Exercise Science - True of False? Large Muscles First for Growth? Cooling Works Before & After Workouts? Senior Olympians Have Healthy Bones? Hypoxia + HIT = WIN?

I know it's difficult to resist guys, but first things first: Study confirms, you better train the large muscle groups of the upper body first, before you go progress to what many of you probably love the most... no, not what you think now, I am talking about training arms ;-)

I know that you probably think that I had forgotten about the exercise science quickie I announced in Saturday's installment of On Short Notice. Today's SuppVersity article is written proof that this is not the case. With topics that range from the redundancy of hypoxia training and intense workouts and the beneficial effects of training the large muscle groups first in your workout to the usefulness of the internal and external application of cold water and other stuff before and after workouts to elicit performance gains and speed up recovery and the unique benefits only heavy resistance training has to offer to elderly bones, I'd hope that everybody will find at least one item he / she is interested in.

And in the fortunate case that you know all the "right" to the true or false", already, you may want to pick up a couple of recent SuppVersity Facebook news to satisfy your cravings.

Adding hypoxia on top of already intense workout is probably useless

(Holis. 2013) -- No further improvement if intensity is already high!? Yep, that's at least what a recently published study by scientists from the University of Exeter would suggest. The researchers subjected 9 physically-active male participants to three weeks of intensive single-leg knee-extensor exercise training.

Erratum: Other than I initially wrote the study used identical training sessions for both legs with the sole difference being that one was trained under hypoxic and the other under normal oxygen conditions for 25 minutes (no cuffs here, thx David for the heads-up!).

Suggested read: A brief summary of a summary o the current state of the art as far as blood flow restricted (BFR) / Kaatsu training is concerned (read it).

When they evaluated the results, Holis et al. found that neither the most straight forward parameter, namely the time-to-exhaustion during incremental exercise nor the changes in muscle metabolite concentrations during the workout were significantly different between the leg that was trained under normal and that which was trained under hypoxic conditions. Now this does not necessarily mean that there may not be minimal or other benefits you could derive in the long run (I am thinking about mitochondrial biogenesis) by making an already intense routine even more intense by training under hypoxic conditions. However, if there was such an effect, it is  probably going to be minuscule and certainly not something anyone, but an Olympic athlete would benefit from.

Large muscle groups first! Common BB-wisdom confirmed once again

(Simã. 2013) -- You've certainly heard about the "growth promoting effects" of squats, deadlifts etc., right? Of course you have! And as a diligent student of the SuppVersity you will also be aware that this growth promoting effect is supposed to be the result of the workout induced endocrine response.

Want another Exercise Science Quickie? What about news on light training with high TUTs, the HIIT vs. Liss Formula for more T, DHT & cortisol and the effects your left leg has on your right one (learn about all).
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"The results indicate that the GH concentration increased after both sessions, but the increase was significantly greater (p < 0.05) after the sequence in which larger muscle-group exercises were performed prior to the smaller muscle-group exercises. No differences were observed between sessions for TT [total testosterone], FT [free testosterone], SHBG [sex hormone binding globulin], C [cortisol], or the T/C [testosterone / cortisol] ratio at baseline or immediately after resistance exercise. These results indicate that performing larger muscle-group exercises first in an upper-body resistance-exercise session leads to a significantly greater GH response." (Simã. 2013)

Don't worry I am not going to discuss for the 1003rd time, whether the absence of any hormonal difference outside of the increased growth hormone response is good or bad for your gain. I just want your to memorize that the GH response corresponds with the workout volume, which was significantly higher, when the 20 male subjects trained the large muscle groups of the upper body before the smaller ones. So even if it was only a question of workout economy, the longstanding rule of thumb to train large muscle groups first would obviously still have its place in today's in parts sometimes ueber-scientificated workout planning.

Competitive sports is not a good means to protect your bone mineral density

(McCory. 2013) -- According to the latest study from the University of Pittsburgh Clinical and Translational Research Center old the mere participation in regular (intense), bot not strength specific physical activity alone does not offer any protective effect against age induced bone loss.

"Our results imply that participation in highly competitive senior athletics does not have a protective effect on BMD, perhaps because of a lower bodyweight or other confounding factors." (McCory. 2013)

Among the parameters which did apparently figure were (you guessed it) bodyweight, and calcium and vitamin D intake. The higher those three parameters were the better the bone mineral density.  Plus: The knee extension peak torque explained another 3.4% of the variance, but only in the hips.

Taking calcium supplement has been associated w/ prostate cancer and CVD in some, but not all studies (Baron. 2005; Spence 2013) With up to 14x elevated lead levels in some OTC calcium supplements the differences may well depend on whether you pick the wrong one (learn more).

That being said I personally believe we'd have seen very different study outcomes if the researchers had not made the common mistake of confusing "sports" with endurance exercise and would thus not have narrow-mindedly focused on those participants of the "Senior Olympics", who competed in running events longer than 400 m (n = 44; 28 males, 16 females), cycling events longer than 5K (n = 17; 11 males and 6 females), and any swimming event (n = 43; 25 males and 18 females). After all, a very recent study from the Catholic University of San Antonio did just confirm that high resistance circuit training (HRC) and heavy strength training can improve the bone mineral density in an elderly population (Romero. 2013).  And what's more, the high resistance had the added benefit of inducing significant improvements in body composition in the thirty-seven healthy men and women (61.6±5.3years) who participated in the randomized trial.

Is cooling a useful tool for performance recovery?

(Poppendieck. 2013) -- According to the latest review by scientists from the University of Saarbrücken, Germany, "the average effects of cooling on recovery of trained athletes were rather small (2.4%, g=0.28)" (Poppendieck. 2013) With a peak in performance increase roughly 4-days after the initially exercise bout and the greatest benefit being observed with endurance athletes, it does also look as if there were particular subgroups of athletes who'd benefit most: Those expose their bodies to several high intensity stimuli within a relatively short timespan, namely.

What about pre-cooling, then? With average performance increases of +8.6%, +6.0% and +4.2% endurance athletes performing open-end tests, graded exercise tests and time trials are the ones who benefit most. Similar effect was observed for intermittent sprints (+3.3%, g = 0.43), whereas performance changes were smaller during short-term, high-intensity sprints (−0.5%, g = 0.03). Across all sports included in the most recent review of the literature (Wegman. 2013), cooling the musculature before a training session will have a larger effect on performance in hot (+6.6%, g=0.62) than in moderate temperatures (+1.4%, g = 0.004).

The most promising cooling methods were cold drinks (+15.0%, g= 1.68), cooling packs (+5.6%, g = 0.70) and a cooled room (+10.7%, g = 0.49), whereas a cooling vest (+4.8%, g = 0.31) and water application (+1.2%, g = 0.21) showed only small effects. Regardless of the method, the best trained subjects (highest VO2Max) saw the greatest benefits.

For those who want to try it and don't have access to a cryotherapy chamber (effect +3.8%), I'd recommend to go "hard core" and do - irrespective of which muscle group you may have been training - a full-body water immersion. The latter has been shown to be 70% more effective than water immersion of individual body parts. The use of icepacks, on the other hand, will rather compromise than promote recovery (-1.4%).

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Two bad, one good news: The first bad news is that this was it for today - at least if you don't count the facebook news that are already available, e.g.

• Black cohosh for breast cancer prevention? The jury is still out there (learn more)
• Adiponektin does not work in women? With a low type II fiber count and correspondingly lower receptor density it is at least not as effective as in men (learn more)
• Whole grains taste like sh*t? That's at least what the participants of a recent epidemiological study thing and probably also the reason they won't eat them (learn more)

as well as as those I am still going to post within what probably would count as "today" at least for some of you.

These pics are more than 2 weeks old and I can tell you that Adelfo's "anatomy chart" physique has kept improving ;-)

The 2nd bad news is that there won't be a SuppVersity Science Round-Up tomorrow. I had hoped that my voice would recover, but since it failed me several times in the cause of the day, I heavily doubt that you would understand anything I would be grunting into the phone, anyway.

But don't worry, there is also good news. Tomorrow is one of those "every other week" Thursday's where Adelfo Cerame is "in the house" and will (at least that was the pan last week) fill you in on the differences between the current and previous content preps... and I can assure you that's going to be a post even those who are not planning to compete will probably find very useful (I hope you read this Adelfo, 'cause I am just rising the bar, here ;-)

References:

• Baron JA, Beach M, Wallace K, Grau MV, Sandler RS, Mandel JS, Heber D, Greenberg ER. Risk of prostate cancer in a randomized clinical trial of calcium supplementation. Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):586-9.
• Holliss BA, Fulford J, Vanhatalo A, Pedlar CR, Jones AM. Influence of intermittent hypoxic training on muscle energetics and exercise tolerance. J Appl Physiol. 2013 Jan 10. 
• McCrory JL, Salacinski AJ, Hunt Sellhorst SE, Greenspan SL. Competitive Athletic Participation, Thigh Muscle Strength, And Bone Density In Elite Senior Athletes And Controls. J Strength Cond Res. 2013 Feb 25. 
• Poppendieck W, Faude O, Wegmann M, Meyer T. Cooling and Performance Recovery of Trained Athletes - a Meta-Analytical Review. Int J Sports Physiol Perform. 2013 Feb 02.
• Romero-Arenas S, Blazevich AJ, Martínez-Pascual M, Pérez-Gómez J, Luque AJ, López-Román FJ, Alcaraz PE. Effects of high-resistance circuit training in an elderly population. Exp Gerontol. 2013 Mar;48(3):334-40.
• Simão R, Leite RD, Speretta GF, Maior AS, de Salles BF, de Souza Junior TP, Vingren JL, Willardson JM. Influence of upper-body exercise order on hormonal responses in trained men. Appl Physiol Nutr Metab. 2013 Feb;38(2):177-81.
• Spence LA, Weaver CM. Calcium intake, vascular calcification, and vascular disease. Nutr Rev. 2013 Jan;71(1):15-22.
• Wegmann M, Faude O, Poppendieck W, Hecksteden A, Fröhlich M, Meyer T. Pre-cooling and sports performance: a meta-analytical review. Sports Med. 2013 Jul 1;42(7):545-64.

Light Weights, Low Oxygen: Hypoxia & Vascular Occlusion Training Yield Similar Increases in Neuromuscular Activation & Maximal Voluntary Force Generation in Female Athletes

The left part of the image shows what scientifically proven hypoxic training looks like. You wear a mask with an exogenous supply of low oxygen air. The right part of the image shows you what the fitness industry will try to sell you as "hypoxic training". That being said, did you know that at least the left version could also help you shed 11%% of your body fat in three weeks (learn more)?

Based on the feedback I got on the mini-summary of the latest review on "Kaatsu" aka blood flow restricted training I posted as part of last Monday's Exercise Science Round Up, I gather that many of you will be interested to hear about the results of a pertinent experiment that has been conducted only recently at the Lincoln University in Christchurch; New Zealand (Manimmanakorn. 2013).

To elicit, whether a combination of resistance training and vascular occlusion would modify the patterns of muscle activation, the development of muscle strength and hypertrophy, and whether these effects could be replicated by training under hypoxic conditions, the scientists who were involved in this research recruited 30 female netballers (age 20.2 ± 3.3 years, height 168.4 ± 5.8 cm; body mass 65.2 ± 6.5 kg, mean ± SD).

Ladies, hold your breath ;-)

The women were in their pre-competition training phase, and matched on their netball ability (had equal training volume, and were trained by the same physical conditioner). They were randomly assigned to either hypoxic training (HT), vascular occlusion (=Kaatsu; KT) and control training (CT) and had them perform bilateral knee extensions and flexions from 0 to 90° on a regular leg extension machine.The detailed experimental protocol for the three groups looked like this:

If you don't intend to suffocate yourself or at least your leg muscles, but still have (for whatever reason) to use lighter weights, you may be interested in another recent study, which was able to show that ballistics lunges activate muscles to the same extent as 34% lighter standardlifts and that this effect can be improved by using elastic band & dumbbells (learn more)

"During each set of knee extensions and flexions, participants in the HT group received normobaric hypoxic gas from a face mask via a hypoxicator system . The fraction of inspired oxygen (FIO2) was automatically adjusted by the hypoxicator using a biofeedback control system to maintain saturation of peripheral oxygen (SpO2) at *80 % (normal SpO2, approximately 99 %). The KT group performed training with restricted leg vascular blood flow in both lower limbs. During training, the pressure exerted by the Kaatsu cuffs (which were approximately 5 cm in width) at the root of the thigh,was gradually increased by 10 mmHg each day, starting from 160 mmHg at Day 1 going up to 230 mmHg at Day 8. The pressure then remained unchanged throughout the remaining of the training (Abe 2006). Heart rate and SpO2 were monitored by a pulse oximeter at the end of each exercise set. The CT group performed knee extension and flexion exercises with the Kaatsu cuffs on but not inflated (<5 mmHg) and breathed normal ambient room air." (my markups in Manimmanakorn. 2013)

In the course of the 5-week training period the participants completed three training sessions per week. Each training session consisted of three sets of knee extensions followed by three sets of knee flexions to failure (unable to complete the exercise successfully). The total number of sets was thus six, with 30s rest between sets and 2-min rest between exercises and a TUT (time under tension) of 1 0 1, which means that the women performed the exercise with a 1s concentric, 0 seconds rest at the top and a 1s eccentric contraction.

"Building strength with 20% of the 1-RM? You are kiddin' me, right?"

The resistance used was light - very light in fact: 20 % of the 1-RM. And as if that was not already light enough, the HT and CT groups of which the scientists expected that they would be able to perform more reps were advised to match the repetitions performed by the KT group "to ensure equal training load between groups" (during the tests the subjects were obviously required to perform as many reps as they could). Against that background, it's actually not surprising that there were no increases in any of the measured parameters in the control group:

Figure 1: Relative changes (in %) in the peak maximum voluntary contraction in 3 s,  area under the 30 s MVC curve,the number of repetitions able to be performed at 20 % 1-RM (left) and changes in surface electromyogram (EMG) amplitude (root mean square RMS %) during the Reps20 test before (pre) and after (post) 5 weeks training (Manimmanakorn. 2013)

As you can see in figure 1 the hypoxia training turned out to be the most effective if training methods - at least, if we go by the absolute increases in maximal voluntary contraction. The difference to the Kaatsu condition, however was trivial for all three parameters: The MVC3, the MVC30 and the total number of reps at 20% of the 1-RM.

The gym of the future a torture chamber or just an "old-school" gym in the basement?

Whether the gyms of the future will hand out cuffs at the door or "simply" have a low oxygen environment... wait a second: Now I know why all the strong guys train in these non-air-conditioned old-school gyms. It's to create a hypoxic environment, one of which the researchers say that it furthers "substantial increases in strength and endurance", which were "undoubtedly" brought about in part due to increased skeletal muscle hypertrophy.

Takarada et al. found that low inten- sity occlusion training can induce greater increases biceps CSA than regular high intensity training even in trained subjects (Takarada. 2000)

"However, indications of specific neuromuscular adaptation were also detected in the form of an increased EMG signal during the MVCs, particularly in the vascular occlusion group, indicating that increased motor unit activation probably also played a role in enhanced force production in these participants. Additionally, during a dynamic fatiguing exercise (Reps20) improvement in performance by the hypoxic and vascular occlusion groups post-training was in part due to improved efficiency of the force production machinery of the muscle." (Manimmanakorn. 2013)

Unfortunately, the actual increases in muscle cross sectional area (CSA) were not measured in the study at hand, but based on the findings of previous studies, which did report (in some cases) pretty impressive increases in CSA (see image next to the citation for one impressive example), I guess the scientists assumption that the ladies in the hypoxia and Kaatsu groups will also have gained more muscle than their peers is more than plausible.

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Looking for readily available intensity techniques? "Unleash the Neanderthal Within" with Adelfo Cerame's "Fav Five Intensity Techniques" (learn more)

Bottom line: Now, let's get back to the "gym of the future" - I am not yet convince that we are soon going to see the air being sucked out of the gyms, but I am more and more convinced that blood flow restriction, Kaatsu, vascular occlusion or whatever else you may be using to reduce the oxygen supply to the muscle and thus increase the amount of eu-stress (=beneficial stress, learn more), will probably become the "intensity technique" of the future - if not on a "whole gym level", then maybe in form of one or two of those neat cages (see image at the bottom of the article).

Whatever the future may hold, I still feel that it is very unlikely that Katsuu and hypoxic training with light weights are ever going to replace "regular" strength training completely. 

After all, working out should be more to you than just a means to develop sleeve bursting biceps. Honestly, if you seriously can say for yourself that you would not miss lifting heavy weights and would willingly content yourself with the knowledge that you should be able to do that, it's no wonder that you are clutching to any straw to finally make those gains you have been chasing for years.

Kaatsu training on methodological dope: Where is the level playing ground?"

You should also keep in mind that neither the study at hand, nor the previously mentioned and unquestionable impressive study by Takarada offered a level playing ground for the contestants, i.e. classic hypertrophy vs. Kaatsu or training in hypoxic conditions.

Is this how the gym of the future looks like? I guess, the results of the study at hand are still not enough to predict the future, but when I was looking for a nice video to go with this article, I found an ABC report that underlines that Victor Conte (yep, the "Balco guy") believes in the success of hypoxic training (watch video)

The "high intensity" condition in the Takarada condition prescribed training loads from 50-80% and would be considered "moderate" by the majority of muscle heads. Manimmanakorn study, on the other hand, the fact that the "HT and CT groups were then instructed to match the repetitions performed by the KT group to ensure equal training load between groups" (Manimmanakorn. 2013) is a major downside to its real world significance and makes me wonder what the ladies in the HT group could have achieved, when they would not have had to stop "before their time"...

... ah, and I don't have to mention that not having a high intensity group in the Manimmanakorn study reminds me of those sponsored pre-workout supplement studies, here the placebo is either plain water or simple sugar - when you want to prove something is superior to common practice you better test it against common practice or your data is of highly questionable practical value. 

References:

• Abe T, Kearns CF, Sato Y (2006) Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol 100:1460–1466 
• Manimmanakorn A, Manimmanakorn N, Taylor R, Draper N, Billaut F, Shearman JP, Hamlin MJ. Effects of resistance training combined with vascular occlusion or hypoxia on neuromuscular function in athletes. Eur J Appl Physiol. 2013 Feb 15.
• Takarada Y, Takazawa H, Sato Y, Takebayashi S, Tanaka Y, Ishii N. Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol. 2000 Jun;88(6):2097-106. 

Blood Flow Restriction, Where Are We? "Don't Hold Your Breath", the Valsalva Maneuver Revisited. Ageless Growth, It's Never Too Late to Start. Plus: EMS as Recovery Tool & HIIT to Heal a Scarred Heart After Myocardial Infarctions

I guess it is a cultural thing that there is apparently a lot more of persuading to be done in the US and Europe to familiarize trainees with (a) the idea of limiting the blood supply to their musculature and (b) the notion that heavy weights are not all that counts.

After the huge success of the SuppVersity Exercise Science Week (read all posts), I did actually intend to put a greater emphasis on training related news in the future. Unfortunately, the number of pertinent papers that don't look at the benefits obese post-menopausal women can derive from walking on a treadmill in the fat burning zone is very limited (Please don't misunderstand this as an offense against the obese women. I anything it's meant as an offense against "experts" still advising those women to do just that). If you look closely enough, there are still a couple of newsworthy papers that have been published within the last weeks... and let's be honest, in the end it does not really matter, if they are from last week, as long as the information they provide is "news" in terms of not being part of common knowledge, yet - right?

Kaatsu - a review: Blood flow restriction research still work-in-progress

(Pope. 2013) -- Pope, Wilardson and Schoenfield have recently published an ahead-of-print paper that offers a very comprehensive overview of the current scientific perspective on training with cuffs (aka Kaatsu training). As the authors point out, the most intriguing aspect of blood flow restricted training (BFR) is that it is totally juxtaposed with the "traditional [strength training] paradigm, which suggests that lifting only higher intensity loads increases" muscle strength and size.

Figure 1: Concurrent lactate & GH increases support the metabolic accumulation hypothesis, one of the most popular explanations for the effects of BFR  (Inagaki. 2011).

One of the most commonly head explanations of the unexpected efficacy of blood flow restricted strength training at low intensities relates to the accumulation of what you could jovially call "metabolic waste" in the trained muscle. The results of a 2011 EMS study by Inagaki et al. (see figure 1), for example; suggest that the accumulation of lactate in the cuffed muscle went hand in hand with a +200% increase in growth hormone (GH) compared to the control condition. 

As Pope et al. rightly point out, these results do yet conflict with previous findings by Reeves et al. who observed similar increases in GH in trainees who wore a cuff while they were doing biceps curls at 30% of the 1-RM, despite identical lactate levels in the cuffed an not-cuffed condition (Reeves. 2006). Accordingly, alternative or rather synergistic effects such as an increase in reactive hyperemia (excess of blood) have been brought forward to explain the growth response to BFR.

I am not going to reiterate the whole review here, but still want to point out a couple of other interesting points, the Pope, Willardson and Schoenfield make. There would be, for example the increase in type II (fast, glycolytic) muscle fiber recruitment that was observed in some, yet not all studies, an increase phosphorylation of the protein synthesis gauge S6K1 (likewise a type II fiber dominant effect) and the accumulating evidence that BFR may "enhance recruitment of higher threshold motor units". In the end, the latter means that you will see similar activation patterns as you would expect them in "classic" heavy duty resistance training with comparably light loads and a cuff.

Will BFR soon become a common training technique?

"Chicken legs no more!" In a previous study even walking on a treadmill provided a growth stimulus, when the legs were cuffed before the participants hopped on the torture machine (learn more).

Yet while the implication (=similar results) appear obvious, Pope et al. are correct, when they point out that the "precise relationship between BFR and muscle recruitment still has to be elucidated" before definite conclusions wrt to the fundamental mechanism and their relation to the well-established metabolic and endocrine and paracrine responses, which do in fact share some, yet not all of the characteristics of "classic" resistance training (e.g. no increase in testosterone in response to BFR training; cf. Reeves. 2006; Fujita. 2007; Abe. 2013) can be made.

Once we have gained a better understanding of the processes that take place during and after BFR resistance training, researchers will probably also be able to provide more concrete advice how training with reduced blood flow can be successfully incorporated into the resistance training regimen of trainees on both ends of the performance continuum that ranges from the cancer cachetic patient to the elite level athlete.

Until then and in the absence of someone who's actually knowing what he/she to "cuff me up", I for my part will stick to traditional high intensity weight and interval training and would suggest that you do the same ;-)

"Deadlift, bench and squat, but God forbid: Never hold your breath!" - True or false?

(Hacket. 2013) -- I guess you will have heard about the fallacy of holding your breath while you bench squat and deadlift. It's one of those things every "I got 2h of instructions, now I am a trainer"-expert will tell his clients: "Don't hold your breath... breath!" On the other hand you will hear some of the "big dudes" tell you that you simply cannot lift weights as heavy as they do, if you don't resort to the Valsalva maneuver (VM) which is actually pretty much what most of us are doing, when we are "holding our breath", when lifting. If you carefully observe yourself, when you try to deadlift 80%+ of your 1-RM max you will realize that you do in fact hold your breath, but not like an apnoe diver would do it, on the contrary actually it's like breathing out yet with having your airways closed up.

So why are we doing bullsh*t like that 100% unvoluntarily? Well, the opponents of "holding your breath" will tell you that the pressure that's building up in your abdomen will stabilize your spine and protect you from injury. Against that background it seems only logical that we are naturally programmed to perform such a maneuver whenever we have to lift a heavy object from the ground or free ourselves from a tree that's lying right across our chest by benching it away ;-)

Even  when you are training for strength, heavy weights are not everything. A study I covered back in 2011 here at the SuppVersity showed - allegedly to my own surprise - that reducing rest times from week to week is another way to make progress and gain more mass and strength - particularly in the legs (read more)

Unfortunately, we all know that not all the things we are programmed to do - e.g. eating as much sugar as humanly (in the literal sense) possible, whenever we hit onto a honey-pot - is not necessarily conducive to our health. The existing literature on the matter appears to confirm this notion. It does however also tell us that the majority of healthy resistance trainees do not just get away pretty well when they follow their instincts and perform the Valsalva maneuver, but also achieve the desired increase in spine stability.

How effective this type of all-natural spine protection actually is, has yet never been fully elucidated. The same goes for the performance increases which are, as the scientists point out, "likely", but not adequately quantified in well-controlled studies. That there is a non-negligibly increased risk involved, especially for people with pre-existing cerebrovascular disease, cardiovascular disease and hernias, on the other hand, is non-debatable.

Against that background and in view of the fact that the hemodynamic response (=increase in blood pressure, etc.) decreases over years of training, the authors conclude that the deliberate use of the Valsalva maneuver for brief time-periods (<3s) should remain a prerogative of the more experienced trainees. 

Electrical muscle stimulation (EMS) as a recover tool

SuppVersity veterans know: Recovery begins before you even hit the gym. "Pre-covery" would in fact be an appropriate term for the scientifically proven benefits of taking a hot bath 2 days before a particular strenuous workout or competition. Sounds hilarious? Well, if that's what you think, you better go back and read up on the results of the 2013 study by Touchberry et al., then.

(Kibisa. 2013) -- Ever since the huge disappointments with EMS ab-trainers, the electro-myostimulation is pretty much depreciated by the average trainee. If you still got one of those belts lying around (don't be ashamed ;-) you may want to wrap it around your calves, instead of your abs to use it as a recovery tool similar to the obviously way more sophisticated EMS devices the scientists from the Lithuania Kaunas College used in their latest study.

Kibisa et al. had recruited a group of 19 long-distance runners who had then been randomize to two groups who performed either their regular post-training routine or were attached to the said EMS device in order to apply what you may call a "post-workout recovery stimulus". Interestingly this treatment lead to significant increases in a subsequent maximal voluntary contraction (MVC) and work capacity (WC) tests, as well as profound decreases in in the 72h post muscle soreness.

As you probably would have guessed, the scientists ascribe these benefits to an "improved blood flow in the stimulated muscles and an increased venous blood pump". This however is nothing you could not achieve by an extended cool down, as well so that the study at hand won't qualify as an excuse to go and buy an EMS belt for your abs from the shopping channel ;-)

HIIT after infarction reduces scarring of heart tissue

In the unfortunate case you missed the Making HIIT a HIT! Series I highly suggest .you go back and learn about the fundamental and not so fundamental rules of how to HIIT it right. Part I comprises a brief research overview to give you an idea of what you can expect from HIIT workouts. Part II provides some theoretical considerations and a comprehensive list of 10 rules of thumbs to follow, in order to make HIIT a HIT ;-)

(Godfrey. 2013) -- The longstanding paradigm that rest facilitates recovery in the really sick is crumbling. Against that background it's not totally surprising to see that researchers from the School of Sport and Education at the Brunel University in the UK dared publishing a case-report dealing with a 50-year old post-myocardial infarction patient, who participated in 60 weeks of increasingly intense (obviously according to what a post-myocardial infarction patient can tolerate) high-intensity aerobic interval exercise.

The man who had sustained an idiopathic acute myocardial infarction had been diagnosed with 16% myocardial scar tissue early after the event saw successive improvement in the physiology of his hard, with an MRI-confirmed decrease in myocardial scar tissue. As the scientists point out, he is thus living proof for the "high efficacy and low risk" of high intensity aerobic interval training as a means not just to prevent future cardiac complications, but even to reverse existing damage.

Resistance training works *fullstop* - Regardless of age

(Mero. 2013) -- In the March issue of the European Journal of Applied Physiology Mero et al. report that their 21-week progressive resistance training regimen (two full-body workouts per week classic progression from 15 reps at 40-60% to 5-8 reps at 70-80%) yielded significant strength and size gains in old and young previously untrained subjects.

Figure 2: Changes in muscle cross sectional area and strength at the end of the 21-week study period (Mero. 203)

What's certainly surprising is the fact that there were no differences in terms of strength gains at the end of the study period between the young and old trainees. This is particularly interesting, because the "old chaps" obviously caught up, in the 2nd (=higher intensity) phase of the study. After 10.5 weeks, the young trainees had had a statistically significant advantage as far as the concentric strength was concerned. This advantage did yet melt away in the subsequent weeks.

Remember the article on the usefulness of HMB for the older trainees? With its anti-catabolic effect it would leave more of the scarce satellite cells for growth. Plus: It appears to have anti-obesity effects as well (read more)

In a way the presence of strength in the absence of size gains fits in nicely with the high myostatin expression in the older trainees which increased by >50% in the course of the study (read more about the role of myostatin building muscle) and the even more pronounced increase in myogenin, which suggest that the recruitment of satellite cells is slow / non-function in older trainees and further growth would hamper the function of the muscle cells (which is what myostatin is supposed to prevent learn more).

That two training sessions per week did yield statistically significant increases in muscle size and strength and that despite suboptimal energy and protein intake in the older individuals (<1g/kg body weight protein per day for many of the older subjects vs. 1.5g/kg of protein in the young guys; overall significantly lower energy intake than the young guys) is still impressive and goes to show you that it's never to late for you to start lifting weight.

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It's never too late! I could hardly imagine a better bottom line to this short potpourri of recent studies and it's unfortunate that for way too many of our fellow men, even an eye-opener like a heart attack is not enough to divert from the well-worn path of a sedentary life... ok, that was more than enough finger wagging for today. After all, the fact that you've found your way to the SuppVersity is evidence tells me that your path probably ain't going to end in the emergency room.

Well, unless you are a post-menopausal woman taking who's determined to take high dose folate supplements for the next 6+ years. In that case, you may well end up in the ER when the tumor in your colon you've been cultivating over the past 72 months bursts. You have now idea, what I am talking about? In that case you probably haven't yet subscribed to the SuppVersity Facebook Channel yet. Certainly a mistake, but as you've learned today, it's never too late and once you've read the respective post, you can still mae up for this lapse ;-)

References:

• Abe T, Loenneke JP, Fahs CA, Rossow LM, Thiebaud RS, Bemben MG. Exercise intensity and muscle hypertrophy in blood flow-restricted limbs and non-restricted muscles: a brief review. Clin Physiol Funct Imaging. 2013 Jul;32(4):247-52.
• Fujita S, Abe T, Drummond MJ, Cadenas JG, Dreyer HC, Sato Y, Volpi E, Rasmussen BB. Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. J Appl Physiol. 2007 Sep;103(3):903-10. Epub 2007 Jun 14.
• Godfrey R, Theologou T, Dellegrottaglie S, Binukrishnan S, Wright J, Whyte G, Ellison G. The effect of high-intensity aerobic interval training on postinfarction left ventricular remodelling. BMJ Case Rep. 2013 Feb 13;2013.
• Hackett DA, Chow CM. The Valsalva maneuver: Its effect on IAP and safety issues during resistance exercise. J Strength Cond Res. 2013 Dec 4.
• Inagaki Y, Madarame H, Neya M, Ishii N. Increase in serum growth hormone induced by electrical stimulation of muscle combined with blood flow restriction. Eur J Appl Physiol. 2011 Nov;111(11):2715-21.
• Kibiša R, Grūnovas A, Poderys J, Grūnovienė D. Restoration of the work capacity of the skeletal muscle with electrical myostimulation. J Strength Cond Res. 2013 Feb;27(2):449-57. 
• Mero AA, Hulmi JJ, Salmijärvi H, Katajavuori M, Haverinen M, Holviala J, Ridanpää T, Häkkinen K, Kovanen V, Ahtiainen JP, Selänne H. Resistance training induced increase in muscle fiber size in young and older men. Eur J Appl Physiol. 2013 Mar;113(3):641-50.
• Pope ZK, Willardson JM, Schoenfeld BJ. A Brief Review: Exercise And Blood Flow Restriction. J Strength Cond Res. 2013 Jan 28.
• Reeves GV, Kraemer RR, Hollander DB, Clavier J, Thomas C, Francois M, Castracane VD. Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance exercise without occlusion. J Appl Physiol. 2006 Dec;101(6):1616-22.