SOCCER EDITION
Linear and COD sprinting
EDITORIAL: THE
SOCCER EDITION
By Chris Beardsley
Welcome to the Soccer Edition!
There is a huge amount of soccer research in this
month's edition. In fact, there is far too much to cover in
one editorial. So here is a quick rundown of the key
soccer studies, before I discuss some of the latest
research into linear sprinting and change of direction
(COD) ability, which are both very important for team
sports athletes, including soccer players.
Strength & Conditioning
In the Strength & Conditioning section, we cover a very
detailed analysis of the match activity of soccer athletes
by Taylor (2017), which includes some very important
detail about the total distance run by elite senior and
junior male and female soccer players, the number of
sprints, the distance sprinted, and the distance per
sprint, as well as the time spent in high-intensity running
not classified as sprinting, the number of accelerations,
decelerations, changes of direction, cutting maneuvers,
lateral shuffles, and jumps. This systematic review is a
great stride forwards for our practical understanding of
soccer match activity; most previous work has focused
extensively on linear sprinting, but COD ability may
actually be more important for team sports athletes. Also
in this section, we cover a valuable study in elite female
soccer players by Emmonds (2017), who explored
relationships between different strength and jumping
tests and both linear and COD sprints, and this study
made some very interesting findings that I will discuss in
my editorial below. Finally in this section, we cover a
study by Sams (2017), which assessed the ability of a
regular squat jump test for monitoring the state of
fatigue in Division I men's college soccer players.
Sports Medicine
In the Sports Medicine section, we cover a number of
studies in high-level soccer athletes. Van Dyk (2017)
reported some very controversial results, when they
showed that measures of hamstrings strength could not
predict future hamstring strain injury. In an equally
controversial study, Schuermans (2017) identified that a
low level of core stability leading to greater anterior
pelvic tilt was associated with hamstring strain injury.
Moving into slightly more familiar territory, Mosler (2017)
showed that groin injuries that cause time lost to either
training or competition affect 1 in 5 soccer players in a
club each year, Kili (2017) showed that professional
soccer players who suffered from severe musculoskeletal
time-loss injuries were 2 7 times more likely to develop
symptoms of common mental disorders in the following
12 months, and Clemente (2017) showed that when
soccer players have two fixtures in a single week, this is
associated with higher measures of self-reported fatigue
and muscle soreness, but lower internal training load (as
measured by the session rating of perceived exertion
multiplied by training session duration) and stress. All
very valuable for the medical teams of soccer clubs!
Introduction
Team sports athletes almost all use some lower body
strength training to help them improve linear sprinting,
as well as agility, by enhancing its physical component,
which is called COD ability. COD ability is tested by a
range of different COD maneuvers, which involve a rapid
series of whole-body movements, while changing velocity
through a series of decelerations and accelerations, while
maintaining balance at all times. Although many studies
have found that COD ability is closely related to linear
sprinting, other studies have reported weak or no
associations. This indicates that COD ability and linear
sprinting are unique qualities that must be developed
separately.
Comparing linear and COD sprints
Analyzing COD ability by using the Strength is Specific
framework reveals that COD ability differs from linear
sprint running in at least 4 very important ways: (1)
contraction mode, (2) velocity, (3) joint angle, and (4)
muscle group. Firstly, COD ability is far more dependent
upon eccentric-specific strength than linear sprinting,
because of its deceleration phases, which are critical to
the overall performance of the COD. Athletes who can
produce more force in the braking phase of a COD
maneuver have superior COD ability. This means that
eccentric-only or eccentric overload training is likely to be
extremely valuable for improving COD ability, and will
probably have an even greater effect on performance in
COD test than in tests of linear sprint running.
Secondly, COD ability is less dependent on high-velocity
strength than linear sprinting, because it involves lower
joint angular velocities, especially during sharp (180o)
COD maneuvers, in which the center of mass comes to a
complete stop before accelerating in the opposite
direction. Linear sprint running does not involve coming
to a complete stop at any point, so the angular velocities
are much higher. This also means that the ground contact
times in sprinting are longer in COD maneuvers. In linear
sprints, ground contact times are already as short as
150ms in the first few steps out of the blocks, and they
reduce thereafter. In contrast, during COD maneuvers,
ground contact times can be as low as 150 250ms for
the easier (45o) turns, 370ms for sharper (75o) turns,
and 440 460ms for the sharpest (180o) turns. Thus,
COD maneuvers appear to be closer to vertical jumping
than to linear sprinting in terms of the time available in
which to exert force. Consequently, developing maximum
strength by using heavy loads at low velocities will
probably transfer better to COD tests than to tests
involving linear sprint running, although improving high-
velocity strength will still have value, especially in those
muscle groups involved in the acceleration phase.
Thirdly, during linear sprinting, the joint angles of the hip
and knee during the ground contact phase range from
30o of flexion through to full extension, which means that
the prime movers are working mainly at short muscle
lengths. In contrast, in COD maneuvers, the hip and knee
joint angles are more flexed. This means that the hip
extensor and knee extensor muscles are producing force
when they are at more moderate (and not short) muscle
lengths. So partial range of motion exercises will likely
have less value for COD ability than for linear sprints.
Comparing linear and COD sprints continued... Importance of COD ability
Finally, although the main muscle groups are essentially In this edition, we cover a new review exploring the
the same in linear sprinting and COD maneuvers, their match activity of soccer athletes by Taylor (2017). This
relative importance is different. In linear sprint running, review identified the various match demands of soccer
the most important muscles are the hips (both hip athletes and unlike many previous reviews, it presented a
extensors and hip flexors), followed by the knee flexors very complete analysis, showing a range of different
(hamstrings). In contrast, during COD maneuvers, the types of activity, including both linear sprints and COD
knee extensors (quadriceps) are far more important, maneuvers. They noted that elite male soccer athletes
because of the critical role that they play in decelerating perform 50 100 accelerations per game, and that the
each COD maneuver, and although the hip extensors are number of decelerations per game may actually be higher
also key, the hip flexors play a very minor role. than the number of accelerations, based on a report by
Wehbe (2014) performed in Australian national league
Summary of determinants of COD ability soccer players. In addition, they noted that up to 700
COD activities have been recorded per game in high-level
Overall, COD ability seems to be determined by the
male soccer players, according to an analysis done by
ability to decelerate quickly, which requires eccentric-
Bloomfield (2007) of English Football Association Premier
specific strength firstly in the knee extensors (the
League athletes. Both of these observations underscore
quadriceps) and only secondarily in the hip extensors
the need to take COD ability (and therefore the ability to
(adductor magnus, gluteus maximus, and hamstrings)
decelerate) very seriously as a quality to develop in
while contracting at moderate muscle lengths. In the
soccer athletes, in addition to linear sprint running.
slightly less important acceleration phase of the COD
maneuver, high-velocity force production is key, and
Different determinants of COD and linear sprints
requires combined hip and knee extension a high speeds,
starting from the same moderate muscle lengths. In this edition, we also covered a study in elite female
soccer players by Emmonds (2017), who explored
Summary of determinants of linear sprinting ability relationships between different strength and jumping
tests and both linear and COD sprints. They found that
Linear sprint running ability seems to be determined
the single best predictors of linear sprint running and
primarily by the ability of the hip extensors (gluteus
COD ability were different from one another, and the best
maximus, adductor magnus, and hamstrings) and hip
predictor of linear sprint running was drop jump height,
flexors to do concentric work at high velocities while at
while the best predictors of COD ability were squat jump
short muscle lengths, and secondarily by the ability of
and countermovement jump (CMJ) heights. In fact, these
the knee flexors to absorb kinetic energy at long muscle
findings are exactly in line with the predictive ability of
lengths (and this requires hamstrings eccentric-specific
the Strength is Specific framework. The drop jump
strength).
involves short ground contact times and extremely high-
velocity joint angle movements, as well as the need to
Summary of training implications for COD sprints
recycle kinetic energy through the lower body in the
Based on the above analysis, we can identify that for
stretch-shortening cycle. It is therefore expected that the
improving COD ability, our main focus should be to
drop jump will be more closely related to linear sprinting
improve the ability to decelerate. And this requires a high
than other jump types. In contrast, the CMJ and squat
level of quadriceps eccentric strength at moderate muscle
jumps involve much longer ground contact times and
lengths. The flywheel squat or accentuated eccentric
slower joint angle movements, and are therefore more
parallel squat with heavy loads (with weight releasers)
closely related to COD ability. This is also why both
are ideal for this, and the reverse Nordic curl can be a
vertical jumping and COD ability usually seem to respond
valuable accessory exercise. We can also see that the
better to developing maximum strength through heavy
secondary focus should be to develop high-velocity
strength training, than linear sprinting.
strength in the acceleration phase, and exercises like the
trap bar deadlift jump or weighted vest jump with light
loads are very useful here. Conclusions
Soccer is a sport that requires a very wide range of
Summary of training implications for linear sprints physical qualities, ranging from aerobic fitness to
For improving linear sprint ability, our main focus should intermittent anaerobic high-intensity running ability, to
be to improve high-velocity strength of the hip flexors linear sprint running, and COD ability. Many analyses of
and extensors, which can be done by kettlebell swing, soccer performance focus closely on the needs for
jump squats, and resisted hip flexion, and our secondary aerobic fitness, intermittent high-intensity running ability,
focus should be to enhance eccentric hamstrings strength and linear sprinting, and do not emphasize the need for
by using exercises that overload this muscle during COD ability. Yet, based on recent literature, there may be
lengthening to at least moderate if not long muscle a larger role for COD ability in soccer than has previously
lengths, such as Nordic hamstring curls and flywheel leg been recognized. Moreover, it is becoming clear that the
curls. Conventional exercises like Romanian deadlifts will right strength training programs for linear sprinting and
never achieve increases in eccentric-specific strength, for COD sprints are not identical, because of the very
because they will always involve more force in the lifting different biomechanical demands. We should therefore be
phase than in the lowering phase, no matter how much cautious about applying the same training methods in
emphasis is placed on the eccentric, because force on team sports athletes that have been successfully used in
the way up is equal to gravity plus inertia, and force on track and field sprinters, as the demands of each sport
the way down is equal to or less than gravity. appear to differ substantially.
ANNOUNCEMENT
Farewell to Bret Contreras
In February 2012, Bret Contreras and Chris Beardsley
set up the Strength & Conditioning Research Review
together. Since that first edition, which was published
on 1st March 2012, there have been 67 editions, over
five and a half years.

Yet all great partnerships must eventually come to an

end. This 67th edition is the last one to be produced by
Bret Contreras and Chris Beardsley together, as Bret
steps away from his responsibilities to pursue exciting
new projects. In future, all editions will be both edited
and written by Chris.

Although Bret Contreras is most famous for his in-depth

understanding of the gluteus maximus (his followers
call him the glute guy), his understanding of all areas
of sports science is extraordinarily broad, and few other
researchers or strength coaches can match the breadth
of his knowledge. In his role as the editor of the
Strength & Conditioning Research Review, he has been
able to bring a very wide focus to each edition, ensuring
that we have covered all of the essential new studies
across many areas, including strength and conditioning,
biomechanics, anatomy and physiology, and physical
therapy and sports medicine. Without Bret on board this
project, this incredibly broad coverage would never
have been possible.

So please join us in thanking Bret for his amazing

contribution to the Strength & Conditioning Research
Review over the last five and a half years, for making it
a uniquely broad sports science review, and raising the
bar for science-based education in the fitness industry!

But don't go away with the idea that the future editions
of the Strength & Conditioning Research Review will be
sub-par. Chris is stepping strongly into the editorial
role, shifting the focus exclusively to our natural home
of strength and conditioning, while bringing his well-
honed infographic skills to bear. The next edition, on 1st
October, will address only the essential information
about strength, size, and sports performance, in full
color, with charts, diagrams, and unmissable content!
CONTENTS
EDITORIAL: THE SOCCER EDITION.....................................................................................................2
ANNOUNCEMENT................................................................................................................................ 6
#1. STRENGTH AND CONDITIONING, POWER, AND HYPERTROPHY.................................................. 11
1. Taylor, J. B., Wright, A. A., Dischiavi, S. L., Townsend, M. A., & Marmon, A. R. Activity Demands During
Multi-Directional Team Sports: A Systematic Review. Sports Medicine, 1-19..............................................12
2. Emmonds, S., Nicholson, G., Beggs, C., Jones, B., & Bissas, A. (2017). Importance of physical qualities for
speed and change of direction ability in elite female soccer players. Journal of Strength & Conditioning
Research........................................................................................................................................... 14
3. Ruas, C. V., Brown, L. E., Lima, C. D., Costa, P. B., & Pinto, R. S. (2017). Effect of three different muscle
action training protocols on knee strength ratios and performance. The Journal of Strength & Conditioning
Research........................................................................................................................................... 16
4. Lopes, C. R., Aoki, M. S., Crisp, A. H., de Mattos, R. S., Lins, M. A., da Mota, G. R., & Marchetti, P. H.
(2017). The Effect of Different Resistance Training Load Schemes on Strength and Body Composition in Trained
Men. Journal of Human Kinetics, 58(1).................................................................................................. 18
5. Senna, G. W., Rodrigues, B. M., Sandy, D., Scudese, E., Bianco, A., & Dantas, E. H. M. (2017). Heavy vs
Light Load Single-Joint Exercise Performance with Different Rest Intervals. Journal of Human Kinetics, 58, 197.
....................................................................................................................................................... 20
6. Chulvi Medrano, I., Rial Rebullido, T., Cortell-Tormo, J. M., Alakhdar, Y., La Scala Teixeira, C. V., Masi-
Tortosa, L., & Dorgo, S. (2017). Manual Resistance versus Conventional Resistance Training: Impact on
Strength and Muscular Endurance in Recreationally Trained Men.............................................................. 22
7. Harries, S. K., Lubans, D. R., Buxton, A., MacDougall, T. H. J., & Callister, R. (2017). Effects of 12-weeks
resistance training on sprint and jump performance in competitive adolescent rugby union players. The Journal
of Strength & Conditioning Research..................................................................................................... 24
8. Kamandulis, S., Bruzas, V., Mockus, P., Stasiulis, A., Snieckus, A., & Venckunas, T. (2017). Sport-Specific
Repeated Sprint Training Improves Punching Ability And Upper-Body Aerobic Power In Experienced Amateur
Boxers. The Journal of Strength & Conditioning Research........................................................................ 26
9. Townsend, J. R., Bender, D., Vantrease, W., Hudy, J., Huet, K., Williamson, C., & Mangine, G. T. (2017).
Isometric Mid-Thigh Pull Performance Is Associated With Athletic Performance And Sprinting Kinetics In
Division I Men And Women's Basketball Players. The Journal of Strength & Conditioning Research................28
10. Bachero-Mena, B., Pareja-Blanco, F., Rodrguez-Rosell, D., Yez-Garca, J. M., Mora-Custodio, R., &
Gonzlez-Badillo, J. J. (2017). Relationships Between Sprint, Jumping and Strength Abilities, and 800 M
Performance in Male Athletes of National and International Levels. Journal of Human Kinetics, 58(1)............30
11. Gonzlez-Badillo, J. J., Jimnez-Reyes, P., & Ramrez-Lechuga, J. (2017). Determinant Factors of the Squat
Jump in Sprinting and Jumping Athletes. Journal of Human Kinetics, 58(1)................................................ 32
12. Sams, M. L., Sato, K., DeWeese, B. H., Sayers, A. L., & Stone, M. H. (2017). Quantifying changes in squat
jump height across a season of men's collegiate soccer. The Journal of Strength & Conditioning Research.. . . .34
13. Ralston, G. W., Kilgore, L., Wyatt, F. B., & Baker, J. S. (2017). The Effect of Weekly Set Volume on
Strength Gain: A Meta-Analysis. Sports Medicine.................................................................................... 36
14. Chu, E., Kim, Y. S., Hill, G., Kim, Y. H., Kim, C. K., & Shim, J. K. (2017). Wrist Resistance Training
Improves Motor Control And Strength. Journal of strength and conditioning research.................................. 38
15. Bartolomei, S., Sadres, E., Church, D. D., Arroyo, E., Gordon III, J. A., Varanoske, A. N., & Hoffman, J. R.
(2017). Comparison of the recovery response from high-intensity and high-volume resistance exercise in
trained men. European Journal of Applied Physiology, 1-12...................................................................... 40
#2. BIOMECHANICS AND MOTOR CONTROL...................................................................................... 41
16. Schaefer, L. V., & Bittmann, F. N. (2017). Are there two forms of isometric muscle action? Results of the
experimental study support a distinction between a holding and a pushing isometric muscle function. BMC
sports Science, Medicine and Rehabilitation, 9(1), 11.............................................................................. 42
17. Prez-Castilla, A., McMahon, J. J., Comfort, P., & Garca-Ramos, A. (2017). Assessment of loaded squat
jump height with a free-weight barbell and Smith machine: comparison of the take-off velocity and flight time
procedures. The Journal of Strength & Conditioning Research...................................................................44
18. Sharif, N. A. M., Li, G. S., Usman, J., & Safwani, W. K. Z. W. (2017). Biomechanical and functional efficacy
of knee sleeves: A literature review. Physical Therapy in Sport................................................................. 46
19. Bampouras, T., Reeves, N., Baltzopoulos, V., & Maganaris, C. (2017). The role of agonist and antagonist
muscles in explaining isometric knee extension torque variation with hip joint angle. European Journal of
Applied Physiology.............................................................................................................................. 48
20. Quinlan, J. I., Maganaris, C. N., Franchi, M. V., Smith, K., Atherton, P. J., Szewczyk, N., & Williams, J. P.
(2017). Muscle and Tendon Contributions To Reduced Rate of Torque Development In Healthy Older Males. The
Journals of Gerontology: Series A......................................................................................................... 50
21. Thompson, B. J., Whitson, M., Sobolewski, E. J., & Stock, M. S. (2017). The influence of age, joint angle,
and muscle group on strength production characteristics at the knee joint. The Journals of Gerontology: Series
A...................................................................................................................................................... 52
22. Doguet, V., Nosaka, K., Guvel, A., Thickbroom, G., Ishimura, K., & Jubeau, M. (2017). Muscle length
effect on corticospinal excitability during maximal concentric, isometric and eccentric contractions of the knee
extensors. Experimental Physiology...................................................................................................... 54
23. Freitas, S. R., Mendes, B., Le Sant, G., Andrade, R. J., Nordez, A., & Milanovic, Z. Can chronic stretching
change the muscle-tendon mechanical properties? A review. Scandinavian Journal of Medicine & Science in
Sport................................................................................................................................................ 56
24. Kanda, K., Sakuma, J., Akimoto, T., Kawakami, Y., & Suzuki, K. (2017). Detection of titin fragments in
urine in response to exercise-induced muscle damage. PloS one, 12(7), e0181623..................................... 58
25. Garca-Ramos, A., Pestaa-Melero, F. L., Prez-Castilla, A., Rojas, F. J., & Haff, G. G. (2017). Differences
in the Load-Velocity Profile Between Four Bench Press Variants. International Journal of Sports Physiology and
Performance, 1.................................................................................................................................. 60
26. Bernard, J., Beldame, J., Van Driessche, S., Brunel, H., Poirier, T., Guiffault, P., & Billuart, F. (2017). Does
hip-joint positioning affect maximal voluntary contraction in the gluteus maximus, gluteus medius, tensor
fasciae latae and sartorius muscles? Orthopaedics & Traumatology, Surgery & Research.............................62
27. Lacourpaille, L., Nordez, A., Hug, F., Doguet, V., Andrade, R., & Guilhem, G. (2017). Early detection of
exercise-induced muscle damage using elastography. European Journal of Applied Physiology......................64
28. Allen, C. R., Fu, Y. C., Cazas-Moreno, V., Valliant, M. W., Gdovin, J. R., Williams, C. C., & Garner, J. C.
(2017). The Effects Of Jaw Clenching And Jaw Alignment Mouthpiece Use On Force Production During Vertical
Jump And Isometric Clean Pull. The Journal of Strength & Conditioning Research........................................66
29. Snarr, R. L., Hallmark, A. V., Casey, J. C., & Esco, M. R. (2017). Electromyographical Comparison of a
Traditional, Suspension Device, and Towel Pull-Up. Journal of Human Kinetics, 58(1), 5-13.........................68
#3. ANATOMY, PHYSIOLOGY, AND NUTRITION................................................................................ 69
30. Clifford, T., Howatson, G., West, D. J., & Stevenson, E. J. (2017). Beetroot juice is more beneficial than
sodium nitrate for attenuating muscle pain after strenuous eccentric-bias exercise. Applied Physiology,
Nutrition, and Metabolism....................................................................................................................70
31. Dankel, S. J., Mattocks, K. T., Jessee, M. B., Buckner, S. L., Mouser, J. G., & Loenneke, J. P. (2017). Do
metabolites that are produced during resistance exercise enhance muscle hypertrophy?. European Journal of
Applied Physiology.............................................................................................................................. 72
32. Christou, M. A., Christou, P. A., Markozannes, G., Tsatsoulis, A., Mastorakos, G., & Tigas, S. (2017).
Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A
Systematic Review and Meta-Analysis. Sports Medicine........................................................................... 74
33. Methenitis, S., Spengos, K., Zaras, N., Stasinaki, A. N., Papadimas, G., Karampatsos, G., & Terzis, G.
(2017). Fiber Type Composition And Rate Of Force Development In Endurance And Resistance Trained
Individuals. The Journal of Strength & Conditioning Research................................................................... 76
34. Bagley, J. R., McLeland, K. A., Arevalo, J. A., Brown, L. E., Coburn, J. W., & Galpin, A. J. (2017). Skeletal
Muscle Fatigability and Myosin Heavy Chain Fiber Type in Resistance Trained Men. The Journal of Strength &
Conditioning Research, 31(3), 602........................................................................................................78
35. Pardue, A., Trexler, E. T., & Sprod, L. K. (2017). Case Study: Unfavorable But Transient Physiological
Changes During Contest Preparation in a Drug-Free Male Bodybuilder. International Journal of Sport Nutrition
and Exercise Metabolism, 1................................................................................................................. 80
36. Zinn, C., McPhee, J., Harris, N. K., Williden, M., Prendergast, K., & Schofield, G. (2017). A 12-week low
carbohydrate, high fat (LCHF) diet improves metabolic health outcomes over a control diet in a randomised
controlled trial with overweight defence force personnel. Applied Physiology, Nutrition, and Metabolism........82
37. Halperin, I., Vigotsky, A. D., Foster, C., & Pyne, D. B. (2017). Strengthening the Practice of Exercise and
Sport Science. International Journal of Sports Physiology and Performance, 1-26.......................................84
#4. PHYSICAL THERAPY AND REHABILITATION............................................................................... 85
38. Kruse, N. T., & Scheuermann, B. W. (2017). Cardiovascular Responses to Skeletal Muscle Stretching:"
Stretching" the Truth or a New Exercise Paradigm for Cardiovascular Medicine? Sports Medicine...................86
39. Van Dyk, N., Bahr, R., Burnett, A. F., Whiteley, R., Bakken, A., Mosler, A., & Witvrouw, E. (2017). A
comprehensive strength testing protocol offers no clinical value in predicting risk of hamstring injury: a
prospective cohort study of 413 professional football players. British Journal of Sports Medicine...................88
40. Schuermans, J., Van Tiggelen, D., Palmans, T., Danneels, L., & Witvrouw, E. (2017). Deviating running
kinematics and hamstring injury susceptibility in male soccer players: Cause or consequence? Gait & Posture,
57, 270............................................................................................................................................. 90
41. Serner, A., Weir, A., Tol, J. L., Thorborg, K., Roemer, F., Guermazi, A., & Hlmich, P. (2017).
Characteristics of acute groin injuries in the hip flexor muscles a detailed MRI study in athletes. Scandinavian
Journal of Medicine & Science in Sports................................................................................................. 92
42. Mosler, A. B., Weir, A., Eirale, C., Farooq, A., Thorborg, K., Whiteley, R. J., & Crossley, K. M. (2017).
Epidemiology of time loss groin injuries in a men's professional football league: a 2-year prospective study of
17 clubs and 606 players. British Journal of Sports Medicine.................................................................... 94
43. Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A., Taeymans, J., & Hilfiker, R. (2017). Effectiveness of
conservative interventions including exercise, manual therapy and medical management in adults with
shoulder impingement: a systematic review and meta-analysis of RCTs. British Journal of Sports Medicine.. . .96
44. Andersson, S. H., Bahr, R., Clarsen, B., & Myklebust, G. (2017). Risk factors for overuse shoulder injuries
in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed. British Journal of
Sports Medicine................................................................................................................................. 98
45. La Touche, R., Paris-Alemany, A., Hidalgo-Prez, A., Lpez-de-Uralde-Villanueva, I., Angulo-Diaz-Parreo,
S., & Muoz-Garca, D. (2017). Evidence for central sensitization in patients with temporomandibular
disorders: a systematic review and meta-analysis of observational studies. Pain practice...........................100
46. Cavanaugh, M. T., Aboodarda, S. J., Hodgson, D., & Behm, D. G. (2016). Foam Rolling of Quadriceps
Decreases Biceps Femoris Activation. The Journal of Strength & Conditioning Research.............................102
47. Nascimento, J. D. S. D., Alburquerque-Sendn, F., Vigolvino, L. P., Oliveira, W. F., & Sousa, C. O. (2017).
Inter and intraexaminer reliability in identifying and classifying myofascial trigger points in shoulder muscles.
Archives of Physical Medicine and Rehabilitation................................................................................... 104
48. Clemente, F. M., Mendes, B., Nikolaidis, P. T., Calvete, F., Carrio, S., & Owen, A. L. (2017). Internal
training load and its longitudinal relationship with seasonal player wellness in elite professional soccer.
Physiology & Behavior, 179, 262........................................................................................................ 106
49. Kili, ., Aoki, H., Goedhart, E., Hgglund, M., Kerkhoffs, G. M. M. J., Kuijer, P. P. F. M., & Gouttebarge, V.
(2017). Severe musculoskeletal time-loss injuries and symptoms of common mental disorders in professional
soccer: a longitudinal analysis of 12-month follow-up data. Knee Surgery, Sports Traumatology, Arthroscopy.
...................................................................................................................................................... 108
50. Lima, Y. L., Ferreira, V. M. L. M., de Paula Lima, P. O., Bezerra, M. A., de Oliveira, R. R., & Almeida, G. P.
L. (2017). The association of ankle dorsiflexion range of motion and dynamic knee valgus: A systematic review
and meta-analysis. Physical Therapy in Sport....................................................................................... 110
#1. STRENGTH AND CONDITIONING,
POWER, AND HYPERTROPHY
Taylor, J. B., Wright, A. A., Dischiavi, S. L., Townsend, M.
A., & Marmon, A. R. Activity Demands During Multi-
Directional Team Sports: A Systematic Review. Sports
Medicine, 1-19.
Link to abstract
Background
Agility and change of direction (COD) ability are separate
skills. COD ability involves performing a rapid series of
whole-body movements in combination with a change in
velocity. This rapid series of movements involves first
decelerating, then changing direction, and finally
accelerating, while maintaining balance at all times.
Agility is defined as the ability to perform a COD
movement in response to an external signal. Essentially,
agility is the same as COD ability, but also includes a
split-second decision-making element that COD ability
does not. Agility is therefore more sports-specific for
most team sports athletes, who frequently need to
respond to the actions of other players on the pitch, in
order to evade them and score goals or points. It is
therefore unsurprising that the research generally finds
that agility is a better predictor of athletic ability in team
sports than COD ability. Even so, COD ability is still
useful, as it much more easily measured reliably than
agility. This is because a COD ability test can involve pre-
determined paths that are followed by the athlete in the
same way every time, such as zig-zag runs, shuttle runs,
or runs with 90-degree turns to either the left or to the
right. COD ability is believed to be a mainly physical
property that is fairly closely related to other athletic
performance measures, such as sprint running, vertical
jumping, and lower body strength and power output.
However, the strength of the relationship between COD
ability and each of these other physical properties
depends upon the COD ability test. As you might expect,
COD ability tests with long sections of sprint running are
fairly well-correlated with sprint running ability. On the
other hand, COD ability tests that have very short
sections of sprint running but a great many changes in
direction tend to show a much closer association with
maximal force producing abilities, because there is a
need to decelerate and accelerate much more often.
OBJECTIVE: To perform a systematic review to describe
the straight-line running and multi-directional running
activities during team sports.
STUDY SELECTION: Studies were included if they were
written in English, provided motion analysis data for the
full duration of a team sports competition match carried
out on a full-sized court or pitch with the regulation
number of players in any of the following sports (soccer,
basketball, lacrosse, handball, field hockey, futsal,
volleyball), where the motion analysis data covered
details of the amount of straight-line running, (including
both accelerations and decelerations), multi-directional
running, jumping, cutting, or lateral movement.
What happened?
Studies selected
A total of 81 studies were included (47 from soccer, 11
from basketball, 9 from handball, 7 from field hockey, 4
from volleyball, and 3 from futsal). The activity demands
of each sport were different from one another (only the
soccer results are shown below).
Soccer findings
Overall, total distance run by elite male soccer players in
a match ranged between 9 12km, while elite female
soccer players run between 9.6 10.4km. Junior soccer
players run smaller distances in both male and female
competitions. Total distances traveled while sprinting
varied according to measurement method, and velocity-
based measures indicate a range in elite males of 117
831m, while qualitative measures indicate a range of 194
1,100m. Typical ranges in elite female soccer players
were 160 615m, and junior athletes sprinted for a
shorter total distance than senior athletes. Total number
of sprints was similar across all ages and across both
males and females, at 7 61 sprints per match, and
each sprint averaged 2 seconds. In terms of high-
intensity running, elite males run between 222 1,900m
per match, junior males run 468 1,740m per match,
elite females run 608 2,452m per match, and junior
females run 458 658m per match. Male athletes
average 69 168 high-intensity running efforts per
match for 1.3 4.4 seconds each in duration, while
females average 125 376 high-intensity running efforts
per match for 2.3 seconds each in duration. Elite male
athletes do 52 100 accelerations per game, while elite
females do 423 accelerations per game. Limited evidence
suggests that the number of decelerations per game may
be higher than the number of accelerations. The number
of cutting maneuvers varied widely according to the
exact definition of the activity, but up to 700 such
changes in direction have been recorded per game in
male soccer players. In addition, a total of 217 549m
per game is traveled during lateral shuffle maneuvers.
Finally, elite males soccer athletes jump 10.4 5.4 times
per game, but junior male soccer players only jump 0.9
3.6 times per game.
What did the researchers conclude?
The researchers concluded that the activity demands of
each sport are different from one another, but the
majority of research has been performed in soccer.
Limitations
The study was limited by the availability of literature.
Emmonds, S., Nicholson, G., Beggs, C., Jones, B., & Bissas,
A. (2017). Importance of physical qualities for speed and
change of direction ability in elite female soccer players.
Journal of Strength & Conditioning Research.
Link to abstract
Background
Agility and change of direction (COD) ability are separate
skills. COD ability involves performing a rapid series of
whole-body movements in combination with a change in
velocity. For a detailed introduction to COD ability, see
the earlier study review.
OBJECTIVE: To identify the physical qualities that
determine linear sprint running speed and change of
direction (COD) ability in elite female soccer players.
MEASUREMENTS: Stature was measured using a
stadiometer, and bodyweight using a standard scale;
body composition was recorded using dual-energy X-ray
absorptiometry (DEXA) to calculate total fat mass (FM),
total fat-free mass (FFM) and percentage body fat; linear
sprint running speeds over 10m, 20m, and 30m were
measured by timing gates; COD ability was recorded by a
505 test using timing gates, and the difference between
505 test time and 10m sprint time was reported as the
COD deficit; countermovement jump (CMJ) height, squat
jump (SJ) height, and drop jump (DJ) height from a
40cm box were each measured by a force plate, along
with reactive strength index (RSI) for the drop jump;
maximum voluntary isometric contraction (MVIC) knee
extension force and rate of force development (RFD)
were measured using a force plate connected to a
custom-made isometric device
SUBJECTS: 10 female soccer players, aged 25.4 7.0
years, from the professional English Womens Super
League team, who were regularly performing 4 5 field
based training sessions per week and 1 2 strength
training workouts.
What happened?
There were 3 eigenvectors that explained the majority of
the variance in the data set, with each of the first two
eigenvectors representing 32 34% of the variance, and
the third representing 14%. The relatively small number
of eigenvectors was also demonstrated by the strong
associations between several groups of the variables. In
one eigenvector, COD deficit was strongly associated with
COD speed (r = 0.86), 10m sprint speed was strongly
associated with 20m sprint speed (r = 0.86), COD deficit
was strongly associated with 10m sprint speed (r =
0.76), COD deficit was strongly associated with 20m
sprint speed (r = 0.83). In another eigenvector, SJ
height and CMJ height were closely related (r = 0.92), as
were SJ RFD and CMJ RFD (r = 0.59), SJ RFD and SJ
height (r = -0.75), CMJ height and CMJ RFD (r = -0.76),
and between DJ height and CMJ height (r = 0.94). By
incorporating multiple variables from each eigenvector
into a multiple linear regression model, the key
performance variables of linear sprint running and COD
ability could be explained with nearly 100% accuracy.
The single best predictor of linear sprint running was
drop jump height, while the single best predictors of COD
ability and the COD deficit were SJ and CMJ heights.
What did the researchers conclude?
The researchers found that sprinting ability is best
explained by characteristics of the very fastest stretch-
shortening cycle jumps (like drop jump height), while
COD ability is best explained by characteristics of slower
stretch-shortening cycle jumps (like CMJ and SJ heights).
Limitations
The study was limited as only a small population were
studied, and different results might be observed in other
groups.
Ruas, C. V., Brown, L. E., Lima, C. D., Costa, P. B., & Pinto,
R. S. (2017). Effect of three different muscle action training
protocols on knee strength ratios and performance. The
Journal of Strength & Conditioning Research.
Link to abstract; link to full text
Background
Muscle action is varied during resistance training when
researchers compare eccentric-only (lengthening),
concentric-only (shortening) or combined (stretch-
shortening cycle) muscle actions. These comparisons can
be made using either isokinetic (constant velocity) or
isoinertial (constant load) types of resistance. It has been
suggested that eccentric-only training might be beneficial
for muscular adaptations (both strength and size) for
several reasons, as follows. Eccentric-only muscle actions
involve a lower energy cost for the same amount of
mechanical tension. Thus, lifters are able to perform a
greater volume of work while taxing their work capacity
to the same degree. Eccentric-only muscle actions enable
athletes to lift a larger amount of weight than during
concentric-only or stretch-shortening cycle muscle
actions with the same percentage of 1RM. This may
produce a higher level of mechanical tension for the
same relative load, and therefore greater adaptations.
Eccentric-only muscle actions may cause earlier
activation of the higher threshold motor units which are
capable of displaying greater amounts of force. However,
the long-term literature is conflicting, particularly when
reviewing isokinetic or isoinertial studies separately, and
when assessing trained and untrained subjects,
separately. To read a full review regarding the effects of
muscle action in strength training on hypertrophy, visit
the S&C Research encyclopedia page HERE. To read a full
review on the effects of muscle action on strength gains,
visit the S&C Research encyclopedia page HERE.
OBJECTIVE: To compare the effects of 3 different
training programs using combinations of concentric and
eccentric phases for the quadriceps and hamstrings, with
an isokinetic dynamometer, in untrained males.
MEASUREMENTS: Concentric and eccentric quadriceps
and hamstrings torques were measured by isokinetic (at
60o/s through a 90o range of motion, where 0o = full
extension) and isometric (at 60o of knee extension) knee
extension and knee flexion torque in a dynamometer;
rate of torque development (RTD) was recorded in the
isometric tests; a conventional hamstrings-to-quadriceps
strength ratio was calculated as concentric knee flexion
to concentric knee extension torques; a functional
hamstrings-to-quadriceps strength ratio was calculated
as eccentric knee flexion to concentric knee extension
torques; vertical jump tests were done on a force plate,
including countermovement jump (CMJ), squat jump
(SJ), and drop jump (DJ) from a 40cm box; 40m sprint
time was recorded on an outdoor playing field, using
electronic timing gates.
SUBJECTS: 40 untrained males, aged 22.87 2.28
years, allocated into 1 of 4 groups: concentric quadriceps
and concentric hamstring (CC), eccentric quadriceps and
eccentric hamstring (EE), concentric quadriceps and
eccentric hamstring (CE), and no training (CONTROL).
INTERVENTION: All 3 training groups did 2 workouts
per week for 6 weeks, using 10 reps for each set. The
first week used 1 set, and an extra set was added each
week for a total of 6 sets in week 6. When doing
concentric efforts, the groups started with reps at 210o/s
and when doing eccentric reps, the groups started with
reps at 60o/s; each week, velocity was decreased by
30o/s for concentric reps, and increased by 30o/s for
eccentric reps, to reach 60o/s during concentric reps and
210o/s during eccentric reps in week 6, respectively.
What happened?
EE displayed the largest increase in the functional ratio (d
= 1.56). However, quadriceps RTD and hamstrings RTD
were increased most by CC (d = 1.23 and 0.58). CMJ
height, DJ height, and SJ height were improved most by
EE (d = 0.78, 0.87, and 1.27). Similarly, the 40m sprint
time was improved most by EE (d = -0.41).
What did the researchers conclude?
The researchers concluded that in this group of untrained
males, the EE training group improved the functional
ratio by most, as well as the measures of jumping and
sprinting. However, the CC group was most effective at
increasing RTD. This underscores the importance of high
mechanical load (in eccentric actions) for developing
maximum strength, and the need for a high level of rate
coding (in concentric actions) for improving high-velocity
strength through increased rate of force development.
Limitations
The study was limited as it was unclear whether the
same effects would be observed in trained subjects.
Lopes, C. R., Aoki, M. S., Crisp, A. H., de Mattos, R. S., OBJECTIVE: To compare effects of moderate and light
Lins, M. A., da Mota, G. R., & Marchetti, P. H. (2017). The load strength training to failure with the same number of
Effect of Different Resistance Training Load Schemes on total reps per workout, on gains in maximum strength
Strength and Body Composition in Trained Men. Journal of and body composition, in strength-trained males.
Human Kinetics, 58(1).
MEASUREMENTS: Maximum strength was measured by
Background 1RM back squat and 1RM bench press; body composition
(including fat mass (FM) and fat-free mass [FFM]), was
It was traditionally assumed that a threshold for relative
estimated by skinfold thickness measurements with a
load (percentage of 1RM) existed, below which gains in
skinfold caliper.
muscular strength and size will not occur. However,
recent research has shown that while strength and rate SUBJECTS: 16 males with strength-training experience,
of force development are both maximized by training allocated to either a moderate load group (MOD, 8
using heavier loads, training with both high and low loads subjects, aged 24.6 5.8 years with 2.3 1.4 years of
can achieve similar levels of muscle growth. Some strength-training experience) or to a light load group
researchers have suggested that there may be fiber-type (LIGHT, 8 subjects, aged 28.6 6.0 years, with 3.1
specific gains in muscle size, where low loads bring about 1.6 years of strength-training experience).
larger gains in muscle size in type I fibers, while high
loads bring about larger gains in the muscle size of type INTERVENTION: All subjects did 4 workouts per week
II fibers, although several studies now indicate that this for 6 weeks. MOD did 6 sets of 10RM with 1 minute of
is not the case. If shown to be accurate, training with rest between sets and 3 minutes of rest between
both high and low loads could be optimal for maximal exercises. Subjects in LIGHT did 3 sets of 20RM, with 1
hypertrophy. However, early research exploring the minute of rest between sets and 3 minutes of rest
effects of using varying loads is not promising. To read a between exercises. Loads were adjusted both within and
full review about the effects of relative load in strength between workouts to ensure muscular failure at the right
training on gain in muscular size, visit our encyclopedia number of reps in each set. In each workout, there were
page HERE. To read a full review about the effects of 8 exercises, including the back squat and bench press.
relative load on strength gains, visit the S&C Research
encyclopedia page HERE. What happened?
The 1RM bench press improved similarly in both groups
(MOD = 6.4 2.5%; LIGHT = 4.9 1.2%), with a trivial
effect size (Cohen's d = 0.14 0.19). Similarly, the 1RM
back squat increased similarly in both groups (MOD =
10.5 7.0%; LIGHT = 8.0 1.9%) with a trivial effect
size (d = 0.15 0.22). Estimated FFM also increased
similarly in both groups (MOD = 4.7 1.0%; LIGHT =
3.7 1.7%) with a small effect size (d = 0.40 0.46).
Estimated FM decreased in both groups (MOD = 4.8
6.3%; LIGHT = 7.7 2.8%) with a small effect size (d
= 0.51 0.56).

What did the researchers conclude?

The researchers found that strength training programs
with either moderate (10RM) or light (20RM) loads
produce similar gains in maximum strength and muscle
growth, when the same number of reps are performed in
each workout, in strength-trained males.

Limitations
The study was limited by the short duration of the study,
and by the use of body composition measured with
skinfold calipers to estimate fat-free mass.
Senna, G. W., Rodrigues, B. M., Sandy, D., Scudese, E.,
Bianco, A., & Dantas, E. H. M. (2017). Heavy vs Light Load
Single-Joint Exercise Performance with Different Rest
Intervals. Journal of Human Kinetics, 58, 197.
Link to abstract; link to full text
Background
It was traditionally assumed that a threshold for relative
load (percentage of 1RM) existed, below which gains in
muscular strength and size will not occur. However,
recent research has shown that while strength and rate
of force development are both maximized by training
using heavier loads, training with both high and low loads
can achieve similar levels of muscle growth. Some
researchers have suggested that there may be fiber-type
specific gains in muscle size, where low loads bring about
larger gains in muscle size in type I fibers, while high
loads bring about larger gains in the muscle size of type
II fibers, although several studies now indicate that this
is not the case. If shown to be accurate, training with
both high and low loads could be optimal for maximal
hypertrophy. However, early research exploring the
effects of using varying loads is not promising. To read a
full review about the effects of relative load in strength
training on gain in muscular size, visit the S&C Research
encyclopedia page HERE. To read a full review about the
effects of relative load on strength gains, visit the S&C
Research encyclopedia page HERE.
OBJECTIVE: To compare the effects of short (1 minute),
moderate (3 minutes) and long (5 minutes) rest period
durations on the number of reps that can be done in each
set of a multiple-set workout, with both light (50% of
1RM) and heavy (80% of 1RM) loads, in strength-trained
males.
MEASUREMENTS: The number of reps in each set were
counted; the rating of perceived exertion (RPE) was
measured by the adult OMNI Perceived Exertion Scale for
Resistance Exercise (OMNI-RES) after each set of each
exercise.
SUBJECTS: 16 males, aged 20.75 2.54 years, with >1
year of strength training experience.
INTERVENTION: All subjects did 6 workouts using the
single-joint triceps pull-down exercise, with either 50% of
1RM or 80% of 1RM and with either 1, 3 or 5 minutes of
rest between 4 sets, with >48 hours of recovery between
workouts.
What happened?
With 50% of 1RM, the subjects did 63.56 16.7 reps in
the workout with a 1-minute rest, 78.44 20.3 reps in
the workout with a 3-minute rest, and 87.37 19.4 reps
in the workout with a 5-minute rest. Therefore, there
were differences between each rest period duration, and
each increase in rest allowed more reps to be performed.
With 80% of 1RM, the subjects did 21.50 6.2 reps with
a 1-minute rest, 31.69 8.8 reps with a 3-minute rest,
and 32.87 7.7 reps with a 5-minute rest. Therefore,
there was only a difference between 1-minute rest and
either 3-minute or 5-minute rests, while there was no
difference between 3-minute and 5-minute rests. Yet
there were reductions in the number of reps performed
from each set to the next with both loads and with all
rest period durations, and the size of this reduction was
much greater with the shortest rest period.
What did the researchers conclude?
The researchers found that rest period durations of up to
5 minutes can be used to increase total workout volume
when using light loads, but rest period durations of up to
3 minutes can be used to increase total workout volume
when using heavy loads, with single-joint exercises.
Limitations
The study was limited as it only tested a single-joint
exercise, and it is unclear whether the same results
would be observed with a multi-joint exercise.
Chulvi Medrano, I., Rial Rebullido, T., Cortell-Tormo, J. M., OBJECTIVE: To compare the effects of long-term
Alakhdar, Y., La Scala Teixeira, C. V., Masi-Tortosa, L., & strength training programs with either manual resistance
Dorgo, S. (2017). Manual Resistance versus Conventional or conventional weights on changes in maximum strength
Resistance Training: Impact on Strength and Muscular and repetition strength (absolute muscular endurance) in
Endurance in Recreationally Trained Men. strength-trained males.
Link to abstract
MEASUREMENTS: Maximum strength was measured by
1RM bench press and 1RM lat pull-down exercises;
Background absolute muscular endurance was measured by the
The strength-endurance continuum is a little-known way maximum number of push ups and pull ups that could be
in which strength is specific. The principle of a continuum performed in a single set; effort during training was
from strength-to-endurance states that lifting heavy measured by the level of perceived exertion described by
weights leads to greater gains in muscular strength, the OMNI-RES scale from 1 10 points.
while lifting light weights leads to greater gains in
SUBJECTS: 20 males, allocated into a manual resistance
muscular endurance. Here, muscular strength is defined
group (MAN, 10 subjects, aged 23.60 2.06 years, with
as the ability to produce maximum force in a single
3.05 1.56 years of strength-training experience) or a
effort, often measured by 1RM. On the other hand,
conventional weight training group (WEIGHT, 10 subjects,
muscular endurance is defined as the ability to produce
aged 24.20 1.95 years, with 3.30 1.70 years of
force repeatedly over an extended period of time, and is
strength-training experience).
most commonly measured by the number of repetitions
to failure as a proportion of 1RM. In this context, INTERVENTION: Both groups trained 2 times per week
strength is more normally called maximum strength, for 8 weeks, using 3 sets of 8 reps, with each rep being
while muscular endurance is often called repetition done using 2-second concentric and 2-second eccentric
strength. Exactly what causes the strength-endurance phases, with 1 minute rest periods between sets, and at
continuum is still very unclear. Currently, the most an intensity of 8 out of 10 points on the OMNI-RES scale.
obvious candidates for explaining the greater gains in The MAN group performed each exercise with manual
maximum strength with heavy loads are more relevant resistance provided by a partner, while the WEIGHT
increases in inter-muscular coordination during multi- group used conventional machines.
joint exercises, larger increases in neural drive, greater
increases in lateral force transmission, and greater
What happened?
increases in tendon stiffness. Oobvious candidates for
explaining greater gains in repetition strength with light None of the changes were significant, when measured by
loads are: greater gains in capillarization and preferential p values. But by reference to Hedges' g as an effect size,
changes in type I muscle fiber area. Other possibilities 1RM bench press increased in both the MAN (g = 0.41)
include changes buffering capacity and in the rate of ion and WEIGHT (g = 0.28) groups. Similarly, 1RM lat pull-
(Na+, K+, Ca+) transport. Given the specific nature of down increased in both MAN (g = 0.84) and WEIGHT (g
strength gains along the strength-endurance continuum, = 0.34) groups. Push up repetition strength increased in
we should be careful about predicting maximum strength both the MAN (g = 0.39) and WEIGHT (g = 0.21) groups,
from repetition strength, or vice versa. For a detailed and pull up repetition strength also increased in both
review of the strength-endurance continuum, see Chris MAN (g = 0.59) and WEIGHT (g = 0.56) groups. By
Beardsley's article HERE. comparing effect sizes, the only clear difference between
the two groups was in relation to the 1RM lat pull-down,
where MAN displayed a large effect and WEIGHT
displayed a small effect. The percentage changes for 1RM
lifts were 6 9% in both groups, and the percentage
changes in muscular endurance were 7 33% in both
groups.

What did the researchers conclude?

The researchers concluded that both manual resistance
and conventional weight training can be used to develop
maximum strength and repetition strength in males with
strength training experience.

Limitations
The study was limited as there were effect sizes and
percentage improvements indicating that changes did
occur after strength training, but these were not detected
by conventional p values.
Harries, S. K., Lubans, D. R., Buxton, A., MacDougall, T. H.
J., & Callister, R. (2017). Effects of 12-weeks resistance
training on sprint and jump performance in competitive
adolescent rugby union players. The Journal of Strength &
Conditioning Research.
Link to abstract
Background
Sprint running is a key athletic quality that is contested
in its own right in track and field, as well as being critical
for success in many team sports, such as soccer, rugby,
and both Australian Rules and American Football.
Consequently, many researchers have performed
extensive work into sprint running, both overall and in
respect of certain specific aspects, including kinematics
(joint angles) kinetics (forces and moments), stiffness,
electromyographic (EMG) activity, and the transfer of
different types of training to sprint running. To see a
complete review of sprint running, visit the S&C Research
encyclopedia page HERE, or read Chris Beardsley's article
on strength training for sprinting HERE.
OBJECTIVE: To compare effects of linear periodization
(LP) and daily undulating periodization (DUP) models of
strength training on changes in sprinting and vertical
jumping performance in adolescent rugby athletes.
MEASUREMENTS: Lower body strength was measured
by a 5RM box squat, and 1RM box squat was predicted
based on this value; 10m and 20 m sprint times were
measured by electronic timing gates; vertical jump
height was measured with a linear position transducer;
jump squat height with an additional 10kg of load was
measured similarly with a linear position transducer;
bodyweight was measured with a scale, and body fat and
fat-free mass were recorded by bio-impedance.
SUBJECTS: 26 male adolescent rugby union players,
allocated into a training group (16 subjects, aged 16.9
1.0 years) and a control group (10 subjects, aged 15.5
1.0 years).
INTERVENTION: Subjects in the training group did a
12-week strength training program in 2 blocks of 6
weeks. The training group was further divided into sub-
groups of LP or DUP, which differed only in the allocation
of volume and relative load for the back squat and bench
press exercises.
What happened?
Estimated 1RM box squat improved by 34% in LP and by
45% in DUP, while CON achieved a change of 8%. The
10m sprint time reduced by -1.6% in LP and by -2.5% in
DUP, while CON achieved a reduction of -1.3%. The 20m
sprint time reduced by -0.5% in LP and by -1.7% in DUP,
while CON achieved a reduction of -0.2%. Vertical jump
height improved by 4.3% in LP but reduced by -1.1% in
DUP, while CON achieved an increase of 1.8%. Jump
height with a load of 10kg increased by 0.6% in LP, by
7.5% in DUP, and by 2.3% in CON. However, the only
significant changes were the improvements in estimated
box squat 1RM in LP and DUP, and the reduction in 10m
sprint time in DUP. There were no significant differences
between LP and DUP programs for any variable.
What did the researchers conclude?
The researchers concluded that both LP and DUP strength
training programs can improve lower body strength,
sprinting ability, and vertical jumping ability in adolescent
rugby athletes, although there may be differences in
respect of the size of the improvement in each outcome
when pursuing each type of periodization model.
Limitations
The study was limited by the various methodological and
conceptual problems that affect all research into the use
of periodized strength training models.
Kamandulis, S., Bruzas, V., Mockus, P., Stasiulis, A.,
Snieckus, A., & Venckunas, T. (2017). Sport-Specific
Repeated Sprint Training Improves Punching Ability And
Upper-Body Aerobic Power In Experienced Amateur Boxers.
The Journal of Strength & Conditioning Research.
Link to abstract
Background
Repeated sprint ability is thought to be a key element of
athletic performance, particularly in the popular team
sports of soccer, rugby and the other football codes. This
is because these sports typically involve the performance
of repeated sprints multiple times over the course of a
single competition or game, interspersed with brief
periods of either low-level activity (such as walking or
jogging) or inactivity (standing). Consequently, the ability
to perform sprints continually at high velocity with little
reduction in speed is thought to be advantageous.
Repeated sprint ability has been defined as the capacity
to carry out multiple short sprints (usually around 20
40m in length) with brief rests between sprints (usually
around 10 30 seconds). However, there are many
different repeated sprint ability tests currently in use in
the research literature and in practice and several indices
have been developed in order to measure the rate of
decline of sprint running speed over the whole test.
Various predictors of repeated sprint ability have been
suggested, including high maximal aerobic capacity and
maximal anaerobic power. However, there is currently no
strong consensus regarding the main determining factor
for repeated sprint ability. Previous reviewers have
generally concluded that repeated sprint ability is a
complex, multifactorial test in which performance is
determine by a range of varying metabolic and neural
factors. Consequently, it is thought that there is no single
type of training that can best improve repeated sprint
ability.
OBJECTIVE: To assess the effects of short-term sports-
specific sprint interval training on punch characteristics
and endurance capacity in boxers.
MEASUREMENTS: Upper-body maximal aerobic power
(MAP) was recorded in an incremental arm-cranking test
to exhaustion, with expired gas analysis in a portable gas
analyzer; punch frequency, punch force, and punching
endurance were measured during a simulated match (in
the same simulated match protocol as used in training)
as well as during two 3s tests (for as many punches as
possible and for as hard a punch as possible), using a
punching bag equipped with a dynamometer; heart rate
(HR) was measured before, during, and for 5 minutes
after the tests with a heart rate monitor; blood lactate
levels were measured before and at 1 minute after the
tests with fingertip blood samples.
SUBJECTS: 18 experienced male amateur boxers,
allocated into a training group (TRAIN, 9 subjects) and a
control group (CON, 9 subjects).
INTERVENTION: All subjects performed standard low-
intensity training for 4 weeks (rope skipping, jogging,
and stretching). TRAIN also did 3 rounds (one round =
14 sets of 3s all-out punching with 10s rest) of a
simulated fight with a punching bag, with 1 minute rest
between rounds, 3 times per week. CON did the same 3
rounds of a simulated fight at low intensity.
What happened?
After the 4-week period, TRAIN increased the number of
punches performed in the simulated match protocol in
rounds 2 and 3, but not the frequency of punches. TRAIN
also increased the mean punch force of punches in
rounds 1, 2, and 3. CON did not improve any of these
measures. During the simulated match protocol, mean
HR was between 182 190bpm in both groups, and
blood lactate was >13.5mmol/L, and these did not
change after training in either group. TRAIN increased
MAP from 33.1 1.2 to 40.7 2.3 mL/kg/min, while
CON increased MAP from 35.0 1.2 to 35.2 1.5
mL/kg/min. TRAIN increased upper body peak power
from 175.6 12.3 to 187.8 14.2W while CON
decreased upper body peak power from 195.7 6.1 to
193.6 14.2W.
What did the researchers conclude?
The researchers concluded that a short-term program of
sports-specific sprint interval training can improve the
number of punches and the mean punching force in a
simulated boxing match, alongside an increase in upper
body MAP and upper body peak power.
Limitations
The study was limited as it was unclear whether another
type of training program could cause similar or superior
adaptations.
Townsend, J. R., Bender, D., Vantrease, W., Hudy, J., Huet,
K., Williamson, C., & Mangine, G. T. (2017). Isometric Mid-
Thigh Pull Performance Is Associated With Athletic
Performance And Sprinting Kinetics In Division I Men And
Women's Basketball Players. The Journal of Strength &
Conditioning Research.
Link to abstract
Background
Sprint running is a key athletic quality that is contested
in its own right in track and field, as well as being criticalstation; change-of-direction ability (CODA) was measured
for success in many team sports, such as soccer, rugby,
and both Australian Rules and American Football.
Consequently, many researchers have performed
extensive work into sprint running, both overall and in
respect of certain specific aspects, including kinematics
(joint angles) kinetics (forces and moments), stiffness,
electromyographic (EMG) activity, and the transfer of
different types of training to sprint running. To see a SUBJECTS: 23 (8 males, aged 20.0 1.7 years; and 15
complete review of sprint running, visit the S&C Research females, aged 19.9 1.1 years) division 1 basketball
encyclopedia page HERE, or read Chris Beardsley's article players.
on strength training for sprinting HERE.
OBJECTIVE: To explore relationships between isometric
mid-thigh pull (IMTP) force, rate of force development
(RFD), and athletic ability in male and female basketball
players.
MEASUREMENTS: During an IMTP, peak force was
measured, and RFD was also measured at intervals of
50ms, 100ms, 150ms, 200ms and 250ms, using a force
plate; 1RM front squat and 1RM hang clean were
recorded using normal methods; countermovement jump
(CMJ) height was measured in vertical jump testing
by a pro-agility test, and by a lane agility test; sprinting
forces (peak and mean force), velocity, and power
outputs in 5m windows of a 20m sprint were recorded by
a portable, 90m cable resistance device incorporating a
servo motor providing 1kg of resistance, with one end
attached to the athlete using a shoulder harness.
What happened?
RFD values recorded during the IMTP in the time windows
between 0 50ms, 0 100ms, and 0 150ms were
unrelated to any performance variable. RFD values
recorded in the IMTP in the time windows between 0
200ms and 0 250ms were related to 1RM hang clean
and CMJ height (r = 0.56 0.70) only. In contrast, peak
force in the IMTP was moderate-to-strongly related to
1RM front squat, 1RM hang clean, CMJ height, pro agility
test and lane agility test performances (r = 0.52 0.89)
with the strongest relationships occurring with the 1RM
lifts, and the weaker relationships with the CODA tests.
Similarly, RFD values in the IMTP were only moderately
associated with sprint times over 20m when measured in
the time windows >200ms, while peak force in the IMTP
was moderate-to-strongly related to sprint times. There
were some relationships between RFD values in the IMTP
and average velocity, force, and power in the 20m sprint
at earlier time windows, however.
What did the researchers conclude?
The researchers concluded that IMTP peak force (and to
a lesser extent RFD) are related to 20m sprint times and
the associated velocity, force, and power in the sprints.
Limitations
The study was limited as it was unable to identify the
determinants of the 20m sprint performance or its 5m
splits using the data recorded by the IMTP.
Bachero-Mena, B., Pareja-Blanco, F., Rodrguez-Rosell, D., OBJECTIVE: To identify relationships between sprint
Yez-Garca, J. M., Mora-Custodio, R., & Gonzlez-Badillo, speed, vertical jump height, maximum squat strength,
J. J. (2017). Relationships Between Sprint, Jumping and and 800m running performance among high-level 800m
Strength Abilities, and 800 M Performance in Male Athletes runners.
of National and International Levels. Journal of Human
Kinetics, 58(1). MEASUREMENTS: Sprint running times were measured
by photocells during a 20m sprint on an indoor track,
Background with gates at 10m and 20m, as well as during a 200m
Sprint running is a key athletic quality that is contested sprint on an outdoor track with gates every 50m;
in its own right in track and field, as well as being criticalcountermovement jump (CMJ) and jump squat heights
for success in many team sports, such as soccer, rugby, with a load at which jump height was equal to 20cm (in a
and both Australian Rules and American Football. Smith machine) were measured with an infrared plate;
Consequently, many researchers have performed squat strength was measured in a Smith machine using a
extensive work into sprint running, both overall and in linear velocity transducer while subjects lifted a range of
respect of certain specific aspects, including kinematics loads with maximum effort until the mean propulsive
(joint angles) kinetics (forces and moments), stiffness, velocity reduced below 1m/s; 800m running time was
electromyographic (EMG) activity, and the transfer of recorded as the nearest official time obtained by an
different types of training to sprint running. To see a athlete (within 2 weeks) in competition.
complete review of sprint running, visit the S&C Research SUBJECTS: 14 athletes competing at national and
encyclopedia page HERE, or read Chris Beardsley's article international levels in 800m (personal best = 1:43 1:58
on strength training for sprinting HERE. minutes), aged 22.9 5.3 years.

What happened?
The 800m running time was most closely related to the
fourth 50m split of the 200m time (r = 0.85) as well as
the overall 200m time (r = 0.84) and the third 50m split
(r = 0.81). The 800m running time was also moderate-
to-strongly related to the first two splits of the 200m
time (r = 0.71 0.72) as well as the 20m sprint time (r
= 0.72). The 800m running time was moderately related
to 10m split sprint time (r = 0.59), CMJ height (r =
0.69), jump squat height with a load corresponding to a
jump height of 20cm (r = 0.65), and squat load
corresponding to a propulsive velocity of 1m/s (r = 0.58).

What did the researchers conclude?

The researchers concluded that 200m sprint running
performance, and especially the final 50m split of a 200m
running race, is the quality most closely related to 800m
running performance in a group of high-level, 800m
running athletes.

Limitations
The study was limited as it was unclear whether the
same results would be observed in other populations.
Gonzlez-Badillo, J. J., Jimnez-Reyes, P., & Ramrez- OBJECTIVE: To assess the relationship between peak
Lechuga, J. (2017). Determinant Factors of the Squat Jump force, rate of force development (RFD), and maximum
in Sprinting and Jumping Athletes. Journal of Human velocity in the squat jump, in a group of track and field
Kinetics, 58(1). athletes.

Background MEASUREMENTS: Using a force plate, the following

variables were recorded: (1) peak force 1 and peak force
Vertical jumping ability is a key athletic quality. Studies
2 (the two peaks in force in the squat jump propulsion
have reported beneficial effects on vertical jump height
phase); (2) the time points at peak force 1 and peak
from many types of training methods, including unilateral
force 2; (3) the rate of force development (RFD) at peak
plyometrics, bilateral plyometrics, loaded jumps,
force 1 and peak force 2, as well as peak RFD; (4) the
unilateral conventional strength training, conventional
force produced at peak RFD 1, peak RFD 2, and peak
strength and/or power training, isometric strength
RFD; (5) mean RFD 1, measured from the start of the
training, Olympic lifting programs, kettlebell training,
contraction to peak force 1, and mean RFD 2, measured
complex training, contrast training, assisted and resisted
from the start of the contraction to peak force 2, (6)
jumps, and combined methods. Studies exploring the
squat depth, as the distance the bar moved when a knee
biomechanics of vertical jumping have identified that co-
angle of 90o was adopted; bar velocity was recorded
ordination, strength, rate of force development (RFD),
using a linear position transducer attached to the barbell.
and elastic energy storage through the stretch-shortening
cycle can all influence vertical jump performance to some SUBJECTS: 32 sprinting and jumping athletes (100m
degree. sprint, long jump or triple jump) of national level, aged
25.4 4.5 years.

INTERVENTION: Subjects did squat jumps from a knee

angle of 90o in a Smith machine while standing on a force
plate.

What happened?
Peak RFD 1 occurred at approximately 100ms, peak force
1 occurred at approximately 200ms, peak RFD occurred
at approximately 400ms, peak force 2 occurred at
approximately 450ms, and maximum velocity occurred at
approximately 475ms, before take-off at approximately
500ms. Maximum velocity during the squat jump was
strongly associated with both peak force 1 (r = 0.82) and
peak force 2 (r = 0.68). Interestingly, it was also
inversely associated with the ratio of peak force 2 to peak
force 1 (r = 0.54). This indicates that if peak force 2 is
proportionally larger than peak force 1, the maximum
velocity in the squat jump will be lower. Curiously,
maximum velocity during the squat jump was positively
associated with peak RFD 1 (r = 0.62) but negatively
associated with peak RFD 2 (r = 0.71).

What did the researchers conclude?

The researchers concluded that peak force 1 (the force at
the beginning of the movement) was the best predictor of
maximum velocity in the squat jump. The negative
relationship between peak RFD 2 and maximum velocity
in the squat jump might be explained by the close
proximity to maximum velocity at this point in the
movement. If an athlete is still able to increase the rate
of force production at this late stage in the jump, then
the coordination of the jump is likely inefficient. Thus, a
lower peak RFD 2 may indicate a more well-coordinated
jump.

Limitations
The study was limited as it only explored the squat jump,
and it is unclear whether similar results would be
observed in the countermovement jump.
Sams, M. L., Sato, K., DeWeese, B. H., Sayers, A. L., &
Stone, M. H. (2017). Quantifying changes in squat jump
height across a season of men's collegiate soccer. The
Journal of Strength & Conditioning Research.
Link to abstract
OBJECTIVE: To measure the state of neuromuscular
fatigue over the course of a collegiate soccer season as
measured by changes in squat jump height, and to relate
this state of fatigue to athlete workload, as measured by
session rating of perceived exertion (sRPE) and training
load.

Background MEASUREMENTS: Squat jump height from a knee angle

Soccer or Association Football is the world's most popular of 90o was measured by a contact mat, on the first day of
team sport and is played by more than 250 million people pre-season practice, and additional tests were carried out
in over 200 separate countries. Through this incredible approximately 4 hours before 18 of the seasons 21
popularity, it is known simply as football in most parts matches; sRPE was recorded approximately 10 minutes
of the world, despite the existence of many other football after each training session and after each game; training
codes, including American Football, Australian Rules load was calculated as the sRPE multiplied by the
Football, Gaelic Football, and Rugby. Soccer is played in duration of the training session or game.
teams of 11 players in two halves of 45 minutes in length
SUBJECTS: 18 outfield Division I mens college soccer
with a 15-minute break between the two halves. Play
players, aged 20 1 years.
runs continuously within halves, such that the clock is not
stopped while the ball is out of play. There is usually a
15-minute half-time break between halves. Every four What happened?
years, the World Cup is held, in which around 200 Squat jump was tested every 5 2 days, and only one of
national teams compete in qualifying tournaments in the the tests revealed a significantly different jump height
hope of becoming one of the 32 national teams that from all of the others in the whole season (test number 8
compete in the 4-week competition. The most recent was 2.3cm higher than baseline, effect size = 1.01).
World Cup was held in Brazil and was the twentieth such There was only a small, positive and non-significant
competition. Germany beat Argentina 10 in the final to relationship between training load and the change in
take their fourth title. Training for soccer requires a focus squat jump height (r = 0.18) when using time-matched
on many different aspects, including physical qualities, outcomes. However, when lagging the training load back
technical skills, and tactical abilities. There are many by one measurement, there was a strong, positive, and
different physical qualities that are important for soccer, significant relationship between training load and the
including aerobic endurance, anaerobic endurance, change in squat jump height (r = 0.55).
strength, power and flexibility. Traditionally, soccer teams
placed the most emphasis on aerobic endurance, noting
What did the researchers conclude?
that players needed to be able to run long distances
The researchers concluded that there is a relationship
during games. Indeed, there is a basic agreement that
between training load and changes in squat jump height
soccer players travel around 9 14km in a single 90-
over the course of a soccer season, although the exact
minute match, although the exact distance depends on
nature of this relationship has yet to be fully understood.
the position played. Training methods for improving
aerobic capacity include interval training, small-sided
games, game simulations, soccer-specific circuits, Limitations
repeated sprints, and agility drills. More recently, soccer The study was limited as it was unclear exactly why there
teams have begun to focus more on sprint running was a strong, positive, and significant relationship
ability, which appears to be crucial in allowing soccer between training load and the change in squat jump
athletes to dominate situations during play. This change height, when training load was lagged by a single
in focus came out of the realization that the nature of the measurement point.
activity performed by soccer players during a game
comprises long periods of low-intensity walking or
jogging, interspersed by short periods of maximal or
near-maximal effort, including accelerating sprints. Some
studies have found that players perform many such
accelerating sprints per match, for a total distance of
around 200m. Sprint running ability can be improved by
various training methods, including sprinting, heavy load
resistance-training, ballistic resistance-training,
plyometrics, and assisted and resisted sprinting. There is
currently no strong consensus around which type of
training is best, although a recent meta-analysis
concluded that novice athletes benefit most from sprint
running practice and more advanced athletes benefit
more from a varied program.
Ralston, G. W., Kilgore, L., Wyatt, F. B., & Baker, J. S.
(2017). The Effect of Weekly Set Volume on Strength Gain:
A Meta-Analysis. Sports Medicine.
Link to abstract
Background
Researchers have studied the effect of volume on gains in
strength and size more than any other single training
variable. Overall, it seems fairly clear that there is a
beneficial effect of greater volume on both strength and
size gains. To read a full review about the effects of
volume on hypertrophy, visit our encyclopedia page
HERE. To read a full review about the effects of volume
on strength gains, visit our encyclopedia page HERE.
OBJECTIVE: To do a meta-analysis (using a pooled
effect size of mean differences in a random effects
model) to compare the effects of low, medium, and high
volumes (<5, 5 9, >10 sets per week) of strength
training on changes in strength as measured in multi-
joint and single-joint exercises.
STUDY SELECTION: Studies were selected where they
described either randomized controlled trials (RCTs) or
randomly assigned trials (RANs) that included strength
training programs of >4 weeks, where >1 major muscle
group was trained (quadriceps, hamstrings, pectoralis
major, latissimus dorsi, deltoids, biceps or triceps), where
the subjects were healthy, adult males, aged 18 60
years, where there were conditions that used single sets
and multiple sets, where an exercise 1RM was measured
both before and after strength training, and where the
appropriate data were available for extraction to use in
the meta-analysis.
What happened?
Studies selected
A total of 9 studies (4 in trained subjects, and 5 in
untrained subjects) for a total of 223 subjects, aged 23.4
2.2 years, were included. The relative load used in
these studies ranged between 74 85% of 1RM, the
training frequency ranged from 2 4 times per week,
and the duration of training ranged from 8 26 weeks
(mean duration = 11.1 5.7 weeks).
Effects of weekly set volume
For both multi-joint and single-joint exercises, there was
only a small difference (effect size = 0.19) between high
(effect size = 1.01) and low (effect size = 0.82) weekly
volumes of sets in relation to their effects on 1RM
exercise strength gains. This was associated with a
moderate amount of inter-study variability (I2 = 45%).
Similarly, there was a very small difference (effect size =
0.15) between moderate (effect size = 0.98) and low
(effect size = 0.83) weekly volumes of sets in relation to
their effects on 1RM exercise strength gains. This was
associated with a large amount of inter-study variability
(I2 = 74%). Comparisons between high and low volumes
for multi-joint exercise only produced similar results, with
a difference in the effect sizes of 0.18 (I2 = 86%).
Comparisons between high and low volumes for single-
joint exercise only produced similar results, with a
difference in the effect sizes of 0.15 while comparisons
between moderate and low volumes for single-joint
exercise only produced marginally different results, with
a difference in the effect sizes of 0.23 (I2 = 0%). When
limiting strength gains to exercise-specific measures, the
results were very similar.
What did the researchers conclude?
The researchers concluded that there are only very
limited grounds upon which to base recommendations
about training volumes for improving strength, as there
are only minimal differences between the effects of low,
moderate, and high volumes.
Limitations
The study was limited by the availability of literature that
can answer the question posed.
Chu, E., Kim, Y. S., Hill, G., Kim, Y. H., Kim, C. K., & Shim,
J. K. (2017). Wrist Resistance Training Improves Motor
Control And Strength. Journal of strength and conditioning
research.
Link to abstract
Background
Strength increases after long-term resistance training
programs because of multiple different adaptations,
many of which we know very little about. Adaptations can
be categorized into two groups, based on where they
occur. Adaptations that are located proximal to the
neuromuscular junction (NMJ) are described as central
or neural adaptations, while those that are distal to the
NMJ are described as peripheral adaptations. Central
adaptations can be further subdivided into those that
occur at the spinal level (including reflex activity) and
those that arise at the supraspinal level (representing
genuinely greater central drive to the muscle from the
motor cortex). Peripheral adaptations cover a huge range
of different changes, including hypertrophy of muscle
fibers, increases in muscle fascicle length and pennation
angle, changes to the surrounding extracellular matrix
(ECM) connective tissue layers, increases in the numbers
of costameres that attach the muscle fibers to the ECM,
increases in titin content and/or changes in titin isoform,
changes in tendon stiffness and size, alterations in ion
transport functions, increases in buffering capacity, fiber
type shifts, changes in single fiber properties, and many
others besides. Although our understanding of peripheral
changes is limited, it is rapidly increasing because of
improvements in scanning technologies, which enable
greater resolution of the structures inside and around
muscle fibers, our knowledge of central changes is still
very opaque. Even so, changes in the neural drive that
arrives at the NMJ are relatively well-understood. The
characteristics of this signal can be largely described by
the degree of motor unit (MU) recruitment and the MU
firing frequency (rate coding), which follow the size
principle (low-threshold MUs are recruited before high-
threshold MUs) and the onion skin principle (later
recruited MUs increase their firing rates more slowly than
earlier recruited MUs). Strength training (especially with
heavy loads or isometric resistance) likely causes a small
increase in MU recruitment. Strength training also causes
a large increase in MU firing frequency (especially when
using high velocities). These effects can be observed as
an increase in voluntary activation (voluntary force
relative to involuntary force). However, the level at which
this signal is altered is less clear. Adaptations may arise
at (1) pre-motor cortex brain regions, (2) the motor
cortex, and/or (2) spinal transmission of neural drive,
potentially involving spinal reflex arcs. In addition, the
extent to which the antagonist and synergist muscles
alter their contribution to a movement after strength
training is still unknown, and the relationship between
these alterations and what is termed motor learning is
opaque.
OBJECTIVE: To assess the effects of long-term direction-
specific strength training program on changes in force
control and strength.
M E A S U R E M E N T S : Maximum voluntary isometric
contraction (MVIC) wrist torques were measured in a
fixed wrist brace fitted with a torque sensor to record
force directed in each of the 6 directions (flexion,
extension, pronation, supination, radial deviation, and
ulnar deviation); isometric force control was tested in the
same device, by requiring the subjects to exert force at
approximately 20% of MVIC in a combination of 2 of
directions (flexion-extension, pronation-supination, and
radial-ulnar deviation), by following a sinusoidal profile
provided by visual feedback (the error rate was recorded
to assess motor control); maximum concentric isokinetic
torques were measured using a dynamometer at 60o/s in
each of 6 directions (flexion, extension, pronation,
supination, radial deviation, and ulnar deviation).
SUBJECTS: 19 subjects, aged 24.1 0.2 years,
assigned to either a wrist training group, or a control
group.
INTERVENTION: Subjects in the training group did 6
wrist strength training exercises, covering 6 different
directions (flexion, extension, pronation, supination,
radial deviation, and ulnar deviation) using a custom-
made wrist training device. Each exercise was performed
for 3 sets with 70% of 1RM, with 2 minutes of rest
between sets, and for 2-second concentric and 2-second
eccentric phases. The training program was followed for 6
weeks. In weeks 1 and 2, 3 5 reps were performed. In
weeks 3 4, 6 8 reps were performed. In weeks 5 6,
8 10 reps were performed. The control group did not do
any strength training.
What happened?
In the training group isometric force control ability
improved after 2 weeks, and continued to improve for 6
weeks. Maximum concentric isokinetic torques in all 6
directions improved after 4 weeks, and continued to
improve for 6 weeks. There were no changes in the
control group.
What did the researchers conclude?
The researchers concluded that a short-term program of
isometric wrist strength training in multiple directions
causes improvements in concentric isokinetic wrist
strength, and also in isometric force control in paired
directions.
Limitations
The study was limited as it is unclear what adaptations
occurred that enabled the improvements in force control.
Bartolomei, S., Sadres, E., Church, D. D., Arroyo, E.,
Gordon III, J. A., Varanoske, A. N., & Hoffman, J. R. (2017).
Comparison of the recovery response from high-intensity
and high-volume resistance exercise in trained men.
European Journal of Applied Physiology, 1-12.
Link to abstract; link to full text
Background
Recovery from training and competition is very important
for athletes. Until they are fully recovered, athletes
cannot function again at their previous high level of
performance. However, recovery is difficult to define
precisely. It is often defined as the rate at which the
fatigue induced by a prior training bout or competition is
dispersed, relative to the magnitude of that fatigue. But
since fatigue is also difficult to pin down and measure
precisely, even this broad definition is problematic.
Additionally, recovery is often measured over multiple
different time periods. In general, there are three main
types of recovery referred to in the literature: immediate
recovery, short-term recovery, and training recovery.
Immediate recovery refers to the recovery that is allowed
during performance, between muscular contractions. For
example, a certain amount of recovery for the leg
muscles occurs during the flight phase of running
between ground contact phases. Short-term recovery
occurs between sets of intervals or between multiple sets
of resistance-training exercises. Training recovery refers
to the period of adaptation between sequential workouts
or between competitions. The definition of the time
periods still does not address the problem of what is
being measured, however. Therefore, in order to bring
some measure of precision to the study of recovery,
researchers have settled on various indirect measures of
recovery, including glycogen re-synthesis, electrolyte
replacement and rehydration, performance measures
(e.g. maximal strength, repetition strength, muscular
power or anaerobic power output), biomarkers of muscle
damage such as creatine kinase (CK), changes in heart
rate variability (HRV), and self-perception of delayed
onset muscle soreness (DOMS). The individual
performance measures are clearly able to provide a
concrete understanding of how much fatigue has affected
the athlete and how long such performance took to
return. However, the exact speed at which performance
returns is affected by any super-compensation that might
occur in response to the training bout. The biomarkers of
muscle damage can appear to be slightly more
scientific measures to some people, as can HRV
measurements. However, the extent to which these
measures (and others) are good measures of overall
fatigue is open to debate. A number of different
interventions have been tested for reducing improving
recovery and reducing DOMS. There is some evidence to
support the use of massage and limited evidence to
support the use of self-myofascial release with a foam
roller for reducing DOMS, in particular. However, the
mechanisms by which such modalities might be effective
for reducing DOMS are not well-understood
OBJECTIVE: To compare the effects of high-volume and
high-load strength training workouts in strength-trained
males.
MEASUREMENTS: Various measurements were taken at
baseline, after 30 minutes, 24 hours, 48 hours, and 72
hours post-exercise, including: counter-movement jump
(CMJ) peak power, on a force plate; maximum voluntary
isometric contraction (MVIC) knee extension torque at
70 knee flexion, and maximum concentric isokinetic
knee extension torque at both 60/s and 180/s using a
dynamometer; isometric mid-thigh pull (IMTP) force and
isometric squat force using a force plate in a power rack;
vastus lateralis muscle cross-sectional area (CSA),
muscle thickness, and echo intensity were recorded by
ultrasound; testosterone, cortisol, interleukin-6 (IL-6), C-
reactive protein (CRP), lactate dehydrogenase (LDH),
creatine kinase (CK), and myoglobin (Mb) were assessed
by blood samples; muscle soreness was measured on a
visual analog scale (VAS).
SUBJECTS: 12 males, aged 24.5 4.2 years, with 6.3
3.4 years of strength training experience.
INTERVENTION: Subjects did a squat workout on 2
occasions, 10 days apart. One workout was a high-
volume workout (8 sets of 10 reps at 70% of 1RM, with
1.25 minutes rest between sets) and the other workout
was a high-load workout (8 sets of 3 reps with 90% of
1RM with 3 minutes of rest between sets).
What happened?
There were greater or more long-lasting reductions in
CMJ peak power, isokinetic peak torque, and MVIC torque
after the high-volume workout, compared to the high-
load workout. Importantly, MVIC torque was still below
baseline 72 hours after the high-volume workout, but
returned to baseline after the high-load workout.
Biochemical markers of muscle damage (LDH, CK, and
Mb) were increased similarly after both workouts, but the
increase in blood lactate and self-reported muscle
soreness were both greater after the high-volume
workout. Post-workout cortisol and IL-6 levels were
increased only after the high-volume workout. The
ultrasound assessment revealed that while both workouts
produced a similar increase in muscle thickness, only the
high-volume workout caused an increase in CSA and echo
intensity. The change in CSA at 30 minutes post-workout
in the high-volume condition was associated with the
change in CMJ peak power (r = -0.68), MVIC torque (r =
-0.58) and isokinetic torque at 180o/s (r = -0.80). The
correlation in the high-volume condition remained at 24
hours for isokinetic torque at 180o/s (r = -0.68). The
change in CSA at 24 hours post-workout in the high-
volume condition was also associated with IL-6 levels at
this time (r =0.66). The change in CSA at 72 hours post-
workout in the high-volume condition was also associated
with CK levels at this time (r = 0.60).
What did the researchers conclude?
The researchers concluded that a high-volume workout
causes greater muscle damage, and larger and more
long-lasting force reductions than a high-load workout.
Limitations
The study was limited by our poor understanding of the
way in which recovery occurs post-workout.
#2. BIOMECHANICS AND MOTOR
CONTROL
Schaefer, L. V., & Bittmann, F. N. (2017). Are there two
forms of isometric muscle action? Results of the
experimental study support a distinction between a holding
and a pushing isometric muscle function. BMC sports
Science, Medicine and Rehabilitation, 9(1), 11.
Link to abstract; link to full text
Background
Until recently, it was widely accepted that there were
only three contraction modes (eccentric, concentric, and
isometric). When we lower a weight, it involves the
lengthening of the prime mover muscles. This is the
eccentric phase. When we lift a weight, it involves
shortening the prime mover muscles. This is called the
concentric phase. Eccentric training places a heavy stress
on the passive elements of the muscle fibers but also
involves low metabolic demand. This raises the likelihood
of experiencing delayed onset muscle soreness (DOMS)
and also likely causes adaptations in the passive
elements, including the extracellular matrix and possibly
also titin. Together with specific neural adaptions, these
changes in the passive elements are likely responsible for
the eccentric-specific strength gains after eccentric
training. Concentric training has a higher metabolic
demand but places less stress on the passive tissues.
This leads to concentric-specific strength gains. The
effects of isometric training are also specific, but the
main way in which this specificity has historically been
investigated is in relation to the joint angle at which the
contractions are performed.
OBJECTIVE: To see if it is possible to differentiate
between the endurance times of holding isometric muscle
actions (HIMs) and pushing isometric muscle actions
(PIMs).
MEASUREMENTS: A strain gauge was used to measure
the force produced in the HIM and PIM efforts, and to
provide feedback about the force levels to the subject on
a visual display; an acceleration sensor was attached to
the strain gauge in order to measure acceleration of the
pneumatic cylinder; muscle and tendon oscillations, were
measured by piezoelectric mechanomyography (MMG)
and tendography (MTG) of the lateral head of the triceps
brachii muscle and its tendon as well as of the abdominal
muscle (external oblique).
SUBJECTS: 10 subjects (5 females, aged 24.4 1.95
years, 5 males, aged 24.0 4.95 years).
INTERVENTION: Subjects did both HIM and PIM tasks
for 15 seconds using a load equal to 80% of MVIC in a
custom-made pneumatic system, while maintaining a
constant joint angle of 90o elbow angle, and while seated
in a chair in both cases. In addition, trials to exhaustion
with 80% of MVIC were performed for each condition.
The HIM task required subjects to resist the pneumatic
cylinder pulling the arm into elbow flexion at the set
force; the PIM task required the subjects to maintain the
required force while performing elbow extension. In both
cases, the triceps brachii muscle was the prime mover.
What happened?
In the 15-second trials, the mean force value of the HIM
was 99.3% of the mean force in the PIM, and there was
no difference in this value between the two conditions. In
the tasks to failure, subjects were able to maintain force
during the PIM for 41.4 seconds, but in the HIM, the
subjects were only able to maintain a stable force output
at the required level for 19.1 seconds. Therefore the
same force output was maintained in the same isometric
position with a PIM for twice as long as with a HIM. In
the final 10% of the tasks to failure, the amplitude of the
MMG of the triceps brachii muscle was higher in PIM than
in HIM, but there were no differences between conditions
for the MMG of the abdominal muscle or the MTG of the
triceps brachii tendon.
What did the researchers conclude?
The researchers concluded that during endurance tasks,
muscles reach failure earlier when they are under holding
isometric conditions, compared to when they are under
pushing isometric conditions. The mechanism for why
this happens is unclear. It is also unclear whether training
using different types of isometric contraction would lead
to different (specific) effects.
Limitations
The study was limited as it was unable to identify the
reasons for the differences between the two conditions.
Prez-Castilla, A., McMahon, J. J., Comfort, P., & Garca-
Ramos, A. (2017). Assessment of loaded squat jump height
with a free-weight barbell and Smith machine: comparison
of the take-off velocity and flight time procedures. The
Journal of Strength & Conditioning Research.
Link to abstract
Background
Vertical jumping ability is a key athletic quality. Studies
have reported beneficial effects on vertical jump height
from many types of training methods, including unilateral
plyometrics, bilateral plyometrics, loaded jumps,
unilateral conventional strength training, conventional
strength and/or power training, isometric strength
training, Olympic lifting programs, kettlebell training,
complex training, contrast training, assisted and resisted
jumps, and combined methods. Studies exploring the
biomechanics of vertical jumping have identified that co-
ordination, strength, rate of force development (RFD),
and elastic energy storage through the stretch-shortening
cycle can all influence vertical jump performance to some
degree.
OBJECTIVE: To compare two ways of measuring vertical
jump height (take-off velocity [TOV] and flight time) in
the loaded jump squat exercise, using both a free weight
barbell and a Smith machine.
MEASUREMENTS: Vertical jump height was calculated
from a force plate, using either the TOV (from the
impulse) or the flight time (between take-off and
landing) to deduce the height reached.
SUBJECTS: 23 physically active, male sports science
students with >2 years of strength training experience,
aged 23.1 3.2 years.
INTERVENTION: All subjects did jump squats on two
occasions with both free weights and in the Smith
machine, with external loads of 17, 30, 45, 60 and 75kg.
Each jump squat was performed after holding the squat
position with a knee flexion angle of 90o for 1.5 seconds.
What happened?
Using the coefficient of variation (CV), the test-re-test
reliability was similar for both the TOV and flight time
methods of calculation (9.9% vs. 8.7%) but test-re-test
reliability in the Smith machine was superior to that of
the free weight barbell (4.6% vs. 9.9%). Vertical jump
heights were higher when recorded using the TOV than
with the flight time method, and also higher when using
the Smith machine than with a free weight barbell.
What did the researchers conclude?
The researchers concluded that jump squat heights are
best estimated using the Smith machine, and that the
flight time method is equally reliable to the TOV method
for assessing jump height.
Limitations
The study was limited as there was no validation of either
method against motion analysis data.
Sharif, N. A. M., Li, G. S., Usman, J., & Safwani, W. K. Z. W. OBJECTIVE: To perform a literature review to assess
(2017). Biomechanical and functional efficacy of knee
sleeves: A literature review. Physical Therapy in Sport.
Link to abstract
Background
Powerlifting is an individual sport in which three lifts, the
squat, the bench press, and the deadlift, are contested in
weight classes. The squat, bench press and deadlift are
common resistance training exercises that are used in
the preparation of athletes for many team and individual
sports. However, it is in powerlifting that performance in
these lifts becomes the goal in itself rather than a tool for
the development of strength and power in the athlete.
Even so, studies have found that muscular strength and
size are strongly correlated with powerlifting ability,
particularly upper back size. In some respects, the sport
of powerlifting as very similar to Olympic weightlifting, in
that the maximal load lifted is the goal. However, unlike
Olympic weightlifting, powerlifting as a sport is
fragmented into many variations that are contested
under the auspices of different federations. The two main
features of the different federations are what types of
supportive equipment are used and whether the athletes
are subjected to drug testing or not. Supportive
equipment includes knee wraps, squat suits, deadlift suits
and bench shirts. In all cases, the supportive equipment
forms a tight hold around the working muscles and allows
greater weights to be lifted. Various hypotheses have
been proposed for the mechanisms through which this
occurs. The most common is that the materials out of
which the equipment is made are elastic and absorb and
release energy as they are compressed. Indeed, the
deadlift is the event for which supportive equipment is
least effective, which supports this proposal.
whether using knee sleeves during any type of lower
body exercise alters the resulting joint angle movements,
net joint moments (NJMs), forces, proprioception, or
balance.
STUDY SELECTION: Studies were selected if they were
published in a peer-reviewed journal in English, between
January 2005 and January 2015, were carried out in
either injured or healthy human subjects, measured
either knee joint angle movements, NJMs, force,
proprioception, or balance during lower body exercise.
What happened?
Studies selected
A total of 20 studies were identified, of which 4 assessed
the effects of knee sleeves during gait; 16 studies
assessed the effects of knee sleeves on proprioception
and/or balance; the most commonly-measured variables
were those related to either proprioception or balance
(e.g. mean joint positioning error in the reproduction of
target angle test, balance score, balance index, and sway
velocity). Some studies reported measures of lower body
function in addition to effects on joint angle movements,
NJMs, forces, proprioception or balance.
Effects of knee sleeves
Knee sleeves were consistently found to increase knee
flexion angle, and reduce knee adduction angle and knee
adduction NJM during gait. Knee sleeves also improved
both static and dynamic balance measures, and largely
seemed to improve proprioception. However, knee
sleeves did not affect functional outcomes, such as the 1-
leg and 2-leg vertical jumps.
What did the researchers conclude?
The researchers concluded that knee sleeves seem to
improve balance and proprioception, increase knee
flexion and reduce knee adduction (angle and moment)
during gait, but do not have any effects on functional
outcomes.
Limitations
The study was limited by the varied nature of the
research included in the review, and by the lack of
research exploring the effects of knee sleeves on
variables recorded during strength training exercise.
Bampouras, T., Reeves, N., Baltzopoulos, V., & Maganaris,
C. (2017). The role of agonist and antagonist muscles in
explaining isometric knee extension torque variation with
hip joint angle. European Journal of Applied Physiology.
Link to abstract
Background
Strength increases after long-term resistance training
programs because of multiple different adaptations,
many of which we know very little about. Adaptations can
be categorized into two groups, based on where they
occur. Adaptations that are located proximal to the
neuromuscular junction (NMJ) are described as central
or neural adaptations, while those that are distal to the
NMJ are described as peripheral adaptations. Central
adaptations can be further subdivided into those that
occur at the spinal level (including reflex activity) and
those that arise at the supraspinal level (representing
genuinely greater central drive to the muscle from the
motor cortex). Peripheral adaptations cover a huge range
of different changes, including hypertrophy of muscle
fibers, increases in muscle fascicle length and pennation
angle, changes to the surrounding extracellular matrix
(ECM) connective tissue layers, increases in the numbers
of costameres that attach the muscle fibers to the ECM,
increases in titin content and/or changes in titin isoform,
changes in tendon stiffness and size, alterations in ion
transport functions, increases in buffering capacity, fiber
type shifts, changes in single fiber properties, and many
others besides. Although our understanding of peripheral
changes is limited, it is rapidly increasing because of
improvements in scanning technologies, which enable
greater resolution of the structures inside and around
muscle fibers, our knowledge of central changes is still
very opaque. Even so, changes in the neural drive that
arrives at the NMJ are relatively well-understood. The
characteristics of this signal can be largely described by
the degree of motor unit (MU) recruitment and the MU
firing frequency (rate coding), which follow the size
principle (low-threshold MUs are recruited before high-
threshold MUs) and the onion skin principle (later
recruited MUs increase their firing rates more slowly than
earlier recruited MUs). Strength training (especially with
heavy loads or isometric resistance) likely causes a small
increase in MU recruitment. Strength training also causes
a large increase in MU firing frequency (especially when
using high velocities). These effects can be observed as
an increase in voluntary activation (voluntary force
relative to involuntary force). However, the level at which
this signal is altered is less clear. Adaptations may arise
at (1) pre-motor cortex brain regions, (2) the motor
cortex, and/or (2) spinal transmission of neural drive,
potentially involving spinal reflex arcs. In addition, the
extent to which the antagonist and synergist muscles
alter their contribution to a movement after strength
training is still unknown, and the relationship between
these alterations and what is termed motor learning is
opaque.
OBJECTIVE: To assess the role of agonist and antagonist
muscles in determining isometric knee extension torque
at different hip joint angles (and therefore with either
long or short rectus femoris muscle lengths).
MEASUREMENTS: Maximum voluntary isometric knee
extension torque (MVIC) in seated and supine positions
in a custom-made dynamometer; agonist and antagonist
muscle contributions to the torque were estimated by
recording electromyography (EMG) amplitudes of the
biceps femoris during the MVIC knee extension torque
effort, as well as during MVIC knee flexion torque efforts
and 3 submaximal (at 20, 40 and 60% of MVIC)
isometric knee flexion torque efforts; submaximal tetanic
stimulation quadriceps torque was also recorded at an
equivalent of 30% of position-specific MVIC.
SUBJECTS: 9 healthy males, aged 30.2 7.7 years.
INTERVENTION: Subjects did MVIC knee extension
efforts in seated (hip joint angle at 90) and supine (hip
joint angle at 160; full hip joint extension = 180)
positions, with the knee and ankle joint angles at 90 in a
custom-made dynamometer. The seated position
corresponded to a short rectus femoris length, while the
supine position corresponded to a long rectus femoris
length.
What happened?
The MVIC knee extension torque (before correcting for
antagonist muscle contribution) was similar in supine
(245 71.8Nm) and seated (241 69.8 Nm) positions.
After correcting for antagonist muscle contribution, the
MVIC knee extension torque was still similar in supine
and seated positions (257 77.7 and 267 87.0Nm).
Even so, the contribution of the antagonist muscle was
higher when seated (26 20.4Nm) than when supine
(12 7.4Nm). Interestingly, involuntary knee extension
torque was greater in supine (111 31.9 Nm) than when
seated (99 27.5Nm).
What did the researchers conclude?
The researchers found that differences in antagonist knee
flexor activation during MVIC knee extension torque
efforts do not affect differences in voluntary torque
between two hip joint positions corresponding to either
long or short rectus femoris muscle lengths. Since
involuntary knee extension torque was greater in supine
than in seated, but voluntary knee extension torque was
similar in both supine and seated positions, this suggests
that a reduction in voluntary activation was responsible
for the lower MVIC knee extension torque when the
rectus femoris is lengthened.
Limitations
The study was limited as it was unclear if voluntary
activation was the reason for the difference in MVIC knee
extension torque at each hip joint angle, as it was not
measured directly.
Quinlan, J. I., Maganaris, C. N., Franchi, M. V., Smith, K.,
Atherton, P. J., Szewczyk, N., & Williams, J. P. (2017).
Muscle and Tendon Contributions To Reduced Rate of
Torque Development In Healthy Older Males. The Journals
of Gerontology: Series A.
Link to abstract
Background
Strength increases after long-term resistance training
programs because of multiple different adaptations,
many of which we know very little about. Adaptations can
be categorized into two groups, based on where they
occur. Adaptations that are located proximal to the
neuromuscular junction (NMJ) are described as central
or neural adaptations, while those that are distal to the
NMJ are described as peripheral adaptations. For a
more detailed introduction to strength determinants, see
the earlier study review.
OBJECTIVE: To assess muscle and tendon contributions
to differences in rate of torque development (RTD)
between young and old males.
M E A S U R E M E N T S : M ax i m al vo l u n t ary i s o m e t ric
contraction (MVIC) knee extension torque was measured
in a custom-made dynamometer with a calibrated load
cell; electromyography (EMG) amplitudes of the vastus
lateralis and biceps femoris muscles were measured by
surface electrodes; voluntary activation of the quadriceps
and involuntary RTD were measured by the interpolated
twitch technique in MVIC knee extension torque efforts
superimposed with electrical stimulation (single pulses);
RTD was measured in rapid isometric knee extension
torque efforts over the first 200ms of a contraction;
quadriceps anatomical cross-sectional area (CSA) and
tendon CSA were measured by MRI; tendon stiffness and
Youngs modulus were measured in voluntary isometric
ramped contractions with ultrasound, vastus lateralis
fascicle length was measured by ultrasound.
SUBJECTS: 28 young males (aged 23.9 yrs 1.1) and
22 old males (aged 68.5 yrs 0.5).
INTERVENTION: Subjects did MVIC knee extension
torque efforts in a rigid tabletop dynamometer with the
knee joint angle at 90 (full extension = 0) for the
assessment of maximal force, as well as similar efforts
with the instruction to produce force as rapidly as
possible for the assessment of maximal RTD.
What happened?
Absolute RTD was lower in older males than in younger
males (577.5 34.6 vs 881.7 45.6Nm/s) and RTD
normalized to quadriceps anatomical CSA was also lower
in older males than in younger males (9.93 0.7 vs.
11.9 0.6Nm/s/cm2). Involuntary RTD was lower in
older males compared to in younger males (1,086 vs
2,209Nm/s) and time to peak EMG amplitude was also
lower in older males compared to in younger males
(154.6 16.6 vs. 109.2 8.6ms). Tendon stiffness was
lower in older males than in younger males (1,222
78.4 vs. 1,771 154.1N/mm) and tendon Youngs
modulus was lower in older males than in younger males
(0.74 0.04 vs. 1.0 0.09 GPa). Absolute voluntary
RTD was associated with MVIC torque (R2 = 80%),
quadriceps anatomical CSA (R2 = 36%), tendon stiffness
(R2 = 28%), time to peak EMG amplitude (R2 = 11%),
and involuntary RTD (R2 = 11%), which is an indicator of
contractile properties.
What did the researchers conclude?
The researchers concluded that a reduced voluntary RTD
in the elderly is caused by smaller muscle size, lower
tendon stiffness, reduced time to peak EMG amplitude,
and slower contractile properties.
Limitations
The study was limited as it was unclear whether any of
these determinants of RTD can be affected by training.
Thompson, B. J., Whitson, M., Sobolewski, E. J., & Stock, M. OBJECTIVE: To assess the effects of age, joint angle,
S. (2017). The influence of age, joint angle, and muscle and muscle group (knee extensors and knee flexors) on
group on strength production characteristics at the knee maximal strength and rate of torque development (RTD).
joint. The Journals of Gerontology: Series A.
M E A S U R E M E N T S : M ax i m al vo l u n t ary i s o m e t ric
Link to abstract
contraction (MVIC) knee extension and knee flexion
torques were measured in a dynamometer; RTD at 50ms
Background and RTD at 200ms into the contractions were measured
Sarcopenia is a syndrome involving low muscle mass and at the same time.
reduced muscle function, typically observed in an aging
SUBJECTS: 21 young males (aged 22.1 2.9 years) and
person. Sarcopenia involves a generalized loss of muscle
23 older males (aged 72.6 6.2 years)
rather than a localized loss of muscle or muscle group-
specific loss of muscle and may follow primarily from INTERVENTION: Subjects did MVIC knee extension and
disuse atrophy. Recent estimates have suggested that knee flexion torque efforts in a dynamometer at 20,
the loss of muscle mass occurs at a rate of 3 8% per 60, and 90 of knee flexion (full extension = 0).
decade after the age of 30 and that a higher rate of
muscle loss occurs in old age. Thus, sarcopenia is a key
What happened?
problem in geriatrics and leads to an increased risk of
several adverse health outcomes, including physical Young males displayed greater MVIC knee extension and
disability, poor health-related quality of life and increased knee flexion torques at all joint angles, compared to
mortality. The prevalence of sarcopenia ranges widely elderly males. All subjects displayed greater MVIC knee
from 7 68%, depending on age, geography and extension torques at 60 and 90 joint angles compared
circumstances of the individuals involved. An increased to the 20 angle. Elderly males displayed greater MVIC
prevalence of sarcopenia is seen in older adults, knee flexion torques in the order 20 > 60 > 90 knee
individuals living in residential nursing homes, individuals flexion. Although young males displayed a similar trend,
who have experienced fractures, individuals who the difference between 20 and 60 was not significant.
habitually perform low levels of physical activity, As expected, elderly males displayed lower RTD at all
individuals with a low body mass index (BMI), and in joint angles, compared to young males. Knee extension
those who score low on functional tests such as single leg RTD was greater at 60 and 90 joint angles, compared
stance time and handgrip strength, or who have a history to the 20 angle. Knee flexion RTD was similar at all joint
of falls. Some studies indicate that sarcopenia may angles.
involve a preferential loss of type II muscle fiber area
and muscle fiber number as a result of denervation. An What did the researchers conclude?
inability to stimulate muscle protein synthesis via The researchers concluded that MVIC knee extension
signaling and increased oxidative stress may also be a torque and RTD are greater at 60 and 90 joint angles
contributing factor leading to accelerated muscle wasting. compared to a 20 angle in both younger and older
Since a number of studies have found that aerobic males, but the effect of joint angle is much less marked
exercise, resistance-training and concurrent training for knee flexion.
programs are able to combat sarcopenia, guidelines have
been produced to provide exercise information for elderly
people. For example, the American College of Sports
Limitations
Medicine (ACSM) recommends that for aerobic exercise, The study was limited as it was unclear what produced
older adults should perform moderate intensity aerobic the differences in MVIC torque and RTD across the joint
activity for >30 minutes, 5 days of the week or vigorous angles, as no other measurements were taken.
exercise for >20 minutes, 3 days of the week. The ACSM
recommends that for resistance-training, older adults
should perform bi-weekly muscle strengthening activities
of 8 10 exercises for 10 15 repetitions. Interestingly,
however, studies have shown that the loss of muscle
mass in sarcopenia is only partially correlated with the
loss of strength, which appears to be much more rapid.
Thus, it appears that there may be neural factors
associated with the loss of muscle strength in the elderly,
which may include reductions in voluntary muscle
activation. Indeed, there are indications that the loss of
muscle power may in fact reduce at a greater rate than
the loss of muscular strength. This is important, as some
studies have reported that muscle power is more
influential than muscular strength in determining
performance on functional tasks in the elderly
population..
Doguet, V., Nosaka, K., Guvel, A., Thickbroom, G.,
Ishimura, K., & Jubeau, M. (2017). Muscle length effect on
corticospinal excitability during maximal concentric,
isometric and eccentric contractions of the knee extensors.
Experimental Physiology.
Link to abstract
Background
Strength gains are specific to the joint angles over which
they are trained. This is particularly evident after training
with isometric contractions, or after training using
dynamic contractions where there is a peak contraction
near to the stretched position of the prime movers, as
occurs in many common axial exercises, such as the
squat and deadlift. Indeed, research has shown that
training with partial range of motion (ROM) in the squat
leads to greater gains in strength at partial ROM than at
full ROM, while training with full ROM in the squat leads
to greater gains in strength at full ROM than at partial
ROM. Interestingly, the transfer between full ROM squat
training and a partial ROM squat 1RM test is greater than
the transfer between partial ROM squat training and a full
ROM squat 1RM test. This is similar to the results
observed after isometric training at long and short
muscle lengths. These results can be explained by two
different mechanisms. The specific gains in strength that
occur at short muscle lengths are likely caused by joint-
angle specific increases in neural drive. In contrast, full
specific gains in strength that occur at long muscle
lengths likely occur through changes in regional
hypertrophy, which may partly reflect increases in muscle
fascicle length. For a more detailed review of this topic,
see Chris Beardsley's article HERE.
OBJECTIVE: To compare corticospinal excitability (as
measured by motor evoked potential (MEP) amplitudes)
and intracortical inhibition (as measured by cortical silent
period (CSP) duration) between concentric, isometric and
eccentric maximal voluntary contractions (MVICs) of the
knee extensors, at short muscle lengths (75 of knee
flexion) and long muscle lengths (100 of knee flexion),
where 0 = full knee extension.
MEASUREMENTS: MVIC knee extension torque was
measured at both 75 and 100 of knee flexion using the
dynamometer; vastus lateralis activation was recorded in
each case by surface electromyography, including the M
wave produced by the electrical stimulation, and the peak
MEPs and CSPs produced by transcranial magnetic
stimulation (TMS).
SUBJECTS: 12 males (8 untrained males, 4 trained
males), aged 27.7 4.9 years.
INTERVENTION: Subjects did a total of 12 MVICs in a
dynamometer at 85 hip flexion (0 = full hip extension)
in each of the contraction types (concentric, isometric
and eccentric), with 5 minutes of rest between
contraction types. Concentric and eccentric contractions
moved between 110 40 of knee flexion. Two
contractions were done at long and short muscle lengths
with (1) superimposed electrical stimulations to measure
the M wave, (2) superimposed TMS stimulations to
measure MEP, and (3) superimposed TMS stimulations to
measure CSP.
What happened?
The MEP amplitude relative to M wave (MEP/M) was lower
in the eccentric contraction, compared to both concentric
and isometric contractions at 75 of knee flexion (short
muscle length) but similar at 100 of knee flexion (long
muscle length). Only in isometric contractions, MEP/M
was higher at 75 of knee flexion (short muscle length)
than at 100 of knee flexion (long muscle length). The
CSP duration was shorter in eccentric contractions than in
both concentric and isometric contractions at 75 of knee
flexion (short muscle length), but longer in eccentric
contractions at 100 of knee flexion (long muscle length).
Only in eccentric contractions, CSP duration was shorter
at 75 of knee flexion (short muscle length) than at 100
of knee flexion (long muscle length). The MEP was not
associated with the CSP duration for any muscle length
or contraction type.
What did the researchers conclude?
The researchers concluded that neural control altered by
joint angle during isometric and eccentric contractions;
corticospinal excitability is increased during isometric
contractions at short muscle lengths, while cortical
inhibition is reduced in eccentric contractions at short
muscle lengths.
Limitations
The study was limited as it is unclear what causes the
alterations in neural control, and whether they can be
altered by strength training.
Freitas, S. R., Mendes, B., Le Sant, G., Andrade, R. J.,
Nordez, A., & Milanovic, Z. Can chronic stretching change
the muscle-tendon mechanical properties? A review.
Scandinavian Journal of Medicine & Science in Sport.
Link to abstract
Background
Flexibility is important for both athletes and for the
general population. Flexibility is defined as the ability to
move through a specific joint range of motion (ROM).
Stretching is commonly used to help individuals achieve
greater joint ROM. Researchers have generally proposed
two types of mechanism by which increases in flexibility
can be achieved. One type of mechanism involves a
mechanical change in the behavior of the muscle tissue
while the other type involves a change in sensation.
However, there are at least four theories that detail ways
in which some kind of mechanical change could occur:
viscoelastic deformation, plastic deformation, increased
number of sarcomeres in series, and neuromuscular
relaxation. However, the evidence to support these has
been found to be weak. In contrast, many studies have
reported that the only variable that changes following
stretching programs in tandem with flexibility is the
sensation of pain (i.e. maximum pain and onset of pain)
during the stretch. This supports the sensation theory of
stretching. Researchers advocating this theory have
formulated the hypothesis that stretching increases
flexibility by reducing the sensation of increasing muscle
length. Nevertheless, irrespective of how stretching
changes joint flexibility, it is apparent that it can achieve
increases in joint ROM that last > 1 day. There are two
main types of stretching that are explored in the
literature: static and dynamic stretching. Static stretching
involves moving a joint to the end of its ROM and holding
this stretched position for a set period of time. On the
other hand, dynamic stretching involves controlled
movements through the active ROM for a joint. While
both static and dynamic stretching have been found to
improve joint ROM, static stretching performed for >45
seconds appears to lead to meaningful acute reductions
in performance tasks, such as vertical jumping, whereas
dynamic stretching performed for long durations appears
to lead to either no improvement or small improvements
in the same type of actions. It is interesting to note that
reviews of the chronic effects of static stretching have
actually found beneficial effects on both athletic
performance and strength measures. The literature is
currently conflicting regarding whether regular static or
dynamic stretching is effective for reducing the risk of
sports injury, whether the stretching is performed
immediately prior to exercise or at another time.
Additionally, the exact duration of stretches, the total
volume and frequency of stretching per week, and the
rest periods between stretches that are optimal for the
most efficient increases in joint ROM are currently
unknown.
OBJECTIVE: To perform meta-analyses (using a random
effects model to produce a pooled effect size [ES]) to
assess if long-term stretching programs do typically alter
muscle-tendon properties.
STUDY SELECTION: Studies were included where they
described randomized or non-randomized long-term trials
in human participants of any age or state of health, in
which a program of static, dynamic, or proprioceptive
neuromuscular facilitation (PNF) stretching was done for
>2 weeks, where >2 sessions per week were performed,
and where >1 of the following measurements was taken
before and after the program: maximal tolerated passive
resistive torque, passive torque at a given angle, angle at
a given passive torque, or slope from the passive torque-
angle relationship, muscle fascicle length, pennation
angle, muscle or tendon stiffness, muscle or tendon
extensibility, muscle or tendon shear modulus, muscle or
tendon thickness, muscle or tendon cross sectional area,
and either muscle or tendon slack length.
What happened?
Studies selected
A total of 26 studies were identified. The stretching
programs used had durations ranging from 3 8 weeks.
Effects of long-term stretching
Long-term stretching produced a small effect on maximal
joint passive resistive torque (ES = 0.54, I2 = 74%), a
trivial effect on joint torque at a given angle (ES = 0.01,
I2 = 82%), a trivial effect on angle at a given torque (ES
= -0.01, I 2 = 0%), a small effect on the slope of the
torque-angle relationship (ES = -0.30, I2 = 84%), and a
trivial effect on muscle stiffness (ES = -0.19, I2 = 70%),
fascicle length (ES = -0.09, I2 = 0%), pennation angle
(ES = 0.02, I2 = 0%), and tendon stiffness (ES = -0.06, I2
= 28%).
What did the researchers conclude?
The researchers concluded that stretching programs
lasting up to 8 weeks do not appear to alter muscle or
tendon properties, but can increase flexibility and
tolerance to a greater tensile force. This indicates that
the main way in which stretching improves flexibility is
through an increased tolerance to stretch. However, there
was a high degree of variability between studies, which
suggests that some protocols may have produced results,
while others did not.
Limitations
The study was limited as the small number of studies
that have identified changes in muscle and tendon
properties after stretching have often done so through
specific protocols, and this systematic review covered a
wide range of interventions. Those protocols that have
identified changes in certain muscle properties have
progressively increased the load on the muscle during the
stretching program, and used static stretches of long (3-
minute) durations.
Kanda, K., Sakuma, J., Akimoto, T., Kawakami, Y., & OBJECTIVE: To carry out a comprehensive proteomic
Suzuki, K. (2017). Detection of titin fragments in urine in analysis of urinary proteins released after a single bout of
response to exercise-induced muscle damage. PloS one, eccentric training.
12(7), e0181623.
MEASUREMENTS: Delayed-onset muscle soreness
Link to abstract; link to full text
(DOMS) of the medial gastrocnemius was measured on a
visual analogue scale (VAS); blood and urine samples
Background were collected before exercise, and at 2, 4, 24, 48, 72,
The sliding filament theory predicts that when and 96 hours post-exercise, and subjected to various
sarcomeres contract isometrically, the maximum possible analyses.
force should be proportional to the number of
SUBJECTS: 9 healthy males, aged 24.8 1.3 years.
overlapping cross-bridges. However, it has been observed
that isometric force is greater than expected when INTERVENTION: All subjects did a bout of eccentric calf
contractions follow eccentric contractions than when they raises with the right leg, while standing on a force plate,
follow concentric contractions at the same muscle length. with the knee extended and the body inclined to 30o to
T h i s p h e n o m e n o n i s k n o w n a s r e s i d u a l f o r c e the horizontal and resting on a backrest; each bout of
enhancement and cannot be explained using the classical calf raises comprised 10 sets of 40 reps between 20o of
sliding filament theory. Previous researchers have found dorsiflexion to 15o of plantar-flexion, at a rate of 1
that the property of residual force enhancement eccentric contraction per second, with a 3-minute rest
increases with increased magnitude of stretch and between sets.
increases even more as the muscle is stretched on the
descending limb of the length-tension relationship, which
What happened?
suggests that a passive mechanism is responsible for its
behavior. Titin is a spring-like protein and is the primary A total of 99 proteins were identified in urine as being
contributor to passive force when sarcomeres are uniquely expressed after the single bout of eccentric
stretched beyond a certain resting length. It is thought to training and might therefore be biomarkers of acute
be a key contributor to the property of residual force muscle damage. One of these 99 proteins was a titin N-
enhancement. However, it appears to be a multi- terminal fragment (molecular weight = 28 kDa). The rate
functional protein and also contributes to other muscle of excretion of this fragment increased at 24 hours post-
functions, including centering of the thick filament, exercise, and continued increasing from 24 96 hours.
sarcomere stability, and a number of signaling events. There were moderate-to-strong correlations between
Titin can be divided into an A-band and an I-band region. percentage changes in the rate of excretion of this
Researchers have concluded that the I-band is extensible fragment and the levels of creatine kinase (CK),
and is made up of a proximal Ig and PEVK spring, which myoglobin, lactate dehydrogenase (LDH), and aldolase
appear to be the primary contributors to the production (ALD) at most time points measured post-exercise. There
of tension in stretch. Some researchers have proposed were also negative and moderate-to-strong correlations
that the sliding filament theory can be modified to between the percentage changes in the rate of excretion
include the behavior of titin and thus explain the spring- of this fragment and ankle ROM at 48 and 72 hours post-
like behavior of sarcomeres and the property of residual exercise (r = -0.71 to -0.76) and peak ankle plantar-
force enhancement. It has been noted that calcium flexion torque at 72 hours post-exercise (r = -0.72).
causes titin to bind to actin while actin and myosin are
forming a cross-bridge. Cross-bridge formation pulls and What did the researchers conclude?
twists the actin (the action is not just a slide as the The researchers concluded that a urinary titin fragment
sliding filament model previously proposed since there is was observed to increase after a single bout of eccentric
a twisting component). When the actin is twisted, since exercise; the changes in the levels of this titin fragment
titin is bound to the actin, titin goes along for the ride. were moderate-to-strongly associated with changes in
The stretching and winding of titin creates stored elastic blood biomarkers of muscle damage, ROM, and muscle
energy which leads to subsequent (or indeed residual) strength, indicating that it is related to the process of
force enhancement. Some researchers have noted that muscle damage and exercise-induced force loss.
titin may in fact explain why skeletal and cardiac muscle
have such different length-tension properties: cardiac
muscle is never stretched when active so it doesnt
Limitations
receive the same spring-like benefits. Titin may also The study was limited as it was unclear whether the loss
explain why activated muscles have enhanced force in titin caused a loss in muscle force, or simply occurred
compared to passive muscles at identical lengths: active in tandem with it.
muscles store elastic energy through stretched titin, and
t h e g re at e r t h e s t re t c h t h e g re at e r t h e fo rc e
enhancement. Titin also explains why eccentric exercise
produces more tension at the same length compared to
concentric exercise: because of the utilization of stored
energy in the titin molecule.
Garca-Ramos, A., Pestaa-Melero, F. L., Prez-Castilla, A.,
Rojas, F. J., & Haff, G. G. (2017). Differences in the Load-
Velocity Profile Between Four Bench Press Variants.
International Journal of Sports Physiology and Performance,
1.
Link to abstract
Background
The bench press is a staple lift in many strength and
conditioning programs, for developing the upper body,
including the pectoralis major, deltoids, and triceps
brachii muscles. There are many different bench press
variations, which can be analyzed by the bench angle
(incline, decline, flat), by the type of load (barbell,
dumbbell, and machine), and by the grip width (narrow,
medium, and wide). To read a complete review regarding
the biomechanics of the bench press, please visit the S&C
Research encyclopedia page HERE.
OBJECTIVE: To compare the load-velocity relationships
of 4 bench press variations.
MEASUREMENTS: Mean bar speed was measured using
a linear velocity transducer attached to the bar.
SUBJECTS: 30 physically-active males, aged 21.2 3.8
years.
INTERVENTION: Subjects performed load-velocity tests
between 17kg and their 1RM in 4 bench press variations
using a Smith machine: (1) concentric-only bench press,
(2) concentric-only bench throw, (3) eccentric-concentric
bench press, and (4) eccentric-concentric bench throw.
The bench press and bench throw variations were
performed in a similar way, except that the throw
involved accelerating to the point of releasing the bar at
arm's length, while the press involved decelerating the
bar to the end of the lift. All lift phases were performed
as fast as possible.
What happened?
There were strong, linear relationships between load and
velocity (bar speed) for all 4 bench press variations (R2 >
96%). Yet there were also differences between the 4
variations. Bar speed at any given percentage of 1RM
was greater when using an eccentric-concentric method,
than when using a concentric-only method, and bar
speeds across the 4 variations were only moderately
associated with one another (r = 0.44 0.76). The
heaviest load used (1RM) was also greater when using
the eccentric-concentric method, compared to when
using a concentric-only method (1RM = 81.4 13.8 vs.
76.7 12.7kg), and the 1RMs in each of the 4 variations
were strongly associated with one another (r = 0.98).
The bar speed of the 1RMs were not associated with each
other (r = -0.11).
What did the researchers conclude?
The researchers concluded that although all 4 bench
press variations displayed strong, linear relationships
between load and velocity (bar speed), the relationships
were exercise-specific.
Limitations
The study was limited as it was unclear exactly why there
were differences in the load-velocity relationships of each
exercise variation.
Bernard, J., Beldame, J., Van Driessche, S., Brunel, H.,
Poirier, T., Guiffault, P., & Billuart, F. (2017). Does hip-joint
positioning affect maximal voluntary contraction in the
gluteus maximus, gluteus medius, tensor fasciae latae and
sartorius muscles? Orthopaedics & Traumatology, Surgery &
Research.
Link to abstract
Background
The gluteus maximus originates on the posterior quarter
of the iliac crest, the posterior surface of the sacrum and
coccyx and the fascia of the lumbar spine. It inserts on
the oblique ridge on the lateral surface of the greater
trochanter of the femur and the iliotibial band of the
fascia latae. In humans, the gluteus maximus is much
larger than in other apes, particularly in respect of the
upper region. Additionally, it is attached to the iliac crest
as well as the ischium, which is not the case in other
apes. Also, in other apes, the gluteus maximus is
subdivided into two separate muscles whereas in humans
it is a single muscle, albeit with multiple subdivisions.
Indeed, the gluteus maximus contains 3 divisions from
top to bottom (superior, middle, inferior) and two halves
from side to side (medial and lateral) that can be shown
to perform distinctly different functions in 6 regions, as
can be shown by both muscle architecture and
electromyography (EMG) activity. The gluteus maximus
can also be subdivided into superficial, deep sacral and
deep iliac layers. The gluteus maximus is an extremely
important muscle and is the largest and heaviest of all
the muscles in the body. It comprises around 13 15%
of total leg muscle mass by weight (around 600g in
elderly males). It has a physiological cross-sectional area
of ~34cm2 and an anatomical cross-sectional area of ~
48.4cm2. The muscle architecture of the gluteus
maximus is extraordinary in that it has both a long
fascicle length and a large cross-sectional area. It is also
strongly pennate, as might be expected from its large
cross-sectional area. The gluteus maximus is 52 68%
percent type I fibers, making it an evenly mixed slow and
fast twitch muscle. It has its most significant moment
arm in the sagittal plane for hip extension but also has a
large moment arm in the transverse plane for external
rotation. It also has a very small adduction moment arm
in the frontal plane. Our current understanding based on
anatomy, muscle architecture and EMG studies indicates
that the gluteus maximus performs a number of different
hip actions from extension, to external rotation and
abduction/adduction. It also raises the trunk when the
femur is fixed in position, and posteriorly tilts the pelvis.
The gluteus maximus therefore requires a range of
different movements performed with these actions in
mind in order to target it fully. Various pathologies have
been associated with gluteus maximus weakness. A weak
gluteus maximus has been associated with an increased
risk of lower back pain, excessive anterior pelvic tilt,
sacroiliac joint pain, piriformis syndrome, anterior
femoral hip glide, knee valgus and increased ACL injury
risk and hip internal rotation and consequent foot
pronation.
OBJECTIVE: To compare the muscle activation of the hip
muscles in different isometric testing positions against
manual resistance, and to explore whether the activation
changes during 3 tests performed over the course of a
single week.
MEASUREMENTS: Surface electrodes were used to
record the electromyography of each muscle, normalized
to the levels observed in a single-leg standing task.
SUBJECTS: 30 young, healthy subjects (16 males, and
14 females, aged 21.2 2.4 years).
INTERVENTION: All subjects did 2 maximum voluntary
isometric contractions (MVICs) against manual resistance
for each muscle group (8 in total), with different joint
angle positions, on 3 separate occasions. The gluteus
maximus was tested in performing hip extension (1) in
prone, with the hip and knee in approximately 45
degrees of flexion, and (2) side-lying, with the hip and
knee in approximately 0 degrees of flexion (i.e. full
extension); the gluteus medius was tested in performing
hip abduction (1) in side-lying, and (2) in standing; the
tensor fasciae latae (TFL) was tested in (1) performing
hip abduction with the hip flexed in side-lying, and (2)
performing hip flexion in side-lying; the sartorius was
tested in hip flexion/abduction/external rotation in (1)
supine, and (2) sitting.
What happened?
There were no apparent differences in EMG amplitudes
according to the MVIC position for any of the muscles.
Comparing tests 1 and 2 for each muscle, there was a
trend for the gluteus maximus to display greater EMG
amplitude in test 1 (19.9 17.1 vs. 14.6 10.8%), for
the gluteus medius to display greater EMG amplitude in
test 1 (13.4 9.0 vs. 9.6 8.8%), for the TFL to display
greater EMG amplitude in test 1 (65.9 51.3 vs. 61.2
47.8%), and for the sartorius to display greater EMG
amplitude in test 1 (101.1 67.9 vs. 72.6 44.6%).
There was no difference between any of the 3 testing
sessions for any of the muscles or tests.
What did the researchers conclude?
The researchers concluded that there is no need to
perform multiple tests for each hip muscle across a single
week, and that a single test per muscle group can be
used. However, the normalization method led to a large
degree of inter-individual variation, which made it very
difficult to discern differences between tests, and this
may have caused a type II error.
Limitations
The study was limited by the normalization method,
which likely made it difficult to detect the presence of any
real differences in EMG amplitude between tests.
Lacourpaille, L., Nordez, A., Hug, F., Doguet, V., Andrade,
R., & Guilhem, G. (2017). Early detection of exercise-
induced muscle damage using elastography. European
Journal of Applied Physiology.
Link to abstract; link to full text
Background
Delayed onset muscle soreness (DOMS) is frequently
experienced by athletes and recreational trainees when
exposed to either novel resistance-training workouts or a
large volume of eccentric muscle actions. Symptoms
include soreness, tenderness upon palpation, and
stiffness during movement. DOMS appears to occur
reliably between 12 24 hours post-workout, with
soreness peaking around 48 hours post-workout. There is
a lack of consensus regarding the underlying mechanisms
that cause DOMS. Some researchers consider DOMS to
be caused entirely by exercise-induced muscle damage
(EIMD). EIMD is similarly characterized by muscle
soreness, muscle swelling, an increase in intramuscular
protein and passive muscle tension, and also involves a
reduction in muscular strength and range-of-motion. In
this model, EIMD causes various disruptive changes,
including sarcomere damage, calcium accumulation,
protein degradation, and increased osmotic pressure.
These changes lead to the sensitization of nociceptors
and other pain receptors, which leads to the sensation of
DOMS being experienced. A number of different
interventions have been tested for reducing both EIMD
and DOMS. There is some evidence to support the use of
massage and limited evidence to support the use of self-
myofascial release with a foam roller. The mechanisms by
which massage or self-massage might be effective for
reducing DOMS are not well-understood and various
possibilities are currently being explored by researchers.
One interesting feature of DOMS is that it is dramatically
reduced when the muscle has been exposed to a similar
stimulus on a recent, previous occasion. This is known as
the repeated bout effect and indicates that central
factors may well be involved in addition to local ones.
OBJECTIVE: To assess whether an increase in muscle
shear modulus measured by shear wave elastography 30
minutes after a single bout of eccentric training is related
to the size of the reduction in force after 48 hours.
MEASUREMENTS: Strength loss after exercise was
measured in maximal voluntary isometric contractions
(MVICs) at knee and elbow angles of 70 and 90,
respectively, in a dynamometer before and at 48 hours
post-exercise; muscle shear modulus was measured
before and at 30 minutes post-exercise, on the knee
extensors at 30, 90, and 110 of knee flexion angle (0
= full extension) and on the elbow flexors at 70, 110,
and 160 of elbow angle (180 = full extension).
SUBJECTS: 53 subjects (35 males and 18 females, aged
24.6 3.4 years), allocated into 5 groups: (1) eccentric
elbow flexion training with a light load (EEL), (2)
eccentric elbow flexion training with a heavy load (EEH),
(3) eccentric knee extension training with a light load
(EKL), (4) eccentric knee extension training with a heavy
load (EKH), and (5) concentric elbow flexion training with
a light load (CEL), as a control group.
INTERVENTION: Subjects in the EKL and EKH groups
did 5 sets of 15 or 30 maximal isokinetic (60/s)
eccentric knee extension contractions between 10
110 of knee angle (0 = full extension), with 1.5
minutes of rest between sets; subjects in the EEL and
EEH groups did 3 or 6 sets of 10 maximal isokinetic
(120/s) elbow flexion eccentric contractions between
60 175 of elbow angle (180 = full extension), with
1.5 minutes of rest between sets; CEL did 3 sets of 10
maximal isokinetic (120/s) concentric elbow flexion
contractions between 60 175 of elbow angle (180 =
full extension).
What happened?
CEL did not display any reduction in strength at 48 hours
post-exercise. However, both EEL and EEH displayed
similar reductions in MVIC elbow flexion torque at 48
hours (26.2 19.9%) with no differences between light
and heavy loads. EKL and EKH displayed reductions in
MVIC knee extension torque at 48 hours, but in this case
the reduction was larger for heavy loads (33.7
19.6%) than for light loads (16.8 15.1%). CEL did
not display any change in shear modulus. However, there
was an increase in shear modulus of the elbow flexors in
the most stretched position after EEL (+70.5 44.3%),
EEH (+153.9 192.4%), EKL (+26.7 19.1%) and EKH
(+79.4 67.1%). This increase in shear modulus at 30
minutes post-exercise was associated with the decrease
in MVIC torque at 48 hours for both the elbow flexors (r
= 0.80) and knee extensors (r = 0.82).
What did the researchers conclude?
The researchers concluded that the increase in shear
modulus in the most stretched position at 30 minutes
after a bout of eccentric exercise was strongly associated
with the subsequent loss in force at 48 hours, in both
upper and lower body muscles.
Limitations
The study was limited as it is still unclear what muscle
shear modulus actually measures, and if it accurately
reflects the amount of muscle fiber disruption and cell
membrane damage that leads to calcium overload.
Allen, C. R., Fu, Y. C., Cazas-Moreno, V., Valliant, M. W., OBJECTIVE: To assess the effects of (1) jaw clenching
Gdovin, J. R., Williams, C. C., & Garner, J. C. (2017). The and (2) a self-adapted, jaw repositioning mouthpiece on
Effects Of Jaw Clenching And Jaw Alignment Mouthpiece Use force produced during a countermovement vertical jump
On Force Production During Vertical Jump And Isometric (CMJ) and on force produced during a maximum
Clean Pull. The Journal of Strength & Conditioning Research. isometric mid-thigh pull (IMTP).
Link to abstract
M E AS U R E M E N T S : Gro u n d re ac t i o n fo rc e s w e re
measured in both the CMJ and IMTP to record peak force,
Background normalized peak force, and rate of force development
Vertical jumping ability is a key athletic quality. Studies (RFD) over 200ms; vertical jump height was measured
have reported beneficial effects on vertical jump height by a Vertec.
from many types of training methods, including unilateral
SUBJECTS: 36 males, aged 23 2.8 years, with
plyometrics, bilateral plyometrics, loaded jumps,
strength-training experience.
unilateral conventional strength training, conventional
strength and/or power training, isometric strength INTERVENTION: Subjects did CMJs and IMTPs under 3
training, Olympic lifting programs, kettlebell training, mouthpiece conditions: (1) self-adapted jaw repositioning
complex training, contrast training, assisted and resisted mouthpiece, (2) self-adapted traditional mouthguard, and
jumps, and combined methods. Studies exploring the (2) no mouthpiece, and in 2 jaw clenching conditions: (1)
biomechanics of vertical jumping have identified that co- jaw maximally clenched, and (2) jaw relaxed. The IMTP
ordination, strength, rate of force development (RFD), was done with a hip angle at 125 and a knee angle at
and elastic energy storage through the stretch-shortening 140, using a goniometer to standardize joint angles.
cycle can all influence vertical jump performance to some
degree.
What happened?
There were no differences in any variable between any of
the conditions for the CMJ. There were no differences in
peak force, normalized peak force, or RFD between
mouthpiece conditions for the IMTP. However, clenching
the jaw involved greater peak force, normalized peak
force, and RFD compared to not clenching the jaw, for
the IMTP.

What did the researchers conclude?

The researchers concluded that maximal jaw clenching
leads to greater force production in maximal isometric
force production, but not in dynamic force producing
movements like the vertical jump.

Limitations
The study was limited as it was unclear whether the
same effects would be observed in strength athletes, or
in combination with psyching up methods.
Snarr, R. L., Hallmark, A. V., Casey, J. C., & Esco, M. R. OBJECTIVE: To compare the muscle activity of the
(2017). Electromyographical Comparison of a Traditional, latissimus dorsi, posterior deltoid, middle trapezius, and
Suspension Device, and Towel Pull-Up. Journal of Human biceps brachii between 3 pull-up variations.
Kinetics, 58(1), 5-13.
MEASUREMENTS: Muscle activation for the latissimus
Link to abstract; link to full text
dorsi, posterior deltoid, middle trapezius, and biceps
brachii was measured using electromyography (EMG)
Background amplitudes, normalized to maximum voluntary isometric
The latissimus dorsi muscle is long and broad and forms contractions (MVICs).
a fan shape with its origins along the thoracic and lumbar
SUBJECTS: 15 subjects (13 males and 2 females), aged
spine and its insertion on the anterior aspect of the
24.87 6.52 years with strength training experience,
humerus. Based on its point of insertion, the latissimus
who could all perform >5 pull-ups with proper form.
dorsi is assumed to perform shoulder adduction,
extension and internal rotation. Additionally, it appears to INTERVENTION: Subjects did 3 reps each of 3 different
be able to perform spinal extension and lateral flexion. pull-up variations, using a 1.5 times biacromial grip width
Rows, pull-ups and lat pull-downs are popular exercises in each case: (1) traditional pull-ups, (2) suspension
for the back musculature. In terms of lat pull-downs, it is device pull-ups, and (3) towel pull-ups.
important to note that this machine permits the use of at
least two different grip variations, being wide and
What happened?
narrow. It has been suggested that a wide grip might
lead to superior EMG activity of the latissimus dorsi than There were no differences in latissimus dorsi EMG
a narrow grip, although the research in this respect is amplitude (range = 80 85% of MVIC), biceps brachii
conflicting, with two studies reporting no difference in EMG amplitude (41 46% of MVIC) and posterior deltoid
EMG activation as a result of grip width and another EMG amplitude (101 106% of MVIC). However, middle
finding a difference in favor of wide grips. In terms of trapezius EMG amplitude was greater in the traditional
rows, some previous research has found that seated rows pull-up (60.52 18.06% of MVIC) compared to towel
produce greater latissimus dorsi EMG activity than lat pull-ups (51.00 14.22% of MVIC) and also tended to
pull-downs, despite the common belief that lat pull- produce greater EMG amplitude than the suspension pull-
downs develop this muscle to a greater extent. up variation (55.21 15.13% of MVIC).

What did the researchers conclude?

The researchers concluded that using a suspension
device or towels does not increase the activation of the
prime movers in the pull-up exercise, and may reduce
the activation of the middle back musculature, even
though the grip width was identical in all variations.

Limitations
The study was limited as it was unclear whether the
same results would be observed after a familiarization
period.
#3. ANATOMY, PHYSIOLOGY, AND
NUTRITION
Clifford, T., Howatson, G., West, D. J., & Stevenson, E. J.
(2017). Beetroot juice is more beneficial than sodium
nitrate for attenuating muscle pain after strenuous
eccentric-bias exercise. Applied Physiology, Nutrition, and
Metabolism.
Link to abstract
Background
Delayed onset muscle soreness (DOMS) is frequently
experienced by athletes and recreational trainees when
exposed to either novel resistance-training workouts or a
large volume of eccentric muscle actions. Symptoms
include soreness, tenderness upon palpation, and
stiffness during movement. DOMS appears to occur
reliably between 12 24 hours post-workout, with
soreness peaking around 48 hours post-workout. There is
a lack of consensus regarding the underlying mechanisms
that cause DOMS. Some researchers consider DOMS to
be caused entirely by exercise-induced muscle damage
(EIMD). EIMD is similarly characterized by muscle
soreness, muscle swelling, an increase in intramuscular
protein and passive muscle tension, and also involves a
reduction in muscular strength and range-of-motion. In
this model, EIMD causes various disruptive changes,
including sarcomere damage, calcium accumulation,
protein degradation, and increased osmotic pressure.
These changes lead to the sensitization of nociceptors
and other pain receptors, which leads to the sensation of
DOMS being experienced. A number of different
interventions have been tested for reducing both EIMD
and DOMS. There is some evidence to support the use of
massage and limited evidence to support the use of self-
myofascial release with a foam roller. The mechanisms by
which massage or self-massage might be effective for
reducing DOMS are not well-understood and various
possibilities are currently being explored by researchers.
One interesting feature of DOMS is that it is dramatically
reduced when the muscle has been exposed to a similar
stimulus on a recent, previous occasion. This is known as
the repeated bout effect and indicates that central
factors may well be involved in addition to local ones.
OBJECTIVE: To compare the effects of a beetroot juice
drink and a nitrate-only drink (sodium nitrate) on
measures of EIMD.
MEASUREMENTS: Loss in strength was recorded by
reference to maximal isometric voluntary contraction
(MIVC) knee extension force, using a portable strain
gauge; pressure-pain threshold (PPT) of the quadriceps
was recorded with a handheld algometer; blood samples
were drawn to measure levels of creatine kinase (CK),
high sensitivity C-reactive protein (CRP) and endogenous
nitric oxide (NO); measurements were taken at baseline
(before exercise), immediately post-exercise, and at 24,
48 and 72 hours post-exercise.
SUBJECTS: 30 recreationally-active males, allocated into
3 groups of 10 subjects who consumed either a beetroot
juice drink (BEET), a sodium nitrate drink (SN), or an
isocaloric placebo (PLAC). The drinks were consumed on
3 occasions on the same day as the workout (one 30
minutes post-exercise, a second at 2.5 hours post-
exercise, and a third in the evening meal) as well as on 2
more occasions at 24 and 48 hours post-exercise. BEET
and SN were matched as closely as possible for nitrate
content (approximately 210mg per 250ml serving).
INTERVENTION: Subjects did a workout designed to
produce EIMD, comprising 5 sets of 20 drop jumps from
a 0.6m high box; after each drop landing, they
descended into a squat (90 knee flexion) and then
jumped vertically as high as possible, with 10 seconds
between jumps, and with 2-minutes rest between sets.
What happened?
Both BEET and SN increased the sum total of nitrate and
nitrite levels recorded in the blood samples, while PLAC
did not. PPT was reduced in all groups post-exercise, but
remained higher in BEET than in either SN or PLA over
the 72 hours post-exercise. By 72 hours, PPT had
recovered to baseline levels in BEET (104.3 25.9%) but
was still depressed in SN (94.1 16.0%) and PLAC
groups (91.2 19.0%), indicating that the beetroot juice
drink was able to reduce symptoms of EIMD including
DOMS to a greater extent than the other drinks. In
contrast to PPT, there were reductions in MVIC knee
extension force, and increases in both CK and CRP levels
that did not recover in the 72 hours post-exercise, and
did not differ between groups.
What did the researchers conclude?
The researchers concluded that neither beetroot juice nor
nitrates can reduce the loss in strength after a muscle-
damaging workout, but beetroot juice is effective for
reducing post-workout muscle soreness (while nitrates
are not). This suggests that certain other phytonutrients
in beetroot may be responsible for analgesic effects post-
exercise.
Limitations
The study was limited as it was unclear what active
ingredient in the beetroot juice was effective for reducing
muscle soreness post-exercise.
Dankel, S. J., Mattocks, K. T., Jessee, M. B., Buckner, S. L.,
Mouser, J. G., & Loenneke, J. P. (2017). Do metabolites that
are produced during resistance exercise enhance muscle
hypertrophy?. European Journal of Applied Physiology.
Link to abstract
Background
The primary stimuli for causing hypertrophy have been
categorized in various ways. One popular framework
divides the stimuli into 3 categories: (1) mechanical
loading, (2) exercise-induced metabolic stress, and (3)
exercise-induced muscle damage. Other frameworks
have proposed limiting the number of primary stimuli to
2 categories (mechanical loading and exercise-induced
metabolic stress), and others have suggested that only
mechanical loading may be the primary driver, as neither
metabolic stress nor muscle damage appear to produce
hypertrophy in the absence of mechanical loading.
OBJECTIVE: To perform a narrative review exploring
whether metabolic stress caused by the production of
metabolites during a strength training workout might
contribute to muscular hypertrophy.
What happened?
Introduction
It is widely-accepted that the primary mechanism by
which hypertrophy results from strength training is the
detection of mechanical loading on the muscle fiber, by
mechanotransduction by certain proteins located at the
outside of the muscle fiber, which link the internal
cytoskeleton to the extracellular matrix (ECM). Yet it has
also been proposed that muscle fibers can also sense the
presence of metabolic disturbances (predominantly the
production of lactate and inorganic phosphate), which
may therefore be considered to cause an anabolic effect.
Anabolic effects of metabolites
In cell culture studies, lactate has been shown to produce
muscle cell growth, and also phosphorylate p70S6K,
which is an important marker on the mTOR pathway
whose acute simulation has been closely linked to long-
term muscle growth. Moreover, oral supplementation with
lactate and caffeine in rats carrying out aerobic exercise
seems to cause additional hypertrophy, compared to a
control group. These methods of providing lactate (in
cells and as a supplement) may work by increasing levels
of testosterone, and may not apply when producing
lactate endogenously, but even the effect of exogenous
lactate on testosterone (and the effects of acute changes
in testosterone) are contentious. In addition to lactate, it
is possible that inorganic phosphate might have anabolic
effects, but such effects have largely only been recorded
in bone and not in muscle. Finally, reactive oxygen
species (ROS) may have anabolic effects, as in vitro
studies have noted that they can increase insulin-like
growth factor 1 (IGF-1) in a dose-responsive fashion,
with only moderate elevations in ROS causing a positive
effect.
Motor unit recruitment
The reviewers suggest it is most likely that metabolites
cause hypertrophy by fatiguing effects on muscle fibers
associated with low-threshold motor units. This fatiguing
effect involves the reduction in crossbridge cycling of the
fibers associated with low-threshold motor units, making
them unable to produce the necessary force. The central
nervous system (CNS) then recruits high-threshold motor
units, in order to maintain the same level of force, and
this stimulates the fibers of these motor units to grow,
which they would otherwise not do.
What did the researchers conclude?
The researchers concluded that metabolites produce
hypertrophy indirectly, by increasing the level of motor
unit recruitment that is achieved with light load training.
Limitations
The study was limited as the reviewers could not explain
why high-velocity strength training produces little muscle
growth, when every single rep will typically involve full
motor unit recruitment (but light load training to failure is
thought to reach full motor unit recruitment only in the
last few reps of each set).
Christou, M. A., Christou, P. A., Markozannes, G.,
Tsatsoulis, A., Mastorakos, G., & Tigas, S. (2017). Effects of
Anabolic Androgenic Steroids on the Reproductive System of
Athletes and Recreational Users: A Systematic Review and
Meta-Analysis. Sports Medicine.
Link to abstract; link to full text
Background
Anabolic androgenic steroids (AAS) are currently in
w i d e s p r e a d u s e b y b o t h c o m p e t i t i ve a t h l e t e s ,
bodybuilders and recreational lifters to increase strength
and muscle mass. The research and development of
synthetic steroid hormones began in the 1930s and
testosterone itself was isolated and synthesized in 1935.
This achievement was in fact considered to be so
important it actually earned the researchers involved the
Nobel prize in chemistry. However, while the use of AAS
to improve the performance of strength athletes is most
strongly associated with the Soviet Olympic weightlifting
teams of the 1950s, there are some researchers who
believe that East German athletes were using AAS prior
to that date. Nevertheless, it is thought that the
introduction of AAS to American athletes occurred
following contact between Soviet and US athletes and
team staff in the 1950s. Current knowledge about AAS is
sorely limited by their prohibited nature (which means
that it is very difficult to assess true prevalence of usage)
and also by ethical considerations, which preclude using
long-term interventions to assess their effects.
Nevertheless, reviews of the available literature have
concluded that in strength athletes, both short- and long-
term AAS use significantly increases lean body mass but
does not alter fat mass. The mechanisms by which AAS
leads to increases in muscle mass are thought to involve
both hypertrophy and (contentiously) hyperplasia.
Moreover, reviewers have concluded that the effects of
AAS on lean body mass are dose dependent, although it
is unknown what parameters of AAS usage lead to the
largest increases. Additionally, researchers have noted
that the upper body (upper back, neck, shoulders and
upper arms) appear to be more susceptible to the use of
AAS than other parts of the body and it is thought that
this occurs following a predominance of androgen
receptors in these areas. Since muscle mass is a key
predictor of strength, it is largely assumed that strength
increases in line with AAS usage. Additionally, many
athletes have reported that AAS use enhances recovery
time from hard training but research has yet to confirm
these anecdotal reports. Finally, although AAS use is
associated variously with highly-desirable increases in
muscle mass, strength, and recovery capacity, a number
of studies have reported a range of adverse effects,
including the development of acne vulgaris, increased
body hair, heightened aggressive behavior, mood
disturbances, heightened blood pressure, and reduced
levels of high-density lipoproteins (HDL). The effects of
AAS on human cardiac structure and function are unclear
although animal studies have revealed adverse effects.
OBJECTIVE: To carry out a systematic review and meta-
analysis (using a random-effects model to produce a
weighted mean difference [WMD]) of the effects of AAS
use on the reproductive system.
STUDY SELECTION: Studies were included if subjects
were athletes or non-athletes who used AAS (AAS users)
of any age, sex, or training background, where the
effects of AAS on the reproductive system was assessed,
including analysis of gonadotropin release by the
pituitary gland (follicle-stimulating hormone (FSH) and
luteinizing hormone [LH]) and where the study used any
design with the exception of case reports, case series,
reviews, or meta-analyses.
What happened?
Studies selected
A total of 33 studies were identified (3 randomized
clinical trials, 11 cohort trials, 18 cross-sectional studies,
and 1 non-randomized parallel clinical trial) covering a
total of 3,879 male subjects (1,766 AAS users and 2,113
non- AAS users). Testosterone esters were studied in the
large majority (94%) of the included studies, followed by
methandrostenolone or methandienone (79% of studies),
and stanozolol (67% of studies).
Effects of AAS
A meta-analysis of studies (65 AAS users) was done to
assess the effects of AAS on LH and FSH levels, and
showed that there were large reductions in both LH
(WMD = -3.37IU/L, I 2 = 89%) and FSH (WMD =
-1.73IU/L, I2 = 55%) among AAS users during a period
of usage. A meta-analysis of studies (43 AAS users) was
done to assess the effects of non-testosterone AAS on
endogenous blood testosterone, and showed that there
was a large reduction (WMD = -10.75nmol/L, I2 = 88%)
among AAS users during a period of usage. Similarly,
another meta-analysis of studies (16 AAS users) was
done to assess the effects of testosterone-based AAS on
endogenous blood testosterone, and showed that there
was a large reduction (WMD = +17.55nmol/L, I2 = 76%)
among AAS users during a period of usage. Studies that
tracked the effects of AAS on the reproductive system
after cessation of AAS usage revealed that LH and FSH
levels gradually recovered after stopping the use of AAS,
and reached normal levels after 16 weeks. Similarly,
endogenous blood testosterone also returned to baseline,
but seemed to take up to 6 months before normal levels
were reached.
What did the researchers conclude?
The researchers concluded that AAS usage is linked to a
reduction in gonadotropin release by the pituitary gland,
which persists for 16 weeks after cessation of use, and
also a reduction in endogenous blood testosterone, which
persists for up to 6 months after cessation of use.
Limitations
The study was limited by the poor availability of studies,
particularly well-controlled studies, exploring the use of
AAS by athletes and non-athletes.
Methenitis, S., Spengos, K., Zaras, N., Stasinaki, A. N.,
Papadimas, G., Karampatsos, G., & Terzis, G. (2017). Fiber
Type Composition And Rate Of Force Development In
Endurance And Resistance Trained Individuals. The Journal
of Strength & Conditioning Research.
Link to abstract
Background
Muscle fibers can be classified with a range of varying fiber type and fiber cross-sectional area (CSA) were
methods, including ATPase histochemistry, immuno- measured by biopsy and APTase histochemisty.
histochemistry, and (much less commonly) metabolic
enzymes. Muscle fiber type is thought to influence the
strength-to-size ratio of individual muscles, as type II
muscle fibers are believed to display a higher specific
force than type I muscle fibers, although the literature is
actually conflicting. Muscle fiber type is also thought to
affect muscle contraction velocity, and indeed it has
consistently been found that type II muscle fibers do
display a faster muscle contraction velocity than type I
muscle fibers. For a full review of muscle fiber types, see
our encyclopedia page HERE.
OBJECTIVE: To assess the relationship between muscle
fiber type, fiber size, and rate of force development
(RFD) in athletes of different training backgrounds.
MEASUREMENTS: RFD was measured in time windows
of up to 600ms in a maximal isometric leg press, with a
120 knee angle and a 100 hip angle; body composition,
including upper and lower body fat-free mass (FFM), was
assessed by dual x-ray absorptiometry; vastus lateralis
S U B J E C T S : 38 males with different training
backgrounds, comprising 10 sedentary subjects, with no
training experience, 9 endurance runners with marathon
running experience (mean performance = 2 hours, 52
mins 10.15 mins), 10 track and field athletes (5 100m
track sprinters with mean performance = 10:80 0:20s;
3 200m track sprinters with mean performance = 21:39
0:24s, and 2 long jumpers with mean performance =
7.23 0.40m) and 10 strength-trained individuals.
What happened?
Over the whole group, there were moderate correlations
between RFD recorded in the time window from 100 to
600ms and lower body FFM (r = 0.32 0.41), type I
fiber proportion (r = -0.32 -0.41), type I fiber CSA (r =
0.60 0.79), and type II fiber CSA (r = 0.63 0.75).
There were also moderate correlations between RFD
recorded in the time window from 100 to 300ms and type
IIX fiber proportion (r = 0.44 0.50) and type IIX fiber
CSA (r = 0.60 0.81). Analyzing the groups of subjects
individually, there were no associations between RFD and
any of the measures of muscle size or fiber type for the
sedentary or endurance groups. The associations in the
strength-trained and track and field groups were similar
to those reported for the whole group, except that the
relationships were stronger, and the track and field group
alone displayed relationships between the RFD recorded
in the time window from 20 100ms, and both type IIX
fiber proportion (r = 0.67 0.77) and type IIX fiber CSA
(r = 0.70 0.83). This relationship with type IIX fiber
CSA remained even when normalizing for lower body FFM
(r = 0.67 0.73).
What did the researchers conclude?
The researchers found that there is a strong relationship
between both type IIX muscle fiber proportion and size,
and early phase RFD in track and field athletes.
Limitations
The study was limited as it was unclear whether this link
between early phase RFD and muscle fiber type can be
affected by training.
Bagley, J. R., McLeland, K. A., Arevalo, J. A., Brown, L. E.,
Coburn, J. W., & Galpin, A. J. (2017). Skeletal Muscle
Fatigability and Myosin Heavy Chain Fiber Type in
Resistance Trained Men. The Journal of Strength &
Conditioning Research, 31(3), 602.
Link to abstract; link to full text
Background
Muscle fibers can be classified with a range of varying
methods, including ATPase histochemistry, immuno-
histochemistry, and (much less commonly) metabolic
enzymes. Muscle fiber type is thought to influence the
strength-to-size ratio of individual muscles, as type II
muscle fibers are believed to display a higher specific
force than type I muscle fibers, although the literature is
actually conflicting. Muscle fiber type is also thought to
affect muscle contraction velocity, and indeed it has
consistently been found that type II muscle fibers do
display a faster muscle contraction velocity than type I
muscle fibers. For a full review of muscle fiber types, see
our encyclopedia page HERE.
OBJECTIVE: To assess the relationship between muscle
fiber type and fatigability in a group of strength-trained
males.
MEASUREMENTS: The reduction in peak torque over 50
reps was measured during a set of isokinetic knee
extension contractions to provide 3 different indices of
fatigability; muscle fiber type was measured by biopsy,
followed by MHC isoform identification.
SUBJECTS: 15 males, aged 24.8 1.3 years, with 5.3
2.7 years of strength-training experience.
INTERVENTION: Subjects did 50 repetitions of maximal
concentric knee extension contractions between 90 10o
of knee flexion at 180o/s.
What happened?
Peak torque reduced from the start of the set (207.0
28.2Nm) to the end of the set at rep number 50 (72.0
13.4Nm), because of the onset of fatigue. Total fiber type
distribution was 19.9 8.4% MHC I, 9.7 6.1% MHC
I/IIa, 57.8 10.5% MHC IIa, 11.2 8.7% MHC IIa/IIx,
2.1 1.3% MHC IIx, and 1.4 0.9 MHC I/IIa/IIx. Yet
there were no relationships between any of the indices of
fatigability and MHC fiber type composition.
What did the researchers conclude?
The researchers concluded that there is no relationship
between fatigability and muscle fiber type, and that tests
of fatiguing strength training exercise cannot be used as
a proxy for the prevailing muscle fiber type in strength-
trained individuals.
Limitations
The study was limited as no other measurements were
taken, and it is therefore unclear what causes the
differences in fatigability among strength-trained males.
Pardue, A., Trexler, E. T., & Sprod, L. K. (2017). Case
Study: Unfavorable But Transient Physiological Changes
During Contest Preparation in a Drug-Free Male
Bodybuilder. International Journal of Sport Nutrition and
Exercise Metabolism, 1.
Link to abstract
Background
Bodybuilding is generally regarded as one of the most
popular strength sports, although it does not involve a
direct test of strength or power. Bodybuilding involves
displaying a physique with high levels of muscularity and
low levels of body fat, by means of a set posing routine.
Contestants typically prepare specifically for shows with
long periods gaining muscular size, followed by long
periods of dieting, in order to bring the condition with the
lowest possible levels of body fat. These preparatory
periods involve carefully designed diets, resistance
training routines, aerobic exercise, and supplementation.
The study of such routines is of great interest but has
rarely been undertaken by researchers. Surveys and
anecdotal reports indicate that most bodybuilders
generally train using body-part splits, with 4 5
exercises per muscle group, with moderate (7 12RM)
loads, for high volumes of around 3 6 sets per exercise,
with moderate inter-set rest periods (61 120 seconds
between sets), and often make use of some advanced
overload techniques with some exercises. However, the
pre-competition period sometimes involves a tendency to
increase the numbers of reps performed (to around 15
reps per set) and to decrease rest periods slightly (to
around 30 60 seconds between sets). Bodybuilders
compete in two distinct types of show: natural and not
natural. Natural bodybuilding involves preparing for the
contest without the use of performance enhancing
substances, which can increase the amount of muscle
mass gained and held for the competition, and which can
enhance the loss of fat and produce a more remarkable
physique. In contrast, competitions not marketed as
being natural bodybuilding are tacitly understood to
permit the use of such performance enhancing
substances, although many of those used might
technically be illegal in certain of the countries in which
the competitions take place. The most commonly-used
performance enhancing substances in bodybuilding are
thought to be steroids of varying kinds, compounds to
reduce any undesirable side effects of the steroids (such
as anti-estrogens), growth hormone, insulin, and fat-
burners (such as clenbuterol or ephedrine).
OBJECTIVE: To assess the effects of contest preparation
(8 months) and recovery (5 months) on a competitive,
drug-free male bodybuilder.
MEASUREMENTS: Blood samples were recorded to
measure serum testosterone, triiodothyronine (T3),
thyroxine (T4), cortisol, leptin, and ghrelin; body
composition was measured by using dual-energy x-ray
absorptiometry (DEXA) as well as by air displacement
plethysmography (BodPod); resting metabolic rate (RMR)
was measured by a metabolic cart; sleep quality was
assessed monthly by self-report, using the Pittsburgh
Sleep Quality Index (PSQI), and by an accelerometer
worn during the night.
SUBJECTS: A 21-year-old, amateur, drug-free male
bodybuilder with 8 years of strength-training experience
and 1 year of competitive bodybuilding experience.
INTERVENTION: Energy intake was gradually decreased
over the 8-month preparation period, reaching a diet
where 1,724kcal was consumed 6 days per week, and
2,130kcal was consumed on 1 day per week (2.9g of
protein per kg of bodyweight per day). Strength training
was done 5 or 6 days per week, with a range of multi-
joint and single-joint exercises, and a range of loads (4
25 reps per set), training each muscle group >2 times
per week. Aerobic exercise included both steady-state
(SS) exercise and high intensity interval training (HIIT),
and a maximum of 4 SS workouts and 2 HIIT workouts
were done each week (starting with none at baseline).
What happened?
Changes in weight, body composition, and RMR
Over the 8-month preparation period, body mass reduced
by 9.1kg, as energy intake was reduced from 3,860kcal
to 1,724kcal per day. Body fat percentage reduced from
13.4% (BodPod) and 13.8% (DEXA) at baseline to 9.6%
(BodPod) and 5.1% (DEXA). After the 5-month recovery
period, bodyweight and body fat percentage had returned
to baseline. RMR reduced from 107% of predicted levels
to 81% of predicted levels over the same time period
(from 2,275.4 to 1,910.1kcal per day) but only reached
2,040.5kcal/day after the 5-month recovery period.
Changes in hormones, sleep, and RMR
Over the 8-month preparation period, serum testosterone
levels reduced from 623 to 173ng/dL, T3 reduced from
123 to 40ng/dL, and T4 reduced from 5.8 to 4.1g/dL,
while cortisol increased from 25.2 to 26.5g/dL and
ghrelin increased from 383 to 822pg/mL. Leptin levels
did not change. Sleep measured by the PSQI decreased,
although the accelerometer-derived data indicated
minimal changes. All hormone levels that altered during
the 8-month preparation period seemed to revert
towards baseline within the 5-month recovery period.
What did the researchers conclude?
The researchers concluded that hormone changes caused
by an 8-month period of bodybuilding contest preparation
are largely recovered after a 5-month period of recovery,
but RMR did not reach baseline levels after this time.
Limitations
The study was limited as it was a case study, and not all
individuals may respond in the same way.
Zinn, C., McPhee, J., Harris, N. K., Williden, M.,
Prendergast, K., & Schofield, G. (2017). A 12-week low
carbohydrate, high fat (LCHF) diet improves metabolic
health outcomes over a control diet in a randomised
controlled trial with overweight defence force personnel.
Applied Physiology, Nutrition, and Metabolism.
Link to abstract
Background
Cardiovascular disease remains the single greatest cause
of death both in the world and also in the United States.
Obesity and overweight are key risk factors for
developing cardiovascular disease. Thus, strategies for
losing weight are of great interest to researchers. Low-
carbohydrate diets are popular for weight loss but have
historically been very contentious, particularly in the
context of preventing cardiovascular disease because of
the diet-heart hypothesis. The diet-heart hypothesis
essentially falls into two parts. The first part states that
the consumption of saturated fat leads to an increase in
serum cholesterol levels, particularly low-density
lipoproteins (LDL-C). The second part states that high
levels of serum cholesterol levels cause a build-up of
atheromatous plaques in the arteries, which is a process
called atherosclerosis. It is thought that the build-up of
these plaques leads to narrowing of the coronary
arteries, reduces blood flow to the heart and ultimately
causes myocardial infarction. The diet-heart hypothesis
was based originally on trials performed in animal models
in the 1930s, which found that dietary cholesterol led to
elevated blood cholesterol levels and arterial damage.
The next phase of human studies were epidemiological
and found correlations between dietary saturated fat and
blood cholesterol levels, and between blood cholesterol
levels and coronary heart disease risk. This led to the
conclusion that consuming dietary saturated fat leads to
an increased risk of coronary heart disease. This
conclusion formed the basis of dietary guidelines for the
standard recommended macronutrient profile, which is
that no more than 30% of calories in the diet should be
consumed from fat. Additionally, in the 1970s, guidelines
also recommended the replacement of saturated fat with
polyunsaturated fat, and then in the 1980s and 1990s,
guidelines suggested the replacement of saturated fats
with dietary carbohydrates. However, in recent years, the
diet-heart hypothesis has been criticized on the basis that
the evidence for a connection between the dietary
consumption of saturated fat and increased coronary
heart disease is limited. Current reviews have now
concluded that the proportion of fat in relation to total
energy intake is not important in relation to coronary
heart disease risk, although certain specific fats, such as
trans fatty acids from partially hydrogenated vegetable
oils appear to have adverse effects. Additionally, reviews
have concluded that little or no benefit occurs to coronary
heart disease risk if saturated fat is replaced by
carbohydrate. In contrast to the now-eroded link between
diet and coronary heart disease, the link between obesity
and increased risk of coronary heart disease has if
anything grown stronger and more persuasive.
OBJECTIVE: To compare the effects of a 12-week low-
carbohydrate (CHO), high-fat diet and a high-CHO, low-
fat diet on changes in bodyweight and metabolic health,
in at-risk New Zealand Defense Force personnel.
MEASUREMENTS: Bodyweight was recorded by using a
standard weighing scale; waist circumference was
measured by a tape; lipids (high-density lipoprotein
cholesterol (HDL-C), low-density lipoprotein cholesterol
(LDL-L), triglycerides (TRIGS) and glycemic control
(serum glucose, serum insulin, HbA1c) were measured
from blood samples, and the HOMA-IR measurement was
used to identify the extent of insulin resistance; visual
analog scales (VAS) were used to measure satiety,
adherence to foods on the recommended list (for each
type of diet); a food frequency questionnaire (FFQ) was
used to assess the foods consumed.
SUBJECTS: 41 overweight subjects, assigned to either a
low-CHO, high-fat diet (LCHF, 21 subjects, aged 39.6
7.8 years) or a low-fat, high-CHO diet (LFHC, 20
subjects, aged 39.7 9.6 years).
INTERVENTION: Subjects attended workshops at
baseline, to help them learn how to carry out the diet
according to their group. After this, they were provided
with online supportive information and resources. All of
the subjects also received dietary advice aimed at losing
weight, based on the principles of (1) portion control and
(2) reducing energy-dense foods. No specific guidance
was provided about calorie intakes, energy intake was
not tracked by the subjects, and set menus were not
provided for either group.
What happened?
Although both groups displayed significant reductions in
both bodyweight and waist circumference, the reductions
were greater in the LCHF group (5.5kg and 4.8cm) than
in the LFHC group (2.0kg and 3.3cm), and the
differences were identified as small effects. There were
no significant changes in LDL-C, insulin, HOMA-IR, or
HbA1c in either group as a result of the diet. However,
HDL-C increased beneficially in the LCHF group (but did
not change in the LFHC group) and both TRIGS and
glucose levels decreased beneficially in the LCHF group
(but did not change in the LFHC group).
What did the researchers conclude?
The researchers concluded that both LFHC and LCHF
diets are able to produce reductions in bodyweight and
waist circumference. They noted that there were slightly
greater reductions in bodyweight and waist circumference
when following a LCHF diet, and this was associated with
greater improvements in HDL-C, TRIGS and one measure
of glucose control. Whether these beneficial effects were
caused by the dietary content, or by the greater weight
loss is unclear.
Limitations
The study was limited as it was unclear whether the
same differences in metabolic health parameters would
be observed if the LFHC diet was continued until the
same amount of bodyweight had been lost.
Halperin, I., Vigotsky, A. D., Foster, C., & Pyne, D. B.
(2017). Strengthening the Practice of Exercise and Sport
Science. International Journal of Sports Physiology and
Performance, 1-26.
Link to abstract; link to full text
Background
When using tests or screens, it is important to be certain
that they are both reliable and valid. Reliable means that
the test routinely produces the same result (output) for
the same performance (input). Valid means that the test
actually measures what it is supposed to measure. Tests
can display very good reliability and poor validity and
vice versa. Validity is often discussed under various
headings, including construct validity, face validity,
content validity and criterion-referenced validity.
Construct validity is the more exact term for overall
validity, or the ability of the test to represent the
underlying theoretical basis upon which outcomes of the
test are interpreted. Face validity, content validity and
criterion-referenced validity are all subordinate elements
of construct validity and provide evidence for it. Face
validity is a measure of the degree to which a test is
perceived by either the subject or casual observers to
measure what it sets out to measure. Face validity is
slightly unusual in that it can be beneficial or harmful to
a test. Where maximal performance is required, a high
degree of face validity can be beneficial, as it helps to
ensure that athletes exert themselves to the greatest
extent. However, where a test is performed on a
movement under controlled conditions in an attempt to
gain an insight by proxy into the same or similar
movements that are performed under non-controlled
conditions, a high degree of face validity is harmful. In
this instance, a high degree of face validity means that
the subjects can manipulate their performances and alter
the outcome of the test. Content validity is defined as the
extent to which a test contains all of the necessary
elements in order to achieve its stated goals, as assessed
by expert opinion. Criterion-referenced validity is the
extent to which outcomes of the test are correlated with
other measures of the same underlying quality and is
often subdivided into 4 sub-types: concurrent,
convergent, predictive and discriminant. Concurrent
criterion-referenced validity describes the extent to which
a test is correlated with other similar tests. Convergent
criterion-referenced validity describes the extent to which
a test is correlated with other gold-standard tests.
Predictive criterion-referenced validity describes the
extent to which a test is able to predict future events that
are associated with the outcome measure. Discriminant
criterion-referenced validity describes the extent to which
a test is not correlated with other dissimilar tests.
OBJECTIVE: To perform a narrative review identifying
problems with reliability and validity in sports science.
What happened?
Inadequate validation of surrogate outcomes
Surrogate outcomes are very often used to predict long-
term outcomes. They are typically easy measurements
that can be performed after or during a single workout,
and which are then used to predict the effects of a long-
term training program. Yet most surrogate outcomes
(such as electromyography (EMG) amplitude, or peak
power output) have not been validated, such that we
know that training with a high EMG amplitude or a high
peak power can cause superior effects to an alternative.
Longitudinal study duration
There is a deficit of long-term studies, which provide the
best evidence for different types of training, and most
long-term studies are still relatively short (<6 weeks).
Undertaking longer duration studies (>12 weeks) would
provide a more ecologically valid understanding of the
effects of different types of training, and reduce the
chance of a novelty effect altering the results.
Too few replication studies
Replication studies are typically performed in order to
confirm or refute the findings of earlier studies, most
commonly when a study has been done in a new area.
Replications can be either direct or conceptual, where
direct tests the reliability of the original methods, and
conceptual tests the validity of the underlying theory.
Limited reporting of null or trivial results
Currently, journals encourage the submission of articles
reporting positive rather than negative results, which
leads to a false picture of the findings in a given area, as
those studies that do detect a negative result, are left
unpublished.
Insufficient scientific transparency
Most journals currently do not require (and indeed some
do not allow) researchers to provide all of their data
when submitting studies for publication, which means
that the full picture of how a group of subjects responds
to a training intervention is lost. Better presentation of
the group effects on an individual level is essential for
understanding how an intervention works, and whether
there is a high degree of inter-individual variability.
What did the researchers conclude?
The researchers found that there is a need to address a
number of issues to improve the field of sports science,
including encouraging validation of surrogate outcomes,
replication studies, and those studies reporting negative
results, as well as using longer durations for long-term
studies, and reporting a larger amount of data in relation
to individual results.
Limitations
The study was limited as it was a review performed by a
small number of researchers, and may not reflect the
views of all sports scientists.
#4. PHYSICAL THERAPY AND
REHABILITATION
Kruse, N. T., & Scheuermann, B. W. (2017). Cardiovascular OBJECTIVE: To perform a narrative review of the
Responses to Skeletal Muscle Stretching:" Stretching" the vascular effects of static stretching (SS).
Truth or a New Exercise Paradigm for Cardiovascular
Medicine? Sports Medicine.
What happened?
Link to abstract
Effects of SS on the autonomic nervous system (ANS)
SS produces a very transient (4 5 seconds) increase in
Background
heart rate (HR) and blood pressure (BP), which seems to
Flexibility is important for both athletes and for the be triggered by group III afferent nerves, causing a
general population. Flexibility is defined as the ability to reduction in cardiac vagal activity and an increase in
move through a specific joint range of motion (ROM). sympathetic nervous system (SNS) activity. Such effects
Stretching is commonly used to help individuals achieve have been observed without any muscle activation or
greater joint ROM. Researchers have generally proposed metabolic activity in the muscles. In contrast, both acute
two types of mechanism by which increases in flexibility and long-term SS causes an increase in parasympathetic
can be achieved. One type of mechanism involves a nervous system (PNS) activity and a reduction in SNS
mechanical change in the behavior of the muscle tissue activity, when measured after stretching. Yet it remains
while the other type involves a change in sensation. unclear whether acute and long-term SS also produce a
However, there are at least four theories that detail ways reduction in BP.
in which some kind of mechanical change could occur:
viscoelastic deformation, plastic deformation, increased Effects of SS on muscle oxygenation (MO)
number of sarcomeres in series, and neuromuscular
Effects of SS on MO can be measured by near infrared
relaxation. However, the evidence to support these has
spectroscopy (NIRS), which provides an indication of
been found to be weak. In contrast, many studies have
muscle tissue hemoglobin saturation. Several studies
reported that the only variable that changes following
have shown that SS does transiently reduce MO levels by
stretching programs in tandem with flexibility is the
producing an ischemic environment through mechanical
sensation of pain (i.e. maximum pain and onset of pain)
loading, in a similar way to strength training, and there is
during the stretch. This supports the sensation theory of
a rebound effect after cessation of stretching. Moreover,
stretching. Researchers advocating this theory have
continuous SS causes a larger reduction in MO compared
formulated the hypothesis that stretching increases
with intermittent stretching of the same duration and
flexibility by reducing the sensation of increasing muscle
volume. This indicates that SS may be able to produce a
length. Nevertheless, irrespective of how stretching
similar set of adaptations (albeit with a smaller impact)
changes joint flexibility, it is apparent that it can achieve
to strength training.
increases in joint ROM that last > 1 day. There are two
main types of stretching that are explored in the
Effects of SS on endothelial function
literature: static and dynamic stretching. Static stretching
There is very limited information about the effects of SS
involves moving a joint to the end of its ROM and holding
on endothelial function in humans. However, in rodent
this stretched position for a set period of time. On the
studies, it appears that daily SS for 30 minutes, 5 days
other hand, dynamic stretching involves controlled
per week for 4 weeks can increase endothelial nitric
movements through the active ROM for a joint. While
oxide-dependent vasodilation and cause angiogenesis
both static and dynamic stretching have been found to
(capillary growth). It is possible that the ischemic
improve joint ROM, static stretching performed for >45
environment produced by SS might cause the vascular
seconds appears to lead to meaningful acute reductions
endothelium to adapt in response through increased
in performance tasks, such as vertical jumping, whereas
levels of shear stress.
dynamic stretching performed for long durations appears
to lead to either no improvement or small improvements
in the same type of actions. It is interesting to note that What did the researchers conclude?
reviews of the chronic effects of static stretching have The researchers concluded that SS causes alterations in
actually found beneficial effects on both athletic muscle blood flow and oxygenation levels, and may also
performance and strength measures. The literature is alter shear stress in blood vessels, and thereby increase
currently conflicting regarding whether regular static or nitric oxide production and cause endothelial adaptations.
dynamic stretching is effective for reducing the risk of
sports injury, whether the stretching is performed
Limitations
immediately prior to exercise or at another time.
Additionally, the exact duration of stretches, the total The study was limited as it was a narrative review based
volume and frequency of stretching per week, and the on a limited amount of available literature.
rest periods between stretches that are optimal for the
most efficient increases in joint ROM are currently
unknown.
Van Dyk, N., Bahr, R., Burnett, A. F., Whiteley, R., Bakken,
A., Mosler, A., & Witvrouw, E. (2017). A comprehensive
strength testing protocol offers no clinical value in predicting
risk of hamstring injury: a prospective cohort study of 413
professional football players. British Journal of Sports
Medicine.
Link to abstract
Background
Hamstring strain injuries (HSI) are a common injury in
many popular team sports and they lead to the loss of
many hours of training and competition, as well as a very
high re-injury rate. HSI account for 12 16% of all
injuries in athletes across a range of popular team sports,
including rugby, soccer, American Football, and Australian
Rules Football. The re-injury rate for HSI ranges from 16
34%, depending upon the sport. Running activities
account for most HSI, with 57 68% of strains occurring
when running. The traditional model for HSI is that there
are various factors that could cause an injury to occur,
including: flexibility, strength, fatigue, core stability,
muscle architecture, and damage resulting from previous
injury. A modern, more sophisticated approach has
suggested that while these factors could individually lead
to an injury, it is more likely that they interact with each
other in order to create multi-factorial scenarios that
raise injury risk. Some researchers have suggested that
there are at least two different types of HSI: those
caused by stretching activities and those caused by high-
speed running movements. The HSI caused by high-
speed running is thought to occur most normally in the
long head of biceps femoris, typically involves the
proximal muscle-tendon junction, displays a greater
reduction in strength following injury than those following
stretching movements, and leads to a long recovery time
to reach pre-injury levels of performance (e.g. around 50
weeks). The biceps femoris (long head) is generally
thought to be the most commonly-injured hamstring
muscle, although some researchers have suggested that
this perception might be incorrect because of inherent
errors in diagnostic approaches. Biomechanically,
however, there are good reasons for assuming that the
biceps femoris might be most at risk. Firstly, this muscle
increases in length by more than the other hamstring
muscles during sprinting. Secondly, the moment arm
lengths of the biceps femoris in the sagittal plane
increase in the late swing position compared to the
anatomical position. Previous research has identified that
HSI occur most frequently either in the late swing or
early stance phases of gait. Late swing involves the
greatest strain in the muscle, while early stance involves
the largest joint moments. Evidence suggests that HSI
can be reduced by eccentric hamstring training but not
by flexibility training alone. This has encouraged many
strength coaches to incorporate the Nordic hamstring curl
into hamstring strain prevention programs. For a review
of how eccentric training might reduce the risk of
hamstrings strains, read Chris Beardsley's article HERE.
OBJECTIVE: To assess whether there are relationships
between several measures of hamstrings strength and a
prospectively-determined risk of HSI.
MEASUREMENTS: Concentric isokinetic knee flexion and
extension torques were measured at 60/s and 300/s,
using a dynamometer, and eccentric isokinetic knee
flexion (hamstrings) torque was measured at 60/s; the
ratio of eccentric hamstrings torque to concentric knee
extension torque was calculated at angles of 30, 40
and 50 knee flexion; eccentric hamstrings strength was
also measured in the Nordic hamstring exercise, as peak
force recorded by uniaxial load cells; training and match
exposure were recorded by the team physician (or lead
physiotherapist); HSI was defined as acute pain in the
posterior thigh arising in either training or match play,
which caused termination of play and the inability to take
part in the next training session or match.
SUBJECTS: All 18 soccer teams who were eligible to
compete in the Qatar Stars League (the premier football
league in Qatar) in 2 football seasons (September 2013
to May 2015), being 237 players for the first season and
279 players in the second season, for a total of 413
unique individuals.
What happened?
There were 69 instances of HSI among the 413 players,
in 66 players. Multivariate regression analysis revealed
that age and playing position were associated with HSI
risk. Each 1-year increase in age was associated with a
1.07 times greater risk of HSI, and outfield players were
5.79 times more likely to incur an HSI than goalkeepers.
Heavier players were less likely to incur an HSI than
players of intermediate bodyweight. Among the injured
players, there were no differences in hamstrings strength
between the injured and uninjured legs. Also, there were
no differences in hamstrings strength or ratios (by any
measure) between the injured and uninjured players.
However, when dividing players into those with high or
low levels of strength for each measure, the greater
strength group for quadriceps concentric torque at
300/s relative to bodyweight was at 2.06 times greater
risk of HSI than the weaker group.
What did the researchers conclude?
The researchers found that neither concentric isokinetic,
nor eccentric isokinetic, nor eccentric Nordic hamstrings
curl strength tests were able to predict the prospective
risk of HSI. Yet age, bodyweight, and playing position
were each associated with HSI risk.
Limitations
The study was limited as it was unable to provide any
useful modifiable measures that could be used to predict
or avoid HSI.
Schuermans, J., Van Tiggelen, D., Palmans, T., Danneels, OBJECTIVE: To assess the association between sprinting
L., & Witvrouw, E. (2017). Deviating running kinematics and joint angle movements and both retrospectively- and
hamstring injury susceptibility in male soccer players: Cause prospectively-determined risk of HSI.
or consequence? Gait & Posture, 57, 270.
MEASUREMENTS: Sprinting joint angle movements
Link to abstract; link to full text
were recorded in 3D using an 8-camera motion analysis
system for the lower body and trunk, while athletes ran
Background on a 40m indoor running track; HSI was defined as a
Hamstring strain injuries (HSI) are a common injury in soccer-related injury of the posterior thigh, after which
many popular team sports and they lead to the loss of the player was unable to take part in either training or
many hours of training and competition, as well as a very competition for >1 week; the incidence of HSI in the
high re-injury rate. For a more detailed introduction to control group only was tracked for 1.5 seasons after the
HSI, see the earlier study review. end of the 2013 season.

SUBJECTS: 30 soccer players with a recent history of

HSI (within previous 2 seasons), aged 24.7 3.4 years;
and 30 matched control soccer players with no recent
history of HSI, aged 23.7 4.5 years.

What happened?
Cross-sectional (retrospective analysis)
There were no differences in the sprinting joint angle
movements between the soccer players with a recent
history of HSI, and the matched control soccer players
with no recent history of HSI.

Prospective analysis
In the control group, 4 players sustained an HSI, for an
injury incidence of 14% over the 1.5-season follow-up
period. The players who sustained an HSI displayed more
anterior pelvic tilt throughout the sprinting motion, but
particularly in the backswing phase, as well as more
thoracic side bending in the front-swing phase.

What did the researchers conclude?

The researchers concluded that a greater risk of HSI was
associated with certain aspects of sprint running joint
angle movements, such that those soccer players who
incurred an HSI were more likely to display greater
anterior pelvic tilt (in the back-swing) and more thoracic
side bend (in the front-swing). This may indicate that a
lack of lumbopelvic control or stability during running
may be a contributory factor for HSI risk.

Limitations
The study was limited by the small number of subjects,
and by the lack of any intervention. It is unknown
whether a core stability training program for improving
lumbopelvic control could alter sprint running joint angle
movements.
Serner, A., Weir, A., Tol, J. L., Thorborg, K., Roemer, F.,
Guermazi, A., & Hlmich, P. (2017). Characteristics of acute
groin injuries in the hip flexor muscles a detailed MRI
study in athletes. Scandinavian Journal of Medicine &
Science in Sports.
Link to abstract
Background
Groin injuries are relatively common in sports, with the
hip adductors being the most frequently strained muscle
group in this region. The hip adductors are a large group
of six muscles comprising the adductor longus, adductor
magnus, adductor brevis, gracilis, obturator externus,
and pectineus. The adductor longus appears to be the
most commonly injured adductor muscle, possibly
because of its muscle architecture or internal muscle
moment arm. Other common groin injuries include
osteitis pubis and sports hernia (athletic pubalgia). Groin
injuries tend to occur most commonly in athletes taking
part in sports involving side-steps, cutting, sudden
accelerations and decelerations, and rapid changes of
direction. Consequently, groin injuries are particularly
common in various forms of hockey and soccer, in which
athletes frequently engage in cutting and side- stepping
movements, as well as rapid accelerations and
decelerations. Indeed, studies have found that groin
injuries account for around 10 11% of all injuries in
professional ice hockey and soccer. Fortunately, some
studies have found that pre-season injury prevention
programs are able to help reduce the incidence of
adductor strains in these sports. Strengthening exercise
programs often involve both adductor and abductor
training and it has therefore been recommended that
adductor strength should be >80% of abductor strength
in order to reduce the risk of injury to this area.
Unfortunately, the anatomy of the groin region is
complex and groin injuries have proved to be difficult to
rehabilitate in many athletes. As a result, many reviewers
have recommended the use of different diagnostic
imaging techniques to identify the exact nature of the
problem in each case.
OBJECTIVE: To report on the typical presentations of
acute hip flexor injuries in athletes with groin pain, as
assessed by magnetic resonance imaging (MRI) scans.
MEASUREMENTS: MRI scans were conducted within 7
days of the injury; muscle injury grading was defined by
the amount of fluid observed on the MRI, on a scale from
1 to 3 points, with grade 1 referring to edema only, grade
2 referring to some architectural disruption, and grade 3
referring to avulsions or complete musculotendinous
disruptions; the location of edema was identified in
relation to the proximal or distal tendons, and its location
within the muscle.
SUBJECTS: A total of 156 male athletes presented with
acute groin pain over 3 sports seasons, of whom 33 were
incorporated into the analysis because they received a
confirmed diagnosis of acute hip flexor injury following
the MRI scan, with a median age of 26 years.
What happened?
There were 16 rectus femoris, 12 iliacus, 7 psoas major,
4 sartorius, and 1 tensor fascia latae injuries. In 15 of
the 16 cases, the rectus femoris was injured in isolation;
10 of the 16 cases were grade 2 muscle injuries, and 5
were grade 1 muscle injuries. The proximal rectus
femoris tendons (tendon insertions and muscle-tendon
junction) were involved in 15 of the 16 cases. Rectus
femoris injuries were mainly recorded after kicking (10)
and sprinting (4). Of the 12 iliacus injuries, 10 were
grade 2 muscle injuries; 5 of the 12 iliacus injuries
occurred in change of direction actions while running, and
these injuries tended not to involve the tendons.
What did the researchers conclude?
The researchers concluded that in a cohort of athletes
presenting with groin pain who displayed acute hip flexor
muscle strain on MRI scans, the rectus femoris muscle
was most commonly the injured muscle, and tended to
occur in isolation along with a tendinous injury. The next
most commonly injured muscles were the iliacus and
psoas, which tended to involve solely the muscle-tendon
junction.
Limitations
The study was limited as it is unclear why the iliacus
might be more at risk of injury during change of direction
activities, while the rectus femoris is more at risk during
linear sprinting.
Mosler, A. B., Weir, A., Eirale, C., Farooq, A., Thorborg, K., OBJECTIVE: To report on the incidence, prevalence, and
Whiteley, R. J., & Crossley, K. M. (2017). Epidemiology of characteristics of groin injuries associated with time loss,
time loss groin injuries in a men's professional football sustained by soccer athletes in the Qatar Stars League.
league: a 2-year prospective study of 17 clubs and 606
players. British Journal of Sports Medicine. MEASUREMENTS: Time lost to injury, and both training
and match play exposure were recorded by club doctors;
Link to abstract
a groin injury was defined as being located at or around
the anterior and/or medial aspect of the hip joint that
Background occurred during soccer, and led to the player being
Groin injuries are relatively common in sports, with the unable to take part in a future match or training session;
hip adductors being the most frequently strained muscle groin injury incidence was measured per 1,000 playing
group in this region. The hip adductors are a large group hours; groin injury prevalence was assessed over the 2
of six muscles comprising the adductor longus, adductor seasons; characteristics of groin injuries were recorded
magnus, adductor brevis, gracilis, obturator externus, descriptively.
and pectineus. For a detailed introduction to groin injury,
SUBJECTS: 606 male soccer players, aged 26.0 4.9
see the earlier study review.
years, from 17 clubs were included, who were actively
playing in the period from July 2013 to June 2015.

What happened?
The players were exposed to 234 114 hours of both
matches and training per season, of which 209 105
hours was training and 26 18 hours was match play.
Out of the 606 players, there were 206 groin injuries
sustained by 150 players. The incidence of groin injury
was 1.0 injury per 1,000 hours of total exposure, 3.5
injuries per 1,000 hours of match play exposure, and 0.7
injuries per 1,000 hours of training exposure. The
prevalence of injured players with groin injury per club
per season was 21%, comprising 6.6 groin injuries per
club of 30 players. On average, soccer players incurred a
median of 10 days of lost time following injury, and each
club lost a total of 85 days of player time per season to
groin injury. The most commonly diagnosed groin injury
was of the adductors (68%) then iliopsoas (12%), and
then finally pubic-related (9%).

What did the researchers conclude?

The researchers concluded that 1 in 5 athletes associated
with each soccer club were affected by a groin injury,
each season. This caused a time loss of 10 days per
player. The most commonly diagnosed groin injury was of
the adductors.

Limitations
The study was limited as it was unable to provide a way
of reducing groin injuries in soccer players.
Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A.,
Taeymans, J., & Hilfiker, R. (2017). Effectiveness of
conservative interventions including exercise, manual
therapy and medical management in adults with shoulder
impingement: a systematic review and meta-analysis of
RCTs. British Journal of Sports Medicine.
Link to abstract; link to full text
Background
Shoulder impingement syndrome (SIS) is often
diagnosed by clinicians when an individual presents with
pain (which is usually worse when the arm is positioned
overhead), shoulder weakness, and a loss of shoulder
range of motion (ROM). Sometimes, individuals also
complain of popping sensations during some shoulder
movements. SIS is also referred to as subacromial
impingement, syndrome, and either swimmer's or
thrower's shoulder. The underlying cause of shoulder
impingement is believed to be compression of the rotator
cuff tendons inside the subacromial space, which is the
area beneath the acromion of the scapula. Researchers
and clinicians generally differentiate between two types
of SIS: primary and secondary. It is thought that primary
SIS is caused by compression of the rotator cuff tendons
between the humeral head and the overlying anterior
third of the acromion, coracoacromial ligament, coracoid
or acromioclavicular joint, most likely following on from
degenerative changes and spurring in the joint area. On
the other hand, is has been suggested that secondary
SIS can also lead to similar compressive symptoms
following underlying instability of the glenohumeral joint
or following scapular dysfunction. Instability of the
glenohumeral joint might feasibly arise where the
shoulder is placed under excessive strain from powerful
or repetitive overhead movements, such as are
performed by swimmers and throwers, which might then
lead to increased humeral head translation within the
joint and consequently an impinged biceps tendon and
rotator cuff. Scapular dysfunction has been linked to a
number of different shoulder disorders, and may cause
secondary SIS by increasing the contact between the
greater tuberosity and posterior-superior glenoid and
thereby impinging the posterior rotator cuff tendons and
labrum. Some researchers who have performed long-
term trials of rehabilitation for SIS have provided details
of their intervention programs. Others have made
recommendations for exercises based on the results of
acute investigations of muscle activity in individuals with
and without SIS. Common exercise guidance for the
treatment of SIS includes strengthening of the middle
trapezius, lower trapezius, serratus anterior and rotator
cuff and stretches for the upper trapezius and pectoralis
minor, levator scapulae, latissimus dorsi and rhomboids.
However, the exact exercise program that is optimal for
SIS rehabilitation remains unclear.
O B J E C T I V E : To investigate whether non-surgical
treatments for improving pain, function, and range of
motion (ROM) are effective in adults with shoulder
impingements, by doing a meta-analysis of randomized
controlled trials (RCTs), using random effects models.
STUDY SELECTION: Studies were included where they
described RCTs exploring the effects of >1 conservative
treatment of shoulder pain on changes in pain, function,
or ROM in adult humans aged >18 years, who had pain
when the shoulder was moved in the 40 120 region of
abduction or flexion, or with active arm elevation; who
tested positive on a commonly-used clinical test; who
had pain or weakness in response to resisted shoulder
abduction or external rotation; and who displayed a
positive impingement test with lidocaine, or tenderness
on palpation of rotator cuff tendons.
What happened?
Studies selected
A total of 200 studies were identified, of which 101 effect
sizes were included in a meta-analysis for the effects of
conservative treatments on pain (10,529 patients), 97
effect sizes were included in a meta-analysis for the
effects of conservative treatments on function (10,621
patients), and 69 effect sizes were included in a meta-
analysis for the effects of conservative treatments on
ROM (6,093 patients).
Effects of conservative treatments
For pain, exercise was better than no treatment, specific
exercise was better than generic exercise, corticosteroid
injections were better than no treatment, ultrasound
guided injections were better than non-guided injections,
non-steroidal anti-inflammatory drugs (NSAIDS) were
better than a placebo, manual therapy was better than a
placebo, and manual therapy combined with exercise was
better than exercise alone, but only in the short-term.
For function, exercise was better than no treatment,
specific exercise was better than generic exercise,
manual therapy was better than a placebo, and manual
therapy combined with exercise was better than exercise
alone, but only in the short-term. For ROM, NSAIDS were
better than a placebo, and exercise was better than non-
exercise modalities.
What did the researchers conclude?
The researchers concluded that exercise can improve
pain, function, and ROM, and specific exercises are better
than generic exercises.
Limitations
The meta-analysis was limited by the very wide range of
studies included in the review, which presented a diverse
approach to methods and populations.
Andersson, S. H., Bahr, R., Clarsen, B., & Myklebust, G.
(2017). Risk factors for overuse shoulder injuries in a
mixed-sex cohort of 329 elite handball players: previous
findings could not be confirmed. British Journal of Sports
Medicine.
Link to abstract
Background
Shoulder impingement syndrome (SIS) is often
diagnosed by clinicians when an individual presents with
pain (which is usually worse when the arm is positioned
overhead), shoulder weakness, and a loss of shoulder
range of motion (ROM). Sometimes, individuals also
complain of popping sensations during some shoulder
movements. SIS is also referred to as subacromial
impingement, syndrome, and either swimmer's or
thrower's shoulder. For a more detailed introduction to
SIS, see the earlier study review.
OBJECTIVE: To assess whether low glenohumeral joint
(GHJ) total rotation, external rotation weakness, and
scapular dyskinesis are associated with shoulder overuse
injuries (SOI) in elite male and female handball players.
MEASUREMENTS: GHJ internal and external rotation
ROM were measured on both arms by using a digital
inclinometer, in supine, with the shoulder abducted to
90 and elbow flexed to 90; GHJ internal and external
rotation isometric forces were measured on the dominant
arm only by using a handheld dynamometer, in supine,
with the shoulder abducted to 90 rotated to 0, and with
the elbow flexed to 90; scapular dyskinesis was
assessed by observation, as players did 5 reps of GHJ
flexion and abduction while holding an external weight
(5kg for males, and 3kg for females); the prevalence and
severity (on a scale from 0 100) of SOI were recorded
prospectively, monthly by the Oslo Sports Trauma
Research Center Overuse Injury Questionnaire (OSTRC).
SUBJECTS: 329 players (168 male, 161 female) from 23
handball teams (12 male and 11 female) from the 2 top
divisions in Norway at the start of the 2014 2015
season.
What happened?
The prevalence of SOI in the season was 23% across
both males and females. Females reported 6% more SOI
than males. No associations were measured between SOI
and sex, age, height, body mass, dominant arm, player
position, team affiliation, competition level, years of
handball experience, shoulder pain at baseline, or history
of SOI in the preceding season. No associations were
measured between SOI and scapular dyskinesis, total
GHJ rotation, and either GHJ external rotation or internal
rotation force. However, a larger internal rotation ROM
was associated with a 1.16 times greater risk of SOI.
What did the researchers conclude?
The researchers concluded that the risk of SOI was not
associated with scapular dyskinesis, reduced total GHJ
rotation and low GHJ external rotation strength. In fact,
it was the elite handball players with greater internal
rotation ROM who were more likely to incur an SOI at
some point during the season.
Limitations
The study was limited as it is unclear why the greater
degree of internal rotation ROM would lead to a higher
risk of SOI in some athletes.
La Touche, R., Paris-Alemany, A., Hidalgo-Prez, A., Lpez-
de-Uralde-Villanueva, I., Angulo-Diaz-Parreo, S., & Muoz-
Garca, D. (2017). Evidence for central sensitization in
patients with temporomandibular disorders: a systematic
review and meta-analysis of observational studies. Pain
practice.
Link to abstract
Background
Pain is very likely the most common reason for visits to a
physician in the United States and chronic pain conditions
such as low back pain are among the most difficult
conditions that physical therapists have to contend with
on a daily basis. It is therefore unsurprising that a large
body of research has established that pain is a complex
and difficult phenomenon to understand. In general, it is
now thought that the best way to conceive of pain is as a
conscious realization that a specific part of the body is
under a certain level of threat. In other words, pain can
be considered as an output of the central nervous system
in response to a certain stimulus, which is then altered
by its perception of the status of the danger. Perception
of the status of the danger is often made in the context
of prior information that is held about the threat. Such
information is often informed by psychosocial factors.
Recent investigations within this model have revealed
several key features of both nociception and of the level
of pain. It has been found that both nociception and the
level of pain can be modulated by a wide range of
different biological, psychological, and social factors and
that acute and chronic pain display different features.
Investigations exploring the effect of various factors on
the pain evoked by a standardized stimulus have found
that several peripheral variables can alter nociception: for
example, increasing inflammation, increasing tissue
temperature and reducing blood flow all serve to increase
nociceptor activity and thus increase nociception.
Similarly, studies have reported that catastrophic beliefs,
anxiety, expectation, and attention towards the
standardized stimulus may all increase the experience of
pain, although the research is conflicting in this area and
the exact way in which these psychological factors affect
pain is unclear. The observation that acute and chronic
pain display different features seems to occur because as
as nociception continues and the experience of pain
persists for a longer period, the neuronal mechanisms
that are involved in each of these phenomena increase in
their sensitivity. The neurons that transmit nociceptive
information become sensitized with continued nociception
and the neuronal networks within the brain that
experience pain also become sensitized with prolonged
pain, which lead to formerly painless stimuli becoming
painful and formerly painful stimuli becoming even more
painful.
OBJECTIVE: To perform a systematic review and meta-
analysis to assess the extent of pain sensitization in
patients with temporomandibular disorder (TMD).
TECHNICAL NOTE: TMD can refer to a range of different
clinical issues affecting the masticatory muscles, the
temporomandibular joint (TMJ), and any associated
structures.
STUDY SELECTION: Studies were included if they
described case-controls, cohort trials, or cross-sectional
trials described in English, that included human adult
patients with a diagnosis of TMD, who were assessed for
central sensitization with quantitative sensory testing by
measuring hyperalgesia at local and remote points from
the site of the original pain (mechanical hyperalgesia by
pressure pain threshold (PPT) testing or thermal
hyperalgesia by hot and cold pain thresholds), as well as
by facilitation of mechanical temporal summation, and
conditioned pain modulation.
What happened?
Studies selected
A total of 22 articles (11 case-control studies and 11
cross-sectional studies) were included in the systematic
review. A total of 12 studies assessed mechanical
hyperalgesia by PPT, 2 studies measured thermal
hyperalgesia by cold pain threshold, and 8 studies
measured thermal hyperalgesia by hot pain threshold.
Evidence of central sensitization
Of the 12 studies that assessed mechanical hyperalgesia
by PPT, 10 reported that PPT was lower in TMD patients
compared to controls. Of the 2 studies that assessed
thermal hyperalgesia by cold pain threshold, both
reported that the threshold was lower in TMD patients
compared to controls. Of the 8 studies that assessed
thermal hyperalgesia by cold pain threshold, 3 reported
no differences between TMD patients and controls, while
5 reported that the hot pain threshold was lower in TMD
patients compared to controls. Some studies also
indicated that there was evidence of increased facilitation
of mechanical temporal summation, but conflicting
evidence of dysfunctional conditioned pain modulation.
What did the researchers conclude?
The researchers concluded that patients with TMD do
display increased central sensitization compared with
healthy control subjects, and that this is most evident
with mechanical and thermal (cold) hyperalgesia. There
was also evidence of a facilitation of mechanical temporal
summation, which may imply an increased level of spinal
and central hyper-excitability.
Limitations
The study was limited as it was not able to determine the
underlying causes for these observations in this cohort of
patients.
Cavanaugh, M. T., Aboodarda, S. J., Hodgson, D., & Behm, OBJECTIVE: To find out whether foam rolling of the
D. G. (2016). Foam Rolling of Quadriceps Decreases Biceps hamstrings and quadriceps would affect hamstrings and
Femoris Activation. The Journal of Strength & Conditioning quadriceps muscle activation.
Research.
MEASUREMENTS: Muscle activation was measured by
Link to abstract
surface electromyography (EMG) amplitudes of the
vastus lateralis, vastus medialis, and biceps femoris,
Background normalized to maximum voluntary isometric contraction
Self-myofascial release (SMR) is the category of (MVIC) levels; vertical jump height was assessed by a
myofascial release techniques that are performed by the Vertec; ground reaction forces were measured during
individual themselves rather than by a clinician. foam rolling, and also upon landing from hurdle jump,
Consequently, SMR techniques most often involve a tool using a force plate; pain during foam rolling was
with which the individual puts pressure upon the affected recorded using a visual analog scale (VAS).
area. The most commonly-used SMR tool is the foam
SUBJECTS: 10 recreationally-active males, aged 25
roller. For a detailed review of foam rolling and SMR, see
4.6 years, and 8 recreationally-active females (21.75
the S&C Research encyclopedia page HERE.
3.2 years).

INTERVENTION: All subjects performed the same test

under 4 different conditions: (1) foam rolling of the
hamstrings, (2) foam rolling of the quadriceps, (3) foam
rolling of both muscles, (4) sitting quietly, with no foam
rolling (control). Each foam rolling bout comprised 4 total
sets of 45 seconds with 15 seconds rest between sets
(the condition involving both muscles used 2 sets per
muscle group). The EMG amplitudes were recorded
during a single leg landing from a hurdle jump onto a
force plate; the hurdle was set to 75% of each subjects
maximal vertical jump height, and the horizontal distance
between the hurdle and the force plate was 25% of this
same distance.

What happened?
Hamstrings activation during single leg landing from a
hurdle jump was reduced after quadriceps foam rolling,
but quadriceps activation was not affected. This effect
was not observed when both the quadriceps and
hamstrings were subjected to foam rolling. Quadriceps
foam rolling was reported to be more painful (5.9 0.5
points) than foam rolling of the hamstrings (2.9 0.4
points).

What did the researchers conclude?

The researchers concluded that foam rolling of the
quadriceps can reduce the activation of the antagonist
(opposing) muscle during a landing task, although foam
rolling of the hamstrings did not exert any effect on the
quadriceps, perhaps because the pain level was greater
during quadriceps foam rolling, which led to a greater
reduction in non-local pain perception.

Limitations
The study was limited as it was unable to determine
whether the greater level of pain experienced during the
quadriceps foam rolling was in fact responsible for the
unique effects recorded afterwards.
Nascimento, J. D. S. D., Alburquerque-Sendn, F., Vigolvino, OBJECTIVE: To assess the inter-rater and intra-rater
L. P., Oliveira, W. F., & Sousa, C. O. (2017). Inter and reliability of trigger point identification, among raters
intraexaminer reliability in identifying and classifying with no clinical experience, for classifying trigger points
myofascial trigger points in shoulder muscles. Archives of in subjects both with and without unilateral subacromial
Physical Medicine and Rehabilitation. impact syndrome (SIS).
Link to abstract
MEASUREMENTS: Inter-rater and intra-rater reliability
of trigger points was measured by percentage agreement
Background (PA), Prevalence and Bias Adjusted Kappa Statistics
Many people make use of massage therapy for helping (PABAK), and weighted Kappa (wK); trigger point
with musculoskeletal pain. However, it is currently presence was measured by binary scales (present or
unclear how manual therapy (including myofascial absent; and active or latent).
release techniques) is able to bring about pain relief.
SUBJECTS: 52 subjects (26 with unilateral SIS, and 26
Several mechanisms have been proposed, including the
without unilateral SIS).
release of endocrine hormones, inhibition of pain
feedback, a reduction in inflammatory signaling, and INTERVENTION: Two different raters, without any
direct effects on myofascial trigger points. In relation to experience in assessing trigger points, and who were
the potential mechanisms involving endocrine hormones, blind to the clinical status of the subjects, assessed the
it has been suggested that manual therapy causes a presence or absence of trigger points in 6 different
pain-relieving release of the endocrine hormone oxytocin shoulder muscles, and classified them as either latent or
i n t o t h e b l o o d . I n d e e d , t h e d i r e c t , s y s t e m i c active, on 2 separate occasions on the same day. The
administration of oxytocin appears to have an analgesic presence and class of a trigger point was identified by (1)
effect on musculoskeletal pain in humans. In relation to a palpable tense band, (2) local pain from digital
potential mechanisms involving inhibited pain feedback, compression of a palpable nodule located in a tense
it has been suggested that pain signaling could be altered band, (3) presence of referred pain caused by pressing
secondary to the activation of mechanoreceptors within the sensitive nodule, and (4) the jump sign. Trigger
muscle fibers by the manual therapy, which then leads to points were assessed in the upper trapezius, lower
the stimulation of large, primary afferent nerve fibers. trapezius, supraspinatus, infraspinatus, pectoralis minor
Signals along these fast-conducting nerve fibers could and middle deltoid.
then interfere with pain signals transmitted along slow-
conducting, tertiary fibers and thereby produce inhibition
What happened?
of pain feedback in the spinal cord. This model essentially
therefore builds on the extremely popular pain gate Intra-rater reliability in identifying trigger points was
control theory. In relation to potential mechanisms moderate to perfect (PABAK = 0.46 1.0 and 0.60 1.0)
involving the modulation of inflammatory signaling, it has for both groups of subjects. Inter-rater reliability was
been suggested that manual therapy could squeeze out also moderate to perfect for the control group (PABAK =
inflammatory molecules, such as bradykinins, from 0.46 0.92) but was poor for the group with SIS. Intra-
m u s c l e t i s s u e s a n d t h e r e b y r e d u c e p e r i p h e ra l rater reliability in classifying trigger points was moderate
sensitization and any sensations of localized tenderness. to high for most muscles, but inter-rater reliability was
The potential mechanism of myofascial trigger points is poor to moderate for all muscles.
possibly the most contentious mechanism. Some
researchers and clinicians have suggested that myofascial What did the researchers conclude?
trigger points are tender spots in discrete, taut bands of The researchers concluded that intra-rater reliability for
hardened muscle that produce local and referred pain. It identifying the presence or absence of trigger points is
is therefore possible that where manual therapy is able to acceptable for clinical practice in any group of subjects,
affect these tender spots, it may be able to relieve but inter-rater reliability is only acceptable for subjects
musculoskeletal pain. However, it is unclear precisely without SIS. Classification of trigger points as either
what myofascial trigger points are and how they might be active or latent is currently not reliable.
measured reliably.

Limitations
The study was limited as it was unclear whether more
experienced raters would have produced more reliable
results.
Clemente, F. M., Mendes, B., Nikolaidis, P. T., Calvete, F., OBJECTIVE: To assess the relationship between internal
Carrio, S., & Owen, A. L. (2017). Internal training load and training load (ITL) and Hoopers Index (HI) and other
its longitudinal relationship with seasonal player wellness in variables across an entire season of soccer.
elite professional soccer. Physiology & Behavior, 179, 262.
MEASUREMENTS: Data were collected during the entire
Link to abstract
season between August 2015 and May 2016; the HI
questionnaire was completed at the start and end of each
Background training session (the HI is the sum of 4 measures,
Soccer or Association Football is the world's most popular assessing self-reported fatigue, stress, muscle soreness,
team sport and is played by more than 250 million people and quality of sleep of the night before); a session-rating
in over 200 separate countries. Through this incredible of perceived exertion (RPE) was recorded at the end of
popularity, it is known simply as football in most parts each training session, and the ITL was calculated as the
of the world, despite the existence of many other football session-RPE multiplied by training duration.
codes, including American Football, Australian Rules
SUBJECTS: 35 professional soccer players from the
Football, Gaelic Football, and Rugby. Soccer is played in
Portuguese premier league, aged 25.7 5.0 years.
teams of 11 players in two halves of 45 minutes in length
with a 15-minute break between the two halves. Play
runs continuously within halves, such that the clock is not What happened?
stopped while the ball is out of play. There is usually a The HI was higher in weeks with 2 matches than in
15-minute half-time break between halves. Every four weeks with 1 match (11.85 3.76 vs. 11.56 3.43),
years, the World Cup is held, in which around 200 but the ITL was higher in weeks with 1 match than in the
national teams compete in qualifying tournaments in the weeks with 2 matches (308.28 159.82 vs. 245.66 1
hope of becoming one of the 32 national teams that 53.97). Out of the 4 components of the HI, self-reported
compete in the 4-week competition. The most recent fatigue and muscle soreness were higher in weeks with 2
World Cup was held in Brazil and was the twentieth such matches than in weeks with 1 match, but stress was
competition. Germany beat Argentina 10 in the final to lower, and sleep was the same. In weeks with only 1
take their fourth title. Training for soccer requires a focus match, HI was unrelated to ITL. In weeks with 2
on many different aspects, including physical qualities, matches, ITL was negatively related to HI, and also to
technical skills, and tactical abilities. There are many each of its 4 components (self-reported fatigue, stress,
different physical qualities that are important for soccer, muscle soreness, and quality of sleep of the night
including aerobic endurance, anaerobic endurance, before).
strength, power and flexibility. Traditionally, soccer teams
placed the most emphasis on aerobic endurance, noting
What did the researchers conclude?
that players needed to be able to run long distances
The researchers concluded that when elite soccer players
during games. Indeed, there is a basic agreement that
have two fixtures in a single week, this is associated with
soccer players travel around 9 14km in a single 90-
higher HI, self-reported fatigue, and muscle soreness,
minute match, although the exact distance depends on
but lower ITL and stress. This may reflect differences in
the position played. Training methods for improving
the effects of matches and training sessions on various
aerobic capacity include interval training, small-sided
aspects of recovery.
games, game simulations, soccer-specific circuits,
repeated sprints, and agility drills. More recently, soccer
teams have begun to focus more on sprint running Limitations
ability, which appears to be crucial in allowing soccer The study was limited as it is unclear what each of the
athletes to dominate situations during play. This change various measures of recovery status mean for athletes.
in focus came out of the realization that the nature of the
activity performed by soccer players during a game
comprises long periods of low-intensity walking or
jogging, interspersed by short periods of maximal or
near-maximal effort, including accelerating sprints. Some
studies have found that players perform many such
accelerating sprints per match, for a total distance of
around 200m. Sprint running ability can be improved by
various training methods, including sprinting, heavy load
resistance-training, ballistic resistance-training,
plyometrics, and assisted and resisted sprinting. There is
currently no strong consensus around which type of
training is best, although a recent meta-analysis
concluded that novice athletes benefit most from sprint
running practice and more advanced athletes benefit
more from a varied program.
Kili, ., Aoki, H., Goedhart, E., Hgglund, M., Kerkhoffs, G.
M. M. J., Kuijer, P. P. F. M., & Gouttebarge, V. (2017).
Severe musculoskeletal time-loss injuries and symptoms of
common mental disorders in professional soccer: a
longitudinal analysis of 12-month follow-up data. Knee
Surgery, Sports Traumatology, Arthroscopy.
Link to abstract; link to full text
Background
Soccer or Association Football is the world's most popular
team sport and is played by more than 250 million people
in over 200 separate countries. Through this incredible
popularity, it is known simply as football in most parts
of the world, despite the existence of many other football
codes, including American Football, Australian Rules
Football, Gaelic Football, and Rugby. For an introduction
to soccer, see the earlier study review.
OBJECTIVE: To examine the prospective relationships
between severe musculoskeletal injuries involving time
lost to training or match play, and symptoms of common
mental disorders in professional football players.
MEASUREMENTS: Measurements were taken at baseline
and also at 2 follow-up points (6 months and 12 months)
using questionnaires to assess symptoms of common
mental health disorders: (1) distress, (2) anxiety and
depression, (3) sleep disturbance, and (4) adverse
alcohol use, using the (1) Distress Screener, (2) the 12-
item General Health Questionnaire, (3) Patient-Reported
Outcomes Measurement Information System (PROMIS),
and the (4) Alcohol Use Disorders Identification Test
(AUDIT-C) respectively; severe musculoskeletal time-loss
injuries were assessed by questionnaire in relation to the
4 weeks prior to baseline, and for the following 6 months,
and were defined as injuries that occurred during team
activities that caused a loss of time to training or match
play for >28 days.
SUBJECTS: 384 male professional football players, aged
27 5 years, from Finland, France, Norway, Spain, or
Sweden initially took part in the study, but only 262
completed the 12-month follow-up period.
What happened?
At baseline, 193 of the 384 athletes presented with no
symptoms of common mental health disorders, while 191
presented with symptoms of common mental health
disorders. At baseline, 336 of the 384 athletes presented
with no musculoskeletal time-loss injuries, while 42 had
severe musculoskeletal time-loss injuries. On the one
hand, displaying symptoms of common mental health
disorders at baseline was not associated with an
increased risk of severe musculoskeletal time-loss injury
in the 12-month follow-up period. However, on the other
hand, having a severe musculoskeletal time-loss injury at
baseline was associated with symptoms of common
mental health disorders in the 12-month follow-up
period, with the relative risk being 1.8 6.9 times higher
for these individuals.
What did the researchers conclude?
The researchers concluded that professional football
players who have a severe musculoskeletal time-loss
injury, are 2 7 times more likely to develop symptoms
of common mental health disorders in the subsequent 12
months.
Limitations
The study was limited as it was only performed in male
professional soccer players, and it is unclear whether the
same results would be observed in other sporting groups.
Lima, Y. L., Ferreira, V. M. L. M., de Paula Lima, P. O.,
Bezerra, M. A., de Oliveira, R. R., & Almeida, G. P. L.
(2017). The association of ankle dorsiflexion range of
motion and dynamic knee valgus: A systematic review and
meta-analysis. Physical Therapy in Sport.
Link to abstract; link to full text
Background
Non-contact anterior cruciate ligament (ACL) injury is a
very common and quite serious injury that occurs
frequently in popular team sports, particularly those
which involve lateral pivoting, jump landing or quick
decelerations during sprint running. Previous research
has identified that ACL injuries occur under two
predominant loading patterns: knee valgus collapse or
anterior tibial shear. While there are advocates and
adversaries of both mechanisms, studies have shown
that female athletes tend to display greater knee valgus
than males and greater ACL injury incidence. Researchers
have also found that the tendency to display greater
knee valgus is a good predictor of ACL injury risk. In
general, the term valgus refers to the outward angling
of the distal segment of a bone. Where a joint or a
neighboring joint has more than one degree of freedom,
this outward angling can involve movements in
transverse, sagittal or frontal planes. Indeed, research
indicates that knee valgus (also called valgus collapse or
medial knee displacement) actually arises as a result of
hip joint or foot joint actions. Knee valgus in stance is
seen in conjunction with a combination of hip joint
adduction and hip joint internal rotation and occurs most
frequently in positions of hip joint flexion. Additionally,
foot pronation is commonly observed where knee valgus
occurs. The joint actions at hip and foot appear to lead to
a medial displacement of the knee, which is accompanied
by knee joint abduction and knee joint external rotation.
Various explanations have been proposed as causes of
knee valgus. One popular proposal is that individuals
have inadequate hip external rotator and hip abductor
strength and/or short, tight or overactive hip adductors
and/or hip internal rotations, leading to a tendency for
the hips to move into hip adduction and hip internal
rotation. Another very popular proposal is that ankle
dorsiflexion mobility is poor or that the lower leg muscles
(soleus, gastrocnemius, and anterior tibialis) are short,
tight or overactive, which prevents the tibia and knee
from moving forwards and causes the foot to compensate
by pronating. This inward foot movement leads to
mirrored movement at the hip (hip internal rotation and
hip adduction) and therefore knee valgus. Two less
popular proposals are that a lack of either vastus
medialis obliquus strength or a lack of medial hamstrings
strength leads to poor knee stabilization and thus allows
the knee to track inward. Changes of direction during
running (cutting) are common in many popular team
sports and the ability to perform them quickly is a key
attribute of successful athletes. However, cutting
maneuvers are also associated with knee valgus and
consequently an increased risk of non-contact ACL injury.
OBJECTIVE: To perform a meta-analysis (in a random
effects model, using a standardized mean difference
[SMD]) to explore the relationship between ankle
dorsiflexion (DF) range of motion (ROM) and dynamic
knee valgus (DKV). A lack of DF ROM is thought to
contribute to increased DKV, as individuals attempt to
compensate for a lack of ROM in the sagittal plane by
performing movements in either the frontal or transverse
planes.
STUDY SELECTION: studies were included if they were
published as full texts, and described a relationship
between DF ROM and joint angle movements of the knee
or hip in the frontal or transverse planes, in any lower
body dynamic movement in healthy males or females of
any age, and with or without musculoskeletal conditions.
What happened?
Studies selected
There were 17 studies that met the inclusion criteria, in
which 3 analyzed DKV during a 2-leg squat, 5 assessed
DKV during a lateral step down, 4 measured DKV during
either a drop landing or a landing from a jump, 3
assessed DKV during a 1-leg squat, and 2 measured DKV
during an overhead squat. DF ROM was measured either
in non-weight bearing tests with the knee flexed, in non-
weight bearing tests with the knee extended, or in the
weight bearing lunge test.
Meta-analysis
The results of the meta-analysis showed that a lower
degree of DF ROM was associated with greater DKV (SMD
= -0.65). This effect displayed a moderately high level of
heterogeneity (I2 = 50%). The effect sizes were similar
for each of the non-weight bearing tests (SMD = -0.54
and -0.56) but was larger for the weight bearing lunge
test (SMD = -1.25).
What did the researchers conclude?
The researchers concluded that reduced DF ROM is
correlated with DKV irrespective of whether the DF ROM
is measured in a weight bearing or non-weight bearing
test.
Limitations
The study was limited as it is still unclear exactly why DF
ROM is related to DKV.