
• Special exercises performed were box squats, special deadlifts, good mornings, and a similar variety of pressing movements for upper body.
• No high repetition work was performed to avoid soreness and a high degree of effect on her traditional triathlon training.  Also, very little time is spent training in this manner.
• She was amazed at the results this training was giving her. She said that she “could now look at any hill, use muscles she never had, and was able to dig deeper than ever before, and have a posture that was solid as stone,” which made her much less fatigued at the end of the run. She had shaved 1/2 hour off of her Iron man, and did about 4 hours less work per week of traditional training.  She had gained 2lbs of weight from the beginning as she trained this way for 8 months. Her bodyfat went down about 2%, and she no longer had back pain, neck pain, and less nagging training injuries and setbacks.

"Training is efficient if the highest sport result is achieved with the least expense of time and energy".

What you need to know:

• Adequate water intake or hydration is determined by many factors.
• Common advice such as "Drink 8 cups of water a day" or "Drink half your body weight in ounces" are far too simplistic and may not provide you with the water you need.

"Dehydration of as little as 2% loss of body weight results in impaired physiological and performance responses."

• Cancers of the breast, colon, and urinary tract
• Urinary stone disease
• Mitral valve prolapse
• Childhood and adolescent obesity

What you need to know:

• Long term athlete development is a process that occurs over many years. This is not an "8 week program". Rather, it starts at an early age and continues on into adulthood. It is not simply a linear process, but is one that must be highly individualized to assist the athlete in reaching their full potential.
• The greatest challenge to coaches, parents, and athletes is the understanding of how difficult this process is. Athletes are dealing with massive changes in physical attributes, brain function, and sport skill acquisition. These all must be managed simultaneously while stressing the concepts of hard work in a positive environment.
The Case for Long-Term Development
When it comes to athletics, critical development begins at a very early age. As children mature, they progress through important developmental stages during their growth and maturation process. If long-term athletic development is of any importance to the coach, parent, or athlete, certain aspects of these stages must be addressed at appropriate time periods, otherwise the chances of the athlete reaching elite status is reduced.

Similar to other facilities and organizations that place importance on long term athlete development, the model used at Gallagher Performance began with a review of research and methods utilized in child and athletic development around the world. Through the review of current and past research/methods used with elite athletes and even military special operations, it was concluded that to truly address athlete development, a new way of looking at how to properly structure "strength and conditioning" programs must be considered.

Long-term athlete development models are being utilized around the world by more than 100 national sport organizations. For example, within the sport of hockey, there is no doubt that countries like the Czech Republic, Finland, and Sweden produce numerous NHL players. The numbers becoming even more impressive when considering the population of these countries. Each of those countries has placed the primary focus on long-term athlete development models.

Early Specialization in Sports: It's Not Working
Early specialization in sport is becoming increasingly more common among children in the United States. The rationale behind such a decision typically being if a child plays one sport, year round, they will be more advanced than their peers, more likely to be the 'star', get recruited, and/or possibly go on to make millions. Is this all fact or just wishful thinking?

Recent research from UCLA reveals that early specialization in sport has very poor connection with young athletes achieving elite status. A survey of almost 300 NCAA Division I athletes found that 88% played two or three sports as children and 70% did not specialize in one sport until after the age of 12. These findings were already understood in former East Germany and USSR within their youth development programs.

Studies in East Germany and the USSR found that children who went through an early specialization program did have more immediate improvement in their performances. But these children also had their best performances between the ages of 15-16, had greater inconsistencies, many quit or 'burnt out' by the age 18, and they had greater rate of injuries because of forced adaptation compared to children who played multiple sports and specialized later in life.

Now coaches are beginning to recognize the negative impact early specialization has on athletes. Brent Sutter, former NHL player and head coach/GM for the WHL's Red Deer Rebels had this to say about players who focus on hockey 10-12 months out of the year:

“You just don’t have as many players today that are as good athletes as they used to be. Too much today, especially in young players, is focused on hockey 12 months a year ... You really notice the guys who are true athletes and the ones who are not. The ones you can take and play baseball or soccer with them and they get it. This is noticeable even at the NHL level. The true athletes are a little bit further ahead ... I want our scouts to look at athletes not just strictly hockey players."

 
"He who treats the site of pain is often lost."

Despite what you may have been told, fat isn’t always the bad guy in the "Battle against the Bulge". Healthy fats such as monounsaturated fats, omega-3s fatty acids, and saturated fats - yes, you read that correctly - all can play a huge role in improving your health, memory, mood, and body composition. Let's take a look.

#1 - Better Health
The human body is about 97% saturated and monounsaturated fat, leaving the remaining 3 % to polyunsaturated fats. Half of that three percent is omega-3 fats, and that balance needs to be maintained. Vegetable oils contain very high levels of polyunsaturated fats, and these oils have replaced many of the saturated fats in our diets since the 1950s.

The body is in a constant state of rebuilding cells and producing hormones, two processes in which fats have a very important role. Regardless of what we consume through our diets, our bodies use the building blocks we give it. When we give it a high concentration of polyunsaturated fats instead of the ratios it needs, it has no choice but to incorporate these fats into our cells during cell repair and creation.

The problem is that polyunsaturated fats are highly unstable and oxidize easily in the body. In fact, they oxidize and become unstable during food processing and even light exposure while sitting in the grocery store. The oxidation of fat creates inflammation and mutation in cells. Inflammation has widespread affects on health and immune function. Inflammation is associated with conditions such as arthritis, asthma, and allergies and is now being identified as a key component in chronic diseases ranging from cardiovascular disease to diabetes to cancer.

Saturated fat is not the enemy. As a matter of fact, saturated fat is essential to optimal health and taking it out of your diet is a disaster waiting to happen.

#2 - Improve Memory, Enhance Mood
If you think fat only affects how you look, you’re in for a surprise. Studies are now demonstrating that staying mentally sharp and maintaing a balanced mood may be largely related to the type of fat you eat. Over the past decade, research continues to link omega-3 fatty acids to benefits ranging from better blood flow to improved mood and memory function.

The brain is 60% fat and thrives on smooth signaling between nerve cells — and the body refreshes these connections with a new supply of fatty acids. In a study published in Neurology, researchers found that those who ate fish regularly scored higher on a battery of tests for memory, psychomotor speed, cognitive flexibility and overall cognition. Furthermore, the researchers claimed that consuming EPA and DHA, fatty acids found in fish and fish oil, specifically contributed to the boost in brainpower. DHA has also been linked to decreasing the risk of Alzheimer's disease as well as overall cognitive decline.

When it comes to mood, studies show omega-3s can improve your mood. Research shows omega-3 fatty acids help nerve cells communicate better. This means feel-good brain chemicals like serotonin and dopamine can get in and out of cells more easily, translating into a better mood. Researchers from the National Institutes of Health report that omega-3 fatty acids are as effective at treating major depressive illness as commonly prescribed antidepressant drugs.

#3 - Less Body Fat, Leaner Physique
Consuming "good" fats can improve body composition and make you leaner. This comes as a surprise to many people because fat contains a lot of calories and is more calorie dense than carbohydrates and proteins. But not all fats have the same effect on the body.

Studies show that the body processes specific types of fat very differently. Essential fatty acids (EFAs), such as omega-3s, are not stored in the body. They are used to rebuild cells and make hormones, resulting in an energy expenditure increase in the body. This means that your body will burn more calories. This effect isn't limit to just EFAs either. When consumed in appropriate amounts, monounsaturated fats such as avocado and nuts do not appear to elevate body fat levels and help support hormone production. Saturated fat sources that are rich in medium-chain triglycerides (MCTs), such as virgin coconut oil and grass-fed butter, don't get stored as fat either and promote optimal body composition.

If you would like more detailed information on how fats can help you achieve your health or fitness goals, please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it..

 

Strength solves a lot of problems.

A high level of maximal strength is arguably the most important physical quality in performance and athletics. Regardless of whether you are an elite athlete, average Joe, weekend warrior, or someone who just wants to look and feel great, training to increase your strength levels with make you better. Period.

Here are three simple reasons why strength is important:

#1 - Move Better, Reduce Injury Risk
Adding strength to a balanced body will aid in preventing injury and help you move with greater ease. Greater ease means greater efficiency. Training for strength improves neuromuscular coordination, thus improving efficiency of movement. As strength increases, it simply takes you less effort to perform the same amount of work. Researchers have identified strength training and its association with stronger connective tissue, enhanced function of the muscle-tendon unit, and reduced injury rate due to improved neuromuscular function and greater muscle mass.

#2 - Be Faster, More Powerful
As you gain strength, the faster and more powerful you become. The body gains strength by motor unit recruitment and neural drive. This means that when you lift something heavy, the body will recruit more motor units and more muscle to accomplish the task. By continually challenging yourself with increasingly heavier weight, the body becomes more efficient and coordinated in its ability to recruit more motor units, activate more muscle and move weight more explosively.

Maximal strength training builds fast-twitch muscle fibers. The muscle that matters. Everyone can benefit from building the fast-twitch, powerful muscles from heavy strength training. All athletes perform at higher levels with improved strength, including distance runners, cyclists, rowers, martial artists, track and field athletes, gymnasts, swimmers, soccer, rugby, baseball, and hockey players. But it's not just for athletes either. Everyday tasks such as getting out of a chair, opening a jar, or lifting groceries all are depended on fast-twitch muscle. Strength is an important element of life because it simply makes daily tasks easier to perform.

#3 - Lose Fat, Gain Muscle by Training for Strength
A missing component of many fat-loss or muscle-building programs is lifting heavy weight. Over the long term, building fast-twitch muscle fibers with strength training increases metabolism. Increased metabolism means you burn greater amounts of calories, even at rest.

Boston University researchers explain,

“Type II muscle fibers have a previously unappreciated role in regulating whole-body metabolism through their ability to accelerate the energy burning processes in remote tissues.”

And if your goal is to gain more muscle, maximal strength is an essential component of your training. As mentioned previously, you gain all the benefits of Type II fibers in addition to the fact that Type II fibers can grow up to two times the size of Type I fibers. To achieve maximal hypertrophy, you have to tap into your Type II fibers with heavy weights. Research has demonstrated that near maximal strength training (93% or higher of 1RM or rep max) activates satellite cells. Satellite cells are dormant muscle cells within Type II fibers and they regulate hypertrophy. Maximal-load training causes greater activation of satellite cells and gene signaling involved in the process of building muscle.

Curious about what a strength training program can do for you? Contact us for more information at This email address is being protected from spambots. You need JavaScript enabled to view it..

References:
Aagaard, P., Andersen, J., Effects of Resistance Training on Endurance Capacity and Muscle Fiber Composition in Young Top Level Cyclists. Scandinavian Journal of Medicine and Science in Sports. 2011. Published Ahead of Print.
Andersen, J., Aagaard, P., Effects of Strength Training on Muscle Fiber Types and Size: Consequences for Athletes Training for High-Intensity Sport. Scandinavian Journal of Medicine and Science in Sports. 2010. 20(Suppl 2), 32-38.
Comfort, P., Haigh, A., et al. Are Changes in Maximal Squat Strength During Preseason Training Reflected in Changes in Sprint Performance in Rugby League Players. Journal of Strength and Conditioning Research. 2012. Published Ahead of Print.