V O L U ME 2 , ISS U E 4 AP RI L 2 0 1 8

MASS
M ONTHLY A PPL ICATIO N S IN
STRE N G TH SPO R T

E R IC H E LMS | G R E G NUC KOLS | MIC HAEL ZO URDO S

 The Reviewers
Eric Helms
Eric Helms is a coach, athlete, author, and educator. He is a coach for drug-free strength and
physique competitors at all levels as a part of team 3D Muscle Journey. Eric regularly publishes
peer-reviewed articles in exercise science and nutrition journals on physique and strength sport, in
addition to writing for commercial fitness publications. He’s taught undergraduate- and graduate-
level nutrition and exercise science and speaks internationally at academic and commercial
conferences. He has a B.S. in fitness and wellness, an M.S. in exercise science, a second Master’s
in sports nutrition, a Ph.D. in strength and conditioning, and is a research fellow for the Sports
Performance Research Institute New Zealand at Auckland University of Technology. Eric earned pro status as a natural
bodybuilder with the PNBA in 2011 and competes in the IPF at international-level events as an unequipped powerlifter.

Greg Nuckols
Greg Nuckols has over a decade of experience under the bar and a B.S. in exercise and sports
science. Greg is currently enrolled in the exercise science M.A. program at the University of North
Carolina at Chapel Hill. He’s held three all-time world records in powerlifting in the 220lb and
242lb classes. He’s trained hundreds of athletes and regular folks, both online and in-person.
He’s written for many of the major magazines and websites in the fitness industry, including Men’s
Health, Men’s Fitness, Muscle & Fitness, Bodybuilding.com, T-Nation, and Schwarzenegger.com.
Furthermore, he’s had the opportunity to work with and learn from numerous record holders,
champion athletes, and collegiate and professional strength and conditioning coaches through his previous job as Chief
Content Director for Juggernaut Training Systems and current full-time work on StrongerByScience.com.

Michael C. Zourdos
Michael (Mike) C. Zourdos, Ph.D, CSCS, is an associate professor in exercise science at Florida
Atlantic University (FAU) in Boca Raton, FL., USA, with a specialization in strength and conditioning
and skeletal muscle physiology.  He earned his Ph.D. in exercise physiology from The Florida State
University (FSU) in 2012 under the guidance of Dr. Jeong-Su Kim. Prior to attending FSU, Mike
received his B.S. in exercise science from Marietta College and M.S. in applied health physiology
from Salisbury University. Mike served as the head powerlifting coach of FSU’s 2011 and 2012
state championship teams. As an associate professor at FAU, Mike is the director of the FAU
Muscle Physiology Research Laboratory. He also competes as a powerlifter in the USAPL, and
among his best competition lifts is a 230kg (507lbs) raw squat at a body weight of 76kg. Mike
owns the company Training Revolution, LLC., where he has coached more than 100 lifters, including a USAPL open
division national champion.

2
 Letter from
the Reviewers

W
ell, here we are. We are officially one year old and this is our 13th is-
sue. First and foremost, we couldn’t have gotten to this point with-
out you, so we want to offer our sincerest thanks for being a part
of MASS. We have had a blast putting this together each month and look
forward to doing this for many years to come.
In the last year, MASS has produced 120 articles and videos and has add-
ed many new features since its inception, including audio recordings for
each written article, an interactive Facebook group, guest articles, a video
interview, and an article categorization on the member site. We know you’ll
trust us when we say there’s only more on the way in year two.
This month, we also have our largest and most content-heavy issue to
date: 11 total pieces thanks to two guest contributors. These guest contri-
butions come from two Ph.Ds.: Eddie Jo and Caleb Bazyler. Eddie, an as-
sistant professor at California State Polytechnic University – Pomona, has
an article analyzing the efficacy of wearable technology, specifically the va-
lidity of the Fitbit Charge for heart rate data. Caleb, an assistant professor
at East Tennessee State University, wrote a concept review on accentuated
eccentric training, which poses the question: Does adding load to only the
eccentric part of the movement enhance hypertrophy and strength? These
are both topics MASS has not covered before, and they are analyzed here
by two of the true experts in these areas.
The three of us are still here too, though, and Greg has reviewed a paper
from the famous journal Nature that explains how muscle might indeed have
an epigenetic “memory.” To continue the mechanistic theme, Mike’s Part
2 of his individualization series focuses on why hypertrophy and strength
occur at individual rates at the cellular level. Eric weighs in on a two-year
protein study and provides an objective analysis of the much-talked-about

3
supplement HMB. Other topics this month include an updated look at
training frequency, practical implementation of autoregulation techniques,
carbohydrate mouth-rinsing and strength performance, the importance of
maximizing intended concentric velocity, and an examination of the differ-
ence between dead stop and touch-and-go deadlifts.
Lastly, the Facebook group is waiting for any questions and discussion
you might have. Now, let’s get to the issue – it’s packed with 11 articles and
videos to get through.

The MASS Team

Eric, Greg, and Mike

4
 Table of Contents

8
BY G R EG NUCKOL S

The Science of Muscle Memory

Many people have noted that, while it takes a long time to build muscle and strength
initially, you can regain muscle and strength much faster after a period of detraining.
A new study reveals a mechanistic reason: epigenetic memory.

19
BY M I CHAEL C. ZOUR DOS

Touch-and-Go or Dead Stop Deadlifts? That is the Question.

Touch-and-go or dead stop deadlift reps? You see both of these strategies all the time.
Is there some magic involved with one of them? Are you missing out on the benefits of
the one you’re not using? This article looks at the kinematic and practical differences
between the rep strategies.

30
BY E RI C HEL MS

High Protein Diets Can Enhance Strength and Lean Mass, but Are
They Safe?
We’ve discussed the importance of protein intake for both muscle gain and fat loss,
but not safety. This case study on a handful of bodybuilders following a high protein
diet for two years is the best data set we have on safety to date.

41
BY E DDI E JO

The Accuracy of Modern-Day Fitness Trackers and Heart Rate

Measurements
Wearable technology has exploded in the past few years, and it can be a great tool
to track variables. But with any technology, it’s crucial that the tracking be accurate.
So what about the popular Fitbit Charge; does it indeed track heart rate accurately?

5
50
BY G R EG NUCKOL S

How to Maximize Results with Velocity-Based Training

Velocity-based training isn’t just a way to select training loads and adjust volume. By
monitoring velocity on each rep, you may also make larger gains.

58
BY M I CHAEL C. ZOUR DOS

A Glimmer of Hope for CHO Mouth Rinsing and Lifting?

Endurance exercise clearly benefits from acute carbohydrate supplementation, but
can a quick swig of Gatorade actually improve your strength? Most data examining a
carbohydrate mouth rinse say “no” for strength, but this study says “yes.”

68
BY E RI C HEL MS

HMB Free Acid: An Objective Assessment

HMB free acid has been a source of controversy, as the validity of the most well-
known studies on it have been called into question. However, new data from other
research groups allows us to make a more objective assessment of its efficacy.

78
BY C AL EB BAZYL ER

Accentuated-Eccentric Loading for Hypertrophy, Strength, and Power:

A Concept Review
You can handle more weight on the eccentric than you can on the concentric portion
of a movement. Does adding more weight to only the eccentric portion enhance
strength? This concept review takes a look.

93
BY G R EG NUCKOL S

Training Frequency Should Primarily Be Used As A Tool to Increase

Volume
A recent meta-analysis found that increased training frequencies led to larger strength
gains when higher frequency allows for higher training volumes, but that frequency
doesn’t independently enhance strength gains when volume is controlled.

6
106
BY M I CHAEL C. ZOUR DOS

VIDEO: What Do We Know About Individualization? Part 2

Most scientific studies simply show the average response in the study, but that
doesn’t tell the whole story. Often times, hypertrophy and strength changes can be
vastly different among individuals – but why?

108
BY E RI C HEL MS

VIDEO: Implementing Autoregulation, Part 2

We’ve written and talked about autoregulation a great deal in MASS up to this
point, but we haven’t yet shown you how to implement the existing research-based
autoregulation strategies into a program in the most practical way possible. In this
video, Eric shows you how to implement each strategy for a bodybuilding program.

7
 Study Reviewed: Human Skeletal Muscle Possesses an Epigenetic
Memory of Hypertrophy. Seaborne et al. (2018)

The Science of
Muscle Memory
BY G RE G NUC KO LS

Many people have noted that, while it takes a long time to build
muscle and strength initially, you can regain muscle and strength
much faster after a period of detraining. A new study reveals a
mechanistic reason: epigenetic memory.

8
 KEY POINTS
1. Gene methylation patterns – which regulate gene expression – change in skeletal
muscle after just one training bout, and after continued training.
2. Many of these changes are retained following a seven-week period of detraining,
indicating an epigenetic memory of prior resistance training, in spite of losses in
muscle mass and strength.
3. This epigenetic memory aids in subsequent retraining, which helps explain why
it’s hard to build muscle initially, but much easier to regain muscle after a period of
detraining (i.e. “muscle memory”).

A
t some point, I’m sure all of
us have taken time away from
training for some reason or an-
other. Maybe you were rehabbing an
injury, maybe your schedule got cra-
zy, or maybe you just lost motivation.
During your time away from the gym,
you probably lost some muscle and
strength. However, as you started re-
training, you probably noticed that
it didn’t take very long to regain the
ground you’d lost. Maybe you lost a
year’s worth of progress on the bench
press in your time off, but you were
back near your old PRs within a month
or two of retraining.
This process has been colloquially
known as “muscle memory” for de-
cades. The ability to rapidly regain
strength has been at least partially
understood for a long time. Namely,
there’s a large neural component of
strength, and the motor patterns you
build during your initial training get a
little rusty with disuse but are re-mas-
tered quickly with retraining. How-
ever, the mechanisms underlying the
ability to rapidly regain muscle mass
aren’t as well-understood.
The study being reviewed is the first
to directly study “muscle memory” of
hypertrophy in humans. It did so by
examining the epigenetic effects of
training, detraining, and retraining.
Epigenetics is the study of genome
modifications. These modifications
affect when and how genes are ex-
pressed, with alterations in gene ex-
pression ultimately affecting the pro-
teins your body produces. Namely, this
study examined gene methylation. An
increase in methylation decreases gene
expression, while a decrease in methyl-
ation increases gene expression (I’ll go
into more detail in the interpretation
as to what methylation is and why it’s
important).
This study found that when un-
trained people begin resistance train-
ing, genome-wide methylation de-

9
 Figure 1 Schematic Representation of the Study Protocol

Measurements
i. Dual Energy X-ray

Muscle Mass
& Strength
Absorptiometry (DEXA) of lean leg
mass

ii. Isometric quadriceps muscle

torque using an isokinetic
dynamometer Baseline Loading Unloading Reloading
(resting) (7 weeks) (7 weeks) (7 weeks)

iii. Assessment of DNA

methylation

iv. Assessment of gene expression

creases in skeletal muscle, is relatively

unchanged after detraining (in spite Purpose and Research
of a loss in muscle mass and strength), Questions
and decreases further following re-
training. Importantly, methylation of Purpose
key genes implicated in hypertrophy The purpose of this study was to ex-
remains suppressed throughout a sev- amine the effects of resistance training,
en-week detraining period, indicating detraining, and retraining on muscle
an epigenetic memory of the previous mass, strength, and skeletal muscle gene
resistance training, which aids in sub- methylation patterns.
sequent retraining.
While the actual methodology of Research Question
this study may go over most MASS The primary research question was
readers’ heads (and, frankly, I had to do whether gene methylation patterns
an inordinate amount of extra reading would change with resistance training,
to really understand this study), the and whether those changes would be
implications are important and easy to maintained during a subsequent period
understand. of detraining in order to facilitate further
increases in muscle mass and strength
during retraining.
10
 Figure 2 Strength Changes

25
Change to Baseline (%)
Isometric Peak Torque

20

15

10

0
Loading Unloading Reloading

* = Significantly greater than baseline

Hypotheses Experimental Design

It was hypothesized that methylation The study was split into three phases.
of genes implicated in muscle growth The first phase involved seven weeks
would decrease during an initial period of progressive resistance training. The
of resistance training, and that those de- training program consisted of two days
creases in methylation would be main- per week of lower body training (squats,
tained during a subsequent period of leg press, knee extensions, leg curls, nor-
detraining. dic curls, weighted lunges, and calf rais-
es) and one day per week of upper body
training (bench press, shoulder press,
Subjects and Methods pull-downs, dumbbell rows, and cable
triceps extensions). Each exercise was
Subjects performed for 4 sets of 8-10 reps, and
The subjects were seven healthy, un- loads were increased when the partici-
trained males (27.6 ± 2.4 years old, 82.5 pants completed 10 reps on their first 3
± 6.0 kg). sets. This initial training phase was fol-
lowed by seven weeks of detraining. Af-

11
 Figure 3 Lean Mass Changes

15
Lean Mass as a Percentage
Change to Baseline

10

0
Loading Unloading Reloading

* = Significantly greater than baseline; ** = Significantly greater than after the initial loading phase

ter the detraining phase, the participants lateralis (quadriceps) muscle biopsies.
entered a seven-week retraining phase, Knee extension strength and leg lean
using the same program they’d been on mass were measured before the start of the
previously. initial training phase, at the end of the ini-
tial training phase, before the start of the
Measures retraining phase, and at the end of the re-
Strength was assessed via maximal iso- training phase. Muscle biopsies were also
metric knee extension torque. Volume performed at those four time points, and
load was also calculated each week, and after an acute lower body training bout
since increases in training loads were based before the start of the initial seven-week
on performance and the number of sets training period.
didn’t change, volume load also serves as
a proxy for whole-body strength increases.
Leg lean mass was assessed via dual-ener- Findings
gy X-ray absorptiometry (DEXA). Gene Leg lean mass increased by 6.5 ± 1.0%
methylation and gene expression (RNA during the initial training phase, de-
from key genes) were assessed from vastus creased by 4.6 ± 0.6% during detraining,

12
and increased further (12.3 ± 1.3% above Figure 4 Number of Sites with Increased and
baseline, and 5.9 ± 1% above the initial Decreased Methylation Following to Initial Seven
training phase) during retraining. Knee Weeks of Training, Detraining, and Retraining
extension torque followed a similar pat-
tern, increasing by 9.3 ± 3.5% during the
20000
initial training phase, decreasing by 8.3 ±
2.8% following detraining, and increas-

Increased Methylation
15000
ing further (18.0 ± 3.6% above baseline)
during retraining.
10000
Genome-wide methylation patterns 8212 8638 8339

changed following the initial training

5000
phase, with decreased methylation at
~9,150 sites and increased methylation
at ~8,200 sites. Following detraining, the 0
same methylation pattern was largely
preserved, with decreased methylation at
Decreased Methylation
-5000
~8,900 sites and increased methylation
at ~8,650 sites. Following retraining, the -10000 9153 8891
number of sites with increased methylation
remained essentially unchanged (~8,350), -15000
while the number of sites with decreased
methylation roughly doubled (~18,800). 18816
-20000
Training Detraining Retraining
The genes with methylation patterns that
changed during the initial training phase
and were maintained during the detrain-
ing phase ran the gamut from genes di- earlier period of load induced muscle hyper-
rectly implicated in hypertrophy, to genes trophy. As reduced DNA methylation of genes
involved in cellular growth and prolifera- generally leads to enhanced gene expression
tion, to genes involved in catabolism and due to the removal of methylation allowing
inflammatory signaling. However, without improved access of the transcriptional ma-
getting too bogged down in the specifics, chinery and RNA polymerase that enable
this nugget from the authors really sums transcription...this would be suggestive that
up the epigenetics findings: the earlier period of hypertrophy leads to in-
“This maintenance of hypomethylation (de- creased gene expression of this cluster of genes
creased methylation) during unloading, sug- that is then retained during unloading to en-
gested that the muscle ‘remembered’ the epi- able enhanced muscle growth in the later re-
genetic modifications that occurred after an loading period.”

13
 Figure 5 Reading DNA to Produce RNA then Translated into Protein

3’ G C
T T TC
GT G C
T T TC
GT G C
T T TC
GT G C
T T TC
GT
3’
T T T T

DNA A A A A A A A A
T T T T
T A T A T A T A
A T A T A T A T
CA CA CA CA

5’ 5’
C G C G C G C G
A A AG A A AG A A AG A A AG

Transcription

AUGCUUUCGUAU UACGA A AGCAUA AUGCUUUCGUAU UACGA A AGCAUA

RNA 5’ 3’

Translation

Met Leu Ser Tyr Tyr Glu Ser Ile Met Leu Ser Tyr Tyr Glu Ser Ile

Protein

Interpretation cell could express any gene and produce

any protein without mechanisms to en-
To understand this study, it’s neces- sure that only the correct genes were ex-
sary to have at least a basic understand- pressed. Many of these mechanisms fall
ing of genetics. DNA contains genes, under the umbrella of epigenetics: mod-
which are “read” (transcribed) to pro- ifications to the genome that regulate
duce RNA. This RNA is then translated which genes can be expressed in which
into proteins, and those proteins carry cells. While some epigenetic modifi-
about essentially every interesting cel- cations essentially function as on/off
lular function in your body. However, it switches for genes (i.e. if they’re present,
gets a little more complicated than that, a gene will simply not be expressed in a
because you’d be in really bad shape if given cell) others also work by fine-tun-
any gene in any cell could be “read” at ing how much a gene is expressed. For
any time. example, in response to the exact same
It’s very important that your DNA has signal, a particular gene may be “read”
ways to ensure that only the right genes 5 times to produce 5 RNA strands to
get expressed. Most of your cells contain code for a particular protein, or it may
a complete copy of your DNA, so any be “read” 50 times to produce 50 RNA

14
 Figure 6 Muscle Memory Mechanism Based on Myonuclear Accumulation
Growth
Fusion of satellite cells
First training
route
Untrained
strands to code for a particular pro-
tein. That’s essentially what increased
or decreased methylation (the epigen-
etic modification investigated in this
study) does: An increase in methylation
means a gene will be read fewer times
and produce fewer RNA strands (lead-
ing to fewer proteins), while a decrease
in methylation means a gene will be read
more times and produce more RNA
strands (leading to more proteins). The
main finding of this study was that, not
only do methylation patterns and gene
Hypertrophy
Re-training De-training
route
Previously Trained
expression change after just seven weeks
of training, but that those changes are
retained and “remembered” through a
period of detraining, which facilitates
rapid hypertrophy and strength gains
with retraining.
This study is groundbreaking because
it’s the first study providing a clear
mechanism for “muscle memory” of hy-
pertrophy in humans. We’ve had clear
evidence of “muscle memory” in humans
for a while now (2), but no prior studies
15
really delved into the mechanisms. Fur-
thermore, some rodent research (3) pro-
vides insight into another mechanism of
muscle memory – myonuclei are gained
with hypertrophy, retained with detrain-
ing, and then aid in subsequent muscle
growth with retraining – but that re-
search has only been partially replicated
in humans.
It’s worth noting that this study
doesn’t tell us how long these epigene-
tic changes last. The detraining period in
this study was seven weeks, but it’s like-
ly that these epigenetic changes persist
for much longer. This was the first study
showing an epigenetic “muscle mem-
ory” of hypertrophy, but other research
(4) has shown that epigenetic modifica-
tions in skeletal muscle during utero or
early childhood can persist throughout
an entire lifespan. Thus, it’s possible that
these epigenetic modifications can last
for years to facilitate enhanced respon-
siveness to retraining after very long lay-
offs (i.e. if you used to lift in high school,
and then started training again in your
40s). Similarly, it’s possible that some of
these modifications could occur during
growth and development if you did a lot
of physically strenuous activity during
childhood, thus facilitating enhanced
responsiveness to strength training later
in life. However, these two possibilities
are speculative.
There are two clear implications of this
study. One relates to the way you should
view your training looking forward, and
WHEN EVALUATING WHAT
STYLES OF TRAINING
WORK BEST FOR YOU,
PAY CLOSE ATTENTION
TO THE PROGRAMS YOU
USED WHEN YOU WERE
REACHING PREVIOUSLY
UNCHARTED TERRITORY.
one relates to the way you should eval-
uate your training looking backward.
Looking forward, this study should give
you more confidence in taking time off
of hard training when dealing with inju-
ries. A lot of lifters make the mistake of
trying to train through injuries because
they fear that dialing back their training
or taking time off will be a major set-
back, costing them months of progress.
This study gives us strong evidence that
your muscles “remember” prior training
for, at minimum, seven weeks, helping
you regain any lost ground quite quickly.
Finally, when looking back at old
training journals to evaluate the effec-
tiveness of past programs, keep in mind
that results during periods when you
were regaining lost ground probably ar-
16
 APPLICATION AND TAKEAWAYS
1. You retain an epigenetic muscle memory of prior training after at least seven
weeks of detraining, which aids in regaining muscle and strength during the
retraining process.
2. With this in mind, be careful that you don’t falsely assume a particular training
program is super effective for you just because it helped you quickly regain lost
ground. You were epigenetically primed to regain lost ground in the first place,
regardless of training program.
3. Similarly, don’t freak out if you need to take it easy in the gym for a few weeks,
or even take some time away from training to deal with injuries. Whatever gains
you lose during this process will come back quickly once you can start training
hard again.

en’t representative of a “normal” train- research), but that should be a feasible

ing response. After a layoff, it’s possible
(likely, even) that just about any program
could get you back near your old levels of
strength and muscularity. Don’t get mar-
ried to a particular style of training just
because it worked super well when you
were coming back from a layoff. Rather,
when evaluating what styles of training
work best for you, pay closer attention to
the programs you used when you were
reaching previously uncharted territory.
Next Steps
In terms of elucidating mechanisms of
“muscle memory” in humans, I’d love for
someone to repeat the myonuclei study
in humans. It would probably need to be
modified to more closely resemble the
design of the present study, rather than
initially inducing hypertrophy with ste-
roids (as was done in the prior rodent
design. Furthermore, I’m intrigued by
the additional decreases in methylation
during the retraining phase in this study;
since decreases in methylation promote
gene expression, it seems that the par-
ticipants in this study were more epige-
netically “primed” to respond to train-
ing after seven weeks of retraining than
they were after the initial seven weeks of
training. I’ve always been curious wheth-
er time away from training resensitizes
people to the anabolic stimuli of lifting,
and I’d be interested in seeing a study in
well-trained lifters who report being at
a plateau that’s designed to answer that
question. For example, one group could
train for 12 weeks consecutively, while
another group trained for 3 weeks, took
3 weeks off, and then trained for 6 weeks,
with a comparison of strength gains and
hypertrophy after the 12 weeks.

17
References
1. Seaborne RA, Strauss J, Cocks M, Shepherd S, O’Brien TD, van Someren KA, Bell PG, Murgatroyd
C, Morton JP, Stewart CE, Sharples AP. Human Skeletal Muscle Possesses an Epigenetic Memory
of Hypertrophy. Scientific Reports. vol. 8, Article number: 1898 (2018)
2. Ogasawara R, Yasuda T, Ishii N, Abe T. Comparison of muscle hypertrophy following 6-month of
continuous and periodic strength training. Eur J Appl Physiol. 2013 Apr;113(4):975-85.
3. Egner IM, Bruusgaard JC, Eftestøl E, Gundersen K. A cellular memory mechanism aids overload
hypertrophy in muscle long after an episodic exposure to anabolic steroids. J Physiol. 2013 Dec
15;591(24):6221-30.
4. Sharples AP, Stewart CE, Seaborne RA. Does skeletal muscle have an ‘epi’-memory? The role of
epigenetics in nutritional programming, metabolic disease, aging and exercise. Aging Cell. 2016
Aug;15(4):603-16.

18
 Study Reviewed: A Biomechanical Analysis of the Effects of Bouncing the
Barbell in the Conventional Deadlift. Krajewski et al. (2018)

Touch-and-Go or Dead Stop

Deadlifts? That is the Question.
BY MIC HAE L C . ZO URD O S

Touch-and-go or dead stop deadlift reps? You see both of these

strategies all the time. Is there some magic involved with one
of them? Are you missing out on the benefits of the one you’re
not using? This article looks at the kinematic and practical
differences between the rep strategies.

19
 KEY POINTS
1. This study examined the joint stress, total work, and performance of 2 sets of 5
repetitions at 75% of one-repetition maximum (1RM) using both touch-and-go and
dead stop reps on the conventional deadlift.
2. The kinematics of the two rep styles are quite different, with greater joint flexion
and more total work achieved with the dead stop style.
3. Subsequent reps with touch-and-go are faster due to the benefit of the stretch-
shortening cycle. While this may lead to more reps, it is unspecific to maximal
strength and leads to less total work when reps are equated, making dead stop
the primary choice for strength; however, the optimal style for hypertrophy is less
clear.

I
t’s always interesting to see how
someone deadlifts – conventional
or sumo? Then, you want to see how
they perform their reps – dead stop or
touch-and-go? Choosing conventional
or sumo is easy to reconcile, in that you
choose the style that’s strongest for you
and best suited to your body proportions.
However, we’ve all seen strong lifters do
both types of reps on the deadlift – dead
stop and touch-and-go (i.e. bouncing)
– so we’re often left wondering if we’re
missing out. Does the potentially great-
er volume associated with touch-and-go
translate to greater strength or hypertro-
phy? Or is touch-and-go too unspecif-
ic to a 1RM to be of any benefit? This
study (1) is the first, to my knowledge,
to examine the biomechanical differenc-
es between dead stop and touch-and-go
deadlift reps in the conventional dead-
lift. In a crossover design, 20 trained
males performed 2 sets of 5 at 75% of
1RM in two sessions, with one session
being dead stop reps and the other being
touch-and-go reps. In both sessions, joint
angles, net joint impulse, and total work
of the ankle, knee, and hip joints, along
with vertical ground reaction forces and
concentric phase duration were calculat-
ed and compared between conditions.
Rating of perceived exertion (RPE) was
also taken after each set. Overall, there
was greater net joint impulse, total work
at the joints, and greater joint flexion
during dead stop deadlifts. However,
the touch-and-go style produced 25.8%
greater ground reaction forces during
the concentric (up phase). Each rep was
completed more quickly with the touch-
and-go style, and per-set RPE was lower
with touch-and-go. In short: dead stop
= more total work, while touch-and-go
= easier reps, possibly allowing for more
total reps. So, what does this mean? If
touch-and-go leads to faster repetitions

20
and possibly more volume, is that good
for hypertrophy? On the other hand,
does the increased joint stress mean a
greater chance of injury associated with
touch-and-go? And what about speci-
ficity? If training for strength, why not
practice with dead stop reps each time
to be specific to a 1RM? This article will
address each of these questions.
Purpose and Research
Questions
Purpose
The purpose of this study was to com-
pare joint stress, total joint work, and
concentric performance during five-rep
sets of dead stop and touch-and-go style
conventional deadlifts.
Research Question
What are the biomechanical and per-
formance differences between dead stop
and touch-and-go conventional dead-
lifts?
Hypotheses
The authors hypothesized that touch-
and-go style deadlifts would lead to
faster concentric reps, and thus the dead
stop deadlifts would cause more me-
chanical work to be done due to slower
repetitions. To understand this hypoth-
esis, remember the equation for Work
(U), which is: U = Force X Displacement,
and remember that greater force will be
needed to move a barbell from a dead
stop than to simply keep it moving. This
thought process is similar to pushing a
car. It’s difficult to get it moving from
a standstill, which is to overcome static
friction; however, once it’s moving, you’re
good to go because overcoming dynamic
friction is easier. So even though touch-
and-go should lead to greater repetition
velocity (primarily because each rep is
benefiting from the stretch-shortening
cycle – more on this later), the amount
of work performed is also lower with
touch-and-go because it takes less force
by the lifter to keep the bar moving than
it does to break the bar from the floor
each time. This phenomenon explains
the hypothesis for greater work in the
dead stop condition. So, if force is high-
er in the dead stop condition and dis-
placement is the same between condi-
tions, the product of the above equation
(force X displacement) would be higher
in the dead stop condition.
Subjects and Methods
Subjects
Twenty men with at least one year of
deadlift experience participated. How-
ever, the strength inclusion criteria were
low, as only a 1RM of ≥62kg was need-
ed to qualify. The 62kg threshold was
likely the case due to the barbells and
plates being in pounds, and 135lbs (one
21
 Table 1 Subject Characteristics
Body Mass
Subjects Age (years) (kg)
20 Males 22.9 ± 2.7 82.7 ± 10.9
Data are mean ± SD
Subjects characteristics from Krajewski et al. 2018 (1).
45lb plate on each side) is roughly 62kg,
which would be the minimum load to get
the barbell to the correct starting height.
However, on average, training status was
solid, as subjects could deadlift about
two times body mass. The available sub-
ject characteristics can be seen in Table
1.
Study Protocol
It took three lab visits to complete the
study. The first visit was to establish each
lifter’s 1RM, and then to familiarize ev-
eryone with the touch-and-go and dead
stop techniques. Touch-and-go was de-
scribed as: “allowing gravity to pull the
barbell down quickly and immediate-
ly performing the concentric portion
of the lift upon contact with the floor,”
while dead stop was described as: “the
bar is to rest on the platform and come
to a stop without letting go before per-
forming the next repetition.”
Four days after the first visit, subjects
Deadlift 1RM to body Deadlift
Height (cm) 1RM (kg) mass ratio Experience (yrs)
177.0 ± 4.9 165.8 ± 35.9 2.01 ± 0.4 3.4 ± 3.3
performed the first experimental condi-
tion, which consisted of 2 sets of 5 reps
at 75% of 1RM using either the touch-
and-go or dead stop technique. After a
few days rest, subjects performed the sec-
ond experimental session with the same
sets and reps but using the other dead-
lift technique. The order of conditions
was randomized. An exact time between
the experimental conditions wasn’t giv-
en, but I assume it was at least 48 hours
(and probably more). The last three reps
of each set were used for analysis. The
protocol can be seen in Figure 1.
Outcome Measures
Borg RPE (not repetitions in reserve)
was taken at the end of each session. In-
frared video and force plates were used
to test the biomechanical measures. The
biomechanical measures are listed and
defined in Table 2 since some of these
terms might be unfamiliar. Further, the
researchers determined the peak height
22
 Figure 1 Protocol Timeline
Visit 1
4 Days 2 x 5 @ 75% on
Deadlift 1RM
Touch & Go
Familiarization OR Dead Stop
1RM = One-Repetition Maximum. Percentages are expressed as a percentage of 1RM
of the bar that was achieved from using
a bounce (touch-and-go), and then used
that same height in the dead stop con-
dition to calculate all of the variables
from “lift off ” of the floor to “peak
bounce height.” For clarity, we can’t
be sure exactly where the barbell was
at peak bounce height based upon the
data presented, but it’s probably knee
height for shorter lifters and a little
below the knees for taller lifters. The
researchers also calculated all the out-
come variables throughout the totality
of the concentric phase.
Findings
Most importantly and as expected,
time to complete the lift was fast-
er (p=0.001) and RPE was lower
(p<0.001) in the touch-and-go condi-
tion. Below are the results compared
between conditions from lift off to
peak bounce height, the between-con-
Visit 2 Visit 3
A few
days later 2 x 5 @ 75% on
Touch & Go
OR Dead Stop
dition differences during the entire
concentric, and differences for individ-
ual joint moments and flexion within
the same condition.
Differences Between Conditions to
Peak Bounce Height
The dead stop condition took 93.4%
longer to break the bar from the floor
(p<0.05).
Joint moments were at least 70%
greater, and total work was at least 64%
greater in dead stop versus touch-and-
go (p<0.001). Average ground reaction
forces were 3.4% greater in touch-
and-go (p<0.05) from lift off to peak
bounce height.
At lift off and peak bounce height,
the ankle and knee were more flexed
during the dead stop condition
(p<0.05); however, the trunk was in
a similar position between conditions
throughout the lift. The hip was more
23
 Table 2 Biomechanical Measurements and Definitions

Biomechanical
Measure Definition

Net Joint The rotational effect on the joint.

Moment Impulse Measured in Newton/Meters, thus
it’s a force over a distance

Total Joint Work Work = Force x Displacement, so this is

simply the amount of work that an
individual joint is doing

Joint Angles The angle the joint is at the time it is tested

Vertical Ground The force exerted by the ground back

Reaction Force onto the lifter

Duration of Simply the time to complete the

Concentric concentric portion of the deadlift

flexed in the dead stop condition at
peak bounce height (p<0.05), but not
at lift off.
Differences Between Conditions During
the Concentric
During the concentric, the dead stop
condition performed 18.8% more to-
tal work across all joints (p<0.05), al-
though no significant differences ex-
isted for individual joints (p>0.05).
Vertical ground reaction forces were
27.6% higher in the dead stop condi-
tion, while the touch-and-go condition
had greater (p<0.05) joint moments for
the ankle, knee, and hip, which were at
least 40% greater.
Within-Condition Differences
In both conditions, hip moments and
hip work were greater than knee and
ankle moments and work from lift off
to peak bounce and during the concen-
tric.

24
Interpretation
Before we begin, we should also note
that bumper plates were used in the
present study. The differences from the
floor to peak bounce height would be
much smaller with metal plates because
the actual “bounce” with metal plates
would be much smaller. Furthermore, I
believe the stretch-shortening cycle is
what is almost fully accounting for the
faster deadlift with the touch-and-go
style. However, let’s briefly discuss the
“bounce” since the authors did examine
how much the bounce may have helped.
There is clearly greater physiological
work and difficulty per repetition with
dead stop deadlifts. This phenomenon
makes sense, as Newton’s third law stip-
ulates than an action will be met with an
equal and opposite reaction. Not only is
the lifter applying force to the ground in
a touch-and-go deadlift, but the barbell
also applies force as it hits the ground at
a relatively fast rate. Consequently, the
ground exerts a force back upward into
the bar, aiding in the start of the next
concentric during touch-and-go dead-
lifts, allowing for faster initial bar speed.
The authors hypothesize that this speed
off the floor might greatly benefit short-
er lifers – at least in terms of completing
more reps per set – compared to taller
lifters.
Despite the benefit of the “bounce,” it’s
highly likely that the touch-and-go dead-
lift is primarily faster off the floor due to
IF YOUR MAIN GOAL IS
POWERLIFTING OR 1RM
STRENGTH, I DO THINK
YOU SHOULD ALMOST
ALWAYS USE THE DEAD
STOP METHOD FOR REPS.
it benefiting from the stretch-shorten-
ing cycle, which stipulates that there will
be increased force of muscle shortening
if the shortening is preceded by muscle
lengthening: in short, the concentric
benefits from doing the eccentric first
(2). If you are more familiar with the
term “stretch-reflex,” that is simply the
neurophysiological component of the
stretch-shortening cycle.
This concept can be illustrated quite
easily. Have you ever seen someone
struggle to complete the first rep of a
deadlift from a dead stop position (looks
like a 9.5RPE), but then do a couple
more quick, easier-looking reps with
the touch-and-go style? The second and
third reps are preceded by an eccentric
(down phase), whereas the first was con-
centric only. It’s the same principle on
a dumbbell shoulder press when you
kick the dumbbells up and the first rep
is hard, but the subsequent reps are eas-
25

IF YOU HAVE 3X3
PROGRAMMED, YOU ONLY GET
THREE CHANCES TO PRACTICE
YOUR SETUP AND TRULY
BREAK THE BAR FROM THE
FLOOR WITH TOUCH-AND-GO,
BUT WITH DEAD STOP, YOU
WOULD GET NINE CHANCES
TO PRACTICE YOUR SETUP.
ier. Although we know all of this from
practice, it’s nice to see a study demon-
strate this in the deadlift. In the pres-
ent study, it took about 93% longer for
the dead stop deadlifts to break from
the floor, and it took less time for the
touch-and-go deadlifts to complete the
concentric portion, clearly demonstrat-
ing the stretch-shortening cycle at work.
Further, RPE was lower in the touch-
and-go condition, and even though this
wasn’t RIR-based RPE, it’s highly likely
that subjects would have predicted more
RIR with the touch-and-go deadlifts
as well, suggesting that touch-and-go
might lead to more volume. Overall,
touch-and-go leads to faster reps and
perhaps more volume, but it’s also clear-
ly not a true “dead” lift on every rep. So,
which one is more advantageous?
If your main goal is powerlifting or
1RM strength, I do think you should
almost always use the dead stop meth-
od for reps (I can’t bring myself to say “al-
ways” on principle that I could be wrong.
I want to, but I can’t). In reality, the
stretch-shortening cycle lasts for about
four seconds (3) following an eccentric
phase, so I would actually wait four sec-
onds between reps so the benefits fully
dissipate. Or you could simply perform
singles for deadlift training.
In this study, lifters in the dead stop
condition were allowed to do a subse-
quent rep immediately after coming to
a dead stop, so they likely received some
benefit of the stretch-shortening cy-
cle, although not nearly as much as the
touch-and-go condition. The recom-
mendation for powerlifters to use the
dead stop is in part for amelioration of
the stretch-shortening cycle, but also
to regain appropriate position. The set-
up is important in all three powerlifts;
however, it is perhaps most important
in the deadlift. Specifically, the middle
of the bar, mid-scapula, and mid-foot
should all be aligned when initiating
the lift. During a touch-and-go dead-
lift, it’s highly unlikely that you will be
in the ideal starting position. Even more,
it’s probable that your starting position
will be slightly different on each repeti-
tion, which might even lead to twisting.
26
 APPLICATION AND TAKEAWAYS
1. Touch-and-go deadlifts produce a lower RPE per set than dead stop when reps
are equated, probably due to touch-and-go benefiting from the stretch-shortening
cycle.
2. For maximal strength, it makes the most sense to use dead stop reps, as this is
most specific to a 1RM, keeps a similar starting position on every rep, and allows
the lifter to practice breaking the bar from the floor.
3. For hypertrophy, it’s possible that both strategies can be used; however, a
bodybuilder should keep in mind that there is lower stress per rep with touch-and-
go. Therefore, more reps, sets, or greater load would likely be needed with touch-
and-go to achieve similar or greater hypertrophy compared to dead stop. However,
this point needs further research.

If you have 3X3 programmed, you only
get three chances to practice your setup
and truly break the bar from the floor
with touch-and-go, but with dead stop,
you would get nine chances to practice
your setup. It’s likely that you would use
a lower load for dead stop, but the spec-
ificity to a 1RM is much greater, and
you can control your starting position
better. Additionally, the much greater
joint flexion observed with dead stop in
the present study demonstrates differ-
ent kinematics between the two styles,
so touch-and-go simply seems too un-
specific to recommend.
Now, if touch-and-go can lead to more
reps and more volume, should a body-
builder utilize touch-and-go? I can’t
give an unequivocal answer to this, but
based upon the present data, touch-
and-go seemed to decrease the total
force production needed and total work
of each joint; therefore, the mechani-
cal stress and potentially metabolic cost
may be lower with touch-and-go, which
would actually be a negative for hyper-
trophy. However, this study equated for
reps per set. In practice, it’s likely that
touch-and-go would lead to more reps
per set or utilization of a higher load, so
it’s possible the increased reps or load
could compensate for the reduced force
production and stress per repetition.
Ultimately, I think if >5 reps are being
used, it makes some sense to use touch-
and-go as the sheer time to complete the
set with a four second dead stop would
be quite long. With lower reps, though,
dead stop seems like a good idea because
that low rep session is targeting strength
adaptation. So for someone mainly in-
terested in hypertrophy, choosing be-
tween repetition style doesn’t have to
be an all-or-none thing; high rep days
could utilize touch-and-go (if desired),
but low rep days should likely be dead

27
stop. solute intensity. That latter design would
One last point: If you do use touch- also be able to test if our hypothesis that
and-go reps, it’s probably not a good resetting every rep – even if it leads to
idea to use a 1RM calculator (i.e. [1RM fewer reps or lower loads – is still better
= Load X Reps X 0.0333] + Load) when for maximal strength.
planning test day attempts. In all like-
lihood, this calculation will lead to a
heavily inflated 1RM prediction. Finally,
Coach Matt Gary has written about this
topic before. I would suggest checking
out his article for his expert opinion on
the topic, as he has had tremendous suc-
cess with many lifters using the methods
he has outlined.

Next Steps
The path forward here is to analyze
what we discussed in our last paragraph.
Does touch-and-go lead to more vol-
ume than dead stop, and if so, would this
lead to more hypertrophy and maybe
strength in the long-term? I’d propose a
training study that has a built-in volume
comparison such as: 3 sets X max reps
@75%. This way, a study would com-
pare how many reps were performed in
each group. Almost certainly, more reps
would be performed with the touch-
and-go style. Then, comparisons could
be made for hypertrophy and strength
at the end of the study. Another way to
do this would be the following: 3 X 5
@9RPE. In that case, reps per set would
be equated, but it’s likely that touch-
and-go would use a higher load and still
be doing more volume at a greater ab-

28
References
1. Krajewski K, LaFavi R, and Riemann B. Hackett, Daniel A., Stephen P. Cobley, and Mark Halaki.
A Biomechanical Analysis of the Effects of Bouncing the Barbell in the Conventional Deadlift.
Journal of strength and conditioning research (2018).
2. Hall JE. Guyton and Hall textbook of medical physiology e-Book. Elsevier Health Sciences; 2015
May 31.
3. Wilson GJ, Wood GA, Elliott BC. The relationship between stiffness of the musculature and static
flexibility: an alternative explanation for the occurrence of muscular injury. International Journal of
Sports Medicine. 1991 Aug;12(04):403-7.

29
 Study Reviewed: Case Reports on Well-Trained Bodybuilders: Two Years
on a High Protein Diet. Antonio and Ellerbroek. (2018)

High Protein Diets Can Enhance

Strength and Lean Mass, But Are
They Safe?
BY E RI C HE LMS

We’ve discussed the importance of protein intake for both muscle

gain and fat loss, but not safety. This case study on a handful of
bodybuilders following a high protein diet for two years is the best
data set we have on safety to date.

30
 KEY POINTS
1. Five resistance-trained males were tracked over a two-year period while consuming
more than 2.2g/kg of protein (1g per pound) to assess if they experienced any
adverse effects on liver or kidney function.
2. Interestingly, there were no trends indicating any consistent changes in lean mass
or fat mass in this group over the entire period, despite the likelihood that these
individuals had the goal of increasing muscle mass.
3. Liver and kidney function metabolic panels occurred every six months. On the
whole, liver and kidney function was unaffected over the two-year period compared
to baseline while the participants consumed 3.2 ± 1.1 g/kg of protein in year one
and 3.5 ± 1.4. g/kg of protein in year two.

H
igh protein diets have been a
source of controversy for as long
as nutrition has been a field of
study. In the world of bodybuilding, the
perception of what constitutes “high
protein” is skewed upward compared
to the sports nutrition world and is
skewed even further upward compared
to the perception in the general nutri-
tion world. Among bodybuilders, their
coaches, and content providers in the
bodybuilding community, the lowest
recommendation I’ve ever seen promot-
ed is 1.8g/kg or right around 0.8 grams
per pound. Much more common are
mainstream (in this community) recom-
mendations in the 1-2 gram per pound
range, or 2.2-4.4 g/kg. Interestingly, very
little research has been conducted exam-
ining protein intakes in this very high
range, despite the perception in the gen-
eral nutrition community that protein
intakes in this range could be potentially
harmful. In the present study, five well-
trained (> 9 years training experience)
males were observed over a two-year pe-
riod, while having their body composi-
tion and metabolic panels for their liver
and kidney function assessed every six
months. During this period, they con-
sumed 3.2 ± 1.1 g/kg of protein in year
one on average, and 3.5 ± 1.4. g/kg of
protein in year two. On the group lev-
el, the mean values for kidney and liver
function remained within normal levels,
and only creatinine and blood urea ni-
trogen (which can fall outside of normal
ranges when assessed in acute proxim-
ity to exercise) inconsistently, and with
no pattern, fell outside of normal ranges
in two and four individuals, respectively.
Interestingly, there were no clear trends
for changes in fat mass or lean mass over
the two-year period. Overall, it appears
that very high protein diets are safe with
regards to kidney and liver function over
two years and that modifying protein in-
take alone is not sufficient to induce lean

31
mass gains or fat loss in the long term,
even when consumed in large amounts.
Purpose and Research
Questions
Purpose
The purpose of this study was to in-
vestigate whether a chronic high protein
(>2.2g/kg/day) diet would have delete-
rious effects on liver or kidney function
if followed for a two-year period and to
assess what effects, if any, it might have
on body composition in trained males.
Hypothesis
The authors noted that this study was a
continuation of their previous one-year
study on protein safety, which showed
no adverse effects of a high protein diet,
indicating they suspected this trend of
healthy blood work would continue.
They also cited their own previous work,
which showed additional fat loss in the
short-term when consuming a very high
protein diet. Thus, it’s safe to assume the
authors expected a decline in fat mass
and sustained healthy blood work during
this two-year observational period.
Subjects and Methods
Subjects and Study Protocol
Five healthy trained males (25 to 38
years of age), all with more than nine
years of training experience, participated
in this observational case study. Volun-
teers were instructed to eat more than
2.2g/kg (1g/lb) of protein daily, with no
upper limit, and were provided whey
protein (four of the participants) or pea
protein (for one participant, who was
a vegan) to assist in reaching this daily
goal. However, they could use as little or
as much protein powder as desired, so
long as their total daily intake from all
protein sources was above 2.2g/kg. The
participants were instructed to maintain
their normal training patterns without
intervention, and training was not mod-
ified by the researchers.
Dietary, Metabolic, and Body Composi-
tion Assessments
Participants were required to log their
food intake using MyFitnessPal three
days per week every week for the two-
year period. All participants had previ-
ous experience logging their food with
MyFitnessPal. At baseline and every six
months thereafter (a total of five occa-
sions), the participants reported to an
independent lab for a metabolic panel to
assess kidney and liver function, and they
had their body composition assessed via
Bod Pod.
Findings
At the group level, the five participants
consumed between 1.5-4.0 g/kg of pro-
32
 Table 1 Protein Intake Data of All Subjects

Baseline PRO Year 1 PRO Year 2 PRO

Baseline PRO Year1 PRO Year 2 PRO intake intake intake
Subject Age (years) intake (g·d-1) intake (g·d-1) intake (g·d-1) (g·kg-1·d-1) (g·kg-1·d-1) (g·kg-1·d-1)

1 25 138 217 255 1.5 2.2 2.6

2 26 193 278 285 2.7 3.4 3.6

3 30 395 524 562 4.0 5.1 5.8

4 31 184 250 222 2.2 3.0 2.7

5 38 163 198 200 2.0 2.5 2.6

Mean ± SD 30.0 ± 5.1 215 ± 103 293 ± 133 305 ± 147 2.5 ± 1.0 3.2 ± 1.1 3.5 ± 1.4

Data are expressed in yearly average protein intake.

d = day; kg = kilogram; PRO = protein

tein at baseline, then increased their in-
takes to 2.2-5.1 g/kg in year one, then
to 2.6-5.8 g/kg in year two. Table 1 dis-
plays the mean grams per kilogram and
absolute protein intake values at base-
line, year one, and year two.
At the group level, mean values for
selected metabolic markers for kidney
and liver health remained within nor-
mal ranges for both year one and two.
Specifically, creatinine, alanine transam-
inase, aspartate transaminase, blood urea
nitrogen, estimated glomerular filtration
rate, and blood glucose levels remained
in the normal range, as shown in Table
2.
With that said, creatinine and blood
urea nitrogen did fall outside of nor-
mal ranges in two and four individuals,
respectively. However, there seemed to
be no consistent pattern to when these
markers were elevated, and this was likely
caused by other factors (more on this in
the interpretation).
Finally, while individuals did see shifts
in their fat and lean mass levels over the
two-year period on average, there was
no consistent pattern to these changes.
In fact, only two of the five participants
gained any significant lean mass over the
two-year period. (A third gained 0.1kg,
but given the Bod Pod’s accuracy, this
was likely not a real, meaningful change.)
Individual body composition changes for
each participant are shown in Table 3.

33
 Table 2 Select Clinical Measures of All Subjects

Baseline Year 1 Year 2 Normal Range

Glucose (mg·dL-1) 83 ± 6 79 ± 2 86 ± 4 65 to 99 (mg·dL-1)

BUN (mg·dL-1) 24 ± 6 21 ± 9 24 ± 8 7 to 25 (mg·dL-1)

Creatinine (mg·dL-1) 1.2 ± 0.4 1.1 ± 0.5 1.2 ± 0.2 0.60 to 1.35 (mg·dL-1)

eGFR mL·min-1·1.73m-2 97 ± 27 102 ± 26 95 ± 28 > or = 60 mL·min-1·1.73m-2

AST U/L 31 ± 8 27 ± 5 28 ± 5 10 to 40 U/L

ALT U/L 29 ± 12 28 ± 11 26 ± 7 9 to 46 U/L

Data are mean ± SD

ALT = alanine transaminase; AST = aspartate transaminase; BUN = blood urea nitrogen;
eGFR = estimated glomerular filtration rate; g = grams; L = liter; mg = milligrams.
All values fall within the normal range.

Interpretation health status of the person in question

Since I’ve been involved in the fit-
ness industry, I’ve heard the claim that
high protein diets can lead to liver and
kidney damage and the degradation of
bone density. Curiously, there is scant
direct evidence to support these claims.
On the surface, the claims aren’t entire-
ly unreasonable, but a closer look reveals
the importance of context. Specifically,
the magnitude of protein intake and the
are likely the most important variables
when considering health implications of
high protein diets. (As is always the case,
the devil is in the details.) Theoretically,
a high protein diet could certainly cause
undue stress on the liver (as the demand
to oxidize protein increases) and the
kidney (as the need to increase filtra-
tion rates increases) (2); however, almost
any nutritional compound (even water)
can prove dangerous – or even fatal – at

34
 Table 3 Individual Data of Subjects 1-5

Subject 1 Subject 2 Subject 3 Subject 4 Subject 5

Baseline

BM (kg) 93.5 72.9 99.1 82.7 82.5

LBM (kg) 85.2 59.4 81.7 70.9 68.2

FM (kg) 8.3 13.5 17.9 11.7 14.2

BF% 8.9 18.6 17.6 14.3 17.3

Year 1

BM (kg) 98.1 80.4 95.1 82.6 78.1

LBM (kg) 83.6 56.9 80.3 70.1 65.3
FM (kg) 14.4 23.4 21.9 12.5 12.7
BF% 14.6 27.4 15.3 15.1 16.4

Year 2

BM (kg) 96.8 78.9 97.7 80.8 77.8

LBM (kg) 87.9 59.5 85.4 68.9 66.7
FM (kg) 8.8 19.4 12.3 11.7 11.0
BF% 9.2 24.6 12.6 14.6 14.2

BM = Body Mass; LBM = Lean Body Mass; FM = Fat Mass; BF% = Body Fat Percent

high enough dosages, but you never hear
“watch your water intake” unless there’s
a medical condition present showing a
need for this. Simply stating the theo-
retical possibility of nutrient overload is
not enough to base a specific claim that
a certain gram per kilogram intake of
protein is dangerous.
If you trace the data back far enough,
the first claims that a high protein in-
take could damage the kidneys and liver
were made nearly a century ago when it
was found that rats with one kidney fol-
lowing a high protein diet experienced
renal hypertrophy (3) or damage (4).
Despite using an animal model – specif-
ically, animals with a surgically removed
kidney to impair their ability to process
protein – this was the original basis of

35
these claims. Today, we know that indi-
viduals with kidney damage due to a dis-
ease-state can improve markers of kid-
ney function by reducing their protein
intake (5), but until recent years, there
has been a lack of long-term research
in healthy, exercising individuals to ad-
dress the claim that high protein diets
are harmful to kidney or liver function.
This specific study by Antonio and
colleagues addresses that gap in the re-
search and is a continuation of their one-
year study on high protein diets investi-
gating the same variables with a larger
sample size of 14 resistance-trained
males (there were no negative effects
of a high protein diet observed in this
study either) (6). The five participants
in the present study were among the
cohort in the initial study; they were
simply willing to continue the proto-
col for an additional year. The only hint
of any deleterious effect of protein on
health in the current study was the in-
consistent creatinine and blood urea ni-
trogen levels that occurred in four out
of the five participants (one participant
remained within normal ranges for ev-
erything, at all times points). However,
it is worth pointing out that exercise can
independently elevate these (and other)
markers (7), and the researchers did not
control temporally for when the panels
were conducted relative to the training
sessions of the participants. Thus, given
the sporadic nature of these findings, the
possibility that exercise influenced these
IN SUMMARY, HIGH PROTEIN
DIETS IN HEALTHY, EXERCISING
INDIVIDUALS APPEAR TO POSE
NO RISK TO LIVER, KIDNEY,
OR BONE HEALTH OVER
PERIODS OF 6-24 MONTHS.
results, and the group mean falling with-
in healthy levels for these markers, it’s a
safe conclusion to make that the protein
intakes observed in these individuals did
not result in any measurable level of kid-
ney or liver stress.
Not directly addressed in this study is
the claim that high protein diets can be
detrimental to bone health. This claim
is also based on theoretical rather than
direct evidence. The argument follows
this logic: High protein diets increase
rates of calcium excretion (although this
is primarily observed in animal versus
plant protein sources). Also, lower uri-
nary pH is observed among individuals
following high protein diets, and it is
thought that bicarbonate from bone is
used to buffer this acidity, followed by
bone calcium excretion. Therefore, it is
claimed that the combination of these
two factors results in a demineralization
36
 Table 4 Bone Health Markers

Control Control High-Protein High-Protein

Pre Post Pre Post

Bone Mineral Content (kg) 2.47 ± 0.35 2.47 ± 0.34 2.55 ± 0.38 2.53 ± 0.40

Bone Mineral Density (g/cm2) 1.22 ± 0.08 1.22 ± 0.09 1.25 ± 0.11 1.24 ± 0.10

Total Body T-Score 1.4 ± 1.0 1.3 ± 1.1 1.7 ± 1.3 1.7 ± 1.3

Lumbar Bone Mineral Content (g) 65.8 ± 16.1 64.5 ± 10.3 69.6 ± 8.9 71.6 ± 9.8

Lumbar Bone Mineral Density (g/cm2) 1.08 ± 0.16 1.05 ± 0.13 1.07 ± 0.11 1.08 ± 0.12

Lumbar T-Score 0.3 ± 1.5 0.0 ± 1.1 0.2 ± 1.0 0.3 ± 1.1

From Antonio 2018 (11)

of the skeleton when consuming a high
protein diet (8). However, increased cal-
cium excretion during a high protein
diet does not result in a net calcium loss.
In fact, some data indicate that high
protein diets cause an increase of intes-
tinal calcium absorption (9). Moreover,
Antonio and colleagues also recently
published a study investigating bone
health in exercising individuals (specif-
ically women, who are at a greater risk
for decrements to bone health due to
the incidence of the female athlete triad
and menopause). Specifically, they com-
pared trained women following either
a habitual (1.5 ± 0.3 g/kg) or high pro-
tein (2.8 ± 1.1 g/kg) diet for six months
while tracking markers of bone health.
The outcomes of this study are shown in
Table 4; as you can see, there were nearly
identical markers of bone health in both
groups despite an 87% higher protein
intake in the high-protein group (10).
In summary, high protein diets in
healthy, exercising individuals appear
to pose no risk to liver, kidney, or bone
health over periods of 6-24 months.
With that said, half a year to two years
of good biomarkers for bone, kidney, and
liver health should not be seen as all-en-
compassing evidence that very high pro-

37
tein diets are completely free of health
risk. Unfortunately, some epidemiolo-
gy points to the fact that lower protein
diets do seem to be correlated to lower
incidences of cancer, and mechanistical-
ly, many of the signals (IGF-1, insulin)
that are upregulated from high-protein,
high-calorie diets that are useful for
muscle growth are also useful for tumor
growth (11).
Now, before you lose your mind over
that sentence, let me clarify what I am
not saying. I’m not saying high pro-
tein diets cause cancer. I’m not saying
strength athletes and bodybuilders are at
a higher risk for cancer compared to the
general population. And I’m not say-
ing researchers have uncovered a clear,
causative link between high protein di-
ets and increased cancer risk. I am only
saying that correlative epidemiological
research and some mechanisms point to
a potential for chronic caloric surpluses
and high protein diets (specifically ani-
mal proteins) as variables that may in-
crease risk. When you think about it, in
a mass-building phase, we’re doing ev-
erything we can to put our bodies in an
anabolic state. Just intuitively, I’d guess
that’s probably not ideal for generating
the maximal amount of life extension
or cancer risk reduction. However (and
this is critical), given that most body-
builders and powerlifters follow cyclical
periods of caloric restriction (well, not
superheavyweights), regularly exercise,
consume plenty of fruits and vegetables
IN SUMMARY, HIGH
PROTEIN DIETS IN HEALTHY,
EXERCISING INDIVIDUALS
APPEAR TO POSE NO RISK
TO LIVER, KIDNEY, OR BONE
HEALTH OVER PERIODS
OF 6-24 MONTHS.
(well, at least bodybuilders do), and en-
gage in many other risk-reducing activ-
ities, the net risk is probably – at worst
– the same compared to the general pop-
ulation. But if I had to bet on it, I’d guess
the average physique or strength athlete
is at a lower net risk than the average
person due to these protective behav-
iors. One big caveat, though: I can only
confidently state that when referring to
drug-free athletes (or, at the very least,
those responsibly using anabolic phar-
macological agents) and those who do
indeed consume a healthy dose of fruits
and vegetables (sorry Mike) and control
their body weight (sorry supers).
Two final depressing notes I want to
make about this study:
1) Unlike some of Antonio’s short-
term work on high protein diets (12), a
38
 APPLICATION AND TAKEAWAYS
1. High protein diets above one gram per pound (2.2g/kg) are unlikely to cause any
negative effects on kidney or liver health, even over multiple years.
2. Exercise alone can result in acute increases in some biomarkers of kidney and
liver function, and the “blips on the radar” observed in this study (specifically
for increased blood urea nitrogen and creatinine) might have been related to the
temporal proximity to training. So, if you’ve got a physical coming up, it might be
a good idea to take a day off prior.
3. While not addressed in this study, other recent work by Antonio and colleagues
suggests high protein diets of a similar magnitude are also not deleterious to bone
health.

fat loss effect was not observed in this

investigation. Thus, it’s likely that peo-
ple habituate to any theoretical increase
in satiety and/or upregulation of energy
expenditure associated with very high
protein diets in the long run.
2) Only two of the five participants
gained lean mass over this two-year pe-
riod. Given they all had at least nine
years of training experience, and given
they followed their own, habitual train-
ing, I think it’s fair to say that you ad-
vanced lifters out there really have to
ensure your training is progressive in
nature and your nutrition (not just your
protein intake) supports your goals of
muscle gain. If you aren’t progressing at
an advanced stage of your lifting career,
you should seriously consider outsourc-
ing your training and/or nutrition to a
qualified coach with a good track record.
Unfortunately, gains at this stage are just
hard to come by.
Next Steps
I’d like to think that the work An-
tonio and colleagues have put in over
the last few years has begun to change
some of the misconceptions around the
supposed kidney, liver, and bone health
risks of high protein diets. I suppose the
next step would be to look more deep-
ly at caloric and even protein restriction
in individuals with cancer to see if the
mechanistic and epidemiological links
that exist could be exploited to reduce
the rate at which tumors grow or maybe
even to aid in the treatment of cancer.
I won’t go into specifics here, as this is
outside of my area, but I think it’s a line
of research worthy of exploration.

39
References
1. Antonio, J. and A. Ellerbroek, Case Reports on Well-Trained Bodybuilders: Two Years on a High
Protein Diet. JEPonline, 2018. 21(1): p. 18-24.
2. Poortmans, J.R. and O. Dellalieux, Do Regular High Protein Diets Have Potential Health Risks
on Kidney Function in Athletes? International Journal of Sport Nutrition & Exercise Metabolism,
2000. 10(1): p. 28.
3. Miller, A.J., The influence of high protein diet on the kidneys. Journal of Experimental Medicine,
1925. 42(6): p. 897-904.
4. Jackson, H. and O.J. Moore, The effect of high protein diets on the remaining kidney of rats. The
Journal of clinical investigation, 1928. 5(3): p. 415-425.
5. Nezu, U., et al., Effect of low-protein diet on kidney function in diabetic nephropathy: meta-analysis
of randomised controlled trials. BMJ Open, 2013. 3(5).
6. Antonio, J., et al., A high protein diet has no harmful effects: a one-year crossover study in resis-
tance-trained males. J Nutr Metab, 2016. 2016.
7. Foran, S.E., K.B. Lewandrowski, and A. Kratz, Effects of exercise on laboratory test results. Labora-
tory medicine, 2003. 34(10): p. 736-742.
8. Fenton, T.R., et al., Low urine pH and acid excretion do not predict bone fractures or the loss of bone
mineral density: a prospective cohort study. BMC Musculoskeletal Disorders, 2010. 11: p. 88-88.
9. Calvez, J., et al., Protein intake, calcium balance and health consequences. Eur J Clin Nutr, 2012.
66(3): p. 281-95.
10. Antonio, J., et al., High protein consumption in trained women: bad to the bone? Journal of the
International Society of Sports Nutrition, 2018. 15(1): p. 6.
11. Levine, M.E., et al., Low Protein Intake is Associated with a Major Reduction in IGF-1, Cancer,
and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metab, 2014. 19(3):
p. 407-17.
12. Antonio, J., et al., A high protein diet (3.4 g/kg/day) combined with a heavy resistance training pro-
gram improves body composition in healthy trained men and women--a follow-up investigation. J
Int Soc Sports Nutr, 2015. 12.

40
 Study Reviewed: Validation of Biofeedback Wearables for
Photoplethysmographic Heart Rate Tracking. Jo et al. (2016)

The Accuracy of Modern-Day

Fitness Trackers and Heart Rate
Measurements
BY E D D I E J O

Wearable technology has exploded in the past few years and it

can be a great tool to track variables. But, with any technology
that tracking must be accurate. So, what about the popular Fitbit
Charge, does it indeed track heart rate accurately?

41
 KEY POINTS
1. Modern-day fitness trackers are increasingly incorporating reflective PPG for heart
rate detection, especially on top of the wrist.
2. This study examined the validity of a wrist-worn tracker by one of the industry
leaders in consumer fitness tech.
3. The Fitbit Charge HR performed with poor accuracy when compared to the gold-
standard electrocardiograph (ECG), especially during higher levels of physical
exertion and specific exercises.
4. The Fitbit Charge HR was not validated for heart rate monitoring, at least during
physical activity or exercise. Better accuracy was observed during resting or low
effort conditions.

H
eart rate monitoring has argu-
ably been at the forefront of fit-
ness and health technologies for
as far back as we can remember. In clin-
ical settings, heart rate is typically mon-
itored using an electrocardiogram, or
ECG, which is recognized as the gold
standard mode of measurement. How-
ever, the relative high cost, difficulty of
access, discomfort, and complexity of
procedures limit their use in everyday
free-living conditions, especially during
sport and exercise. Because of the use-
fulness and value of heart rate data in
both health and fitness, technological
advancements have enabled more prac-
tical means of monitoring heart rate, es-
pecially for the physically active.
Devices like those from Polar® are
loosely based on ECG technology and
allow for the detection of heart rate via
an electrode-like chest strap that is wire-
lessly interfaced to a monitor, usually
in the form of a watch. Polar, without
a doubt, has been the household name
for personal heart rate monitoring, and
its devices have stood the test of time,
largely due to the backing of scientific

Guest Reviewer: Eddie Jo, Ph.D.

Dr. Eddie Jo is an Assistant Professor of Exercise Physiology and Founder and Director of
the Human Performance Laboratory at California State Polytechnic University – Pomona.
He earned a Ph.D. in Exercise Physiology at Florida State University in the Skeletal Muscle
Physiology Lab. His overarching research agenda is to innovate and advance application of
exercise and nutrition programming for the optimization of human performance, metabolism,
body composition, and muscular health in populations ranging from elite athletes to clinical
populations. He is a distinguished Strength and Conditioning Specialist through the NSCA and
has been a Certified Personal also through the NSCA for over 15 years.

42
research that demonstrates their ac-
curacy (1). But certainly, the tech in-
dustry is constantly looking for ways
to innovate new, better, and more ver-
satile devices. Here enters a new class
of personal heart rate detection called
reflective photoplethysmography, or
PPG, which can be found on almost
all the latest wearables or fitness track-
ers, such as the Fitbit, Apple Watch,
Samsung Gear, Garmin, and Suun-
to. If there is a flickering green light
on the back of the tracker, heart rate
is being measured by said tracker via
PPG.
So how does reflective PPG gen-
erally work? Fitness trackers like the
Fitbit Charge HR, Apple Watch, and
Samsung Gear detect heart rate by
emitting green light into the skin and
blood vessels. Green light is poorly
reflected by blood, but the reflectance
level changes slightly with alterations
in blood volume passing through the
vessel, such as during a heartbeat. The
altering reflectance back toward the
sensor with each beat and relaxation of
the heart is “sensed” by the device and
is ultimately used to compute heart rate
using proprietary algorithms and esti-
mation formulas. This wearable PPG
technology has enabled less obtrusive
assessment of heart rate and activity
and allows for continuous monitoring
throughout the day without the need
for a chest strap or other separate sen-
sors. The PPG-based heart rate is of-
ten integrated with other sensors like
accelerometers in a single device, pro-
viding the capacity to compute mul-
tiple measures other than heart rate,
such as caloric expenditure.
The value of PPG sensor technology
has likely contributed to the expansive
growth of the fitness tracker industry,
but without proportionate level of sci-
entific scrutiny of their accuracy. Al-
though PPG may be a breakthrough
in personal heart rate monitoring, the
accuracy of these devices remains con-
sistently challenged, considering the
number of factors that may interrupt
proper heart rate detection by PPG
(more on this later). So, let’s first take a
look at the research. Below, I detail the
results of one of the most comprehen-
sive studies examining the accuracy of
a wearable PPG-based fitness tracker
from one of the leading fitness tech-
nology companies, Fitbit. My research
team examined the accuracy and valid-
ity of the Fitbit Charge HR, and the
study was published in the Journal of
Sports Science and Medicine in 2016.
Purpose and Research
Questions
We sought to determine the capabili-
ty of the Fitbit Charge HR (first gener-
ation) to accurately measure heart rate
during a variety of laboratory-based ex-
ercise tasks in reference to the ECG.
43
 Figure 1 Correlation Between Time Synced Heart Readings from Fitbit Charge HR and ECG
220
r = 0.83
p < 0.0001
Fitbit Charge HR (beats/min)
180
140
100
60
20
20
Subjects and Methods
This was one of the most comprehen-
sive validation studies on PPG heart
rate monitors, as approximately 80,000
time-synced ECG and Fitbit heart rate
data pairs were collected from 24 male
and female participants. During testing,
participants were connected to a 12-lead
ECG and wore a Fitbit Charge HR ac-
cording to manufacturer instructions.
Time-synced heart rate data from each
device was simultaneously and continu-
ously collected electronically via a data
acquisition computer program during
a 77-minute exercise protocol. The ex-
ercise protocol included the following
60 100 140 180 220
ECG (beats/min)
five-minute tasks in the listed order: 1)
cycling at 60W, 2) cycling at 120W, 3)
treadmill walk, 4) treadmill jog, 5) tread-
mill run, 6) dumbbell lateral arm raises
(12 reps), 7) alternating resisted lunges
(12 reps), and 8) isometric abdominal
plank (60-second hold). Five minutes of
rest was implemented between each ex-
ercise task, during which time heart rate
data was continuously collected.
Findings
When examining time-synced ECG
and Fitbit Charge HR heart rate data
in aggregate (87,340 ECG-Fitbit heart
rate data pairs), there was a moderate-
44
 Figure 2 Correlation Between Time Synced HR Readings from Fitbit Charge HR and ECG During Higher Intensity Exercise
220
200
Fitbit Charge HR (beats/min)
180
160
140
120
100
80
60
40
100
ly strong correlation between ECG and
FB (r = 0.83) and an average underesti-
mation by the Fitbit of 8.8 ± 16.9 bpm.
Analysis also showed that the range
of deviation from ECG was anywhere
from +24 bpm to -42 bpm, indicating a
large average tendency to underestimate
heart rate.
With further analyses, we found that
the accuracy of the Fitbit Charge HR
was greatly affected during higher inten-
sities of exercise. When examining the
heart rate data pairs above the average
ECG/true heart rate of 116 bpm (i.e.
higher intensities of exercise), the cor-
relation between the Fitbit Charge HR
and ECG heart rate drastically weak-
r = 0.58
p < 0.05
120 140 160 180 200 220
ECG (beats/min)
ened (r = 0.58) to a level demonstrat-
ing inaccurate measures by the Fitbit
(Figure 2). The average underestimation
increased to -12.7 ± 21.1 bpm with the
range of deviation from ECG anywhere
from +29 bpm to -54 bpm, demonstrat-
ing an extremely large tendency to un-
derestimate heart rate.
When examining the data pairs below
the average ECG/true heart rate (i.e. rest
to lower intensities of exercise), the Fit-
bit Charge HR appeared to have accept-
able accuracy with a moderately strong
correlation with ECG (r = 0.73) and an
average underestimation of 5.3 ± 10.7
bpm (Figure 3). The range of deviation
from ECG was narrower from +16 bpm
45
 Figure 3 Correlation Between Time Synced HR Readings From Fitbit Charge HR and ECG During Rest and Lower Intensity Exercise
160
140
Fitbit Charge HR (beats/min)
120
100
80
60
40
20
0
0 20
to -26 bpm, indicating a slight tendency
to underestimate heart rate during rest
to lower intensities of exercise.
When examining the accuracy of the
fitness tracker during specific tasks, the
Fitbit Charge HR performed the best
during resting conditions. However, the
performance of the Fitbit was excep-
tionally poor during cycling, resisted
arm raises, resisted lunges, and abdom-
inal plank with underestimations up to
21 bpm.
Interpretation
We determined that the Fitbit Charge
HR failed to satisfy validity criteria,
largely due to the substantial decrease in
r = 0.73
p < 0.05
40 60 80 100 120 140
ECG (beats/min)
accuracy during higher exercise intensi-
ties. Overall, the tracker had a very large
tendency to underestimate heart rate, es-
pecially during higher intensities of ex-
ercise in which an individual’s heart rate
measure could be potentially underesti-
mated by almost 54 bpm (average being
-13 bpm). The Fitbit device appeared to
measure heart rate to a reasonable degree
of accuracy during resting conditions,
but these results offer very little practical
relevance, considering the actuality that
consumers utilize these fitness trackers
to, in fact, track physical activity. We of-
fer several possible explanations for the
observed results, which may apply to any
PPG-based fitness tracker currently on
the market.
46
 APPLICATION AND TAKEAWAYS
1. If you are looking for a fitness tracker to monitor your heart rate (and activity level),
we highly recommended looking into the independent research examining their
accuracy. This article is a great resource for such information.
2. Reflective PPG technology for consumer-level heart rate and indirect activity
monitoring is imperfect due to a multitude of factors that can interrupt proper
detection. Until further research and development efforts can help better control
for these factors, the PPG-based fitness tracker industry is, to an extent, a buyer-
beware environment.
3. If you are interested simply in heart rate monitoring devices for exercise, a more
traditional electrocardiac device with a chest-strap sensor (e.g. Polar) may be the
most effective at this point.

First, the compression of the PPG
sensor against the skin may negatively
influence the quality of the PPG sig-
nal, and higher compression between
the sensor and the skin may introduce
contact-related noise to the signal (3).
This may, in part, explain the poor lev-
el of accuracy during exercises that in-
volved forearm contractions, such as the
dumbbell arm raises, lunges with dumb-
bells, planks, and cycling (holding onto
the handle bars). This is one reason why
most manufacturers recommend not
over-tightening the watch strap. Anoth-
er possible factor influencing accuracy is
movement of the sensor/watch. It is as-
sumed that during higher intensities of
exercise, there are generally more bodily
movements involved, possibly “shaking”
the sensor while it is capturing PPG
signals. Other important variables that
have been discussed by other research-
ers include skin pigmentation, sweat,
and location of the sensor. In fact, heart
rate monitoring on the top of the wrist
using reflective PPG has shown to have
reduced accuracy compared to other
sites (4, 5). It can be argued with decent
scientific justification that PPG-based
sensors have more factors impacting
their accuracy compared to electrocardi-
ac heart rate sensors (e.g. Polar).
Overall, the Fitbit Charge HR may
be permissible as an accurate heart rate
monitor only when used during rest or
very low physical exertion. The Fitbit
Charge HR fails to provide accurate
heart rate measurements with increasing
physical effort and during specific exer-
cise tasks. These data corroborate more
recent findings in the second-genera-
tion Fitbit Charge HR (Charge HR 2),
which demonstrated very similar results,
i.e. reduced accuracy with higher phys-
ical exertion (6). Therefore, those using
heart rate data to design exercise train-

47
ing prescriptions or as a precautionary perform with the same level of accuracy
measure due to health risks must use (or inaccuracy). Other research studies,
Fitbit devices and perhaps other PPG- although not as comprehensive as the
based monitors with caution. study presented here, have shown dif-
fering levels of accuracy across a number
of PPG-based devices (7). Publications,
Next Steps such as MASS, are a useful resource for
It is important that consumers of these continuously informing consumers of
fitness trackers understand that the in- the ongoing scientific investigations on
dependent research concerning their sport and fitness technologies, especially
accuracy lags behind the sale and mar- concerning their accuracy.
keting of the devices, and any initial
information regarding their accuracy is
largely predicated on consumer reviews,
advertisements, and in-house testing re-
sults (which are not always available to
the public). With that said, the fitness
tracker industry is a “buyer beware” en-
vironment. Thus, it is imperative that
independent researchers continuously
scrutinize and test the performance of
these devices, especially those that mea-
sure an important variable such as heart
rate. Research and development initia-
tives for PPG-based trackers should fo-
cus on better controlling for the multiple
factors that influence PPG signals and
modify hardware and software accord-
ingly.
As for the consumers, when using
a device specifically for heart rate de-
tection, there are other alternatives to
PPG-based trackers that have been
shown to be accurate. These include the
Polar monitors using electrocardiac sen-
sors (chest straps) (1). It should also be
noted that not all PPG-based trackers

48
References
1. Terbizan D, Dolezal B, Albano C: Validity of Seven Commercially Available Heart Rate Monitors.
Measurement in Physical Education and Exercise Science 2002;6:243-247
2. Jo E, Lewis K, Directo D, Kim MJ, Dolezal BA: Validation of Biofeedback Wearables for Pho-
toplethysmographic Heart Rate Tracking. J Sports Sci Med 2016;15:540-547
3. Allen J: Photoplethysmography and its application in clinical physiological measurement. Physiol
Meas 2007;28:R1-39
4. Rafolt D, Gallasch E: Influence of contact forces on wrist photoplethysmography--prestudy for a
wearable patient monitor. Biomed Tech (Berl) 2004;49:22-26
5. Teng XF, Zhang YT: The effect of contacting force on photoplethysmographic signals. Physiol Meas
2004;25:1323-1335
6. Benedetto S, Caldato C, Bazzan E, Greenwood DC, Pensabene V, Actis P: Assessment of the Fitbit
Charge 2 for monitoring heart rate. PLoS One 2018;13:e0192691
7. Gillinov S, Etiwy M, Wang R, Blackburn G, Phelan D, Gillinov AM, Houghtaling P, Javadikasgari
H, Desai MY: Variable Accuracy of Wearable Heart Rate Monitors during Aerobic Exercise. Med
Sci Sports Exerc 2017;49:1697-1703

49
 Study Reviewed: The Effect of Augmented Feedback Type and
Frequency on Velocity-Based Training-Induced Adaptation and
Retention. Nagata et al. (2018)

How to Maximize Results with

Velocity-Based Training
BY G RE G NUC KO LS

Velocity-based training isn’t just a way to select training loads and

adjust volume. By monitoring velocity on each rep, you may also
make larger gains.

50
 KEY POINTS
1. Receiving feedback about velocity on each rep led to increases in squat jump
velocity over four weeks.
2. On the other hand, seeing average velocity on each set and getting video feedback
on each set led to no improvements, while receiving no feedback at all led to
decreases in performance.
3. Receiving feedback about velocity on each rep may enhance performance by aiding
in maintaining external focus (i.e. focusing on movement outcomes) and enhancing
motivation.
4. Setting up for velocity-based training so that you can get velocity feedback on
every rep may improve training results.

W
e’ve discussed velocity-based
training in MASS before (one,
two), but the focus has been on
the ways velocity can be used to moni-
tor and adjust training volume, intensity,
and proximity from failure. However, I’ve
always believed that the largest benefit
of velocity-based training boils down to
something much more basic: It encour-
ages you to try to move every rep as fast
as possible. For velocity-based training
to “work,” and for the velocity feedback
it provides to give you any meaningful
data, you have to try to move every rep
as explosively as possible. This focus on
moving every rep as explosively as pos-
sible has been shown to promote larger
strength gains (2).
The present study takes that concept
one step further by asking what type
and frequency of feedback enhance per-
formance the most. In this study, well-
trained athletes performed loaded jump
squats for four weeks. One group was
told their average velocity for each rep
immediately after every rep, one group
was told their average velocity for the
entire set after every set, one group re-
viewed a video of their performance after
every set without being given feedback
about velocity, and one group received no
feedback at all. Feedback after every rep
and video feedback both enhanced squat
jump velocity for the first few sessions,
but only the group receiving velocity
feedback after every rep increased per-
formance over four weeks. Furthermore,
at a post-training retention test 10 days
later, performance was still enhanced in
the group receiving feedback after every
rep, whereas it was unchanged in the
group getting velocity feedback after ev-
ery set and the group getting video feed-
back, while performance was actually
lower than baseline in the group getting
no feedback.

51
Purpose and Research
Questions
Purpose
The purpose of this study was to exam-
ine the effects of feedback frequency and
type of feedback on loaded jump squat
velocity.
Research Questions
Would more frequent feedback (after
every rep vs. after every set) enhance
loaded jump squat velocity?
Would feedback focusing on perfor-
mance (velocity) enhance loaded jump
squat velocity more than feedback fo-
cusing on the movement (video)?
Hypotheses
No hypotheses were directly stated.
However, it can be inferred from the
wording of the introduction that the au-
thors expected more frequent feedback
to produce better results than less fre-
quent feedback.
Subjects and Methods
Subjects
The subjects were 40 elite male rug-
by players (20.89 ± 0.8 years old, 1.71 ±
0.05 cm, 77.82 ± 12.56 kg). Three par-
ticipants dropped out during the course
of the study, leaving 37 participants to
finish the study. They had 3.3 ± 1.0 years
of training experience, and the average
back squat was a shade over 2x body-
weight. They were matched for strength
before being divided into groups so that
average squat 1RM was very similar be-
tween groups, ranging from 152.5kg to
157.5kg.
Training program
The subjects performed 3 sets of 5
weighted jump squats with a load of
60kg (132lb) on the bar, twice per week.
They were told to jump as high as possi-
ble on each rep and to put their full ef-
fort into every rep. They also performed
one heavier squat session per week, using
75% of their 1RM for 3 sets of 8 reps.
All training sessions were separated by
at least 48 hours.
Feedback type and frequency
The participants were divided into four
groups. One group was told their aver-
age velocity after every jump squat rep
(n=9). One group was told their average
velocity for the whole set after each set
of jump squats (n=10). One group was
shown video of their jump squats after
each set (n=10). Finally, one group was
given no feedback (n=8).
Measures
Prior to training, all participants per-
formed 1 set of 5 jump squats with 30kg
with no feedback. The average velocity
of these reps served as their baseline.
52
 Figure 1 Mean Velocity Across Feedback Groups
No Feedback Video Feedback Velocity Feedback Velocity Feedback
(n=8) (n=10) After Each Set (n=8) After Each Rep (n=9)

1.70

1.60
Mean Velocity (m/s)

1.50

1.40

1.30

1.20

1.10

1.00
Baseline Wk1 Wk1 Wk2 Wk2 Wk3 Wk3 Wk4 Wk4 Retention
T1 T2 T1 T2 T1 T2 T1 T2

During the four-week training period,

average velocity (assessed using a Gy-
mAware) of the first set was recorded for
each session. The second session of week
four served as the post-test, which was
a repeat of baseline testing (1 set of 5
jump squats without feedback). Finally,
a retention test was performed 10 days
after the last training session, follow-
ing the same procedure as baseline and
post-testing.
Findings
Velocity increased in the group receiv-
ing feedback after each rep. From the
first session of week two through the
retention test, this was a medium effect
(d=0.50-0.79).
Velocity decreased initially in the
group receiving velocity feedback after
each set. This decrease was considered
a large effect for the second session of

53
 Figure 2

Maintains external focus

Velocity feedback Enhanced

Better results
after each rep motivation

Higher concentration on
per-rep performance

week two and the first session of week
three (d=1.11-1.28). However, perfor-
mance rebounded by the end of the
study through the retention test to settle
around baseline values.
Velocity initially increased slightly in
the group receiving video feedback after
each set, before decreasing through the
rest of the study. From the second ses-
sion of week three through the post-test,
performance dropped below baseline.
This decrease was considered a medium
effect (d=0.60-0.74). However, perfor-
mance returned near baseline for the re-
tention test.
Velocity stayed below baseline for the
entirety of the study for the group receiv-
ing no feedback. This was considered a
trivial-to-medium effect (d=0.17-0.70).
However, performance decreased fur-
ther at the retention test. This decrease,
relative to baseline, was considered a
large effect (d=0.85).
By the second session of week two,
the group receiving feedback after every
rep was performing better than all other
groups. These effects ranged from medi-
um to large (d=0.60-1.58).
Interpretation
The results of this study, while
eye-catching, are consistent with oth-
er literature on the subject, which finds
that providing feedback about lift ve-
locity leads to faster progress than not
providing feedback, and that providing
more frequent feedback leads to faster
progress than providing less frequent
feedback (3, 4).

54
 The authors provide two hypotheses to
explain their results. First, they hypothe-
size that providing feedback on every rep
maintains an external focus (i.e. focusing
I THINK A LOT OF PEOPLE GET
on the outcome of a movement, instead SO HUNG UP ON PLANNING
of focusing on a particular muscle or the
positioning of your body). Maintain- THEIR TRAINING THAT THEY
ing an external focus has been shown
to enhance results compared to an in- OVERLOOK THE IMPORTANCE
ternal focus in a wide array of tasks (5),
as we’ve discussed in MASS previously.
OF PUTTING FORTH AS MUCH
One would assume that receiving veloc- EFFORT AS POSSIBLE WHEN
ity feedback on every rep would keep
you focused on your movement velocity. EXECUTING THEIR TRAINING.
Second, they hypothesize that receiving
feedback on every rep may enhance mo-
tivation. This also seems like a plausible
explanation; knowing your velocity for rectly provided, but we can make some
the previous rep gives you a goal to aim guesses. First, the authors tell us that
for on the next rep, making each rep a the participants were already familiar
mini competition against yourself. with loaded jump squats, so it’s not like
we’re seeing performance regressions in
While this study used loaded squat
a novel movement (which would be very
jumps instead of heavy squats, I don’t see
surprising). Second, we know that the
why the results would be different with
participants were rugby players, so it’s
heavy strength training. Assuming the
likely that they were also participating
authors’ proposed explanations (main-
in rugby practice and conditioning work
taining external focus and enhancing
in addition to the squat and jump squat
motivation) for their results are correct
training in this study (though that wasn’t
– and they seem like perfectly plausible
explicitly stated). This is supported by the
explanations – those same factors would
fact that three of the initial participants
also be in play with heavy strength train-
sustained injuries over the course of just
ing.
four weeks – it’s very unlikely they’d see
It’s worth noting that performance that sort of injury rate from jump squats
actually decreased from pre-training to and one session of moderately heavy
the retention test in the group receiving back squats not performed to failure. If we
no feedback. A reason for that wasn’t di- assume that the participants in this study

55
 APPLICATION AND TAKEAWAYS
Over four weeks, receiving velocity feedback after every rep increased jump squat
velocity, while velocity feedback after each set, video feedback, and no feedback failed
to increase performance or even led to decrements in performance. Receiving velocity
feedback after each rep may help maintain an external focus, enhance motivation, and
keep you acutely focused on maximizing performance on each rep, all of which will
benefit performance. If you do velocity-based training, try to maneuver your setup so
that you can see your velocity after each rep, or have a partner call out your velocity
each rep.

were also taking part in rugby practices,
the decrease in performance in the group
receiving no feedback may be reflective of
accumulated fatigue. Hence, a decrease in
performance would be seen as the base-
line. A mere maintenance of performance
in the groups receiving video feedback and
velocity feedback after each set would be
a positive result, relatively speaking, and
the increases in performance in the group
receiving velocity feedback after every rep
look even more impressive.
There are a couple of things I really like
about this study. I’m a sucker for anything
that can enhance results independent of
the “traditional” training variables (vol-
ume, intensity, and frequency). If you can
do the same sets and same reps with the
same weight and get better results, why
wouldn’t you? People focus on things like
eating enough protein and getting enough
sleep because they know that doing so
will allow them to get larger performance
outputs from the same training inputs;
the same principle applies here. I’m also
a sucker for anything that keeps people
focused on the actual rep-to-rep, set-to-
set execution of their training program. I
think a lot of people get so hung up on
planning their training that they overlook
the importance of putting forth as much
effort as possible when executing their
training. This strategy of receiving velocity
feedback every rep shifts the focus away
from the PR you’re planning on hitting
two months from now, and focuses you on
maximizing performance on your next rep.
Most people know they’re supposed to do
that, but this strategy provides a further
external reminder to stay focused on the
task at hand when you’re under the bar.
Next Steps
The obvious next step is to perform a
similar study using heavy squats or bench
press instead of light jump squats. I’d hy-
pothesize that results would be similar, but
you can never be sure until someone does
the study.

56
References
1. Nagata A, Doma K, Yamashita D, Hasegawa H, Mori S. The Effect of Augmented Feedback Type
and Frequency on Velocity-Based Training-Induced Adaptation and Retention. J Strength Cond
Res. 2018 Feb 14.
2. González-Badillo JJ, Rodríguez-Rosell D, Sánchez-Medina L, Gorostiaga EM, Pareja-Blanco F.
Maximal intended velocity training induces greater gains in bench press performance than deliber-
ately slower half-velocity training. Eur J Sport Sci. 2014;14(8):772-81.
3. Keller M, Lauber B, Gehring D, Leukel C, Taube W. Jump performance and augmented feedback:
immediate benefits and long-term training effects. Hum Mov Sci. 2014 Aug;36:177-89.
4. Randell AD, Cronin JB, Keogh JW, Gill ND, Pedersen MC. Effect of instantaneous performance
feedback during 6 weeks of velocity-based resistance training on sport-specific performance tests. J
Strength Cond Res. 2011 Jan;25(1):87-93.
5. Wulf G. Attentional Focus and Motor Learning: A Review of 15 Years. Int Rev Sport Exerc Psychol.
2013;6(1):11-104.

57
Study Reviewed: Carbohydrate Mouth-Rinsing Improves Resistance
Training Session Performance. Decimoni et al. (2018)

A Glimmer of Hope for CHO

Mouth Rinsing and Lifting?
BY MIC HAE L C . ZO URD O S

Endurance exercise clearly benefits from acute carbohydrate

supplementation, but can a quick swig of Gatorade actually
improve your strength? Most data examining a carbohydrate
mouth rinse say “no” for strength, but this study says “yes.”

58
 KEY POINTS
1. This study examined if carbohydrate mouth rinsing could increase the amount of
reps performed in a training session in trained women.
2. Mouth rinsing did not significantly increase volume in any individual exercise, but
at the end of the 50-minute training session, total session volume was higher with
the mouth rinse.
3. There are multiple other studies in disagreement with this study. However, the
other studies all used shorter protocols and just one exercise: the bench press. So,
for CHO mouth rinsing to acutely improve volume performance, it seems that the
training session needs to be longer and use multiple sets on multiple exercises.

W
hen it comes to supplements
that may increase volume ca-
pabilities, there seems to be
equivocal evidence surrounding many
of them. Beta-alanine has some, but not
overwhelming evidence to increase lift-
ing volume performance (2). And as we
know from Eric’s past MASS article, the
recent evidence on citrulline malate is not
in its favor despite past studies showing
support. Carbohydrate (CHO) mouth
rinsing, which involves about 10 seconds
of rinsing your mouth (like mouthwash)
with a maltodextrin solution then spit-
ting it out, does meaningfully increase
endurance performance (3), but it is
also on the equivocal list with one study
showing a benefit for lifting volume (4)
and three others showing no enhance-
ment (5, 6, 7). The lack of convincing
evidence for resistance training makes
sense, as the proposed primary mecha-
nism of rinsing is increasing availability
of blood glucose, which spares glycogen
(8). However, resistance training gen-
erally doesn’t deplete a ton of glycogen.
This study (1) examined the effects of
6g of maltodextrin or a placebo mouth
rinse (before and during each session)
on volume performance, rating of per-
ceived exertion (RPE), and heart rate in
a double-blind crossover design in 15
trained women. The women did about
12% more volume in the squat, leg press,
bench press, military press, and seated
row combined. They had lower RPE af-
ter each set on average, but similar heart
rate between conditions. These results
are unique and somewhat contradictory
to prior literature because they show an
important increase in training volume
using compound lifts with CHO mouth
rinsing. So why are these conflicting
results occurring? This article will take
a more in-depth look at the proposed
mechanisms and the methodologies of
previous studies to attempt to explain
these results, then provide some conclu-
sions based upon the totality of evidence
to date.

59
 Table 1 Subject Characteristics

Body Mass Training Age 10RM Back 10RM Leg 10RM Bench 10RM Military 10RM Seated
Subjects Age (years) (kg) Height (cm) (years) Squat (kg) Press (kg) Press (kg) Press (kg) Row (kg)

15 Women 26 ± 4 59 ± 8 161 ± 0.05 1 to 2 44 ± 13 165 ± 39 22 ± 6 23 ± 6 27 ± 8

Data are mean ± SD

Subjects characteristics from Decimoni et al. 2018 (1).

Purpose and Research session durations have been too short

Questions
Purpose
The purpose was to determine if CHO
mouth rinsing before and midway
through a training session enhanced
volume capability and reduced RPE and
heart rate compared to a placebo.
Research Question
When used both before and midway
through a training session, does CHO
mouth rinsing for 10 seconds with 6g of
maltodextrin increase upper and lower
body volume capabilities and attenuate
the increase in RPE and heart rate?
Hypotheses
No hypothesis was given, and the au-
thors presented both pro and contra-
dictory evidence for CHO mouth rins-
ing in the introduction. However, the
authors also pointed out that mouth
rinsing benefits have not been seen in
previous studies because total training
and only included one or two exercises.
So, it seems that the authors expected
improvements with mouth rinsing be-
cause they used five exercises for multi-
ple sets each.
Subjects and Methods
Subjects
Fifteen women with 1-2 years of
training experience participated. The
full details of the subjects are available
in Table 1.
Study Protocol
This study had four sessions with the
first two being used to test 10RMs. The
sessions were performed a few days
apart. The highest 10RM of both test-
ing sessions for each exercise was used
as the load in the experimental sessions.
A few days after the second 10RM ses-
sion, subjects performed the first of two
experimental sessions (72 hours apart),

60
which involved performing three sets of
max reps on the squat, leg press, bench
press, military press, and seated row
with two minutes between sets. Fur-
ther, Borg RPE – which measures ef-
fort and not repetitions in reserve (seen
here in Figure 2) – and heart rate were
taken after each set. The only difference
between experimental sessions is that
in one session, subjects mouth rinsed
with 6g of maltodextrin in a 100mL
solution immediately beforehand and
again immediately before the first set
of bench press. In the other session,
subjects mouth rinsed with a 100mL
placebo, which was a non-caloric con-
centrate sweetened with aspartame and
saccharin to taste the same as the CHO
solution. Figure 1 shows the procedures
of an experimental session.
Findings
Volume
There was no significant difference be-
tween conditions when comparing volume
in any single exercise (p>0.05). However,
when summing the volume of all exercises
together, training volume was significantly
higher (p=0.039, effect size=0.49) in the
CHO mouth rinse condition. In Figure 2,
you can see the very slight but non-signif-
icant edge for individual exercise volume
for the CHO rinse, and how, when added
up, this translated into a larger and signifi-
cant session-volume advantage.
Figure 1 Protocol of Experimental Sessions
3x Max Reps with
10RM
Half-Squat
Leg Press
Mouth Rinse
Carbohydrate
OR Placebo
Bench Press
Military Press
Seated Row
*Heart rate and RPE
taken after each set
This depicts one experimental session. The second session
occurred 72 hours later and was the exact same except the mouth
rinse (carbohydrate or placebo) was the opposite of session 1.
RPE = Rating of perceived exertion; RM = Repetition Maximum
Heart Rate and RPE
Heart rate was not different between
conditions after any set. However, RPE
was different between conditions five
times, and every time showed a higher
RPE in the placebo condition. Further,
the average RPE across all time points
was higher in the placebo condition
(p=0.020, effect size=0.28) than the
CHO mouth rinse condition. A line
graph showing the RPE after each set
is in Figure 3.
Interpretation
These results show that mouth rinsing
for 10 seconds with a CHO solution can
meaningfully improve session volume,
possibly leading to greater hypertrophy
61
 Figure 2 Comparison of Volume Performance Betwen Conditions

12000
PLA
(Sets * repetitions * load)

CHO
9000
Volume workload

6000

3000

0
Half Leg Chest Military Seated Total
Squat Press Press Press Row Workload

PLA = Placebo condition; CHO = Carbohydrate mouth rinse condition;

* = Significantly greater volume in carbohydrate mouth rinse condition

(and maybe strength) over time. How-
ever, the totality of data on CHO mouth
rinsing is mixed, with a 3-2 vote against
(including this study in the vote) a bene-
fit for resistance training performance in
recent studies. Let’s examine the mecha-
nism at play, then decipher the protocols
of the recent studies to help explain the
discrepancy in the literature.
Potential Mechanisms
Haff et al. (8) suggest that the chief
mechanism for CHO mouth rinsing
is increased blood glucose, which can
acutely compensate for diminished gly-
cogen stores. Based on this mechanism,
it makes sense that endurance training
(glycogen depleting exercise) consis-
tently benefits from CHO rinsing. But
lifting weights doesn’t fully deplete gly-
cogen (9), which also explains the con-
flicting results for resistance training.
In a low-rep session or even a high-rep
but short duration session of only a few
exercises and sets, depleting glyco-
gen isn’t a concern, so a CHO mouth
rinse might not be a good supplement
candidate. Consistent with this theo-

62
 Figure 3 RPE in Both Conditions After Every Set

10

8
RPE (CR-10)

5
PLA

4 CHO

0
HS 1 HS 2 HS 3 LP 1 LP 2 LP 3 BP 1 BP 2 BP 3 MP 1 MP 2 MP 3 SR 1 SR 2 SR 3

RPE = Rating of perceived exertion; HS = Half-Squat; LP = Leg Press; BP = Bench Press; MP = Military Press; SR = Seated Row; PLA = Placebo
condition; CHO = Carbohydrate mouth rinse condition; * = Significantly greater RPE in placebo condition

ry, Painelli et al. showed that a CHO benefit from the mechanism of spar-
mouth rinse before every set when ing glycogen. Carter et al. proposed an
testing six sets to failure at 70% of alternative mechanism: CHO rinsing
1RM did not increase reps performed activates various brain regions to an
(5). Although the protocol in Painelli’s elevated extent (10), specifically acti-
study involved performing more reps vating dopaminergic pathways which
per set than the present study (most are associated with arousal (11). These
can do more than a 10RM at 70%), pathways may also counteract fa-
they used the mouth rinse before each tigue, which would suggest benefits in
set and did six sets of an exercise. Also, long-duration as opposed to short-du-
the protocol had a total duration of ration protocols. However, a just-pub-
only 20 minutes, which makes it un- lished study from Black et al. (12) had
likely that the mechanism of increased subjects perform a muscle endurance
blood glucose would matter. test, then use a CHO rinse, and then
In the present study, I’m not entirely test max strength and percentage of
sold that the primary proposed mech- voluntary action (a measure of cen-
anism of increased blood glucose ac- tral drive) and showed that the CHO
counts for the benefits. Although the rinse did not attenuate the decline in
present protocol had subjects perform central drive or strength, thus calling
three sets to failure on five exercises Carter’s mechanism into question as
over 50 minutes, that still shouldn’t well. We can’t know for sure which
mechanism is primarily driving this

63
response, but either way, the benefits
of CHO mouth rinsing for resistance
training seem to be limited to longer
duration sessions (>45 min) or very
IN A LOW-REP SESSION OR
high rep (>20) protocols. In support EVEN A HIGH-REP BUT SHORT
of the duration argument, Dunkin and
Phillips observed that CHO mouth DURATION SESSION OF ONLY
rinsing did not increase performance
in a short training session that consist- A FEW EXERCISES AND SETS,
ed of just a 1RM bench press and max
reps at 40% of 1RM versus a control DEPLETING GLYCOGEN ISN’T
condition. Also, another recent study
from Clarke et al. in 2015 showed that A CONCERN, SO A CHO MOUTH
a CHO mouth rinse did not improve
bench press 1RM or one set of reps
RINSE MIGHT NOT BE A GOOD
to failure at 60% of 1RM (7). The one
other recent study, by Bazzuchi et al.
SUPPLEMENT CANDIDATE.
(2017), showed that mouth rinsing be-
fore five sets of 30 reps of biceps curls
mouth rinsing for lifting, although
on a dynamometer (isokinetic contrac-
evidence supports its efficacy for en-
tion) resulted in greater maintenance
durance exercise. To confirm this no-
of force production than a control
tion, Peart (2017) calculated an effect
condition, thus leading to greater total
size of -0.09 for rinsing on lifting
work (4). Ultimately, it seems that the
performance and a 0.20 effect size
best argument to explain the benefit
(small but meaningful) for rinsing to
of rinsing in the present study is that
help long-duration endurance exer-
the participants performed 15 total
cise (3). If you’re looking to improve
sets over 50 total minutes of training.
volume capabilities, caffeine is the go-
A summary of the recent studies test-
to. Caffeine may even enhance 1RM
ing the effects of a CHO mouth rinse
strength (13), which would be an un-
on volume performance is in Table 2.
likely outcome for mouth rinsing (see
Note: The study from Black et al. men-
Table 2 – rinsing doesn’t have a hit in
tioned above is not included in the table
three at-bats for 1RM improvement).
as it tested maximum force output and
For volume performance, I would put
not volume performance.
mouth rinsing in the same category as
Based upon the totality of the data, Eric’s article on capsaicin: I need to
it’s difficult to recommend CHO see more. However, to counter my pes-

64
 Table 2 Summary of Recent Studies on CHO Mouth Rinse

Improvement for CHO

Study Rinse Protocol Training Protocol Duration of Session Mouth Rinse

Decimoni et al. 6g malto rinse or 3 x Max Reps @ 10RM 50 minutes Yes

2018 (1) placebo before on 5 compound
(Present Study) and during training exercises

6g maltodextrin 1RM test and 6 sets to 20 minutes No

Painelli et al.
rinse or placebo failure @ 70% of 1RM
2011 (5)
before every set on bench press

18% CHO 1RM test and 6 sets to 20-30 minutes No

Dunkin & Phillips
solution before failure @ 40% of 1RM
2017 (6)
both tests on bench press

6g maltodextrin 1RM test and 1 set to 20-30 minutes No

Clarke et al.
rinse prior to failure @ 60% of 1RM
2015 (7)
training on bench press

6g maltodextrin 3 x 30 isokinetic contractions 20 minutes Yes

Bazzuchi et al.
rinse or placebo of the biceps; force output
2017 (4)
prior to training measured during each

Summary of recent studies on CHO (carbohydrate) mouth rinse and resistance training volume performance in a single
session. The studies (including the present one) show a 3-2 vote against its efficacy. 1RM = One-Repetition Maximum.

simism, using a CHO mouth rinse is
easy to do, as a 6% maltodextrin con-
centration can be found in most sports
drinks. So, if you have a Gatorade or
Powerade at home and want to give it
a shot, why not try? It’s a very low risk,
low cost intervention, and you can
evaluate your personal response to it.
Next Steps
As with any acute study, it would be
nice to see long-term data: at least a
six-week study with one group CHO
rinsing before and during each train-
ing session, and another group using
a placebo rinse. The key in this long-
term study would be having each day
set up to test volume. For example, if
two training sessions per week were
used, training session one could be 3 X
Max Reps at 70% of 1RM, and train-
ing session two could be 4 X Max Reps
at 80% of 1RM. This design would test
volume capabilities frequently enough
that if the CHO rinse does indeed
produce more volume, it should lead
to greater hypertrophy and possibly
strength (although that design is a lit-
tle bit better suited for hypertrophy).
To test strength, I would set up each
day something like this: In session one,
work up to three sets of a 12RM, and in
session two, work up to three sets of an

65
 APPLICATION AND TAKEAWAYS
1. CHO mouth rinsing did not significantly increase volume in any individual lift, but
when volume in all five lifts performed was added together, total session volume
was 12% higher in the CHO mouth rinse condition.
2. The benefits of the mouth rinse in this study are at odds with other recent research
on rinsing and volume performance; however, this study used the longest duration
training session (five exercises and 15 sets total) to date. To realize the benefits
of mouth rinsing, it seems that a long and demanding high-rep session may be
necessary.
3. Practically, CHO mouth rinsing can be accomplished with a sports drink. The
recommended protocol is to rinse 6g of maltodextrin (probably in a 100mL solution)
for 10 seconds and then spit it out. This should be done immediately prior to
training and perhaps midway through the training session.

8RM. In the latter design, if the CHO

rinse works, the lifter would be using a
heavier load to hit the prescribed RM,
thus a heavier load used twice a week
for six weeks should translate to great-
er strength than a placebo rinse.

66
References
1. Decimoni LS, Curty VM, Almeida L, Koch AJ, Willardson JM, Machado M. Carbohydrate mouth
rinsing improves resistance training session performance. International Journal of Sports Science &
Coaching. 2018 Jan 25:1747954118755640.
2. Saunders B, Elliott-Sale K, Artioli GG, Swinton PA, Dolan E, Roschel H, Sale C, Gualano B.
β-alanine supplementation to improve exercise capacity and performance: a systematic review and
meta-analysis. Br J Sports Med. 2016 Oct 18:bjsports-2016.
3. Peart DJ. Quantifying the effect of carbohydrate mouth rinsing on exercise performance. The Journal
of Strength & Conditioning Research. 2017 Jun 1;31(6):1737-43.
4. Bazzucchi I, Patrizio F, Felici F, Nicolò A, Sacchetti M. Carbohydrate Mouth Rinsing: Improved
Neuromuscular Performance During Isokinetic Fatiguing Exercise. International journal of sports
physiology and performance. 2017 Sep;12(8):1031-8.
5. Painelli VS, Roschel H, Gualano B, Del-Favero S, Benatti FB, Ugrinowitsch C, Tricoli V, Lancha
AH. The effect of carbohydrate mouth rinse on maximal strength and strength endurance. European
journal of applied physiology. 2011 Sep 1;111(9):2381-6.
6. Dunkin JE, Phillips SM. The Effect of a Carbohydrate Mouth Rinse on Upper-Body Muscular
Strength and Endurance. The Journal of Strength & Conditioning Research. 2017 Jul 1;31(7):1948-
53.
7. Clarke ND, Kornilios E, Richardson DL. Carbohydrate and caffeine mouth rinses do not affect
maximum strength and muscular endurance performance. The Journal of Strength & Conditioning
Research. 2015 Oct 1;29(10):2926-31.
8. Haff GG, Lehmkuhl MJ, Mccoy LB, Stone MH. Carbohydrate supplementation and resistance
training. The Journal of Strength & Conditioning Research. 2003 Feb 1;17(1):187-96.
9. Knuiman P, Hopman MT, Mensink M. Glycogen availability and skeletal muscle adaptations with
endurance and resistance exercise. Nutrition & metabolism. 2015 Dec;12(1):59.
10. Carter JM, Jeukendrup AE, Jones DA. The effect of carbohydrate mouth rinse on 1-h cycle time trial
performance. Medicine and science in sports and exercise. 2004 Dec;36(12):2107-11.
11. Berridge KC, Robinson TE. What is the role of dopamine in reward: hedonic impact, reward learn-
ing, or incentive salience? Brain research reviews. 1998 Dec 1;28(3):309-69.
12. Black CD, Schubert DJ, Szczyglowski MK, Wren JD. Carbohydrate Mouth Rinsing Does Not
Prevent the Decline in Maximal Strength Following Fatiguing Exercise. Journal of strength and
conditioning research. 2018 Jan.
13. Grgic J, Trexler ET, Lazinica B, Pedisic Z. Effects of caffeine intake on muscle strength and power: a
systematic review and meta-analysis. Journal of the International Society of Sports Nutrition. 2018
Dec;15(1):11.

67
 Study Reviewed: Pre-Exercise β-Hydroxy-β-Methylbutyrate Free-Acid
Supplementation Improves Work Capacity Recovery: A Randomized,
Double-Blinded, Placebo-Controlled Study. Correia et al. (2018)

HMB Free Acid:

An Objective Assessment
BY E RI C HE LMS

HMB free acid has been a source of controversy, as the validity of

the most well-known studies on it have been called into question.
However, new data from other research groups allows us to make a
more objective assessment of its efficacy.

68
 KEY POINTS
1. Twenty-three resistance-trained male athletes took part in a double-blind acute
parallel group study comparing the effects of 3g of HMB free acid against a
placebo on muscle swelling, counter-movement jump performance, maximal
voluntary isometric torque, and work capacity after a highly damaging drop-jump
session.
2. While the majority of variables were not significantly different between groups
over the testing period, work capacity returned to baseline after 24 hours in the
HMB group, while it was still suppressed at 72 hours in the placebo group.
3. While startling performance and body composition outcomes were reported in
some studies on HMB free acid, the legitimacy of these specific studies has been
questioned. However, data from other groups collectively suggests HMB may
reduce some of the negative effects of exercise-induced muscle damage, so it
could be useful when undergoing stressful training periods or for beginners who
experience large amounts of initial muscle damage.

A
metabolite of leucine – β-hy-
droxy-β-methylbutyrate
(HMB) – has been investigated
for over two decades as an ergogenic
aid for improving resistance training
performance and increasing lean body
mass via a reduction in muscle protein
breakdown (2). While the original
form of HMB investigated was a cal-
cium salt, in the last decade, a free-ac-
id form of HMB was found to be more
bioavailable and efficiently delivered to
tissue (3). Thus, in the present study, a
double-blind, placebo-controlled, par-
allel-group investigation was conduct-
ed to see if resistance trained males in
either a 3g single-dose HMB free-acid
group (n = 12; age 22.8 ± 3.0 years)
or a placebo group (PLA; n = 11; age
22.9 ± 3.1 years) experienced different
outcomes in muscle swelling, count-
er-movement jump performance,
maximal voluntary isometric torque,
or work capacity after a high volume
bout of drop jumps. While the major-
ity of variables were not significant-
ly different between groups over the
72-hour testing period, work capacity
was significantly higher in the HMB
group. Specifically, work capacity re-
turned to baseline after 24 hours in
the HMB group, while it was still sup-
pressed at 72 hours relative to baseline
in the placebo group. While the legiti-
macy of recent HMB free-acid studies
from a single research group report-
ing uncanny improvements in per-
formance and body composition have
been drawn into question, the find-
ings of the present study (along with
other recent research from different
research groups) suggests that HMB

69
 Table 1 Physical Characteristics and Training Status of Studied Individuals

HMB-FA PLA
(n=12) (n=11) p-value

Age (years) 22.75 ± 2.96 22.82 ± 3.09 0.957

Weight (kg) 81.17 ± 6.29 76.30 ± 7.28 0.100

Height (m) 1.82 ± 0.04 1.79 ± 0.02 0.085

BMI (kg/m2) 24.52 ± 1.98 23.85 ± 2.14 0.447

Knee extensor thickness (mm) 41.41 ± 5.41 41.25 ± 6.45 0.950

CMJ (cm) 40.64 ± 7.51 42.30 ± 4.86 0.539

Peak Torque (N.m) 319.55 ± 37.97 293.97 ± 47.87 0.169

Work capacity (J) 5378.66 ± 366.57 5346.75 ± 525.79 0.867

Training Experience (years) 3.38 ± 1.49 3.86 ± 2.77 0.600

Training Frequency (days/weeks) 4.33 ± 0.98 4.91 ± 0.94 0.168

Training Duration (min/day) 62.08 ± 18.52 59.09 ± 17.72 0.697

BMI = body mass index; CMJ = counter-movement jump

free acid may indeed be useful. While

these outcomes are much more modest Purpose and Research
compared to the extraordinary results Questions
reported in the aforementioned stud-
ies in question, HMB free acid could Purpose
plausibly be useful when performing The purpose of this study was to inves-
highly damaging training (overreach- tigate the effects of a single-dose supple-
ing), or in beginners who experience mentation of HMB free acid on muscle
high levels of muscle damage after ini- recovery after a high-intensity exercise
tiating resistance training. bout.

70
 Figure 1 Testing Protocol
Measure
Muscle Swelling
CMJ
MVIT
WC
HMB-FA 60 min
or
Placebo
HMB-FA = HMB free acid; CMJ = counter-movement jump; MVIT = maximum voluntary isometric torque; WC = work capacity
Hypothesis
The authors pointed out that in some
studies, divergent findings are report-
ed when supplementing with a single
3g dose or three divided doses of 1g of
HMB. They also acknowledged the re-
cent controversy surrounding the legit-
imacy (4) of the studies published by
Wilson and Lowery (5, 6). Based on
these comments, I think the authors
went into this study without expecta-
tions given the novelty of HMB free
acid itself, a lack of consensus on an ap-
propriate dosing protocol, and a lack of
trustworthy data on this compound.
Subjects and Methods
Subjects, Study Design, and Experimen-
tal Protocol
Twenty-three healthy, trained male
athletes (18 to 30 years of age) involved
in competitive sports (rugby, swimming,
cycling, or basketball) who had been
Induce 24 hrs 24 hrs 24 hrs
muscle
damage
participating in strength training for
at least one year were recruited for this
study (Table 1). A randomized, dou-
ble-blinded, placebo-controlled study
was conducted with two separate groups,
with each group receiving only one form
of treatment. A single 3g dose of HMB
free acid or a non-distinguishable place-
bo was given to participants 60 minutes
prior to drop-jump training. Volunteers
came to the lab and were assessed for
strength, work capacity, muscle swelling,
and counter-movement jump perfor-
mance at baseline prior to supplemen-
tation, immediately after the drop-jump
training protocol, and then at 24, 48, and
72 hours post-training (Figure 1).
Performance and Muscle Swelling As-
sessment and Standardization
Lower body strength was assessed via
isometric knee extension peak torque,
and lower body work capacity was as-
sessed with 30 maximal isokinetic knee
extensions at 120º/s. Specifically, work
71
 Table 2 Muscle Swelling, CMJ and MVIT on both groups and all time-points

Variables (mean ± SD) HMB-FA (n=12) PLA (n=11)

Muscle Swelling (mm)

Pre 41.41 ± 5.41 41.25 ± 6.45
Post 49.41 ± 6.21* 48.52 ± 8.50*

24 hours 42.48 ± 5.61 43.06 ± 7.25

48 hours 42.79 ± 5.28 42.53 ± 6.20

72 hours 42.56 ± 4.86 42.45 ± 6.53

CMJ (cm)
Pre 40.64 ± 7.51 42.30 ± 4.86

Post 36.60 ± 8.87* 39.91 ± 4.27*

24 hours 39.35 ± 6.72 39.45 ± 4.24

48 hours 39.85 ± 7.21 39.80 ± 4.69

72 hours 41.52 ± 7.14 41.00 ± 4.22

MVIT (N.m)

Pre 319.55 ± 37.97 293.97 ± 47.87

Post 254.66 ± 59.89* 232.42 ± 39.03*

24 hours 300.43 ± 38.71 266.60 ± 53.02

48 hours 305.14 ± 39.28 282.94 ± 65.67

72 hours 310.37 ± 39.54 280.89 ± 56.60

CMJ = Counter-movement jump; MVIT = maximal voluntary isometric

torque
* = p < 0.05, significantly different from pre-exercise values

capacity was calculated as the total Exercise-Induced Muscle Damage Protocol

torque produced over all 30 repetitions.
Counter-movement jump performance
was assessed via jump height, and ultra-
sound was used to assess acute changes in
muscle thickness of the quadriceps. Time
of day was standardized, and a sports nu-
tritionist experienced in food recall pro-
cedures ensured within-participant diets
were maintained over the four days the
study was conducted.
The volunteers performed seven sets
of 20 drop jumps from a 60cm box with
two-minute rest intervals between sets.
Participants received verbal encourage-
ment to exert maximal effort during each
rep, which – on average – took five sec-
onds to perform. With rest times, the full
protocol took 24 minutes to complete on
average.

72
 Figure 2 Time Course of Work Capacity Changes
7000
6000
5000
WC (J)
4000
3000
2000
Pre Post
WC = work capacity; HMB-FA = HMB free acid; PLA = placebo
* = Significantly different from baseline (p<0.05); # = Significantly different from HMB-FA (p<0.05)
Findings
As shown in Table 2, isometric peak
torque and counter-movement jump
performance were similarly depressed in
both groups and followed a similar time
course. Likewise, muscle swelling in-
creased in both groups to a comparable
degree and followed a similar pattern of
change over 72 hours (Table 2). Howev-
er, while work capacity was initially sup-
pressed in both groups to a similar degree
(p < 0.01), it returned to baseline after
24 hours in the HMB free-acid group,
while the placebo group’s work capacity
remained suppressed for the length of
the study, resulting in significantly lower
values compared to the HMB group at
HMB-FA
PLA
# # #
24hr 48hr 72 hr
24 (p = 0.039), 48 (p = 0.021), and 72
hours (p = 0.048) post-training.
Interpretation
Before I can dive into the findings of
the present study, we have to take a walk
down HMB-memory lane. Research on
HMB is not new, as the first study on
performance in humans was conducted
in 1996 (2). In it, the authors reported
promising results for both resistance
training performance and body compo-
sition changes in untrained individuals.
As further studies came out on HMB
over the next few years, positive data
mounted. In fact, in a meta-analysis of
studies conducted up to 2001 on the ef-
73
fects of dietary supplements on muscle
and strength gain, it was concluded that
among all the supplements assessed, only
HMB and creatine produced significant
changes (7). However, as more research
was conducted on trained individuals,
the findings became less impressive. In-
deed, a 2009 meta-analysis reported that
while small positive effects for strength
in untrained lifters supplementing with
HMB were found, trained lifters gained
no such benefits, and only trivial chang-
es in body composition were found, re-
gardless of training experience (8).
While research regarding the clinical
uses for HMB in muscle-wasting condi-
tions continued, sports performance re-
search waned after this point. However,
in 2011, Fuller and colleagues reported
that a free-acid gel capsule form of HMB
resulted in nearly two-fold greater plas-
ma concentrations and a 25% improved
clearance rate of HMB from plasma,
compared to the traditional calcium salt
form of HMB (9). This spurred a resur-
gence of interest in HMB (in free-acid
form) for performance and body com-
position changes, eventually resulting
in the first published studies on well-
trained lifters using HMB to report not
only positive, but incredible increases in
strength and muscle mass with concur-
rent reductions in body fat (5, 6). Specif-
ically, the results in fat loss, muscle gain,
and strength gain in trained lifters us-
ing HMB free acid were not only much
greater than found in the placebo group
IT MAY BE THAT HMB
FREE ACID COULD PROVE
PLAUSIBLY USEFUL IN
TRAINED LIFTERS WHEN
PERFORMING TRAINING THAT
INDUCES LARGE AMOUNTS
OF MUSCLE DAMAGE.
and in previous research on trained lift-
ers using HMB, but as written about by
Greg here, greater than even the gains
observed in studies on anabolic steroids.
This outcome alone prompted some to
dismiss the results as fraudulent on so-
cial media and led others to point out
that these studies were funded by a sup-
plement company producing and selling
HMB free acid. However, while online
gossip and claims of funding influence
only carry so much weight (indeed, as-
suming all studies funded by a company
are fraudulent is a mistake), in response
to these uncanny findings, three inde-
pendent letters to the editor were writ-
ten regarding these studies by promi-
nent researchers in the sports science
community.
The first was written due to the incon-
gruity with previously published data
74
on HMB, the incredible magnitude of
changes, and a lack of a plausible mech-
anism for these changes (10). The sec-
ond (for transparency’s sake, I was one
of the 17 authors) was written due to the
remarkably consistent between‐group
changes and the surprisingly small gains
in strength and muscle mass observed in
the placebo group despite, according to
the authors’ response to the initial letter
to the editor, receiving optimal nutrition
and training and being selected from
“…a responsive population who pos-
sess a quantity of lean mass indicative
of previous responses to resistance train-
ing…” (11). Finally, the most recent let-
ter to the editor pointed to inconsisten-
cies with the data collection procedures
and recruitment that did not match the
protocols recorded at clinicaltrials.gov
(specifically, the same control group was
used across multiple studies yet was re-
ported differently in each), and it also
questioned how the means and standard
deviations reported could be so remark-
ably homogeneous (4), of which the like-
lihood is a near statistical impossibility.
All told, there was a great deal of skep-
ticism in both the scientific community
and the broader “evidence-based” fitness
community regarding the legitimacy
these studies (5, 6).
In my opinion, the letters to the ed-
itor and social media skepticism were
appropriate and a good thing to pro-
vide realistic clarity into this line of re-
search. However, this doesn’t mean that
HMB free acid is a useless compound
(a conclusion I saw many people jump
to). Rather, we are just back to square
one; we know HMB in its calcium form
might be nominally useful in cases where
large amounts of muscle protein break-
down are present (damaging protocols,
new lifters), and we know the free-acid
form is likely superior. However, what
we were lacking (until recently) was new
data published by other research groups.
Today, the story hasn’t changed much
in terms of the broad picture of HMB.
This compound still has a plausible role
as “an anti-catabolic agent” because it
primarily exerts a physiological effect by
reducing muscle protein breakdown, in
turn potentially having an overall effect
of making muscle protein turnover pos-
itive. In the present study, this might be
why work capacity and strength were im-
pacted differently by supplementation. If
you recall from a previous MASS review
by Mike, after a high-volume, damaging
session, strength recovers faster than vol-
ume capacity, indicating that an attenu-
ation of muscle damage (such as could
be caused by HMB) might produce a
more measurable effect on your ability to
perform volume, as was observed in the
present study. With that said, I think in
the vast majority of cases, you truly have
to “create” a situation where there is an
abnormal amount of muscle damage for
HMB to be useful (such as in the case of
the present study). In most cases, normal
or even hard phases of resistance train-
75
 APPLICATION AND TAKEAWAYS
1. Trained lifters following normal yet progressive resistance training protocols will
likely not benefit from taking HMB in calcium form. It is unknown at this point
whether HMB in its free-acid form would prove beneficial, although based on the
two forms sharing the same mechanism of action, it is unlikely the free-acid form
would be any better.
2. Untrained lifters might see better gains in strength or muscle mass while
supplementing with 3g of HMB in calcium or free-acid form during the first 1-3
months of resistance training, as it would likely dampen the negative effects of
excess muscle damage.
3. While further research is required to assess the specific efficacy of HMB free acid,
trained lifters taking 3g of HMB free acid prior to lifting could possibly make better
gains during overreaching periods of high-volume, high-RPE training, or during the
first 1-2 weeks after an extended layoff from lifting.

ing in trained lifters probably won’t cut it.
In support of this, in a recently published
meta-analysis on body composition and
strength changes in competitive athletes
and resistance-trained participants using
HMB, it was concluded that there are
no significant benefits from HMB sup-
plementation (12). However, the studies
reviewed in this meta-analysis did not
include any using the free-acid form. As
was seen in the present study, it may be
that HMB free acid could prove plausibly
useful in trained lifters when perform-
ing training that induces large amounts
of muscle damage. Likewise, given that
muscle damage is preferentially repaired
before muscle gain is initiated (as I wrote
about here), and since new lifters expe-
rience large amounts of muscle damage
having not yet undergone the repeated
bout effect, HMB might also prove use-
ful in the initial months of first undertak-
ing resistance training or when returning
from a long layoff.
Next Steps
This is an acute study on performance
recovery from drop jumps. The next step
would be to conduct a longitudinal study
on resistance training overreaching to see
if the ability to maintain greater work ca-
pacity carried over to this mode of train-
ing and/or led to greater gains in perfor-
mance or hypertrophy in the long run.
Given this is also a study only on males,
it would be great to see a study on or in-
cluding females, as some studies have re-
ported differences in stretch-shortening
cycle properties between the sexes.

76
References
1. Correia, A.L.M., et al., Pre-exercise beta-hydroxy-beta-methylbutyrate free-acid supplementation
improves work capacity recovery: a randomized, double-blinded, placebo-controlled study. Appl
Physiol Nutr Metab, 2018.
2. Nissen, S., et al., Effect of leucine metabolite β-hydroxy-β-methylbutyrate on muscle metabolism
during resistance-exercise training. Journal of Applied Physiology, 1996. 81(5): p. 2095-2104.
3. Fuller, J.C., et al., Comparison of availability and plasma clearance rates of beta-hydroxy-beta-meth-
ylbutyrate delivery in the free acid and calcium salt forms. Br J Nutr, 2015. 114(9): p. 1403-9.
4. Gentles, J.A. and S.M. Phillips, Discrepancies in publications related to HMB-FA and ATP supple-
mentation. Nutr Metab (Lond), 2017. 14: p. 42.
5. Wilson, J.M., et al., The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate free acid supple-
mentation on muscle mass, strength, and power in resistance-trained individuals: a randomized,
double-blind, placebo-controlled study. Eur J Appl Physiol, 2014. 114(6): p. 1217-27.
6. Lowery, R.P., et al., Interaction of Beta-Hydroxy-Beta-Methylbutyrate Free Acid and Adenosine
Triphosphate on Muscle Mass, Strength, and Power in Resistance Trained Individuals. J Strength
Cond Res, 2016. 30(7): p. 1843-54.
7. Nissen, S.L. and R.L. Sharp, Effect of dietary supplements on lean mass and strength gains with
resistance exercise: a meta-analysis. J Appl Physiol (1985), 2003. 94(2): p. 651-9.
8. Rowlands, D.S. and J.S. Thomson, Effects of beta-hydroxy-beta-methylbutyrate supplementation
during resistance training on strength, body composition, and muscle damage in trained and un-
trained young men: a meta-analysis. J Strength Cond Res, 2009. 23(3): p. 836-46.
9. Fuller, J.C., Jr., et al., Free acid gel form of beta-hydroxy-beta-methylbutyrate (HMB) improves
HMB clearance from plasma in human subjects compared with the calcium HMB salt. Br J Nutr,
2011. 105(3): p. 367-72.
10. Hyde, P.N., K.L. Kendall, and R.A. LaFountain, Interaction of Beta-Hydroxy-Beta-Methylbutyrate
Free Acid and Adenosine Triphosphate on Muscle Mass, Strength, and Power in Resistance-Trained
Individuals. The Journal of Strength & Conditioning Research, 2016. 30(10): p. e10-e11.
11. Phillips, S.M., et al., Changes in Body Composition and Performance With Supplemental HMB‐
FA+ATP. The Journal of Strength & Conditioning Research, 2017. 31(5): p. e71-e72.
12. Sanchez-Martinez, J., et al., Effects of beta-hydroxy-beta-methylbutyrate supplementation on
strength and body composition in trained and competitive athletes: A meta-analysis of randomized
controlled trials. Journal of Science and Medicine in Sport, 2017.

77
Accentuated-Eccentric Loading for
Hypertrophy, Strength, and Power:
A Concept Review
BY C ALE B BAZYLE R

You can handle more weight on the eccentric than you can on the
concentric portion of a movement. So, does adding more weight
to only the eccentric portion enhance strength? This concept
review takes a look.

78
 KEY POINTS
1. Accentuated-eccentric loading (AEL) training does not appear to improve whole
muscle hypertrophy or maximal strength (1RM) to a greater extent than traditional
resistance training in strength-trained individuals.
2. There is evidence that AEL jump training can chronically enhance vertical jump
performance; however, it is unknown whether it is superior to traditional loaded jump
training.
3. In addition to the paucity of supporting evidence, many researched AEL training
methods are currently impractical for strength athletes to implement in their programs.
4. Based on the current evidence, we cannot unequivocally recommend AEL training
as superior to traditional resistance training for hypertrophy, strength, or power in
strength athletes.

I
am sure many of you have seen guys
like Mike Tuchscherer squat heavy
singles with weight releasers or seen
athletes dropping dumbbells before
performing a box jump. However, does
that mean this training method is effec-
tive for improving maximal strength or
jumping performance? Also, what ex-
actly is accentuated eccentric loading
(AEL)? And, why would you even train
using AEL to begin with? Does it pro-
mote greater hypertrophy, strength, and
power than traditional resistance train-
ing? These are some of the questions
that we aim to address in this concept
review. Unfortunately, there is limited
research investigating AEL for hyper-
trophy, strength, and power in strength-
trained subjects. Similar to other train-
ing studies, we are hard-pressed to find
AEL research using strength athletes
or at least strong subjects (squat greater
than two times body mass) (1); howev-
er, we will discuss these study findings,
limitations, future directions, and distill
practical applications for strength ath-
letes. Thus, our purpose is to provide a
conceptual review of the AEL literature

Guest Reviewer: Caleb Bazyler, Ph.D.

Dr. Bazyler earned his PhD in sport physiology and performance at East Tennessee State University
where he is now an Assistant Professor in the Department of Sport, Exercise, Recreation, and
Kinesiology. He has worked as a strength and conditioning coach over the past eight years with
various sports including powerlifting, weightlifting, tennis, soccer, volleyball, basketball, softball,
and track and field. He is a Certified Strength and Conditioning Specialist through the NSCA, and
has published and presented on strength training for athletic performance, peaking for competition,
and single-case research in high level athletes. His current research, funded by ETSU and the NSCA,
examines the time course of peaking for weightlifting competitions, and uses mass spectroscopy to
identify key muscle signaling proteins modified following different strength training interventions.

79
by addressing hypertrophy, strength,
and power adaptations compared to
traditional resistance training, and
then give practical recommendations
for strength athletes.
Section 1: Rationale,
Definitions, and Types
of AEL
Rationale
It is well-established that eccentric
strength can be as much as 50% great-
er than concentric strength (Figure 1)
(2). Considering that traditional resis-
tance training typically uses isoinertial
loads (same external resistance during
concentric and eccentric muscle ac-
tions), eccentric muscle actions are be-
ing relatively underloaded compared
to concentric muscle actions. Further, it
has been shown that eccentric strength
plays an important role in many sport-
ing tasks involving the stretch-short-
ening cycle (sprinting, jumping, squat-
ting), partly through its influence on
the subsequent force generated during
the concentric muscle action. Thus,
AEL was designed to more optimally
develop eccentric strength by providing
a relatively greater overload stimulus
during the eccentric phase followed by
a reduced load during the concentric
phase.
What’s a concept review?
A written concept review is similar
to our signature video reviews. The
aim of this article type is to review a
cornerstone topic in physiology or
applied science research.
Definition
In a recent review published from
our sports science lab at East Tennes-
see State University, Wagle et al. (3)
defined AEL as a “prescribed eccentric
load magnitude in excess of the concen-
tric prescription using movements that
require coupled eccentric and concen-
tric actions, with minimal interruption
to natural mechanics.”
Types
This brings us to the two primary types
of AEL implemented in training stud-
ies: 1) supramaximal and 2) submaxi-
mal eccentric loading. Supramaximal
loading uses an eccentric load greater
than or equal to concentric 1RM and
generally has been used as a method for
enhancing maximal strength. Submaxi-
mal AEL uses eccentric loads less than
concentric 1RM and generally has been
used to improve performance during a
ballistic task such as vertical jumping.
Studies have used different means to
apply AEL including weight releas-
ers, computer-driven load adjustments,
elastic bands, flywheel resistance, and
80
 Figure 1 Eccentric and Concentric Torque-Velocity Curve

Torque (N·m)
Flexors
120

Extensors
Isometric
60

30
Eccentric Concentric

-360 -180 0 180 360

Joint Angular Velocity ( ˚/s)

This figure depicts the torque-joint angular velocity relationship for

eccentric, isometric, and concentric actions of extensor and flexor muscles.

manual adjustments by study assistants.

It is important to note that some litera-
ture has focused on the acute effects of
AEL on metabolic/hormonal markers,
maximal strength, and ballistic perfor-
mance. While some of these studies are
briefly discussed, we will focus most of
our attention on hypertrophy, strength,
and power adaptations to chronic AEL
training.
Section 2: AEL for
Hypertrophy
Before we dive into whether AEL
enhances muscle hypertrophy, let’s first
discuss how hypertrophy is commonly
measured. Hypertrophy resulting from
training has been commonly quantified
using girth measurements, ultrasound,
magnetic resonance imaging (MRI),

81
 Figure 2a Whole Muscle Cross-Sectional
Area of the Vastus Lateralis via Ultrasonography

This figure depicts the vastus lateralis muscle cross-sectional area

measured at ½ of the femur length from a male weightlifter.

and sizing of single muscle fibers. Girth
measurements, such as thigh circum-
ference, may be useful in field settings,
but are not considered a valid measure
of whole muscle hypertrophy because
it is possible that other factors (e.g. fat,
connective tissue, and swelling) could
contribute to changes in the measure-
ment (4). MRI is considered the “gold
standard” for assessing hypertrophy (5).
MRI can provide precise measures of a
muscle’s cross-sectional area along its
full length and can also be used to de-
termine muscle volume. However, it’s
time-consuming, expensive, and requires
technical expertise. Ultrasonography, on
the other hand, is less time-consuming
and can provide information regarding
muscle architecture in addition to ana-
tomical cross-sectional area (Figure 2A).
When CSA is measured at multiple
sites along a muscle’s length, it provides
a valid means for assessing whole mus-
cle hypertrophy following training (5).
Lastly, hypertrophy can be assessed in
vitro from a muscle biopsy by determin-

82
 Figure 2b Single Fiber Cross-Sectional Area from the
Vastus Lateralis via Immunohistochemistry

This figure depicts the vastus lateralis muscle cross-sectional area measured at ½
of the femur length from a male weightlifter. Courtesy of Dr. Kevin Carroll.

ing the CSA of individual muscle fiber
types (Type I-slow, IIa-fast, IIx-faster)
using immunohistochemistry (Figure
2B) (6). Now that you know how hyper-
trophy is commonly measured, let’s talk
about how AEL may affect it.
It has been suggested that eccentric
actions have a greater contribution to
hypertrophy than concentric or isomet-
ric actions due to greater muscle dam-
age-associated increases in protein syn-
thesis and intracellular anabolic signaling
(7). A recent meta-analysis, which com-
bined the effects from 15 studies, found
no significant difference in hypertrophic
changes following eccentric or con-
centric training. However, there was a
small practical difference with eccentric
training resulting in a 10% increase in
hypertrophy, compared to 6.8% follow-
ing concentric training (8). It should be
noted that many of the studies included
in the analysis used isokinetic devices
in training, which do not replicate the
training strength athletes do in the gym.
Nonetheless, it may be possible that
training with a greater relative eccentric
load could result in greater hypertrophy
than traditional resistance training.
To test this, Brandenburg and Do-

83
 Figure 3 Whole Muscle Hypertrophic Response to AEL vs. Traditional Resistance Training

CON/ECC+ CON/ECC

140
p < 0.001 p < 0.001
120
CSA [cm2]

100

80

60

pre post pre post

This figure depicts changes in whole muscle cross-sectional area of the vastus lateralis (via MRI)
before and after six weeks of accentuated eccentric loaded (CON/ECC+) or isoinertial (CON/ECC)
quadriceps strength training. Median values with the 5th, 25th, 75th and 95th percentiles are
shown. p<0.001 indicates a significant difference between pre- and post-measurements within
groups. There were no significant between-group differences.

cherty (9) assigned 18 strength-trained 3x6RM/10RM on leg press, knee exten-

men to an AEL or traditional strength
training group. The traditional group
trained 4x10 @75% of 1RM on preacher
curls and elbow extensions, whereas the
AEL group trained 3x10 @110-120%
of concentric 1RM for the eccentric
phase and 75% of 1RM for the concen-
tric phase, 2-3 times per week for nine
weeks. The traditional group performed
an additional set to equalize work be-
tween groups. MRI measurements did
not show significant hypertrophy of the
biceps and triceps in either group fol-
lowing training. In another study, Walk-
er et al. (10) divided 28 strength-trained
men into a control, traditional, or AEL
group. The traditional group trained
sions, and knee flexions twice per week
for 10 weeks. The AEL group trained
using the same exercises and set x rep
scheme, but with eccentric loads 40%
greater than the concentric loads. As a
result, work was not equated between
the two groups. Quadriceps CSA in-
creased in both groups following train-
ing with no difference between groups.
Taken together, these findings indicate
that AEL does not increase whole mus-
cle hypertrophy to a greater extent than
traditional strength training in trained
males. However, these studies only as-
sessed hypertrophy at the whole muscle
level. Friedmann-Bette et al. (11) had
25 male athletes complete either 6x8

84
traditional or 5x8 AEL knee extensions
using a computer-driven device three
times per week for six weeks. The AEL
eccentric loads were adjusted to ~1.9
times the concentric load in the AEL
group. Similar to the other studies, both
groups increased quadriceps CSA mea-
sured via MRI with no differences be-
tween groups (Figure 3). However, only
the AEL group significantly increased
Type IIx fiber CSA. Studies from this
lab have also found that AEL enhanc-
es factors involved in anabolic signaling
and anaerobic metabolism to a similar or
greater extent than traditional resistance
training (11, 12). Taken together, these
findings suggest that AEL induces a
shift toward a faster muscle phenotype,
but does not induce greater whole mus-
cle hypertrophy compared to traditional
resistance training.
In summary, the available research
does not support the use of AEL for
superior whole muscle hypertrophy. Its
effects seem to be similar to those of tra-
ditional resistance training. Considering
concentric and eccentric training can re-
sult in different patterns of hypertrophy
along the length of the muscle (eccentric
– more distal growth; concentric – more
mid-portion growth in the vastus lat-
eralis) (13), future studies should see if
AEL results in any regional differences
in hypertrophy compared to traditional
resistance training. Further, AEL may
preferentially increase Type IIx fiber hy-
pertrophy, but this finding still needs to
be replicated in future studies.
Section 3: AEL for
Maximal Strength
AEL has been purported to enhance
maximal strength both acutely and
chronically by facilitating the recruit-
ment of high threshold motor units,
greater motor unit discharge frequency
and voluntary activation, reduced reflex
inhibition, and an enhanced myotatic
(stretch) reflex. In support of this, Doan
and colleagues (14) found that using su-
pramaximal AEL loads (105% concen-
tric 1RM) acutely improved bench press
1RM by 5-15 lb in strength-trained
men. In contrast, Ojasto and Hakkinen
(15) observed significant acute decreases
in bench press 1RM using three differ-
ent supramaximal AEL loads (105, 110,
120% 1RM). In this study, subjects com-
pleted the initial 1RM and AEL + 1RM
tests in the same session, whereas Doan
et al. (14) allowed five days of rest be-
tween the initial 1RM test and the AEL
+ 1RM test, which may partly explain
the difference in findings. Although
using AEL to acutely potentiate 1RM
strength appears to have some merit, it is
important to consider the fatigue effects
that AEL has on concentric force pro-
duction. Currently, the optimal supra-
maximal eccentric load needed to elicit
the greatest acute improvement in 1RM
without undue fatigue is unknown.
In regard to the chronic effects of AEL
85
 Figure 4 Whole Muscle Hypertrophic Response to AEL vs. Traditional Resistance Training

500

400
Isometric Torque (nm)

TRAD
300

AEL
200
CON

100

0
Pre-Training Mid-Training Post-Training

This figure depicts changes in maximal knee extensor isometric torque production following 10 weeks of weeks of
isoinertial (TRAD) or accentuated eccentric loaded (AEL) strength training. CON-control group. *p<0.05 indicates
significant increases in maximal isometric torque from pre- to mid-training, and pre- to post-training in AEL and
TRAD; however, only AEL increased maximal isometric torque from mid- to post-training. There were no significant
between-group (AEL vs TRAD) differences.

training on maximal strength, the results
are equivocal. Godard and colleagues
(16) found no statistical difference in
the change in concentric knee extensor
strength between an AEL (120% eccen-
tric / 80% concentric 1RM) and tradi-
tional-loading group of untrained males
and females (80% 1RM) training two
days per week for 10 weeks. In one of
the few investigations that used exercis-
es more commonly incorporated in the
strength athlete’s programs, Yarrow and
colleagues (17) found similar increas-
es in back squat (22%) and bench press
(10%) 1RM in the AEL (100-121%
eccentric / ~49% concentric) and tradi-
tional resistance training (~75% 1RM)
groups. However, the AEL in the study
achieved similar results with a lower to-
tal volume-load. In the Walker et al. (10)
investigation mentioned earlier, maxi-
mal isometric force production increased
significantly over the control (self-se-
lected, unsupervised strength training)
in the AEL group (18% vs. 1%) but not
the traditional resistance training group
(11% vs. 1%) (Figure 4). The AEL group
continued to improve isometric force

86
from weeks 5 to 10, whereas the tradi-
tional group did not. Also, increases in
isometric force produced were accom-
panied by increased maximal voluntary
activation of the quadriceps (measured
using the interpolated twitch technique)
in the AEL group only. These findings,
along with the similar changes in mus-
cle hypertrophy between groups, suggest
the increases in isometric strength fol-
lowing AEL were primarily due to neu-
ral adaptations. In the only isoinertial
measure performed, there was no sig-
nificant difference in changes in 1RM
knee extension between AEL (31%) and
traditional resistance training groups
(36%) following the 10 weeks of train-
ing. It should also be noted that overall
work was greater in the AEL group, so
it is unknown whether similar improve-
ments in isometric strength (compared
to control) would have been observed
in the traditional group had their over-
all work been matched. Nonetheless,
the AEL group continued to improve
maximal isometric force throughout
the study and was able to sustain a sig-
nificant acute hormonal response to a
standardized training session, whereas
the traditional group was not (10, 18).
Therefore, it’s possible that AEL train-
ing may have produced superior increas-
es in 1RM strength compared to the
traditional group if the study were ex-
tended. However, this is speculative and
remains to be determined.
The results from these studies do not
conclusively support the use of AEL
training to chronically enhance maxi-
mal strength (1RM) over traditional re-
sistance training. Although it does not
appear that AEL training has a negative
effect compared to traditional resistance
training, the equipment needed, addi-
tional time demands, and personnel re-
quired currently limit the application of
AEL. Also, many of the training stud-
ies incorporate exercises not used in a
real-world setting (isokinetic devices)
or with poor transfer to athletic tasks
(knee extensions, bicep curls). Therefore,
further evidence is needed before rec-
ommending AEL be implemented in
training programs aimed at improving
maximal strength.
Section 4: AEL for
Power
Multiple studies have demonstrat-
ed the efficacy of submaximal AEL
to acutely potentiate performance
during ballistic tasks (counter-move-
ment jumps, drop jumps, bench press
throws). For example, Sheppard,
Newton, and McGuigan (19) had
national-level male volleyball play-
ers perform counter-movement block
jumps with and without an AEL load
(20kg, 10kg weight plates in each
hand). The athletes performed the ec-
centric phase of the jump with plates,
then released them before jumping.
The AEL load resulted in an acute in-
87
 Figure 5 Jumping Performance Response to AEL vs Bodyweight Jump Training

0.60

0.55
Displacement (m)

0.50

0.45

0.40

0.35
AEJ
BMJ
0.30
Pre-Test Post-Test

This figure depicts changes in vertical jump displacement following five weeks of
accentuated-eccentric loaded (AEJ) or body mass-only (BMJ) jump training. *p<0.05
indicates a significantly greater increase in vertical jump displacement in AEJ
compared to BMJ.

crease in jump height (4.3%) and peak
power (9.4%) compared to perform-
ing the jumps with body mass only.
Similarly, Bridgeman and colleagues
(20) found that drop jumps performed
with an AEL load equivalent to 20%
body mass produced significant acute
improvements in counter-movement
jump height and peak power. While
these acute studies indicate a poten-
tial for AEL to chronically enhance
ballistic performance, few studies have
directly addressed this.
In the previously mentioned study,
Friedmann-Bette (11) found signif-
icant improvements in squat jump
height (measured on a force platform)
in the AEL group only. The authors
attributed this to the increases in Type
IIx fiber hypertrophy and intracellu-
lar signaling related to muscle growth
and anaerobic metabolism in the AEL
group. In a follow-up investigation,
Sheppard and colleagues (21) divided
16 high-level male and female volley-
ball players into an AEL or body mass
counter-movement jump training
group that trained three days per week
for five weeks. Athletes in the AEL

88
 APPLICATION AND TAKEAWAYS
1. Current evidence does not support the use of AEL training as a superior method
for enhancing hypertrophy, strength, or power compared to traditional resistance
training, although it does not appear to have detrimental effects.
2. It is possible that AEL can induce preferential shifts toward a faster muscle fiber
phenotype; however, given the paucity of the data, more research is required before
this can be confidently concluded.
3. Strength athletes interested in incorporating AEL into their training should start
by taking a conservative approach and should progress based on their individual
responses.
Hypertrophy: Perform 1-2 sets of 8-10 reps with an eccentric to concentric load
ratio of 80%-85% / 60-65% 1RM
Maximal Strength: Perform 2-3 sets of 1-3 reps with an eccentric to concentric load
ratio of 105%-110% / 85%-90% 1RM
Power: Perform 2-3 sets of 3-5 reps of eccentric loaded jumps with dumbbells
totaling 10%-20% of your body mass

group performed counter-movement forming more jumping work. These

jumps with a 40kg (male) or 20kg
(female) eccentric load, which they
released before jumping. The AEL
group significantly improved count-
er-movement jump displacement
(11% vs. -2%), velocity (16% vs. -3%),
and power (20% vs. +1%) over the
body mass-only jump training group
(Figure 5). It is important to note that
these superior improvements were
achieved while both groups continued
their scheduled strength training and
volleyball practices. The only differ-
ence between the two groups was how
they trained counter-movement jumps
during their strength training sessions,
with the AEL group necessarily per-
findings demonstrate that AEL train-
ing enhances vertical jumping perfor-
mance over body mass jump training.
However, these studies do not address
whether AEL is superior to isoiner-
tial loaded (or matched work) vertical
jump training. Also, overloading plyo-
metric exercises should be considered
an advanced application of AEL be-
cause the athlete needs to have the
ability to transition quickly between
the eccentric and concentric phase
of a vertical jump. Thus, AEL jump
training can be recommended for
high-level athletes seeking to further
improve vertical jump performance.

89
Section 5: Conclusions paucity of supporting evidence, many
researched AEL training methods are
and Next Steps currently impractical for strength ath-
In summary, AEL training has been letes to implement in their programs.
promoted as a method for induc- Therefore, based on the current evi-
ing greater improvements in maximal dence, we cannot unequivocally rec-
strength, rate of force development, ommend AEL training as superior
vertical jump height, and power out- to traditional resistance training for
put compared to traditional resistance hypertrophy, strength, or power in
training. AEL is thought to provide strength athletes.
a superior training stimulus by using
a greater load during the eccentric
phase compared to traditional resis-
tance training. Despite its theoretical
basis, AEL training does not appear
to produce greater improvements in
whole muscle hypertrophy or maxi-
mal strength (1RM) than traditional
resistance training. Based on single fi-
ber adaptations and markers of muscle
growth and anaerobic metabolism, it
appears that AEL training promotes
a shift toward a faster muscle pheno-
type. In support of this, there is some
evidence that AEL jump training en-
hances vertical jumping performance;
however, it is unknown whether it is
superior to isoinertial loaded jump
training. Future investigations should
address whether training AEL jumps
are superior to isoinertial loaded
jumps for improving vertical jump
performance. Also, studies should in-
vestigate the efficacy of supramaxi-
mal AEL for maximal strength with
exercises more commonly used by
strength athletes. In addition to the

90
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92
Study Reviewed: Effect of Resistance Training Frequency on Gains in Muscular
Strength: A Systematic Review and Meta-Analysis. Grgic et al. (2018)

Training Frequency Should

Primarily Be Used As A Tool to
Increase Volume
BY G RE G NUC KO LS

A recent meta-analysis found that increased training frequencies led

to larger strength gains when higher frequency allows for higher
training volumes, but that frequency doesn’t independently enhance
strength gains when volume is controlled.

93
 KEY POINTS
1. Strength gains tend to increase as training frequency per muscle increases, from
1 to 4+ times per week.
2. In studies where volume was equated, increased training frequency didn’t seem
to enhance strength gains. This suggests that frequency isn’t a driver of strength
gains per se, but it can be used to enhance strength gains when used as a tool
for increasing volume.
3. Higher frequencies were associated with significantly faster rates of strength
gains for upper body strength but not lower body strength, for women but not
for men, and for younger adults but not for older adults, potentially suggesting
differences in recovery rates.

T
he role of training frequency in
promoting strength gains has been
debated throughout the history of
iron sports, from early traveling strongmen
practicing their feats daily, to bodybuild-
er-inspired powerlifters of the ‘70s and
‘80s often only training each lift once per
week, to the more recent pendulum-swing
back to higher frequencies.
We recently discussed studies by Col-
quhoun et al. and Fu et al. looking at the
effects of training frequency on strength
gains, but research on the subject dates
back to the early ‘80s. As such, it was high
time for this meta-analysis on the subject
to give us a thorough overview of the cur-
rent state of the literature.
The authors identified 22 studies exam-
ining the effects of training frequency on
strength gains, dating back to 1981. The
main finding of the meta-analysis was that
higher training frequencies are associated
with significantly faster strength gains
(~46% faster strength gains when train-
ing a muscle or movement 4+ times per
week compared to just once per week, for
example). However, many of the studies
allowed for higher training volumes to fol-
low higher training frequencies. In stud-
ies where volume was controlled, higher
frequencies weren’t associated with faster
strength gains. As such, it seems that in-
creased frequency doesn’t inherently lead
to faster strength gains. However, increas-
ing frequency is a viable strategy to in-
crease training volume, which will lead to
faster strength gains.
Purpose and Research
Questions
Purpose
The purpose of this meta-analysis was to
statistically analyze all of the research in-
vestigating the effects of training frequen-
cy on strength gains.

94
Research Question
Does increased training frequency en-
hance strength gains? Further, does in-
creased training frequency enhance
strength gains when accounting for po-
tential moderating factors, including sex,
upper versus lower body, whether train-
ing volume is controlled, whether sets are
performed to failure, age, and single- vs.
multi-joint exercises?
Hypotheses
Generally, hypotheses aren’t stated for
meta-analyses. This one was no exception.
Subjects and Methods
To be included in this meta-analysis, a
study needed to meet five inclusion crite-
ria:
1. It needed to be published in a peer-re-
viewed, English-language journal.
2. It needed to compare at least two dif-
ferent training frequencies using dy-
namic resistance exercise (i.e. studies
only using isometric exercise were ex-
cluded).
3. Maximal strength needed to be as-
sessed using either a 1RM test, an
isokinetic test, or an isometric test (i.e.
something like jump height wouldn’t
count as a strength assessment).
4. The study needed to last at least four
weeks.
5. The participants needed to be healthy,
WHILE HIGHER FREQUENCIES
WERE ASSOCIATED WITH
LARGER STRENGTH GAINS,
THIS RELATIONSHIP
COLLAPSED WHEN ONLY
ANALYZING STUDIES WHERE
VOLUME WAS CONTROLLED.
without any metabolic or musculo-
skeletal diseases.
Twenty-two studies with a total of 912
participants met these inclusion criteria.
These studies had between 11 and 192
participants (the median was 29 partici-
pants), lasted for between 6 and 24 weeks
(the median was 12 weeks), and they in-
cluded participants of both sexes and of
a wide array of ages. Of the 22 studies, 4
were judged to be of good methodologi-
cal quality, while 18 were judged to be of
moderate methodological quality.
The meta-analysis itself was performed
as a meta-regression. This means that the
independent variable (training frequency)
was treated as continuous, rather than bi-
nary (i.e. 1 vs. 2 vs. 3 vs. 4+ times per week
frequency, instead of just “lower” vs. “high-
er” frequency).
95
 Figure 1a Summary of meta-regression results

All Studies Volume-Equated Studies

1.25 1.25

1.00 1.00
Effect Size

Effect Size
0.75 0.75

0.50 0.50
Significant; p = 0.003 Significant; p = 0.421
0.25 0.25

0.00 0.00
1x / wk 2x / wk 3x / wk 4+x / wk 1x / wk 2x / wk 3x / wk 4+x / wk

Multi-Joint Exercises Single-Joint Exercises

1.25 1.25

1.00 1.00
Effect Size

Effect Size
0.75 0.75

0.50 0.50
Significant; p < 0.001 Significant; p < 0.324
0.25 0.25
3x / wk
0.00 0.00
1x / wk 2x / wk 3x / wk 4+x / wk 1x / wk 2x / wk

Upper Body Strength Lower Body Strength

1.25 1.25

1.00 1.00
Effect Size

Effect Size

0.75 0.75

0.50 0.50
Significant; p < 0.004 Significant; p < 0.07
0.25 0.25

0.00 0.00
1x / wk 2x / wk 3x / wk 4+x / wk 1x / wk 2x / wk 3x / wk

All data are mean ± standard error of the mean.

Findings joint exercises (p<0.001), for upper body

exercises (p=0.004), for young adults
(p=0.024), and for women (p=0.030).
Significant Associations
Higher training frequencies were sig- Non-significant Associations
nificantly associated with larger strength Higher training frequencies were
increases (p=0.003) overall. Furthermore, not significantly associated with larger
higher training frequencies were associ- strength increases for studies with equat-
ated with larger strength gains for multi-
96
 Figure 1b Summary of meta-regression results

Training to Failure Not Training to Failure

1.25 2.00

1.00
1.50

Effect Size
Effect Size

0.75
1.0
0.50
Significant; p < 0.078 Significant; p < 0.16
0.50
0.25

0.00 0.00
1x / wk 2x / wk 3x / wk 4+x / wk 1x / wk 2x / wk 3x / wk

Middle-Aged and Older Adults Young Adults

1.25 1.50

1.00

1.00

Effect Size
Effect Size

0.75

0.50 Significant; p < 0.024

Significant; p < 0.093 0.50
0.25

0.00 0.00
1x / wk 2x / wk 3x / wk 1x / wk 2x / wk 3x / wk 4+x / wk

Men Women
1.25 2.00

1.00
1.50
Effect Size

Effect Size

0.75
1.0
0.50
Significant; p < 0.019 Significant; p < 0.03
0.50
0.25

0.00 0.00
1x / wk 2x / wk 3x / wk 4+x / wk 1x / wk 2x / wk 3x / wk 4+x / wk

All data are mean ± standard error of the mean.

ed volume (p=0.421), for single-joint ex-

ercises (p=0.324), for lower body exercises
(p=0.07), for studies where participants
trained to failure (p=0.078), for studies
where participants didn’t train to failure
(p=0.16), for middle-aged and older adults
(p=0.093), and for men (p=0.19).
Interpretation
Let me get the boring stuff out of the
way first: I’m going to gripe about the sta-
tistics a little bit, but I promise I’ll keep it
brief. If you don’t care about stats, feel free
to skip the next paragraph.
I’m not entirely sure that the meta-re-
97
gression model used in this study is the
most appropriate way to analyze these
data, as I don’t think it can adequately ac-
count for the heterogeneity of study pro-
tocols. As a really simplistic example, let’s
assume that higher frequencies are truly
more effective than lower frequencies, and
let’s assume we have Study A comparing a
frequency of once per week to a frequency
of twice per week, and we have Study B
comparing a frequency of twice per week
to a frequency of three times per week. In
Study A, the participants are placed on a
really challenging training program, and
the folks training once per week get 20%
stronger, while the folks training twice per
week get 25% stronger. In Study B, the
participants are placed on a really easy, low
volume, low intensity training program,
and the folks training twice per week get
3% stronger, while the folks training three
times per week get 5% stronger. In this
sort of meta-regression model, those dif-
ferences in training programs can’t be fully
accounted for, so with two studies in the
model, it looks like increased frequency
decreases strength gains: 20% for once per
week, 14% for twice per week (average of
25% and 3%), and 5% for three times per
week. Obviously, this sort of effect would
be washed out a bit with more studies, and
the type of model used in the present study
(random effects model rather than a fixed
effects model) is built to withstand some
heterogeneity between protocols by wid-
ening the confidence interval around each
effect size estimate, but I’m not confident
that it’s fully up for the task. For example,
in volume-equated studies, a training fre-
quency of twice per week was associated
with the largest effect size (0.80), while
frequencies of once, twice, and 4+ times
per week were associated with effect siz-
es ranging from 0.53-0.64. Furthermore,
the standard error was quite low for all
frequencies except for twice per week. The
model (rightly, by my estimation) said that
there wasn’t a significant relationship be-
tween frequency and strength gains in this
sample of studies, but I’m at a loss for a
physiologically plausible reason why the
point estimate would be higher and the
confidence interval would be bigger with a
training frequency of twice per week. Rath-
er, I think the model was picking up a lot of
noise (heterogeneity of study participants
and protocols) and not much signal (effects
truly attributable to training frequency)
for that particular comparison. The rest of
the subgroup analyses don’t look nearly as
screwy, likely because they include studies
where volume wasn’t equated (so higher
frequencies = higher volume = larger gains,
which smooths things out), but the analy-
sis where the largest confounder (volume)
was controlled for makes me think that
the studies were a bit more heterogeneous
than would be ideal for a meta-regression.
Now, I don’t necessarily think the results
of the present meta-analysis are incorrect.
There would certainly be drawbacks to the
alternate ways of analyzing these studies,
and the type of model used was a pretty
conservative one (i.e. false negatives – a less
serious form of error – are more likely than
false positives), so I’m not trying to say the
98
authors did anything wrong. I just want to
present my reservations so you know I’m
not just accepting the results uncritically.
The main finding of this meta-analysis
was that, while higher frequencies were as-
sociated with larger strength gains, this re-
lationship collapsed when only analyzing
studies where volume was controlled. As
such, this meta-analysis largely confirms
the meta-analysis we’ve reviewed previ-
ously showing that higher volumes are as-
sociated like larger strength gains (2).
The subgroup analyses are interesting,
in that they lend credence to some com-
mon beliefs regarding rates of recovery
and training frequency. Namely, it’s often
assumed that people who can recover fast-
er from training will benefit from higher
training frequencies. We also have some
evidence that younger people recover fast-
er than older people (3), and that women
recover faster than men (4) (though results
are mixed [5]). Furthermore, people often
assume that you recover faster from upper
body training than lower body training
(though, strangely, I couldn’t find a study
to support that assumption). In this me-
ta-analysis, higher frequencies were sig-
nificantly associated with faster strength
gains in women but not men, in younger
but not older adults, and in upper body but
not lower body exercises, which supports
the notion that higher frequencies may
be most beneficial for people or exercises
that recover faster from each training ses-
sion (which should be a pretty intuitive as-
sumption). On the other hand, there was
WHILE TRAINING FREQUENCY MAY
NOT INFLUENCE STRENGTH GAINS
WHEN VOLUME IS CONTROLLED IN
STUDIES ON PRIMARILY UNTRAINED
LIFTERS, THE EVIDENCE MAY
LEAN SLIGHTLY IN FAVOR OF
HIGHER TRAINING FREQUENCIES
BEING BENEFICIAL FOR TRAINED
LIFTERS, ESPECIALLY FOR THE
BENCH PRESS, EVEN WHEN WEEKLY
VOLUME IS CONTROLLED.
a general trend toward higher frequencies
being better for men, older adults, and low-
er body exercises as well (just with p-values
that didn’t clear the bar for significance),
so this may just be a coincidence. The fact
that some of the studies had people train
to failure, while others didn’t, further mud-
dies the water. We know that training to
failure takes longer to recover from, so it’s
possible that higher frequencies would
be a drawback when training to failure in
groups that take longer to recover, but that
higher frequencies could be beneficial in
these groups when not training to failure.
One drawback of this meta-analysis was
that, of the 22 studies that met the inclu-
99
sion criteria, only 3 of the studies were
performed on trained lifters. However,
since this meta-analysis was submitted
for publication, four more studies look-
ing at the effect of training frequency on
trained subjects have been published. All
seven studies on trained lifters were matched
for volume.
McLester et al. (6) found that training
three times per week (one set per exercise
per day) led to larger strength gains than
training once per week (three sets of each
exercise on that training day). For all of the
exercises tested, the difference was only
significant for leg press (~46% vs. ~22%),
but the trend was clear across the board.
Across all exercises, strength increased by
roughly 35% in the group training three
times per week, and by roughly 20% in the
group training once per week. Bench press
strength increased by 27.2% in the group
training three times per week, and 10.6%
in the group training once per week.
Schoenfeld et al. (7) compared a
per-muscle group frequency of once per
week versus three times per week (split vs.
full-body routine). However, exercise fre-
quency was once per week in both groups.
For example, in the split routine, bench
press, incline press, and hammer chest
press were all performed on the same day,
whereas they were performed on three
separate days in the whole-body routine.
In this study, the participants training
with a whole-body routine tended to have
larger bench press gains (10.6% vs. 6.8%),
though the difference wasn’t significant.
Increases in squat strength were virtually
identical.
Thomas and Burns (8) used a similar
design to Schoenfeld et al., testing chest
press and hack squat strength. The dif-
ference in this study was that chest press
was performed twice per week in the high
frequency group for three sets both days,
whereas it was performed once per week
for six sets in the low frequency group.
Hack squat was performed once per week
in both groups (though, again, the high fre-
quency group did train quads three times
per week; they just used different exercises
on the other two days). Chest press gains
tended to be larger in the high frequency
group, though the difference wasn’t signif-
icant (9.1kg vs. 5.8kg). Increases in hack
squat strength were virtually identical.
Fu et al. (9), as you’ll remember from
a recent MASS article, tested squat and
bench press strength. One group squatted
and benched three times per week, while
the other group squatted and benched
once per week. In this study, gains in both
squat and bench press strength were virtu-
ally identical between groups.
Colquhoun et al. (10) (also discussed in
MASS) also tested squat and bench press
strength. One group squatted and benched
six times per week, while the other group
squatted and benched three times per
week. In this study, squat gains were virtu-
ally identical between groups, and bench
press gains were also very similar (8.6% for
six times per week versus 7.7% for three
times per week).
100
 Figure 2 Bench Press or Chest Press Gains in Volume-Equated Studies on Trained Lifters
30
Percentage Strength Increase
20
10
0
Higher
Frequency
A brand new study by Gomes et al. (11)
used a design similar to that of Schoen-
feld et al. and Thomas and Burns. Gains in
both the bench press (5.6kg vs. 9.7kg) and
squat (8.0kg vs. 12.0kg) strength tended
to be a bit larger in the higher frequency
group, but neither difference was signifi-
cant.
Another brand new study by Brigatto et
al. (12) compared once per week frequency
to twice per week frequency. Gains in both
squat and bench press strength were virtu-
ally identical in both groups.
All together, we have one study on
trained lifters finding a significant differ-
ence in strength gains favoring higher fre-
quency, three studies with non-significant
but possibly meaningful differences favor-
ing higher training frequencies (especially
for bench press), and three studies finding
McLester
Schoenfeld
Thomas and Burns
Fu
Gomes
Colquhoun
Brigatto
Average
Lower
Frequency
no meaningful differences whatsoever. As
such, while training frequency may not in-
fluence strength gains when volume is con-
trolled in studies on primarily untrained
lifters, the evidence may lean slightly in
favor of higher training frequencies being
beneficial for trained lifters, especially for
the bench press, even when weekly volume
is controlled. When pooling the results of
these seven studies, the group with the
higher frequency tended to gain almost
50% more strength on the bench press
or chest press (12.73% vs. 8.72%; simple
average), though the difference isn’t quite
as large when removing the results of Mc-
Lester et al. (10.33% vs. 8.41%). The dif-
ference was much smaller for compound
lower body exercises (14.6% vs. 18%, for a
relative difference below 25%), and most
of that difference was driven by just two
101
 Table 1 Bench Press or Chest Press Strength Gains

Relative Difference
Lower Higher (favoring higher
Author Frequency Frequency frequency)

McLester 10.6% 27.1% 156%

Schoenfeld 6.8% 11.0% 62%

Thomas and Burns 7.4% 10.7% 45%

Fu 15.7% 14.3% -9%

Gomes 5.4% 9.6% 78%

Colquhoun 7.7% 8.6% 12%

Brigatto 7.5% 7.8% 4%

Average 8.7% 12.7% 46%

= possible meaningful difference (>25%)

studies. As always, though, more research
is needed. Of note, I didn’t include the
famed “Norwegian Frequency Project” in
this analysis since it’s not yet published,
but its bench press results are basically in
line with the rest of the frequency liter-
ature on trained lifters (a mean increase
of 11% in their group training six times
per week, compared to a mean increase
of 6% in their group training three times
per week). I also didn’t include a study by
Crewther et al. (13) in this analysis (and it
wasn’t included in the meta-analysis) since
it used a crossover design with each train-
ing phase only lasting four weeks.
So, based on this meta-analysis and my
mini-review of the frequency studies on
trained lifters, let’s end on some practical
recommendations and takeaways:
1. As long as training volume is suffi-
cient, basically any weekly training
frequency can be used to get stronger.
2. Practically, it may be easier to handle
higher training volumes with some-
what increased training frequencies
(2-4x per lift, per week). If you’re
doing 12 challenging sets of squats
per week, for example, it’s probably
going to be more feasible and tolera-
ble to do 6 sets twice per week, 4 sets
102
 Table 2 Squat, Leg Press, or Hack Squat Strength Gains

Relative Difference
Lower Higher (favoring higher
Author Frequency Frequency frequency)

McLester 22.3% 46.1% 107%*

Schoenfeld 10.6% 11.3% 7%

Thomas and Burns 24.0% 21.0% -13%

Fu 13.8% 11.9% -14%

Gomes 6.0% 9.7% 62%

Colquhoun 12.2% 12.0% -2%

Brigatto 13.5% 13.9% 3%

Average 14.6% 18.0% 23%

* = Significant difference
= possible meaningful difference (>25%)

three times per week, or 3 sets four
times per week than to do all 12 sets
on a single training day.
3. If your ability to tolerate more vol-
ume within a single training session
is capped out, increasing frequency
as a strategy for increasing volume
will likely lead to larger strength
gains.
4. People who take longer to recover
between sessions and exercises that
take longer to recover from may ben-
efit from somewhat lower frequen-
cies (1-2 times per lift per week),
while people who recover quicker
and exercises you recover from faster
may benefit from somewhat higher
frequencies (2-4+ times per lift per
week), potentially along with an in-
crease in volume.
5. For trained lifters, increased frequen-
cy may only be beneficial for squat
strength gains if the increased fre-
quency facilitates an increase in vol-
ume. However, increased frequency
for bench press may be beneficial,
even when equating volume.

103
 APPLICATION AND TAKEAWAYS
Higher training frequencies seem to be associated with faster strength gains. However,
most of this association seems to be attributable to higher frequencies allowing for
higher volumes. As such, as long as volume is sufficient, frequency probably doesn’t
matter too much for strength gains. However, when you need to increase training
volume, it may be most feasible to increase frequency while increasing weekly volume.

Next Steps failure). A study designed to test this idea

could have four arms: one with low fre-
All I want is for the Norwegian Fre- quency training to failure, one with high
quency Project study to get published. Is frequency training to failure, one with low
that too much to ask? I’d also be interested frequency training not to failure, and one
in a study designed to directly test wheth- with high frequency training not to fail-
er there’s a relationship between rate of ure. The hypothesis would be that higher
recovery and optimal training frequency. training frequencies may prove more ben-
For example, before training, all subjects eficial when not training to failure, as any
could complete a standardized bench press potential benefits of higher frequency may
workout, and their recovery rates (using be offset by inadequate recovery when
both performance and molecular markers training to failure.
of recovery) over 72 hours could be mon-
itored. From there, split the subjects into
four groups: fast recoverers benching with
a high frequency, fast recoverers bench-
ing with a low frequency, slow recoverers
benching with a high frequency, and slow
recoverers benching with a low frequen-
cy. The hypothesis would be that the faster
recoverers benching with high frequency
and slow recoverers benching with a low
frequency would get better results than the
people in the two groups with mismatched
frequencies and recovery rates. It would
also be good to see whether training to
failure impacts optimal training frequency
(with the assumption that it takes longer to
recover from each session when training to

104
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Frequency on Gains in Muscular Strength: A Systematic Review and Meta-Analysis. Sports Med.
2018 Feb 22.
2. Ralston GW, Kilgore L, Wyatt FB, Baker JS. The Effect of Weekly Set Volume on Strength Gain: A
Meta-Analysis. Sports Med. 2017 Dec;47(12):2585-2601.
3. Fell J, Williams D. The effect of aging on skeletal-muscle recovery from exercise: possible implica-
tions for aging athletes. J Aging Phys Act. 2008 Jan;16(1):97-115.
4. Judge LW, Burke JR. The effect of recovery time on strength performance following a high-intensity
bench press workout in males and females. Int J Sports Physiol Perform. 2010 Jun;5(2):184-96.
5. Flores DF, Gentil P, Brown LE, Pinto RS, Carregaro RL, Bottaro M. Dissociated time course of
recovery between genders after resistance exercise. J Strength Cond Res. 2011 Nov;25(11):3039-44.
6. McLester JR, Bishop P, Guilliams ME. Comparison of 1 day and 3 days per week of equal-volume
resistance training in experienced subjects. J Strength Cond Res. 2000;14(3):273–81.
7. Schoenfeld BJ, Ratamess NA, Peterson MD, Contreras B, Tiryaki-Sonmez G. Influence of Resis-
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2015 Jul;29(7):1821-9.
8. Thomas MH, Burns SP. Increasing Lean Mass and Strength: A Comparison of High Frequency
Strength Training to Lower Frequency Strength Training. Int J Exerc Sci. 2016; 9(2): 159–167.
9. Fu Y, Karsten B, Larumbe-Zabala E, Seijo M, Naclerio F. Comparison of Two Equated Resistance
Training Weekly Volume Routines Using Different Frequencies on Body Composition and Perfor-
mance in Trained Males. Appl Physiol Nutr Metab. 2017 Dec 7.
10. Colquhoun RJ, Gai CM, Aguilar D, Bove D, Dolan J, Vargas A, Couvillion K, Jenkins NDM,
Campbell BI. Training Volume, Not Frequency, Indicative of Maximal Strength Adaptations to
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fective than low-frequency resistance training in increasing muscle mass and strength in well-trained
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12. Brigatto FA, Braz TV, Zanini TCC, Germano MD, Aoki MS, Schoenfeld BJ, Marchetti PH, Lopes
CR. Effect of Resistance Training Frequency on Neuromuscular Performance and Muscle Mor-
phology after Eight Weeks in Trained Men. J Strength Cond Res. 2018. Epub Mar 6.
13. Crewther BT, Heke TOL, Keough JWL. The effects of two equal-volume training protocols upon
strength, body composition and salivary hormones in male rugby union players. Biol Sport. 2016 Jun;
33(2): 111–116.

105
 VIDEO: What Do We Know
About Individualization? Part 2
BY MIC HAE L C . ZO URD O S

Most scientific studies simply show the average response in the study,
but that doesn’t tell the whole story. Often times, hypertrophy and
strength changes can be vastly different among individuals – but why?
Click to watch Michael's presentation.

106
References
1. Snijders T, Nederveen JP, McKay BR, Joanisse S, Verdijk LB, van Loon LJ, Parise G. Satellite cells
in human skeletal muscle plasticity. Frontiers in physiology. 2015 Oct 21;6:283.
2. Petrella JK, Kim JS, Mayhew DL, Cross JM, Bamman MM. Potent myofiber hypertrophy during re-
sistance training in humans is associated with satellite cell-mediated myonuclear addition: a cluster
analysis. Journal of applied physiology. 2008 Jun;104(6):1736-42.
3. Bamman MM, Petrella JK, Kim JS, Mayhew DL, Cross JM. Cluster analysis tests the importance of
myogenic gene expression during myofiber hypertrophy in humans. Journal of Applied Physiology.
2007 Jun;102(6):2232-9.
4. Hubal MJ, Gordish-Dressman HE, Thompson PD, Price TB, Hoffman EP, Angelopoulos TJ,
Gordon PM, Moyna NM, Pescatello LS, Visich PS, Zoeller RF. Variability in muscle size and
strength gain after unilateral resistance training. Medicine & Science in Sports & Exercise. 2005
Jun 1;37(6):964-72.

107
 VIDEO: Implementing
Autoregulation, Part 2
BY E RI C HE LMS

We’ve written and talked about autoregulation a great deal in MASS

up to this point, but we haven’t yet shown you how to implement the
existing research-based autoregulation strategies into a program in
the most practical way possible. In this video, Eric shows you how to
implement each strategy for a bodybuilding program.
Click to watch Eric's presentation.

108
References
1. Ralston, G.W., et al., The Effect of Weekly Set Volume on Strength Gain: A Meta-Analysis. Sports
Med, 2017. 47(12): p. 2585-2601.
2. Schoenfeld, B.J., D. Ogborn, and J.W. Krieger, Effects of Resistance Training Frequency on Mea-
sures of Muscle Hypertrophy: A Systematic Review and Meta-Analysis. Sports Med, 2016. 46(11):
p. 1689-1697.
3. Schoenfeld, B.J., D. Ogborn, and J.W. Krieger, Dose-response relationship between weekly resis-
tance training volume and increases in muscle mass: A systematic review and meta-analysis. J Sports
Sci, 2017. 35(11): p. 1073-1082.
4. Peterson, M.D., M.R. Rhea, and B.A. Alvar, Maximizing strength development in athletes: a me-
ta-analysis to determine the dose-response relationship. J Strength Cond Res, 2004. 18(2): p. 377-82.
5. Peterson, M.D., M.R. Rhea, and B.A. Alvar, Applications of the dose-response for muscular strength
development: a review of meta-analytic efficacy and reliability for designing training prescription. J
Strength Cond Res, 2005. 19(4): p. 950-8.
6. Rhea, M.R., et al., A meta-analysis to determine the dose response for strength development. Med
Sci Sports Exerc, 2003. 35(3): p. 456-64.
7. Schoenfeld, B.J., et al., Strength and hypertrophy adaptations between low-versus high-load resis-
tance training: A systematic review and meta-analysis. J Strength Cond Res, 2017. 19(20): p. 21.
8. Zourdos, M.C., et al., Novel Resistance Training-Specific Rating of Perceived Exertion Scale Mea-
suring Repetitions in Reserve. J Strength Cond Res, 2016. 30(1): p. 267-75.
9. Helms, E., Using the Repetitions in Reserve-based Rating of Perceived Exertion Scale to Autoreg-
ulate Powerlifting Training. 2017, Auckland University of Technology.
10. Helms, E.R., et al., Rating of Perceived Exertion as a Method of Volume Autoregulation Within a
Periodized Program. The Journal of Strength & Conditioning Research, 2017.
11. Pareja-Blanco, F., et al., Effects of velocity loss during resistance training on athletic performance,
strength gains and muscle adaptations. Scand J Med Sci Sports, 2016.
12. Rauch, J.T., et al., Auto-regulated exercise selection training regimen produces small increases in
lean body mass and maximal strength adaptations in strength-trained individuals. J Strength Cond
Res, 2017.
13. Mann, J.B., et al., The effect of autoregulatory progressive resistance exercise vs. linear periodization
on strength improvement in college athletes. Journal of Strength and Conditioning Research, 2010.
24(7): p. 1718-1723
14. McNamara, J.M. and D.J. Stearne, Flexible Nonlinear Periodization in a Beginner College Weight
Training Class. Journal of Strength & Conditioning Research, 2010. 24(1): p. 17-22
15. Colquhoun, R.J., et al., Comparison of Powerlifting Performance in Trained Men Using Traditional
and Flexible Daily Undulating Periodization. J Strength Cond Res, 2017. 31(2): p. 283-291.

109
 Just Missed the Cut
Every month, we consider hundreds of new papers, and they can’t all be
included in MASS. Therefore, we’re happy to share a few pieces of research
that just missed the cut. It’s our hope that with the knowledge gained from
reading MASS, along with our interpreting research guide, you’ll be able to
tackle these on your own.

1. Mitchell et al. The effect of dietary arachidonic acid supplementation on

acute muscle adaptive responses to resistance exercise in trained men:
a randomized controlled trial.
2. Knowles et al. Inadequate sleep and muscle strength: Implications for
resistance training.
3. Orvidas et al. Mindsets applied to fitness: Growth beliefs predict exercise
efficacy, value and frequency.
4. Paquette et al. Muscle Activation Patterns of Lower Body Musculature
Among Three Traditional Lower Body Exercises in Trained Women.
5. Winwood et al. The Tapering Practices of Strongman Athletes.
6. Jagim et al. Acute Effects of the Elevation Training Mask on Strength
Performance in Recreational Weight lifters.
7. Berton et al. Effects of weightlifting exercise, traditional resistance and
plyometric training on countermovement jump performance: a meta-
analysis.
8. Loureiro et al. Effects of Coffee Components on Muscle Glycogen
Recovery: A Systematic Review.
9. Miller et al. Resistance Training Combined With Diet Decreases Body Fat
While Preserving Lean Mass Independent of Resting Metabolic Rate: A
Randomized Trial.
10. Miller et al. Prophylactic stretching does not reduce cramp susceptibility.
11. Kawakami et al. When You Become a Superman: Subliminal Exposure
to Death-Related Stimuli Enhances Men’s Physical Force.

110
 Thanks for
reading MASS.
The next issue will be released to
subscribers on May 1.

Graphics by Katherine Whitfield, and layout design by Lyndsey Nuckols.

111