It’s a resource that allows you to access our rehab experts 24/7, to be able to ask any question you would like, while also being able to learn from the amazing insights of the people within our community. What’s more is that you get first-hand updates into what’s going on within MTP, including first access to exclusive competition offers (some massive one’s planned in the near future).

Unfortunately, it’s a resource that isn’t used as much as it should be.

As such we wanted to make a short guide for you, in order to show you some of the incredible features the group offers access to. Let’s dive in!

JOIN HERE 

Ask Your Questions

One of the most empowering tools that we can give you access to, is instant access to our expert knowledge by being able to ask questions about your specific situation. When it comes to complex issues like injury, experience pays dividends. That’s why we have placed a premium on being available to answer any questions you might have ahead of seeing us. In our opinion, it would be doing a disservice to not make sure you were fully comfortable with our answer before coming in to see us.

This is incredibly important to us because, at the end of the day, our mission is to help over 1 million people by improving the way they move. If you run the numbers, this is simply impossible for us to achieve simply by seeing people in person. Hence why we have made ourselves available online to answer any questions you have in order to help you as much as possible.

Where seeing a practitioner might cost you up to $150 for an hour, we think that it is crucial to be able to get an opinion on your situation before you come in. This might be a second opinion from your current healthcare practitioner, or simply a question you want to know the answer to. Either way it’s something we’re incredibly proud to be able to offer.

Access To Experts

Within our community is some world-leading experts in multiple different areas. From sports medicine to surgery, to nutrition and academia, we have people who are at the top of their game. If there is a topic you would like to see more material on, please let us know. Everything we have in the group is constantly being updated based on your specific feedback!

Check out the ‘Units’

The units section of our Facebook group has specific content loaded into various modules that you can go through in your own time. There is tonnes of useful information in there, across many different areas.

The Units Tab can be accessed Via the Group Home Page & Has Tonnes Of Useful Resources

The post How to Use Our Facebook Group [The MTP Community] appeared first on MTP Health Programs.

“Nothing Happens Until Something Moves” – Albert Einstein

Have you ever wondered what you need to be doing each and every day to improve your mobility and flexibility?

Do you think working on your mobility is something you should do more of?

Would you like to have a simple set of exercises that can go with you absolutely anywhere & teach you more about the overall health of your body than any other exercise in existence?

Fortunately, if you answered yes to any of these questions then you are absolutely in the right place!

Enter CARs [Controlled Articular Rotations]

CARs represent the backbone of what is required to maintain healthy joints over the course of our lives.

They stand for Controlled Articular Rotations. This simply means that we are moving each of our articulations (i.e. the joints of the body) through the maximum amount of controlled rotation possible. They come from a system of mobility training known as Functional Range Conditioning (FRC).

The reason why the rotational component is so important is because, in order to fully explore the range of motion within each of our joints, there must be some form of rotation being explored (this is a bit of a paradigm shift for some textbook anatomists).

Thus CARS are simply a systematic way for us to explore our full range of motion, each and every day. The beauty of these exercises is that in the process of exploring our range of motion through these movements we will see continual progress toward improving that range over time.

It’s the ultimate daily routine that leaves us healthier, more mobile and feeling better each and every time we do it.

To see the full list of benefits these drills can provide check out this comprehensive video.

CARs serve two main functions

For the purposes of how we use them in our clinic, CARs serve two main purposes.

1. Check-in with our joints to see how they are functioning
2. Provide a ‘maintenance stimulus’ to help our joints repair & function optimally

As a joint health check-in CARs are fantastic as they expose us to potentially vulnerable ranges of motion (i.e. our end ranges where our body lacks control). The large majority of injuries occur at our end ranges of motion, so CARs are a great way to see where we might be at risk of injury. If our movement is altered or we experience discomfort in a certain range, this is a good indication that there is something that needs to be looked into further. Because CARs are ideally performed every single day, they represent a great baseline that tells us how our body is feeling at any given point in time.

As a Maintenance (& Improvement) Stimulus CARs serve as the ultimate form of Kinetic Hygiene. In the same way that we brush our teeth to maintain the health of our mouth, CARs form the basis of hygienic practices that maintain the function of our musculoskeletal system. This works in a number of ways, that ultimately preserves the health of our movement. By moving each Joint individually, we ensure that the synovial fluid and other fluid delivery systems of the body are able to reach the joint in order to maintain it’s structural integrity and clear away any waste products. To move each of these joints our muscles have to work. Because this movement is occurring at our end ranges, this will require considerable effort from the muscles, which creates an adaptive stimulus, allowing the muscle to be stronger over time. To create movement in the muscle our nerves that innervate each muscle must receive a signal from the motor cortex of the brain. By sending this signal regularly we ensure that our body recognises the need for this kind of movement & thus continues to adapt over time. This ultimately allows for optimal functioning of the whole body (not just the joints), as if we chose not to move, we would begin to lose our capability through each of these individual systems to move well (i.e. Use it or lose it).

The ‘use it or lose it’ principle is a very accurate representation of the way mobility works, showing  how our body adapts. One of the best examples of seeing this idea applying to mobility is with kids. Every child will have the ability to get into all sorts of positions that an adult typically isn’t able to. From getting into a full split to sitting comfortably in a deep squat. Children possess the capabilities to move freely as their bodies haven’t had to adapt to their environment (In the case of many people this means stiffening up and tightening muscles to conserve resources & protect weak areas that aren’t used).

How to perform optimally

1. Irradiate & tense the whole body as much as is appropriate to the intensity required. Irradiation simply means tensing our muscles as much as possible to optimise force production. This allows us to push our joint through their end range of motion (therefore eliciting maximal mobility benefits), as well as to prevent movement occurring in the joints of the body that aren’t the focus of the CAR (i.e. movement compensation). Identifying the joints outside of the joint we’re focusing on that have a tendency to move when we are performing CARs is a great way to identify potential areas that could cause injury down the line.
2. Move the joints through their fullest range of motion possible. This will feel like straining & applying a lot of effort to the movement. This is absolutely natural to do, as this type of drill is designed to push our body in its end ranges of motion. In this way, it is very similar to strength training in terms of the effort applied (in fact it is strength training, just at our end ranges).
3. Scale intensity to the effect that is desired. If this is simply a body scan go at about 40-60% effort. If it’s a workout where you want to optimise mobility go at 100% (a great time to use this is in between sets of training). There is no right or wrong to the intensity you choose. Just pick what is appropriate for how you’re feeling at the time.
4. Move outside of painful ranges. If any form of pain is experienced when doing CARs, the best bet is to adjust movements so that only pain-free ranges are being explored. The pain response of the body is helping to indicate that something might not be quite right with that particular joint. If the pain has come on out of nowhere, then it might just be a minor tweak. If it persists, however, then it could be indicative of something a little more sinister. This is why CARs are such an amazing tool. They allow us to screen our body for any potential issues, before they get exposed in a less controlled environment (i.e. leading to injury). The best way to adjust your movements is to minimise the size of the joint rotation & moving more gently through the range until the pain subsides. If the pain sticks around (typically longer than 2 weeks), then proper treatment should be sought out.

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The Bottom Line

While CARs provide a systematic way to go about achieving optimal joint mobility, it is important to remember that they are simply movement at the end of the day. Any movement that causes us to reach our end ranges of motion & challenge our joints in these ranges will provide a similar stimulus to what CARs can do (Rock Climbing & Dancing are perfect examples of activities that regularly provide this kind of challenge). The reason why CARs are so beneficial is because they allow us to break down every single part of our movement individually, to isolate each component in order to see what is functioning as it is supposed to. For this reason, they are a great tool to ensure you leave no stone unturned when it comes to your joint mobility.

The Exercises [Flexibility & Mobility In One]

Ankle CAR

Knee CAR

Hip CAR

Spinal CAR #1 – Cat & Camel

Spinal CAR #2 – Jefferson Peel Down

Neck CAR

Scapula CAR

Shoulder CAR

Thoracic CAR

Full Body CARs Routine

The post Improving Your Mobility 101 [All About CARs] appeared first on MTP Health Programs.

The Prevalence of Osteoarthritis in the Australian Population [CREDIT: AIHW 2019]

Why You Have Knee Pain

First of all, to make sure that you are able to get the most out of the 6 exercises we want to give a brief idea of why the knee pain you’re experiencing exists in the first place. The graphic below summarises the 3 main areas that equate to knee pain.

The key to this understanding is that your knee pain is simply a response of the brain to a perception of threat. Once we start to re-educate the brain and teach the body that there is no threat, then the pain will start to dissipate. This often means controlling a number of factors that are often associated with pain, from healthy thought patterns to healthy tissues to overall healthy lifestyle factors. Below, you can see how we aim to address all of these factors in our in-person knee program.

How We Aim Address the Main Reasons Behind Knee Pain

The Movements

1. Glute Bridge Activation
2. Terminal Knee Extension (TKE)
3. Hip Hinge
4. Calf raise
5. Step Up
6. Sit To Stand

Chances are you have tried one or more of these exercises in the past. Yet what we can almost guarantee is that you haven’t been optimising these exercises to get the maximum benefit that you can out of them. As movement specialists, our job is to work with surgical precision in order to break down the execution of movement in order to elicit the largest benefit possible. In today’s case, that benefit will be helping you to move pain-free!

By watching the links above, you will get a quick snapshot of the exercises to get an idea of what needs to be done. To get a thorough understanding of each exercise, pay extra attention to each video below, as we break down the what, why and how of each key movement.

1. Level 1: Purple Band.
2. Level 2: Orange Band.
3. Level 3: Grey Band.

Exercise 3: Hip Hinge [Changing How You Move To Combat Knee Pain]

Exercise 5: Step Up [Strengthening Your Hips To Avoid Knee Pain]

The step-up is crucial to giving you options that allow you to be more functional in your daily life.

For many people, stairs pose a serious problem. They fear the pain that is associated with them, in particular going up! Yet, walking upstairs is one of the best things we can do to continue maintaining our function into our old age. It can quickly become one of the biggest things that limits someone’s ability to be functional as they get older & is often the first warning sign of severe knee pain that could have an impact on the quality of life.

This demonstration will show how to start to progress towards pain-free stair climbing.

Reps: 5-15 each side (Find the amount that you can do pain-free)

Sets: 1-3

Notes on performance 

• Multiple options for stepping is crucial
• Aim for a vertical shin with minimal knee bend to start with

Levels & Scaling

1. Level 1: Using support to step up
2. Level 2: No support to step up on one leg
3. Level 3: No support to step up on one leg & controlling all the way down
4. Level 4: Stepping up with one leg and weight in the opposite hand & controlling all the way down

Exercise 6: Sit To Stand [Changing How You Experience Knee Pain Through Better Squatting]

Squatting with Knee Pain can be quite difficult. This exercise is designed to slowly introduce your body to get comfortable with the squat movement, while also providing a new movement pattern to help you in the future.

It’s incredibly relevant to anyone who sits and stands regularly (i.e. everyone) and is a really solid functional marker.

Reps: 5-15

Sets: 1-3

Notes on performance 

• Sit back into your hips as though you’re sitting into a chair.
• Control knee bend as per what is comfortable.

Levels & Scaling

1. Level 1: Using support to sit down and up
2. Level 2: No support to sit down, but support to stand up
3. Level 3: No support to sit down or up
4. Level 4: On one leg, no support to sit down, but support to stand up
5. Level 5: On one leg, no support to sit down or up

What Will These Exercises Do For My Knee Pain?

By following these basic exercises every other day & progressing using the suggestions we have given, you will be well on your way to starting to drastically improve your knee pain. If you gradually work your way up to performing 3 sets on each of these movements, for 3 days out of the week, over the next 12 weeks, we guarantee you will notice a change in your knee pain.

When doing these exercises, it is incredibly important to remember that each person will be at a different level. If you experience knee pain on any of these movements, or simply find that every single one of these movements are too difficult for you to complete, we’re here to say, that it’s ok. Every day we work with people who struggle with performing these movements because of pain or a lack of function. What we say to these people is that no matter where they’re at with their knee pain, they can always get better. Sure the exercises might require some modifications to suit their specific level, however, the principles behind these 6 key movements remain exactly the same.

We would recommend purchasing some resistance bands in order to complete these exercises over the next 12 weeks. Our personal preference are these, as they allow for many different exercises to be performed, are of high quality and can be assembled anywhere. They’re the exact same bands that we use in our clinic, as well as within our comprehensive online Knee Program.

The post If You Suffer From Knee Pain OR Hip Pain, Here Are 6 Science Backed Exercises to Kill It appeared first on MTP Health Programs.

This routine is a fantastic full-body routine that can be done before or after a run. It is designed to release the tight spots that most commonly limit runners, while also strengthening key areas that are often neglected. To understand the general theory behind these exercises we recommend watching this video, which we created to explain how our mobility programs work. Essentially the most important concept for real mobility is that there is ‘active’ intent (i.e. muscles are being contracted & not simply relaxed into).

Most common limited areas for runners.

1. Hips
2. Spine
3. Shoulders

This routine addresses all three of these areas.

Breakdown of the Exercises

Standing Assisted Knee Drives – This exercise is really designed to focus on opening up the entire hip flexor complex. It is a great drill to provide an active mobility stimulus in order to help the often tight hip flexor to release. This is important for running because of a concept known as reciprocal inhibition. Essentially reciprocal inhibition is the idea that we can create range in one muscle group by releasing or activating the muscle group opposing. In this particular exercise, we are aiming to utilise this concept in order to improve our hip extension and the ability of our glutes to fire effectively.

An Anatomical Look at the Hip Flexors – Credit: Fitness Physio

Standing Hip Flexor Drives – This is the same concept above, with a strength training focus applied (i.e. placing a loaded stimulus on the muscle). Because we are working on our end range strength we are able to actually work towards increasing our mobility long term. This is because we are causing a tissue response to occur, that will interplay with our nervous system, thus allowing greater trust from our brain when moving in ‘risky’ end ranges due to the increased control we have.

Spinal Peel downs – Moving our spine is one of the best things we can do for our overall longevity. Because absolutely everything that our body does runs through our spine, it is critical that we keep healthy. One of the best ways to maintain spinal health is through movement. This drill is designed to create articulation through each one of the individual spinal facet joints in order to get our spine articulating properly. A lack of movement in the spine can be a contributor to pain, particularly if our brain perceives a lack of control over certain segments of the spine.

It’s Best to Have Movement in Each of the Spinal Facets Shown (Cervical, Thoracic & Lumbar)

Egyptians – It’s incredibly important to get our shoulders moving through their rotational axis, allowing the humeral head to move in the glenoid fossa. This is one of the first things to go in a healthy shoulder that lacks movement, which can lead to aberrant shoulder function over time. This exercise does just this, allowing our shoulder to rotate through its full range of motion, while also

The Complexity of the Shoulder

Neck CAR – A lot of people ask the question, is it safe to move my neck like this? Our answer is always if you can move it there, then it was designed to go there. Where people come into problems is through the ‘use it or lose it’ principle. A lot of the time, people don’t move their neck much at all [See detailed anatomy here]. The body the maladapts to this lack of movement & starts to perceive less control. When someone is in this state, all it takes is an unexpected application of force & their brain will send a pain signal in response to the perceived threat. By performing this exercise we can help our brain to communicate with the muscles in the neck, providing a movement stimulus to the joints. This tells our body that our neck is still in use and is safe to move.

1/2 Kneeling Hip Flexor Drill – An active isometric drill. This has the effect of reciprocal inhibition for our hip extension (glutes) that we described above, as well an effect of increased range that is best described by a concept called Proprioceptive Neuromuscular Facilitation. Essentially when we contract our muscle at its end range of motion isometrically we send a stimulus to our brain that our body it is safe to move in this range of motion. Our brain then recognises this and allows our muscles to move in this increased range of motion by approx. 10-15 degrees. By doing this drill regularly we can not only temporarily increase our range of motion, but also create strength in this range (as we are forcefully contracting). Creating strength means that our body will be able to maintain this range, as it will cause an adaptation to the tissue itself, making it more resilient so our brain will recognise the end range as a now ‘safe range’. NOTE: this typically applies to ‘lost’ ranges of motion that are within anatomical limits.

90:90 PAILs/ RAILs – The principles behind this exercise is the same as above. This drill is incredibly important for runners, as a lot of soft tissue restrictions stem from internal rotation of the hip. The main limiter of hip internal rotation is the hip capsule itself, which is mostly ligamentous (non-muscular). This tissue will respond to active stimulus over time. This drill is crucial for runners who regularly struggle with any form of hip limitation, as in almost all cases people with hip issues struggle with their internal rotation.

Hip Anatomy – CREDIT: Thinglink

Hip Internal Rotation 90:90: “This drill is crucial for runners who regularly struggle with any form of hip limitation, as in almost all cases people with hip issues struggle with their internal rotation.”

Swivel Hips – An active end range mobility drill to take advantage of the increased ROM (Range Of Motion) created by the last drill.

Glute Bridge – A strength-focused exercise that will help build strength by working the large glute muscles in hip extension to cement the range of motion that has been created by the exercises above. Hip extension loss and glute dysfunction are two of the most musculoskeletal dysfunctions we see in sedentary populations.

Hip CAR – An active end range mobility drill to take advantage of the increased ROM created by the last drill. Remember that active mobility is what helps our nervous system to trust us in ranges of motion.

Founder – This exercise is going to provide strength in the low back, mid-back, while lengthening the hamstrings in a loaded position. It also highlights the importance of breathing into mobility positions. Breathing allows us to relax effectively and causes our brain to calm down its nervous response the facilitates muscle tension. Essentially when we breathe, our brain trusts our ability to control itself.

Warrior – Another example of an active hip flexor stretch that is placing load on the tissue (i.e. Hip Flexor).

So Why The Detail?

The aim of this article is to educate you on how the amazing structure that you’re walking around in daily (i.e. your body) actually works through a practical introduction to achieving your goals, We find that when people understand what they’re doing, they’re able to get significantly better results and enjoy the process a whole lot more.

The post Anatomical Breakdown [Runners Mobility Routine] appeared first on MTP Health Programs.

FAQ: Do I Need To Keep Seeing You Forever To Get The Best Outcome?

Absolutely not, as Luke talks about in the video above, our aim with all the programs that we run at MTP Health is to create programs that focus on the best long term result. While most people find that they tend to see us more than other rehab providers in the short term, we typically find that this leads to less ongoing treatment. This is because we focus on empowerment in order to allow people to manage their own injuries and get back to activities that they love

“Give a man a fish and he eats for a day. Teach a man to fish and he eats for life!” 

What Is Empowerment? 

What Do You Think Would Be Easier to Do? 1000 Step Ups In The Gym or 1000 Step Ups in Nature on a Hike?

Empowerment is crucial for us and the results we get, as it helps the people we work with to get the best possible outcome. A big part of empowerment is gearing people up to returning to the activities they love most. All movement is good movement and so the more we can gear people up to be able to move safely in ways that they enjoy, the less likely they are to experience issues over the long run [See Why Movement Is So Beneficial In This Article Series].

FAQ: Why Are Your Programs So Much Longer Than Most Other Physios?

Two main reasons:

1. We don’t just want to treat the symptom (often pain).
2. We want to address the root of what is causing those symptoms.

Addressing the root cause of the problem is the real solution to providing long-lasting treatment outcomes that genuinely last. While it takes a deeper dive initially and more responsibility from the patient, the result is well worth it.

With Any Problem, There Are Always a Set of Things At The Root Of The Problem That Cause The Symptom to Arise. This Very Apparent In the Human Body.

Resources

1. Empowerment, MTP’s Core Principle – A look at the science behind empowerment and why it’s so beneficial for our health long term.
2. What Actually Causes Osteoarthritis – An in-depth look at the benefits of movement through the lens of a chronic musculoskeletal disease.

The post FAQ: Will I Have To See You Forever? appeared first on MTP Health Programs.

The post Supermums! The unsung heroes of the Commonwealth Games appeared first on MTP Health Programs.

Question: “How does that weight feel?”

This is a frequent question you will hear our practitioners asking. If the weight is too easy for certain exercises it means the intensity of effort will be too low, and consequently the adaptation you are trying to achieve will suffer. Intensity is one the most important variables to improve body composition, strength and overall health and fitness. Research investigating the individual responses to resistance training in terms of effort has shown that exercise practitioners and strength and conditioning coaches can predict how hard clients and athletes are working and can in fact avoid the risk of overtraining and musculoskeletal injuries.

What is intensity of effort and how is it measured?

Intensity of effort literally refers to how hard you are working during exercise. It is often measured subjectively using a scale called rate of perceived exertion (RPE), which is a 6-20 scale or 10 scale assessing fatigue during exercise. The 0-10 scale is often used for assessing resistance training intensity. Unfortunately, this scale is not very sensitive to assessing fatigue during strength training sessions, as noted in a paper by Hackett et al., 2012: “…RPE scores at volitional fatigue were less than maximal for bench press and squat exercises”.

Research / Evidence

The paper by Hackett et al., 2012 looked at using a new scale to assess the intensity of effort / muscular fatigue in strength trained men.

Purpose: “To determine the validity of a novel subjective estimated-repetitions-to-failure for predicting muscular failure during resistance exercise. To do this we compared estimated-repetitions-to-failure (ERF) with actual-repetitions-to-failure and related both to RPE across multiple resistance-exercise bouts in experienced resistance-trainers”

The authors gathered 17 strength-trained (bodybuilders) men (age 32.3 ± 4.7 years) and they underwent a training protocol which involved 2 sessions of 5 sets x 10 reps at 70%1RM* with 5 minutes rest between sets for the bench press and squat exercises. After each set was performed participants were shown the both the RPE and ERF scales and asked to score each. After the participants rated each scale they performed repetitions to failure and this was referred to actual-repetitions-to-failure (ARF).

Results

There were “high positive correlations between ERF and ARF for all subjects” and during the later sets (3, 4 and 5), the ERF “accurately predicted the number of ARF” for both exercises.

Essentially, as the training session progressed, the accuracy of participants estimating their reps to failure increased.

What does this mean for you?

With this information, trainers can accurately predict a level of fatigue in clients for certain exercises based on their estimated reps to failure in the later sets of an exercise. This will allow the modification of training loads to ensure that fatigue is not reached prematurely and that optimal adaptation can occur without overtraining. Therefore, if a weight is too light or heavy, let the trainers know because the intensity of effort will be affected and you might fatigue too quickly and start to overtrain, which can affect the rest of the session or be working at too low an intensity. Most of the time the trainers will know what weights you are capable of and if technique starts to deteriorate in the early sets it is usually a sign that the weight is too heavy and can be reduced.

How to Use ‘Estimated Reps to Failure’

Estimated reps to failure is an incredibly useful guide to indicate the right intensity to be used for resistance to stimulate hypertrophic adaptations. The main advantage of using this scale is increasing the awareness of the lifter on the importance of lifting at a submaximal intensity. If you haven’t had a look at our extensive series on strength, we suggest that you do in order to get a comprehensive understanding as to why this sub max intensity so important. It often flies in the face about what most people think about when they go to the gym (i.e. heavier & harder is better always), but that’s what intelligent training is all about.

A general guide

• When you finish an exercise give yourself an estimate as to how many more repetitions you thought you could’ve performed at that weight if you had to go ALL OUT (this may require some experimentation to see how close your estimates are to actual ability).
• When you estimate that you can do more than 5 reps with a weight, it’s a sign that you might want to increase the weight being lifted in order to maximise the hypertrophic benefits.
• If you feel you could get less than 2 reps with that weight, then you may want to look at using a lighter weight.
• When observing the exercise being performed, pay attention to the speed at which it is being performed. This will give another clue as to how much you might be able to lift.
• This tool is mainly useful for hypertrophic adaptations and is a simple guide to ensure intensities are right without needing to record weights week to week. 

Reference: Hackett, D. A., Johnson, N. A., Halaki, M., & Chow, C. (2012). A novel scale to assess resistance-exercise effort. Journal of Sports Sciences, 30(13), 1405. doi:10.1080/02640414.2012.710757

*1RM = 1 repetition maximum

The post What Weight Should I Be Using? [Estimated Reps To Failure A Guide to Optimal Training] appeared first on MTP Health Programs.

Question: Can even modest exercise produce health benefits??

The benefits of exercise are well researched and documented. Improvements are seen in strength, body composition and general well-being. The term “exercise is medicine” is often thrown around within an Exercise Physiology clinic because it has been shown that certain exercise such as aerobic and resistance training can provide similar benefits to that of drugs used to treat conditions such as diabetes, obesity and hypertension. Typically, in order to achieve optimal health benefits, 150 minutes of moderate physical activity per week is recommended (e.g.  30 minutes a day for 5 days).

But what if you could increase your life expectancy as a result of doing less than the recommended dosage regular exercise?

Here’s where things start to get interesting. The study by Wen et al., 2011 explored whether lower amounts of leisure-time physical activity could also reduce the risk of death and extend life expectancy.

What did the researchers do?

Aim: Wen et al (2011) aimed to assess the health benefits of different volumes of physical activity with a particular focus on whether less than 150 min a week of exercise was sufficient to reduce mortality or extend life expectancy

Participants: Taiwanese adults aged 20 years or older (416 175 individuals [199 265 men and 216 910 women] 

Methods: Medical screenings were undertaken between 1996 and 2008.  Medical history and lifestyle screening was conducted using a self-administered questionnaire. There were 3 questions which individuals were asked:

• 1) Types and intensities of weekly physical activity that they did during the previous month
• 2) Duration per week spent on various activities within the previous month
• 3) Amount of physical activity done at work.

Once the researchers gathered all the data from the questionnaires, they placed subjects into one of five categories of exercise volumes and “…calculated hazard ratios (HR) for mortality risks for every group compared with the inactive group, and calculated life expectancy for every group”.

1. = inactive
2. = low
3. = medium
4. = high
5. = very high activity

RESULTS

Individuals in the inactive group had a 17% increased mortality risk compared to the low-volume activity group. The low activity group who exercised for an average of 92 min per week benefited from a 14% reduction in all-cause mortality and could expect a three-year improvement in life expectancy. These benefits continued to increase with higher levels of activity. This study, therefore, found a dose-response gradient of all-cause mortality (i.e.­ increased levels of physical activity = decreased risk of death) (see graph below).

The following graph shows that as little as 15 min/day of exercise can reduce the all-cause mortality by 15%, and “…every additional 15 minutes of exercise (up to 100 min/day) could lead to an additional reduction of 4% all-cause and 1% all-cancer mortality.”

WHAT DOES THIS MEAN FOR YOU?

Quite simply, this study shows that if you want to reduce the risk of all-cause (cardiovascular, cancer and diabetes mellitus) mortality and increase life expectancy, low volume exercise (as little as 15 min/day) can contribute BUT the greatest benefit is seen when performing higher intensity (e.g. vigorous) exercise. Additionally, performing longer duration (e.g. up to 100 min/day) exercise is beneficial. 

Limitations: It is important to understand that this study is an observational study, not a randomized controlled trial, systematic review or meta-analysis (highest levels of scientific evidence), so results must be taken with caution. 

Relevance to Practice

When it comes to getting in our exercise, the key message that we always want to relay to our clients is that some is always better than none. Better still, more exercise is typically better than less (up to 100 minutes and up to a certain intensity as suggested by this paper).

Yet information alone isn’t always empowering…

The need to consciously seek movement is a relatively modern phenomenon and the idea of exercise as it is commonly conceived (in gyms, running etc) doesn’t appeal to everyone. However, keeping in mind that physical activity can come in many forms, it is important to recognise the opportunity to explore the amazing range of movement on offer. This could be something as simple as going for a walk in nature or it could be something more intense, like learning to dance or getting involved in a sport. The point of ‘lifestyle’ movement, as opposed to exercise, is that we enjoy it. Once we enjoy it, it no longer becomes something that we ‘have to do’, instead becoming something we want to do. It becomes the very thing we live for, not just something that keeps us alive. To find out how to make this form of ‘exercise’ attainable for the long term, check out our article on motivation.

The key to making it work is to start small while pursuing your natural inclination & curiosity when it comes to exploring movement. We will be here to support you every step of the way.

“That’s why we make an effort to show people the facts, as well as giving them the tools.”

TAKE HOME-MESSAGE

Any movement has the potential to improve your health outcomes, even as little as 15 min/day or 90 min/week.

Reference: Wen, C. P et al., (2011). Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. The Lancet, 378(9798), 1244-1253. doi:10.1016/S0140-6736(11)60749-6

The post Research Review (Opinion): Minimum Amount of Physical Activity for Reduced Mortality & Extended Life Expectancy appeared first on MTP Health Programs.

On one end we have the typical fitness trainee who thinks of their strength as a measure of their physical competency, being the manifestation of their ego. This is the mindset (which is more common than we like to admit) that leads us to believe that our strength needs to be maximally displayed at all times (unfortunately, displaying our maximum strength all the time can lead to serious injury, fatigue and lack of long term progress). On the other end, we have the person who never wants to exert themselves because they are either in fear of sustaining an injury or simply don’t have the appropriate belief systems to see the value in what they are doing [See our article on why motivation & Laziness are red herrings and a lack of belief in value is the true culprit behind a lack of exercise]. In both of these cases, the person in question has some very misleading perspectives on strength, what it actually means for them, the benefits of pursuing it and how to best go about doing so!

And this is a real problem. Because muscular strength is something that is critical to our lives. The intelligent pursuit of it can be somewhat of a fountain of youth and one of the main things we can all do to give ourselves the best chance of a life of good health.

We most commonly hear this term being thrown around by well-meaning people who have heard that muscular strength is a good thing. This could be a physician, surgeon or rehab provider that has told the person that ‘getting stronger’ will provide them with improvements to their condition, pain and function. While this is true, it is unfortunately not always that simple and so today we want to provide you with some of the basic physiology behind strength and then go into the best ways to sustain and build it.

How to use this Article Series

• This is the summary of 4 years of undergraduate study in human physiology, so it will take some time to fully digest.
• Think of it as the schema to hang all of your knowledge of human physical performance on, whether it be athletic endeavours, our ability to get out of pain, or simply how we adapt to the environment around us. It will help to explain what separates elite athletes from the average everyday person, the potential each of us has within our own body, why we get injured, the most likely causes of injury and pain as well as a heap of other highly relevant topics.
• We suggest that you use this article as a reference guide to cross-check anything that you read in the future.
• Think of this resource like a comprehensive guide that is incredibly well-referenced, with pre-eminent articles from both the research and from the field.
• The best way to get an understanding is to skim through the articles at first. We have provided a nice summary at the bottom of each article in order for you to quickly understand the context of the material. We want for you to first become aware of the concepts, by reading what we have written then constantly refer back to the article and the materials linked within it to pique your interest over time. Should you have any questions about any of it, we will be available to answer them for you.
• We have purposefully written this article in a manner that makes it directly relevant to the reader. We have designed the whole article to be able to give context about the story of human performance, without going into too much detail. While going through this story we have provided reliable links to important resources that we know and trust so that you can delve into information that has been well-curated, should you want more detail and context. This series has around 50+ independent articles linked within it, which is a mass of information. We would not suggest reading this all at once. Use the articles like an encyclopedia, saving them somewhere easy to access so that you can readily access the information when you need it.

So, what actually is strength?

Physical (Muscular) Strength: An animals ability to exert force on an object.

Force is our measure of muscular strength. Typically strength is talked about without factoring in acceleration (which is a factor in muscular power)

Muscular strength is often thought of as one of the most admirable physical qualities anybody can possess. A large part of this is the fact that our society holds strength up as a virtue with the noblest connotations of heroism and courage being associated with the word. For the purposes of our discussion today, let’s separate the way most people think of strength from a mental and emotional standpoint to (typically thought of as our ability to pursue a difficult endeavour) from the physical quality of muscular strength. This will allow us to separate our use of the term ‘strength’ from the positive mythological connotations that are often associated with it.

To break down the component parts of strength nice and simple, I have enlisted the help of Muscular Physiologist, Dr Andy Galpin to explain the Physiology of Strength in 5 minutes. Dr Galpin breaks it down into 3, simple component parts, which I have adapted for our purposes.

1. 1. 1. Neural component or CNS (i.e. Mobility, Force production, lack of inhibition, balance, coordination etc.) 
      2. Muscle contractile component (i.e. Morphological changes e.g. fibre hypertrophy, calcium sensitivity, fibre type transformation) 
      3. Connective tissue component (i.e. Tendon Strength, Collaginous matrix, Tendon Stiffness & force absorption + elasticity, bone density) 

These components give us our first look at seeing what goes into muscular strength. You can find out more about the specifics by clicking on the associated links within the above text.

Now we want to give you some practical information to set you on the right path in your understanding and pursuit of strength (see a brief history of modern strength understanding for more detail on the science).

It’s Not All Or Nothing [Frequency & the importance of sub max strength]

How does this apply to your life?

When training it’s important to work consistently & frequently. This is the same for the person who has severe knee pain & struggles to get out of the chair, as it is the elite CrossFitter. The key is to intelligently ‘train’ at the right sub max intensities to elicit a given result.

The importance of long term ‘periodisation’ when it comes to training. Periodisation is simply a fancy way to describe planning. The reason why it’s called periodisation is because it involves breaking a period of extended training (anywhere from a few months to multiple decades) into a series of component parts that focuses on particular qualities in each part. Because the human system is a series of chemical reactions occurring constantly (Lets say a rough estimation of 37000000000000000000 per second) that contribute to the functioning of a whole host of independent systems that all leads to our ability to function in certain tasks (this example uses sport as the task), things can get quite complex. There are a lot of independent systems that contribute to our ability to perform in sporting endeavours (i.e. Muscles, Nervous system, Skeleton, Connective tissue, Cardiovascular, Gene expression, pancreas and hormonal function), each of which will adapt differently to different kinds of training stimuli. What we know from years of studying sporting performance is that the body responds to these stimuli in a fairly predictable manner (i.e. The specific demand that is placed upon the body will lead to a specific adaptation in response to that demand). The principle that underlies this response is known as the SAID principle. What this principle shows is that that human system as a whole will respond to a specific set of stimuli in a specific manner to impose a specific adaptation on the host of independent systems that are involved in responding to that stimuli. In other words, when we practice we get better.

But here’s the catch.

There are certain rules that govern our ability to adapt to the demands our body faces. In fact, certain physiological qualities will compete for the valuable adaptive resources our body has. One example of this is the cell signalling pathway for endurance (AMPK) when compared with muscular hypertrophy (mTOR). This classic review shows how the biochemical signalling process related to the synthesis of mitochondria (the energy-producing components of a cell related to endurance) can actually have a blocking effect on protein synthesis (the creation of muscle). This serves as a perfect example of one of the chemical reactions that govern our ability to adapt and the interference that training for two different qualities at the same time can have on it (other examples are the competing demands of maximal strength VS maximal Power VS maximal speed, body fat % VS physiological performance, Strength VS Skill, Maximum strength VS Maximum muscle size). Sadly, there isn’t sufficient research to document a lot of these competing adaptations, however, coaches have anecdotally known these things for years. That is why they came up with the theory of periodisation, so they could take into account the overarching goals of the person they are working with and apply basic physiological principles to best manage the training of that person over the length of their entire training career.

This same concept applies to you. Whether it’s your physical training, sporting or your rehab, intelligent planning is a must to help you get the most out of what you’re doing. For most people, the best form of periodisation they can apply TODAY to reach their goals is a simple load management chart [See our Guide to calculating loads here], along with using the principles of movement hierarchy. Sadly, this is something that is seldom done, which is why so many people never achieve their physique, performance or rehab goals.

A Universal Guide to Simple Load Management in Any Activity

Another example of competing training demands ties back into the first example we have of the person who’s ego is attached to their physical strength. They feel the need to maximally exert themselves at every opportunity and think in an all or nothing manner. If they aren’t able to outperform everyone else in the room, then they feel like they would be better not coming at all. This is a flawed mindset that can lead to two major things happening. Firstly they will almost definitely underperform over the long term, as they will very likely not be able to respect the focus it requires to properly periodise in their training and focus on what they need to do now to achieve their long term goals. This most commonly plays out in the max strength VS max size tradeoff. If this person is aiming for maximum muscular size, then the most important thing is their overall training volume. What we would see if they tried to show off their strength at every opportunity they got would be an increase in their overall fatigue and thus training quality decreasing over time. Eventually, this would put them at much greater risk of injury and underecovery as their body simply wouldn’t be able to adapt to the intense stimulus it faced [See More On Optimal Training Volumes]. On top of this, because their ego is getting in the way of their ability to intelligently train, they are much more likely to become discouraged with their training and give up entirely. You can see how this quickly becomes a zero-sum game. Training is not black and white. Doing something is always better than nothing.

When Volume Goes Up Intensity Has to Go Down. This is Why We Cannot Exert Our Maximal Strength 100% of The Time

To further hammer this point home, I want to showcase the example of Andy Bolton, the man who deadlifted 1000 pounds for the first time & didn’t go over 800 pounds in his 8 weeks of training beforehand. That’s how fatiguing truly intense strength training can be. What allowed him to perform such a crazy feat of strength, was lots and lots of intelligently planned (circa 30 years of training that respected the human body’s physiological adaptations), frequent practice at submaximal intensities (between 30-80% of his max). If we jump back into our present reality & apply this example to ourselves, we are left with the golden rule of training to create an adaptation: consistency (or volume as Strength training calls it) always wins. Any step towards achieving your movement goal is better than nothing. It takes stimulus to cause an adaptation to our body. The more frequent and habitual that stimulus becomes the more likely the body will adapt.

When Considering Strength It’s Incredibly Important To Address the Components That You’re Lacking Within The Movement Hierarchy Before Going All Out On Strength

Common Misleading Perspectives on Strength

Strength training is bad for my back [Insert another joint]

Strength Training is for macho guys who are too vain to care about anything else

Strength training isn’t that good for my health

Strength training will stunt my growth

The benefits of pursuing Strength

The list is extensive, but here’s the summary: It’s amazing.

• Systematic review improved all Health-Related Quality of Life measures.
• Anecdotally Strength training seems to be the most cost-effective and time-efficient way to optimise someone’s health. It makes sense. We evolved lifting things. Our body was designed to be exerted and adapt. Without doing this, our system begins to maladapt and fail.
• Strength underpins just a large majority of physiological adaptations that improve someones ability to perform.
• Research has shown benefits to specific things like Mood, pain management, prevention of chronic disease,  prevention of cognitive decline, positive weight management, lower body fat, more muscle mass, improved sense of well being & confidence. This is just a brief summary.

What Does Strength Actually Mean For You?

Why are you wanting to strength train? Do you want to look good? Did your doctor tell you to do it? Is it for your X condition? Do you want to be able to do a certain activity?

The question of why is fundamentally critical to designing an effective strength training program. Often people confuse muscular size with strength [See our article on CNS to understand why this is a problem]. Similarly, many people see strength training as their sure-fire way to get fit, strong and better at anything they wish. This is also an oversimplification. While strength training certainly has a litany of benefits, it can also be specifically applied to create different types of benefits that could be more suited towards a certain goal. E.g. Does the person simply need as much muscular strength as possible or do they want muscular size? Or do they need to perform at a given activity as best as they can? All of these 3 goals involve 3 quite different training protocols.

How to Best Go About Building It

We’ll try to make this as simple as possible.

Without touching on all of the different goals we spoke about above, there are some things that work. Here is our shortlist

1. Plan your training for the long term (at least 1 year). Think about how long you plan to train for. It should ideally be as long as you are alive. What do you want to be able to do as a result of your training? This is how you start.
2. Use 55-90% of your max when training (See Prilipens chart below for a great starting guide). NB: The example of Andy Bolton listed above features %’s that are adjusted to someone with an incredibly high training. This means that he has spent years optimising his bodies capacity to handle high loads, while teaching his nervous system to disable it’s safety mechanisms that regulate force production (i.e. his body his minimal regulations). This means that he is able to use lower %’s that still stimulate massive adaptations as his body is incredibly efficient at producing force. A human frame is still a human frame and so 400+ kgs will cause fatigue no matter who it is.
3. If you’re serious about it, see a professional. Physiological change is pretty damn complex if you hadn’t realised already. That’s why people spend at least 4 years in specialised university programs to learn how to most effectively elicit these changes in the human body. There are thousands of factors that need to be accounted for and if one of these is not properly factored in, it could result in suboptimal performance, fatigue and or serious injury.

Quite possibly the greatest simplification of how to create physiological adaptations to improve Muscular Strength

Ok, I Get it Strength is Complex, But What Do I Do With All This Information?

The Bottom line is this: Strength is a complex phenomenon that is extremely beneficial for human health when pursued intelligently.

In this article, we wanted to showcase how we can go about pursuing it intelligently. We have broken down the rough physiology of strength and hopefully, shed some light on what goes into it. We then went on to talk about some of the misleading perspectives many people have on strength and what this means for them. Littered throughout this article are pragmatic ways to more appropriately implement strength training into your life, as well as why it is so important. Here are a few key takeaway points:

1. You will learn to love it (everyone should be doing it): The benefits of strength training are too vast for you not to enjoy it once you start to see progress. This is because of our inbuilt reward mechanisms that are perfectly set up to find physical exertion in the form of resistance training highly addictive.
2. Plan for the long term: the key to achieving absolutely anything is finding something you want to achieve & creating an effective, clear plan that fits with your lifestyle in order to achieve that thing. Strength training is something that everyone should be doing and should suit your life accordingly.
3. Take all factors into account: The human body is incredibly complex. Only when as many factors as possible are taken into account, can we come up with a program that will produce the ideal result that we desire.
4. Something is infinitely better than nothing: Don’t think on an all or nothing scale. Work at your own level, respect your place on the movement hierarchy & load management continuum and progress appropriately.
5. Doing it often is your best bet for success: The king of all adaptations is frequency. Think of exercise like a drug. It needs to be taken often enough and in the right dose to create the response you desire (find a professional who can tell you what this dosage is if you’re unsure). The best way to think about approaching strength training is to think as if you’re going to be doing it for the rest of your life. So take your time, build into it slowly and set yourself some goals that will constantly build upon each other.

Other Parts of this series

• Part 1.1 – The The Neuromuscular component [A Body With No Limits]
• Part 1.2 – The Neuromuscular component [Movement Hierachy]
• Part 2 – The Muscular Component [Physcial, contractile Muscle]
• Part 3 [Coming SOON] – The Connective Tissue Component [The Forgotten Child]

Links

1. The Effect of resistance training on health-related quality of life in older adults
2. How does training volume affect muscle growth 
3. Is there an optimal training volume per session
4. The basics of Hypertrophy Training
5. Research Review on the interference effect of training
6. Basic practical introduction to periodisation
7. Optimal recovery time for strength & power gains
8. Andy Bolton and the Story of 1000 pounds [everything that goes into superhuman performance] – this is a great example of intelligently planned training that anyone can take a lesson from
9. Resistance training, a scientific evolution of our understanding – a detailed look at the scientific study of strength over the years.
10. What is Strength – Showcasing the difficulty in defining strength, due to the vague nature of the term and the many ways in which our body can exert strength.

The post How We Actually Get Stronger appeared first on MTP Health Programs.

Are they someone who is in pain, not very active, in their older years and doesn’t have lot of muscle mass? Or are they an athlete trying to gain strength and size in order to improve their performance in their chosen sport? Once we have considered exactly who we have in front of us we can start to determine what are the necessary areas of strength that need to be improved in order to produce the desired result that person is after.

The first part of our series gave us some insight into why these questions are important to answer. A lot of people confuse strength with things such as muscle hypertrophy and muscular power. Similarly, people rarely respect the carryover that an increase in strength will have into the task they are trying to build the strength for i.e. will improving their overall ability to produce more force actually achieve the goal they are trying to reach? The answer to this question typically a yes, but it’s only part of the equation. Because there are typically a range of other factors that limit someones ability to perform a task effectively other than simply muscle size itself. This idea was highlighted in both parts 1.1 & 1.2, where we talked about the neural factors that create strength, as well as our bodies tendency towards self-protection.

What is a ‘Muscle’? 

As we discussed the neural components in our previous articles today we will go into the predominant contractile factors that regulate muscular strength.

The best way to think about our individual muscles is to consider their function like that of a city. A cities sole objective is to stay operational and produce economic growth. Every single component within that city, from the people who live in it, to the various organisations that exist will be working in some way to help contribute to this goal. Some components may have more of a contribution than others, however, no one part can have the impact that a set of combined actions has. If we extend this analogy to our muscle we see the same principle applying. The muscle has thousands of independent structures (cells, fibres, nerves) that are controlled by many other structures in the body (brain, organs, etc.) in order to produce one overarching goal, muscular contraction in order to facilitate survival. All of these thousands of units play their own specific role to contribute to the overall function of the muscle [See an overview of how muscles work HERE].

This is important to keep in mind when we look at the various physiological adaptations that occur within our muscle as a result of resistance training. There will be many adaptations, as our body will adapt to any stimulus according to the SAID principle (i.e. a specific adaptation to whatever demands is placed on it). Below we will cover the major things that affect our actual muscle and the contractile components of it. This does not include the neural factors that we touched on in previous parts (NOTE: the nerves in the diagram below show how abundant ‘neural’ connections are within our muscle fibres).

A Muscle Is a Set Of Thousands Of Thousands of Independent Structures Working In Sync. CREDIT: Functional Anatomy Blog

What Is Happening Physiologically When We Gain Strength (Muscle Contractile Component)

The Main Physiological adaptations in response to resistance training in terms of the contractile component of our muscles are listed below (see a full review showcasing these). With this said, just about every aspect of what makes our muscle work will adapt in response to resistance training (49 mins into this video covers this pretty well). These factors will contribute to our ability to increase strength. We can think of these muscular adaptations as increasing our overall potential to produce force. Without having an optimised neural system (as talked about in parts 1.1 & 1.2) we will never be able to produce a maximum amount of force. That’s why muscle size isn’t the only factor that contributes to strength.

1. Increased Muscle Size (i.e. Muscle cross-sectional area via hypertrophy).
2. Change in Muscle architecture (i.e. pennation angle)
3. Fibre type shifts (e.g. selective hypertrophy of fast-twitch fibres through adaptations on the fibre continuum)
4. ATP site changes (e.g. possible changes in energy sources).
5. Mitochondrial number (depending on the type of training; although this is more related to endurance).
6. Capillary density (i.e. Bloodflow changes).
7. Molecular-adaptations (e.g Calcium sensitivity, protein synthesis, cell signalling pathways).

Increased Muscle Size (Hypertrophy)

When our muscles increase in size as a result of resistance training, there is one main mechanism that allows this to occur. This is known as muscular hypertrophy. Hypertrophy is an increase in the size of our individual muscle fibres, as opposed to the addition of new muscle fibres (which is known as hyperplasia). An increase in muscle size has been shown to directly correlate with an increase in overall strength.

An important factor to consider with this component of resistance training adaptations is the benefits of muscular size on overall quality of life (many individual trials have shown this in specific populations e.g. Here & Here). The most compelling highlights of these benefits comes from the evidence on functional muscular decline with ageing. This evidence suggests that muscle loss with age is one of the main determinants of a decrease in function and a major component in frailty. It suggests that a loss of body mass > 40% is fatal. We have highlighted in the past how ageing isn’t necessarily a death sentence. What we know is that with strength & resistance training we can slow the effects of ageing and have highly positive benefits on overall quality of life.

Age-adjusted death rates per 10 000 person-years from all causes by thirds of muscular strength and age groups [CREDIT: Ruiz et al. 2008]

The same principle of muscle loss with age can be seen in a decrease inactivity (highlighted below). Essentially, because our body is an adaptive organism, it is important to continue challenging it with resistance stimulus in order for muscular adaptations to remain. If we don’t do this, we risk experiencing some of the negative effects of decreased muscular size associated with ageing.

Muscle hypertrophy is by far the most physically observable change that occurs as a result of strength training. It is often the most sought after consequence of strength training for the large majority of trainees. The key to creating this adaptation in muscular hypertrophy is overall ‘volume’. It is also incredibly important to highlight what life is like when this part of our strength begins to decline. This is why we spoke about the effects of inactivity and ageing above. We find this to be an incredibly important factor for our own patients, as a large majority of them are suffering the consequences of a predominantly sedentary life and thus could benefit from gaining some muscular hypertrophy.

More Muscle = More Strength??

It seems simple right, the more muscle we have the more weight we should be able to lift?

Well, then why wasn’t the person to lift the most weight in history a professional bodybuilder? Bodybuilders are judged based on their overall muscularity, so it would make sense that if all that went into strength was simply an increase in muscle mass then the worlds greatest bodybuilder would also be very likely the be one of the strongest people on the planet. Now there are many problems with this hypothetical, as strength is a relative definition. What are we using to measure strength? If we look at conventional testing measures (i.e. a specific lift), our ability to express strength is highly task-specific based on: 1) our skill in performing the movement, 2) our unique anatomy & 3) Our level of fatigue (we touched on all of these factors in part 1.1). To further highlight this point we can draw on the anecdotal accounts of professional bodybuilders. In this account one of the worlds greatest bodybuilders, Jay Cutler suggests that maximum strength wasn’t a big factor in his ability to develop maximum muscularity. Instead, it was his overall use of training volume at optimal intensities to elicit the response he desired (We spoke a bit about this in our introduction). This reinforces what we discussed in previous articles, showing us that muscularity is only a part of what goes into generating maximum strength.

Many People Are Very Surprised To Hear That Someone Like Jay Cutler is Nowhere Near The Strongest Person On The Planet

Change in Muscle Architecture

We said above that essentially all of the structural and functional components in muscle will adapt to resistance training. This includes the actual architecture of our muscle fibre, in terms of how it produces force, based on the type of training we do (referred to as muscle pennation angle). These changes can be specific to either speed of contraction, or maximal force production (i.e. train for speed and the muscle adapts to this, train for strength and the muscle adapts differently for this). This is independent of any increase in size, the energy production of the muscle or any neural adaptations that increase force production.

An Example Of Pennation Angle in The Muscle Based In Two Different Muscles. The Hamstring Muscle Shows An Example Of A Speed Muscle, Where The Quad Shows An Example Of a Force Producing Muscle (Due To Difference In Total Size & Ability TO Shorten/ Lengthen)

Fibre Type Shifts

Certain muscle fibres in our body require different properties, depending on the function that they need to perform. Muscles that need to contract constantly (e.g. Postural muscle fibres such as our spinal erectors) need to be able to maintain a low force output for a longer period of time. This low force output is suited to being a type I, slow-twitch muscle fibre. This type of muscle fibre is more efficient at utilising aerobic metabolism, which is a slower source of energy, that is much more efficient at utilising energy. On the other end of the muscle fibre type spectrum is what is known as a fast-twitch, type II muscle fibre. These fibres are able to contract more rapidly than a type I muscle fibre. Within this type II classification, there is both a type IIa & type IIx fibre. A type IIa muscle fibre is the largest muscle fibre in the body and can utilise both aerobic and anaerobic metabolism. A type IIx fibre is the fastest pure fibre, mainly due to it’s ability to utilise anaerobic metabolism. Utilising anaerobic metabolism means that they fatigue much more rapidly.  There are 6 different sub-classifications of Muscle Fibres within the type I & II classification existing on more of a continuum, than a discrete exact ‘type’. No whole muscle in our body is 100% in any of these classifications (even individual muscle fibres can have all of these different types within). This is important to note, as with training these fibre types can gradually shift their properties based on the demands they face.

The 6 Different Types Of Muscle Fibres Mapped Out on a Continuum

Muscle Fibre Property Differences With The Various Types Of Fibres. These Helps To Showcase the Various adaptations that Can Occur To a Muscle With Training.

These fibre types have been shown to be able to shift, depending on the adaptations we place on the body. Another example of the SAID principle at work. Looking at these fibre type shifts, allows us to see is another component in our adaptations to the muscle that contributes quite significantly to performance, yet is far less observable. It also highlights why it is so important to train ‘functionally’ with a specific goal in mind. For the rehab trainee, it means performing your rehab, constantly progressing toward the activity you wish to get back to. In a lot of our clients, that might simply look like getting up and down from a chair with one leg, aiming to do things more powerfully each and every time they train. For the performance-oriented individual, it means knowing what adaptation you are looking for with your training and how to best go about causing the body to create this (e.g. Speed VS Strength VS Size VS Sporting Performance), , considering fatigue and your overall capacity to recover.

To go into more of specifics on fibre type shifts, you can check out all of Andy Galpin’s great work on this topic: Part 1, Part 2 & Part 3. The key concept in all of this information is that while a large part of our fibre type composition is genetically determined, there is still a huge capacity for us to impact our own makeup. This will depend on the type of training we do. Take a simple look at the kind of training that can be done to stimulate each muscle fibre type.

An Example Of Just How Different Fibre Composition Can Be In Elite Trained Athletes (CREDIT: Bagley et al. 2016)

ATP Site changes

This is related to the changes in fibre type and represents one of the many shifts that occurs when a fibre type begins to move along the spectrum of slow-fast. When a certain adaptable fibre is placed under a demand the requires more long duration, slower contractions, the fibre will begin to adapt by improving its ability to utilise aerobic fuel sources (i.e. create more mitochondria). Conversely, when conditions on the muscle are shifted towards anaerobic demands (i.e. exercise less than 15-90 seconds) the muscle fibre will begin to adapt to utilising glucose via anaerobic metabolism (e.g. increase number of Creatine Kinase enzymes, improve glucose storage capacity).

In response to resistance training, which tends to be far more on the anaerobic ‘fast’ side of the muscle fibre type continuum, we see an increase in glycolytic capacity of the muscle fibres and ultimately a shift to more fast-twitch fibres. This is important to remember, as any exercise that goes into the aerobic domain (i.e. longer than around 90 seconds of continuous effort) will begin to cause more aerobic ‘slow-twitch’ adaptations. While this isn’t an all or nothing thing, it is definitely worth mentioning as it highlights the importance of rest in training and helps to provide an understanding of why training needs to be periodised, so as the ensure interfering adaptations don’t occur.

Mitochondrial Changes

Mitochondria are the aerobic energy-producing organelles in our cells. They are incredibly important for overall health and recovery, as they regulate our ability to use aerobic energy. Exercise has been shown to be incredibly important in stimulating and maintaining mitochondrial function due to its energy-producing demands. Mitochondrial changes in the muscle are one of the factors involved in the overall fibre type change described above.

Resistance training, while typically requiring anaerobic demands (i.e. bouts of exercise lasting longer than 90 seconds), still stimulates mitochondria, as aerobic energy is required to clear away the waste products from anaerobic metabolism. Evidence suggests that resistance training does stimulate mitochondrial adaptations.

As outlined in the muscle fibre type section, our muscles will adapt to both aerobic and anaerobic demands. This is not an all or nothing thing. Our muscles can adapt concurrently to both sets of stimulus at different times. This is referred to as concurrent training. There is a popular notion that when we perform endurance training, we will block the biochemical pathway that leads to us being able to maximally build muscle [We talked about this in our introduction]. While this is certainly the case acutely (i.e. in the same few hours within a session), what we actually know is that this is one of many adaptations taking place that cause improvement. The research on concurrent training has shown us that in theory, it should be impossible to be elite at both strength/ power dominated sports and endurance sports, but the examples of these people exist [BONUS: Boundaries of human performance to show what is actually possible].

This is important, as while mitochondria don’t necessarily play a role in our ability to exert maximal strength in the moment (in the absence of fatigue) they do play an incredibly important role in our ability to recover. This could be in recovering from a bout of intense activity in order to exert maximal strength once again, or it could be recovering from a training session and causing the body to adapt. In this way, mitochondria are absolutely essential to our overall health and ability to get stronger.

Molecular Adaptations

While the molecular adaptations in the muscle aren’t part of the contractile component itself, there are incredibly important to showing how our adaptations take place overall. From an upregulation in protein synthesis to an increase in dealing with waste byproducts from energy metabolism, molecular adaptations are what creates the biochemical response needed to elicit change in the muscle fibre. While there are too many specific adaptations to list here, the key concept remains that strength training elicits a biochemical response, that causes our body to adapt. As we said before, just about every factor that goes into muscular function will adapt in response to resistance training, as our muscular system is extremely plastic (i.e. has the capacity to change). These biochemical responses can be acute and only last for 24-48 hours, or more chronic. The key to ensuring these adaptations remain is continuing to train frequently enough to keep the body creating these responses.

A Brief Summary Of What Goes on Biochemically In Response To Resistance Training – Source: Ahtiainen. P 2008 – Physiological and Molecular Adaptations to Strength Training, From: ‘Concurrent Aerobic & Strength training’   

Capillary Density

When muscles contract, they required blood flow in order to continuously supply the resources needed for them to continue contracting. This includes energy substrates such as glucose, structural molecules in the form of proteins, as well as the transportation of waste products that occur as a result of the contraction. Capillaries supply the muscle with the blood needed to transport these various substrates around the body and become more engaged during strength training. Research has shown that over time our body will adapt to strength training by increasing the overall amount of capillarization in the muscle. This has big implications in overall muscle hypertrophy and maintenance of muscle size. It also has a significant impact on our metabolic health, as it allows our muscles to more effectively utilise energy substrate like glucose. This can have implications on factors that contribute to chronic disease such as lowering insulin resistance.

So How Do I Actually Build Muscle?

To answer this completely would take another article series in and of itself. What we will say is this: Volume is KING (the right amount of volume that is)! Like anything, the devil is in the details, so we have provided one of the most useful, scientifically supported guides available: The Renaissance Periodisation Hypertrophy Training Hub. The bottom line is that muscle gain (& subsequently) strength remains one of the best things we can pursue for our health, metabolism, overall quality of life & risk of injury/ disease. It helps us to decrease the negative effects of ageing (see our many articles linked above showcasing this), ultimately extending our functional lifespan through allowing our body to continue functioning optimally. As always we must remember the goal in mind, while having a consideration for how our body actually operates in order to adapt to to training stimulus [TRY: 6 Physiological principles that dictate how we improve with training for a high-level overview of this].

A Very Sound General Overview Of Strength Training For Optimum Muscularity (Recommendation is to split this up over 3-10 sessions per week)

Conclusion

After all of this, we want to sum up by saying ONE thing: We adapt to the specific demands that we place on our body.

This is the most fundamental concept of all of human performance and is something that is critical to our work as Exercise & Rehab Professionals. To ensure we get the demands right, in order to elicit the response we desire we need to consider three key things. 

1. We need to know exactly where we are at now
2. We must know the exact result we desire.
3. We need to be incredibly specific about understanding the exact physiological mechanisms that go into creating this result.

And that is where the difficulty lies. That is why to be able to give proper exercise programs that produce a desired result, we must undergo at least a 4-year course of higher education, with thousands of hours of clinical practice. Human Physiology is complex and producing a result that changes it requires a firm grasp of the concepts.

To illustrate this, let’s take an example of someone who simply wants to get out of pain. Perhaps they have been told by their doctor that they should improve their ‘strength’ and try resistance exercise. This is incredibly general. What type of resistance exercise? What kind of adaptation do they want? What can they do now? How do they manage their pain with training? If it hurts them to do certain exercises, should they continue doing it? What activity do they want to be able to do for the rest of their life? All of these questions are things that should be asked when looking to improve strength. We have highlighted today and in previous parts precisely why we need to be specific about what we want. If this person didn’t answer any of these questions and simply underwent ‘strength’ training they would likely not get the result they desire. We see this all the time in people who go to their local gym and decide that they should use the machines at the gym, following the instructions on the equipment. What usually happens is that they certainly improve their strength, but their issue doesn’t go away. Maybe their pain decreases a little bit, but the movement issue that caused the pain to come about certainly didn’t. This form of artificial, non-specific strength training becomes a problem, as the person avoids any activity that causes their pain to worsen. It’s not just the lack of strength that caused their pain, it’s their ability to move (which underlies strength as highlighted in part 1.2) that did. So the ‘strength’ itself didn’t address the issue. That’s not to say that strength doesn’t have a litany of general benefits. It’s more to highlight that we need to know the exact result we want, while understanding where we are now and precisely what physiological mechanisms need to be manipulated in order to produce that result!

With all of that said, this was only a small number of the overall adaptations our body experiences. We covered what is arguably the most notable adaptations that are important to take note of, due to their capacity to influence overall performance, along with the role they play in injury. Understanding how muscle adapts is crucial to sustaining long term performance & preventing injury for good. Yet, there is arguable an even more important factor in the prevention of injury (Our connective tissue). We will cover this in great detail in part 3!

Summary

• Muscles are a complex multi-structured organ with thousands of moving parts.
• Muscles adapt specifically to the demands that are placed to them.
• More muscle does not mean more strength.
• There are a whole host of specific adaptations that occur to the muscle itself in response to training.
• Muscle fibre type shifts occur on a continuum from fast to slow.
• The key to building muscle is the overall volume that is placed on it up to a certain dosage, in order to produce an optimal biochemical response.
• Adaptation of muscle is incredibly complex, with many different physiological mechanisms controlling it’s adaptation.

Resources

1. Adaptation of Skeletal Muscle To Resistance Training
2. The Independent structure of Muscle (Complexity in action) 
3. Muscle Function & ageing
4. The Ultimate Guide to Fibre type changes
5. The Rules of Fitness, 6 Physiological Principles that Dictate How We Get Better at Anything
6. Association Between Muscular Strength & Mortality in Men

The post How We Actually Get Stronger – Part 2 [Muscle Contractile Component] appeared first on MTP Health Programs.