2020•Medicine & Science in Sports & ExerciseOpen access

On “The Basics of Training for Muscle Size and Strength”

Michael Henry Stone, Kent Adams, Caleb D. Bazyler, Clive Brewer, George K. Beckham, Kevin M. Carroll, Robert D. Chetlin, Paul Comfort, Brett A. Comstock, Aaron J. Cunanan, Brad H. DeWeese, Jacob E. Earp, Sandor Dorgo, Steven J. Fleck, Andrew C. Fry, Andrew J. Galpin, John Garhammer, Daniel E. Gahreman, Stuart N. Guppy, G. Gregory Haff, Keijo Häkkinen, Disa L. Hatfield, Cody T. Haun, Guy Hornsby, Chad Kersick, William J. Kraemer, Hugh S. Lamont, Jeff M. McBride, Satoshi Mizuguchi, Robert Usher Newton, Kyle C. Pierce, Michael W. Ramsey, Nicholas A. Ratamess, Hugo Alexandre de Paula Santana, Margaret E. Stone, Timothy J. Suchomel, Dylan G. Suarez, Kyle Travis, Christopher B. Taber, N. Travis Triplett, Jakob Langberg Vingren, John P. Wagle, Dan Wathen

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Abstract

Dear Editor-in-Chief, We read the article of Buckner et al. (1), hoping to find new insights on resistance training. Unfortunately, the article is a restatement of information contained in previously published reviews from this group. Here are our major concerns: HYPERTROPHY AND STRENGTH GAINS Buckner et al. believe that high-volume phases are unnecessary. Initial alteration in body composition (including myofibrillar hypertrophy) is conceptually (along with the more important increased work capacity) a tenet of resistance training periodization. The paradigm of first developing muscle cross-sectional area (CSA) is not new (2) and has substantial theoretical support. We believe there is sufficient evidence indicating that hypertrophy resulting from resistance training, along with other factors, enhances maximum strength (3). The degree of enhancement depends on several factors, including training methods and trained state. Although we agree that the impact can be relatively small, particularly in early phases of training in inexperienced trainees compared with neurological adaptations, and so on, total hypertrophy (myofibrillar) resulting from long-term resistance training substantially contributes to strength development (3). Evidence from both early muscle activation and CSA studies and later studies (4) indicates that initial gains (up to 6–8 wk) in hypertrophy (myofibrillar) are small and likely do not contribute markedly to increased strength. This evidence also suggests that later alterations (~4–8 wk) in CSA (myofibrillar) can begin to contribute to alterations in strength and related characteristics. TRAINING VARIATION Buckner et al. (5) suggest that there is minimal evidence supporting the use of variation in resistance training programming or periodization. It should be noted that individuals cannot tolerate high-volume and/or heavy multijoint exercise loading for extended periods without experiencing nonfunctional overreaching or overtraining syndrome. Altering fitness phase order (therefore programming) produces different outcomes, sometimes subtle, but different (6). Researchers in early studies examined programming variation versus various constant repetition programming schemes and demonstrated that the variation groups produced superior adaptations. Furthermore, a recent systematic review indicates that using the same training stimulus for >6 wk, especially in trained subjects and athletes can result in a plateau in maximal strength (7). TRAINING TO FAILURE The majority of studies and reviews indicate training to failure is unnecessary, and loading does make a difference (7). Evidence from both cross-sectional and longitudinal studies indicate selective hypertrophy can result from different loading schemes; training to failure, particularly with higher repetitions, tended to select type I motor units, whereas heavier loading and ballistic movements targeted type II motor units (8). These observations likely play an important role in the training and performance outcomes of athletes. MISREPRESENTATION OF THE LITERATURE Finally, selective use of references, careless editing of quoted statements, and what appear to be misrepresentations of literature in this review fosters misconceptions among readers. One particular example is that of Morehouse and Miller (2). We encourage interested readers to examine pages 59 to 60 and 244 to 246 to surmise what the authors actually stated; the meaning derived directly from the source text is substantially different than what was quoted. Hopefully, those interested will critically review the available literature in its entirety. Michael H. Stone Director, Exercise and Sport Science Lab Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kent Adams Kinesiology Department Exercise Physiology Lab CSU Monterey Bay, CA Seaside, CA Caleb Bazyler Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Clive Brewer Director of Performance Columbus Crew Columbus, OH George Beckham Assistant Professor, Kinesiology Department CSU, Monterey Bay Seaside, CA Kevin Carroll Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Robert D. Chetlin Department of Sports Medicine Mercyhurst University Erie, PA Paul Comfort Directorate of Psychology and Sport University of Salford Salford, Greater Manchester, UNITED KINGDOM Centre for Exercise and Sport Science Research Edith Cowan University Joondalup, AUSTRALIA Bret Comstock Department of Exercise Science Bloomsburg University Bloomsburg, PA Aaron Cunanan Sports Science Coordinator San Francisco Giants Brad DeWeese Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Jacob E. Earp University of Rhode Island Kingston, RI Sandor Dorgo Department of Kinesiology The University of Texas at El Paso El Paso, TX Steven J. Fleck FlecksRx LL Andrew C. Fry Exercise Physiology Graduate Program Dir. of Research, Research & Coaching Performance Team Director Jayhawk Athletic Performance Laboratory University of Kansas Lawrence, KS Andrew Galpin Co-Director: Center for Sport Performance Director: Biochemistry & Molecular Exercise Physiology Lab California State University Fullerton, CA John Garhammer Professor Emeritius California State University Long Beach, CA Daniel Gahreman College of Health and Human Sciences Charles Darwin University Darwin, NT, AUSTRALIA Casuarina NT, AUSTRALIA Stuart Guppy Centre for Exercise and Sports Science Research Edith Cowan University Joondalup, WESTERN AUSTRALIA G. Gregory Haff Professor of Strength and Conditioning Course Coordinator Masters of Exercise Science (Strength & Conditioning) Edith Cowan University Joondalup, WESTERN AUSTRALIA Keijo Häkkinen Neuromuscular Research Center Biology of Physical Activity Faculty of Sport and Health Sciences University of Jyväskylä, FINLAND Disa Hatfield Department of Kinesiology University of Rhode Island Kingston, RI Cody Haun Speed Center Sport Science Coordinator Exercise Science Lagrange College LaGrange, GA Guy Hornsby Coaching and Performance Science College of Physical Activity and Sport Sciences West Virginia University Morganton, WV Chad Kersick Exercise Science Exercise and Performance Nutrition Laboratory School of Health Sciences Lindenwood University St. Charles, MO William J. Kraemer Department of Human Sciences Program Area: Kinesiology The Ohio State University Columbus, OH Hugh Lamont Department of Kinesiology Coastal Carolina University Conway, SC Jeff McBride College of Health Sciences Department of Health & Exercise Science Director: Neuromuscular & Biomechanics Laboratory Appalachian State University Boone, NC Satoshi Mizuguchi Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Robert U. Newton Exercise Medicine, Exercise Medicine Research Institute Edith Cowan University Joondalup, WESTERN AUSTRALIA Kyle Pierce Kinesiology and Health Science Louisiana State University at Shreveport Michael W. Ramsey Department of Sport, Exercise, Recreation, and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Nicholas Ratamess School of Nursing, Health, and Exercise Science The College of New Jersey Ewing, NJ Hugo Santana College of Education, Federal University of Mato Grosso Do Sul, Avenida Costa E Silva, Campo Grande, Mato Grosso do Sul, BRAZIL Margaret E. Stone Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Timothy J. Suchomel Department of Human Movement Sciences Carroll University Dylan Suarez Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kyle Travis Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University, Johnson City Chris Taber Exercise Science College of Health Professions Sacred Heart University Fairfield, CT N. Travis Triplett Exercise Science Exercise Science Undergraduate Program Director Department of Health and Exercise Science Appalachian State University Boone, NC Jakob Vingren Chair Department of Kinesiology, Health Promotion and Recreation Professor of Exercise Physiology and Biological Sciences Co-Director Applied Physiology Laboratory University of North Texas Denton, TX John Wagle Performance Science/Player Development Kansas City Royals Surprise, AZ Dan Wathen Athletic Trainer Emeritus Youngstown State University Youngstown, OH

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Dear Editor-in-Chief, We read the article of Buckner et al. (1), hoping to find new insights on resistance training. Unfortunately, the article is a restatement of information contained in previously published reviews from this group. Here are our major concerns: HYPERTROPHY AND STRENGTH GAINS Buckner et al. believe that high-volume phases are unnecessary. Initial alteration in body composition (including myofibrillar hypertrophy) is conceptually (along with the more important increased work capacity) a tenet of resistance training periodization. The paradigm of first developing muscle cross-sectional area (CSA) is not new (2) and has substantial theoretical support. We believe there is sufficient evidence indicating that hypertrophy resulting from resistance training, along with other factors, enhances maximum strength (3). The degree of enhancement depends on several factors, including training methods and trained state. Although we agree that the impact can be relatively small, particularly in early phases of training in inexperienced trainees compared with neurological adaptations, and so on, total hypertrophy (myofibrillar) resulting from long-term resistance training substantially contributes to strength development (3). Evidence from both early muscle activation and CSA studies and later studies (4) indicates that initial gains (up to 6–8 wk) in hypertrophy (myofibrillar) are small and likely do not contribute markedly to increased strength. This evidence also suggests that later alterations (~4–8 wk) in CSA (myofibrillar) can begin to contribute to alterations in strength and related characteristics. TRAINING VARIATION Buckner et al. (5) suggest that there is minimal evidence supporting the use of variation in resistance training programming or periodization. It should be noted that individuals cannot tolerate high-volume and/or heavy multijoint exercise loading for extended periods without experiencing nonfunctional overreaching or overtraining syndrome. Altering fitness phase order (therefore programming) produces different outcomes, sometimes subtle, but different (6). Researchers in early studies examined programming variation versus various constant repetition programming schemes and demonstrated that the variation groups produced superior adaptations. Furthermore, a recent systematic review indicates that using the same training stimulus for >6 wk, especially in trained subjects and athletes can result in a plateau in maximal strength (7). TRAINING TO FAILURE The majority of studies and reviews indicate training to failure is unnecessary, and loading does make a difference (7). Evidence from both cross-sectional and longitudinal studies indicate selective hypertrophy can result from different loading schemes; training to failure, particularly with higher repetitions, tended to select type I motor units, whereas heavier loading and ballistic movements targeted type II motor units (8). These observations likely play an important role in the training and performance outcomes of athletes. MISREPRESENTATION OF THE LITERATURE Finally, selective use of references, careless editing of quoted statements, and what appear to be misrepresentations of literature in this review fosters misconceptions among readers. One particular example is that of Morehouse and Miller (2). We encourage interested readers to examine pages 59 to 60 and 244 to 246 to surmise what the authors actually stated; the meaning derived directly from the source text is substantially different than what was quoted. Hopefully, those interested will critically review the available literature in its entirety. Michael H. Stone Director, Exercise and Sport Science Lab Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kent Adams Kinesiology Department Exercise Physiology Lab CSU Monterey Bay, CA Seaside, CA Caleb Bazyler Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Clive Brewer Director of Performance Columbus Crew Columbus, OH George Beckham Assistant Professor, Kinesiology Department CSU, Monterey Bay Seaside, CA Kevin Carroll Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Robert D. Chetlin Department of Sports Medicine Mercyhurst University Erie, PA Paul Comfort Directorate of Psychology and Sport University of Salford Salford, Greater Manchester, UNITED KINGDOM Centre for Exercise and Sport Science Research Edith Cowan University Joondalup, AUSTRALIA Bret Comstock Department of Exercise Science Bloomsburg University Bloomsburg, PA Aaron Cunanan Sports Science Coordinator San Francisco Giants Brad DeWeese Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Jacob E. Earp University of Rhode Island Kingston, RI Sandor Dorgo Department of Kinesiology The University of Texas at El Paso El Paso, TX Steven J. Fleck FlecksRx LL Andrew C. Fry Exercise Physiology Graduate Program Dir. of Research, Research & Coaching Performance Team Director Jayhawk Athletic Performance Laboratory University of Kansas Lawrence, KS Andrew Galpin Co-Director: Center for Sport Performance Director: Biochemistry & Molecular Exercise Physiology Lab California State University Fullerton, CA John Garhammer Professor Emeritius California State University Long Beach, CA Daniel Gahreman College of Health and Human Sciences Charles Darwin University Darwin, NT, AUSTRALIA Casuarina NT, AUSTRALIA Stuart Guppy Centre for Exercise and Sports Science Research Edith Cowan University Joondalup, WESTERN AUSTRALIA G. Gregory Haff Professor of Strength and Conditioning Course Coordinator Masters of Exercise Science (Strength & Conditioning) Edith Cowan University Joondalup, WESTERN AUSTRALIA Keijo Häkkinen Neuromuscular Research Center Biology of Physical Activity Faculty of Sport and Health Sciences University of Jyväskylä, FINLAND Disa Hatfield Department of Kinesiology University of Rhode Island Kingston, RI Cody Haun Speed Center Sport Science Coordinator Exercise Science Lagrange College LaGrange, GA Guy Hornsby Coaching and Performance Science College of Physical Activity and Sport Sciences West Virginia University Morganton, WV Chad Kersick Exercise Science Exercise and Performance Nutrition Laboratory School of Health Sciences Lindenwood University St. Charles, MO William J. Kraemer Department of Human Sciences Program Area: Kinesiology The Ohio State University Columbus, OH Hugh Lamont Department of Kinesiology Coastal Carolina University Conway, SC Jeff McBride College of Health Sciences Department of Health & Exercise Science Director: Neuromuscular & Biomechanics Laboratory Appalachian State University Boone, NC Satoshi Mizuguchi Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Robert U. Newton Exercise Medicine, Exercise Medicine Research Institute Edith Cowan University Joondalup, WESTERN AUSTRALIA Kyle Pierce Kinesiology and Health Science Louisiana State University at Shreveport Michael W. Ramsey Department of Sport, Exercise, Recreation, and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Nicholas Ratamess School of Nursing, Health, and Exercise Science The College of New Jersey Ewing, NJ Hugo Santana College of Education, Federal University of Mato Grosso Do Sul, Avenida Costa E Silva, Campo Grande, Mato Grosso do Sul, BRAZIL Margaret E. Stone Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Timothy J. Suchomel Department of Human Movement Sciences Carroll University Dylan Suarez Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kyle Travis Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University, Johnson City Chris Taber Exercise Science College of Health Professions Sacred Heart University Fairfield, CT N. Travis Triplett Exercise Science Exercise Science Undergraduate Program Director Department of Health and Exercise Science Appalachian State University Boone, NC Jakob Vingren Chair Department of Kinesiology, Health Promotion and Recreation Professor of Exercise Physiology and Biological Sciences Co-Director Applied Physiology Laboratory University of North Texas Denton, TX John Wagle Performance Science/Player Development Kansas City Royals Surprise, AZ Dan Wathen Athletic Trainer Emeritus Youngstown State University Youngstown, OH

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Available abstract

Dear Editor-in-Chief, We read the article of Buckner et al. (1), hoping to find new insights on resistance training. Unfortunately, the article is a restatement of information contained in previously published reviews from this group. Here are our major concerns: HYPERTROPHY AND STRENGTH GAINS Buckner et al. believe that high-volume phases are unnecessary. Initial alteration in body composition (including myofibrillar hypertrophy) is conceptually (along with the more important increased work capacity) a tenet of resistance training periodization. The paradigm of first developing muscle cross-sectional area (CSA) is not new (2) and has substantial theoretical support. We believe there is sufficient evidence indicating that hypertrophy resulting from resistance training, along with other factors, enhances maximum strength (3). The degree of enhancement depends on several factors, including training methods and trained state. Although we agree that the impact can be relatively small, particularly in early phases of training in inexperienced trainees compared with neurological adaptations, and so on, total hypertrophy (myofibrillar) resulting from long-term resistance training substantially contributes to strength development (3). Evidence from both early muscle activation and CSA studies and later studies (4) indicates that initial gains (up to 6–8 wk) in hypertrophy (myofibrillar) are small and likely do not contribute markedly to increased strength. This evidence also suggests that later alterations (~4–8 wk) in CSA (myofibrillar) can begin to contribute to alterations in strength and related characteristics. TRAINING VARIATION Buckner et al. (5) suggest that there is minimal evidence supporting the use of variation in resistance training programming or periodization. It should be noted that individuals cannot tolerate high-volume and/or heavy multijoint exercise loading for extended periods without experiencing nonfunctional overreaching or overtraining syndrome. Altering fitness phase order (therefore programming) produces different outcomes, sometimes subtle, but different (6). Researchers in early studies examined programming variation versus various constant repetition programming schemes and demonstrated that the variation groups produced superior adaptations. Furthermore, a recent systematic review indicates that using the same training stimulus for >6 wk, especially in trained subjects and athletes can result in a plateau in maximal strength (7). TRAINING TO FAILURE The majority of studies and reviews indicate training to failure is unnecessary, and loading does make a difference (7). Evidence from both cross-sectional and longitudinal studies indicate selective hypertrophy can result from different loading schemes; training to failure, particularly with higher repetitions, tended to select type I motor units, whereas heavier loading and ballistic movements targeted type II motor units (8). These observations likely play an important role in the training and performance outcomes of athletes. MISREPRESENTATION OF THE LITERATURE Finally, selective use of references, careless editing of quoted statements, and what appear to be misrepresentations of literature in this review fosters misconceptions among readers. One particular example is that of Morehouse and Miller (2). We encourage interested readers to examine pages 59 to 60 and 244 to 246 to surmise what the authors actually stated; the meaning derived directly from the source text is substantially different than what was quoted. Hopefully, those interested will critically review the available literature in its entirety. Michael H. Stone Director, Exercise and Sport Science Lab Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kent Adams Kinesiology Department Exercise Physiology Lab CSU Monterey Bay, CA Seaside, CA Caleb Bazyler Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Clive Brewer Director of Performance Columbus Crew Columbus, OH George Beckham Assistant Professor, Kinesiology Department CSU, Monterey Bay Seaside, CA Kevin Carroll Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Robert D. Chetlin Department of Sports Medicine Mercyhurst University Erie, PA Paul Comfort Directorate of Psychology and Sport University of Salford Salford, Greater Manchester, UNITED KINGDOM Centre for Exercise and Sport Science Research Edith Cowan University Joondalup, AUSTRALIA Bret Comstock Department of Exercise Science Bloomsburg University Bloomsburg, PA Aaron Cunanan Sports Science Coordinator San Francisco Giants Brad DeWeese Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Jacob E. Earp University of Rhode Island Kingston, RI Sandor Dorgo Department of Kinesiology The University of Texas at El Paso El Paso, TX Steven J. Fleck FlecksRx LL Andrew C. Fry Exercise Physiology Graduate Program Dir. of Research, Research & Coaching Performance Team Director Jayhawk Athletic Performance Laboratory University of Kansas Lawrence, KS Andrew Galpin Co-Director: Center for Sport Performance Director: Biochemistry & Molecular Exercise Physiology Lab California State University Fullerton, CA John Garhammer Professor Emeritius California State University Long Beach, CA Daniel Gahreman College of Health and Human Sciences Charles Darwin University Darwin, NT, AUSTRALIA Casuarina NT, AUSTRALIA Stuart Guppy Centre for Exercise and Sports Science Research Edith Cowan University Joondalup, WESTERN AUSTRALIA G. Gregory Haff Professor of Strength and Conditioning Course Coordinator Masters of Exercise Science (Strength & Conditioning) Edith Cowan University Joondalup, WESTERN AUSTRALIA Keijo Häkkinen Neuromuscular Research Center Biology of Physical Activity Faculty of Sport and Health Sciences University of Jyväskylä, FINLAND Disa Hatfield Department of Kinesiology University of Rhode Island Kingston, RI Cody Haun Speed Center Sport Science Coordinator Exercise Science Lagrange College LaGrange, GA Guy Hornsby Coaching and Performance Science College of Physical Activity and Sport Sciences West Virginia University Morganton, WV Chad Kersick Exercise Science Exercise and Performance Nutrition Laboratory School of Health Sciences Lindenwood University St. Charles, MO William J. Kraemer Department of Human Sciences Program Area: Kinesiology The Ohio State University Columbus, OH Hugh Lamont Department of Kinesiology Coastal Carolina University Conway, SC Jeff McBride College of Health Sciences Department of Health & Exercise Science Director: Neuromuscular & Biomechanics Laboratory Appalachian State University Boone, NC Satoshi Mizuguchi Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Robert U. Newton Exercise Medicine, Exercise Medicine Research Institute Edith Cowan University Joondalup, WESTERN AUSTRALIA Kyle Pierce Kinesiology and Health Science Louisiana State University at Shreveport Michael W. Ramsey Department of Sport, Exercise, Recreation, and Kinesiology Center of Excellence for Sport Science and coach Education East Tennessee State University Johnson City, TN Nicholas Ratamess School of Nursing, Health, and Exercise Science The College of New Jersey Ewing, NJ Hugo Santana College of Education, Federal University of Mato Grosso Do Sul, Avenida Costa E Silva, Campo Grande, Mato Grosso do Sul, BRAZIL Margaret E. Stone Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Timothy J. Suchomel Department of Human Movement Sciences Carroll University Dylan Suarez Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University Johnson City, TN Kyle Travis Sports, Exercise, Recreation and Kinesiology Center of Excellence for Sport Science and Coach Education East Tennessee State University, Johnson City Chris Taber Exercise Science College of Health Professions Sacred Heart University Fairfield, CT N. Travis Triplett Exercise Science Exercise Science Undergraduate Program Director Department of Health and Exercise Science Appalachian State University Boone, NC Jakob Vingren Chair Department of Kinesiology, Health Promotion and Recreation Professor of Exercise Physiology and Biological Sciences Co-Director Applied Physiology Laboratory University of North Texas Denton, TX John Wagle Performance Science/Player Development Kansas City Royals Surprise, AZ Dan Wathen Athletic Trainer Emeritus Youngstown State University Youngstown, OH

Key concepts: Muscle hypertrophy, Resistance training, Myofibril, Strength training, Muscle strength, Periodization, Resistance (ecology), Medicine

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