Elite Training 2017

International Meeting on High Performance Sports

Detecting Functional Asymmetries

From the Strength Lab to the Weight Room
Dr. Matt Jordan, PhD, CSCS
Director, Strength and Conditioning, Canadian Sport Institute Calgary
Director, Sport Science/Sport Medicine, Alpine Canada Alpin
Adjunct Professor, Faculty of Kinesiology, University of Calgary

Sao Paolo, Brazil

October, 2017
 Movement
Neuromuscular
Medical Competency
Monitoring
Evaluation Assessment
(S&C/Physio) (Sport Science)

Athlete Sport Specific

Readiness Competency
(Pysch Factors) Assessment
A few of the key takeaway messages for today
Measuring functional asymmetry matters
There may be ‘functional’ functional asymmetries
Returning to first principles helps to unravel
functional asymmetries
(Gio Auletta, Pentaphoto)
 Strength / Fitness Thigh Muscle Maximal and
Fatigue Factors Mass Repetitive Load
Technical Ability Thigh Muscle Tolerance
Psycho-Emotional Maximal Increasing Cognitive Performance Risk Taking
Modifiable Strength and Physical On Demand
Closed Balance Concentric/ Demands
Kinetic Chain Eccentric Symmetry
Intrinsic On Snow Performance
Extrinsic (SLeg, DLeg)
Advance Quantify Technical Stabilization
Muscle Through Training Load Re-Acquisition
Recruitment Milestones! Stabilization of
Pre-Injury SLeg Weight Fear of Re- Fitness Factors
Active/Passive Bearing Psych
Factors Injury
ROM Mvmnt Neuromuscular
Mechanism Factors
Strategy Monitoring RETURN
EARLY MID PHASE LATE
INJURY! PHASE EARLY RETURN PHASE RETURN TO TO PODIUM
REHAB
REHAB TO SPORT?? REHAB SPORT PHASE
0-2 Mnths 2-5 Mnths 5-8 Mnths Perceived vs. 8-12 Mnths 12-36 Mnths
Graft
SURGERY Vulnerability! ACTUAL
Subjective Return to RETURN TO
Re-injury? readiness?? Psych
Procedure Knee Form / Sport SPORT
Ecc Decel /
Time from Giving Way? Training MONITORING
Injury Complications? Landing Mechanics RETURN TO Training Snow
ABC’s / SPORT LoadAdaptive
Reactive ASSESSMENT Performance
Associated Pivoting FNS Technical
Strength Potential
Pathology Ability
Explosive Graft
Meniscus
Capsule Strength Strength / Functional
Bilateral Knee Neuromuscular
Bone Sleg and Fitness Assessment /
Symmetry stability Athlete
Bruise DLeg Muscle Envelope of
Articular Recovery and Confidence Accepted
Power Function
Cartilage Multi- Regeneration Timelines
ligament Strategies! Medical
Team
Subjective
Opinion /
Consensus
What the S&C Coach Brings to the Conversation
• Ability to produce force (concentric work)
• Ability to dissipate force (eccentric work)
• Synergist strength

Neuromuscular
Monitoring RETURN
What
INJURY!
EARLY
the S&CPHASE
CoachMIDBrings
PHASE to the LATE
Conversation
PHASE RETURN TO
Neuromuscular TO PODIUM
REHAB
REHAB REHAB SPORT PHASE Monitoring
• Ability to produce
0-2 Mnths force (concentric
2-5 Mnths 5-8 Mnths work) 8-12 Mnths 12-36 Mnths

• SURGERY
Ability to dissipate forceReturn
(eccentric
Sport
to work) RETURN TO
Functional
SPORT
• Synergist strength Training
RETURN TO MONITORING
Neuromuscular
SPORT
Associated ASSESSMENT Assessment /
Pathology
Envelope of
Function
Functional
Neuromuscular
Assessment /
Envelope of
Function
“[Those] who have excessive faith in their theories or ideas are not only ill-
prepared for making discoveries; they also make poor observations.”
Claude Bernard
 INCREASE KNEE
Fz R Fz L Fz R Fz L ABDUCTION MOMENT
AI = 22.5% AI = 17.5% (Kristianslund et al., 2014)
Determine what matters, measure what matters, change what matters
 Fz ACLR Limb

Fz Contralateral
Limb
Functional Asymmetry Testing
ACLR Limb
1000 Contralateral Limb

800

Fz Contralateral Fz ACLR Limb

FORCE (N)

600 Limb

400

200

0
15,2 15,7 16,2
Jordan et al., Scan J Med Sci Sports: 2015
TIME (s)
Squat Jump Functional Asymmetry

1250 ACLR Limb

Contralateral Limb

1000
FORCE (N)

750 Fz Contralateral Fz ACLR Limb

Limb

500

0.2 0.4 0.6 0.8 1.0

TIME (s)

Jordan et al., Scan J Med Sci Sports: 2015

Elevated functional asymmetries despite return to sport and competition
 CMJ ECCENTRIC DECEL PHASE KINETIC IM
STATUS
5 Asymmetry
CMJ vs. Muscle Mass SJ Late Takeoff vs. Muscle Mass Asymmetry ACL−R
CONTROL
RE-INJURY

SJ MID TO LATE PHASE KINETIC IMPULSE ASYMMETRY INDEX (%)

CMJ CONCENTRIC PHASE KINETIC IMPULSE ASYMMETRY INDEX (%)
CMJ Concentric Phase Asymmetry (%)

R2 = 0.32

SJ Late Takeoff Phase Asymmetry (%)

15 20
R2 = 0.44
0

10
10
STATUS
STATUS
ACL−
ACL−R
5 CONT
CONTROL

ACL−R CONTROL
0
STATUS
0

−10
−5

−4 −2 0 2 4 6 8 10 −4 −2 0 2 4 6 8 10
ASYMMETRY LEG MUSCLE MASS (%) ASYMMETRY LEG MUSCLE MASS (%)
Asymmetry Leg Muscle Mass (%) Asymmetry Leg Muscle Mass (%)
Jordan et al., Scan J Med Sci Sports: 2015
 Jer Barnert, Strength Coach
CSI Calgary

Can we apply this framework to the upper body?

How should we think about functional asymmetries?
Are all asymmetries problematic?
Is it only the magnitude of functional asymmetry?
Preatoni et al., 2013: Sports Biomechanics
“Repetition without repetition” (i.e. repetition of a movement
is impossible due to the inherent variability in the system
and complexity of the environment) (Bernstein, 1996)

This variability is not noise but is fundamental to the system

and the environment (Bernstein, 1996)
What are the effects of injury on between-limb loading variability?
Thinking About Functional Asymmetry
Functional Asymmetry Index (%) 40

Early Takeoff
0

Late Takeoff

Landing
-40

1 20
JUMP NUMBER
 Thinking About Functional Asymmetry
40 6 MONTHS POST ACLR
40
20

0
20 Early Takeoff
−20

−40
Asymmetry Index (%)

40 0

(%) (%)
20
Late Takeoff
SQUAT JUMP KIAI (%)

Index
0 −20

JUMP KIAI
−20
JUMP PHASE JUMP PHASE

Asymmetry
−40 BA3 −40 BA3
40 BA2
BA1 40 5 5YEARS
YEARSPOST
POSTACLR
ACLR BA2
Landing
BA1
20

FunctionalSQUAT
Functional

0
20
−20

−40
40 0

20

0 −20

−20

−40 −40
0 5 10 15 20
0 5 10 15 20
JUMPJump
NUMBER
Number JUMP
JumpNUMBER
Number
Thinking About Functional Asymmetry

+ LEFT LIMB UNINVOLVED LIMB

ASYMMETRY (%)

0%

– RIGHT LIMB INVOLVED LIMB

UNINJURED ATHLETES ACLR ATHLETES

Thinking About Functional Asymmetry

+
ASYMMETRY (%)

0%

–
Think about the solution space and movement variability

UNINJURED ATHLETES ACLR ATHLETES

Thinking About Functional Asymmetry

+
ASYMMETRY (%)

0%

–
Think about the solution space and movement variability

UNINJURED ATHLETES ACLR ATHLETES

Evidence of reduced between-limb loading variability?
ACLR Skiers: Less Between Limb Loading Variability
ACLR Group Control Group

*** P<0.0001 ACLR Group

KINETIC IMPULSE ASYMMETRY INDEX (%)

Control Group
5
4.9%

Quick Reminder of
ACLR Group
0 Squat Jump PhasesControl Group

-3.8%
−5
-5.1%

Early Late Land Early Late Land

JUMP PHASE
Early Late Land Early Late Land
JUMP PHASE Jordan et al., Med Sci Sports Exercise: 2017
ACLR Skiers: Less Between Limb Loading Variability
ACLR Group Control Group

KINETIC IMPULSE ASYMMETRY INDEX (%)

5

ACLR Group
0
Control Group

−5

Early Late Land Early Late Land

JUMP PHASE Jordan et al., Med Sci Sports Exercise: 2017
Consequences of this limb loading pattern unclear
It’s Rarely About Good or Bad, and More How It Fits

Objectively Determined Data Coach Instinct In the Face of

Accounts for Confirmation Bias Highly Complex Systems
Nurture your instincts, look for facts and don’t force facts
to harmonize with your aspirations
Inspired by Thomas Huxley
Self organizing systems
‘Functional’ functional asymmetries?
 You don’t have force plates … can you still evaluate
functional asymmetries and eccentric deceleration ability?
Yes – although your eye can deceive you
 Assessing Asymmetry in Locomotion
Asymmetry presents as a
 Slow velocity movements – directional change towards
injured side
expand and contract the
movement space

 Sled pulls
Assessing Asymmetry in Eccentric Deceleration

 Quality of the landing (soft vs. hard)

Assessing Asymmetry in Eccentric Deceleration

 Quality of the landing (soft vs. hard)

 Alignment (valgus landings) Hewett et al., 2005

Assessing Asymmetry in Eccentric Deceleration

 Quality of the landing (soft vs. hard)

 Alignment (valgus landings) Hewett et al., 2005

 Confidence to decelerate
 Increase demands – from a height, reactive ability, increase
proprioceptive demands, change vectors, challenge coordination
Considerations for unravelling functional asymmetries
 CNS Factors
Peripheral
Neuromuscular
Factors Muscle Force
Velocity
Relationship

Intramuscular and
Intermuscular
Coordination

Muscle Force Length

Relationship
“The Strength Curve” Muscle Mass/
Muscle
Architecture
Factors to Consider When Training Asymmetries

MUSCLE GROUP CONTRACTION TYPE FORCE-VELOCITY

MUSCLE MUSCLE
FORCE-LENGTH
FORCE ARCHITECTURE

INTRA-MUSCULAR

MUSCLE SIZE
FIBER TYPE / NEURAL
INTER-MUSCULAR
MHC COMPOSITION FACTORS
CENTRAL
Time to wrap it up
Systematic functional asymmetry may not always be problematic
Considerations for unravelling functional asymmetries
Did you consider a single movement cycle, multiple movement cycles,
and contextualize the nature of the functional asymmetry?
Is the functional asymmetry important for performance?
Does the asymmetry amplify the potential for MSK injury?
Understanding the nature of a functional asymmetry
Functional asymmetries are movement action
movement, muscle action,
force-length,
force-length and force-velocity dependent
Return to first principles and evaluate factors affecting muscle force
ACKNOWLEDGEMENTS:
Dr. Walter Herzog, Dr. Per Aagaard, Dr. Dave Smith,
,

Dr. Steve Norris, Dr. Mark Heard

The Herzog Group (Azim Jinha)
Stu McMillan, Dan Pfaff, Graeme Challis, Erik Groves,
Tyler Goodale, Jer Barnert, and The CSI Calgary S&C
Team
 Thank You
@JordanStrength
www.jordanstrength.com
 Elite Training 2017
International Meeting on High Performance Sports

Eccentric Muscles Actions

and Eccentric Deceleration Ability
Dr. Matt Jordan, PhD, CSCS
Director, Strength and Conditioning, Canadian Sport Institute Calgary
Director, Sport Science/Sport Medicine, Alpine Canada Alpin
Adjunct Professor, Faculty of Kinesiology, University of Calgary

Sao Paolo, Brazil

October, 2017
A journey into eccentric muscle actions and assessing
eccentric deceleration ability
Why it matters to measure things that matter
 Case study examples on assessing
eccentric deceleration abilities in elite athletes
Where We Are Headed
Injury
Muscle Prevention
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Increased
CNS
Excitability Ecc/Con
Muscle
Strength
Where We Are Headed
Injury
Muscle Prevention
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Increased
CNS
Excitability Ecc/Con
Muscle
Strength
Types of Muscle Actions
ISOMETRIC CONCENTRIC ECCENTRIC
Potent training stimulus and a challenge for scientists
 I imagine that special features have been evolved which allow this
elongation (of muscles) to take place without damaging the muscle.

I suspect that many of the unexplained phenomena associated with

muscle lengthening are related to these special features, and have
little relation to the processes that take place during shortening.
Huxley, Reflections on Muscle: 1980
Force Velocity Relationship
Maximal Eccentric
Strength
160
Maximal Isometric Strength
140
RELAITVE FORCE 120
100
Maximal Concentric Strength
80
60
40
20
0
-50 0 50 100
VELOCITY OF SHORTENING
Hill, 1938; Herzog, 2009
Maximal Eccentric
Strength 160
140 Maximal Isometric Strength

RELAITVE FORCE
120
100
Maximal Concentric Strength
80
60
40
20
0
-50 0 50 100
VELOCITY OF SHORTENING

This is in intact whole muscle

not under voluntary control of
the CNS
Maximal Eccentric
Strength 160
140 Maximal Isometric Strength

RELAITVE FORCE
120
100
Maximal Concentric Strength
80
60
40
20
0
-50 0 50 100
VELOCITY OF SHORTENING

What about when the muscle

is under voluntary control?
Neural Inhibition During Eccentric Muscle Actions
Maximal Eccentric
Strength 160
140 Maximal Isometric Strength

RELAITVE FORCE
120
100
Maximal Concentric Strength
80
60 In Vivo

40
20
0
-50 0 50 100
VELOCITY OF SHORTENING
Hill, 1938; Herzog, 2009
Why can’t we access the full potential of skeletal muscle
during eccentric muscle actions?
 Evidence of Neuromuscular Inhibition in Ecc Actions
CONCENTRIC ECCENTRIC

Aagaard, 2003
Where We Are Headed
Muscle
Neural Architectural
Factors
Changes
Eccentric Eccentric
Potent
Muscle Strength Training
Stimulus
Actions Training
Features of
Muscle
Effects of Eccentric Exercise on Muscle Architecture:
Hypertrophy (PCSA)

` `
Ecc Loading and Muscle
Hypertrophy (PCSA) ` `

 Decreased myostatin expression Heinemeier et al.,

2007

 More persistent gains in hypertrophy vs.

concentric training Hather, 1991; Schoenfeld et al., 2017
 Selective hypertrophy of Type II fibres Hortobagyi
2000; Vikne 2006

 Increased local IGF-1 production in

muscle and extracellular matrix vs.
concentric training Bamman et al., 2001
 Hypertrophy in
Where We Are Headed Another
Dimension?
Muscle
Architectural
Changes
Eccentric Eccentric
Muscle Strength
Actions Training
Do you remember the sarcomere?
Effects of Eccentric Exercise on Muscle Architecture

` `
Short Term Eccentric Loading Increases Fascicle Length

From: Seynnes et al. J App Phys: 102, 2007

 Evidence for Fascicle Elongation After
Eccentric Loading in Humans
Seynnes et al., JAP 102, 2007
Blazevich et al., JAP 103, 2007
Duclay et al., Muscle Nerve, 39, 2009
Potier et al, EJAP, 105, 2007
Reeves et al., Exp Physiol, 94, 2009
Baroni et al., Muscle Nerve, 48, 2013
Franchi et al., Acta Physiol, 210, 2014
Timmins et al., MSSE, 48, 2016
Guex et al., Front Physiol, 7, 2016
Bourne et al., Br J Sports Med, 2016

Slide Adapted from Per Aagaard, 2017

Why might this be of interest for human performance?
Force Generating Capacity at Highest Shortening Velocities
CS HYPERTROPHY SARCOMERE ADDITION
1

NORMALIZED FORCE ` `
0,8

0,6 Increase Vmax, and force at

highest shortening velocities
0,4

0,2

0
0 0,2 0,4 0,6 0,8 1
NORMALIZED VELOCITY
Edgerton et al., 1986
 Right Shift in Maximal Muscle Power
SARCOMERE ADDITION
NORMALIZED POWER 1

0,8

0,6 Improve muscle power at

highest shortening velocities
0,4

0,2

0
0 0,2 0,4 0,6 0,8 1
NORMALIZED VELOCITY
Edgerton et al., 1986
 In theory, fascicle elongation results in increased
maximal velocity of shortening (V0) and greater forces
at the fastest velocities
Where We Are Headed
Muscle
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Where We Are Headed
Muscle
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Increased
CNS
Excitability
How can we evaluate CNS excitability?
Evaluating Effects of Eccentric
Strength Training on the CNS

Twitch
++ H Reflex

Aagaard, 2003
H-reflex provides an indication of spinal motoneuron excitability
Depression of Motor Unit Excitability During
Eccentric Actions
ISOMETRIC CONCENTRIC ECCENTRIC

xx

Duclay and Martin, 2005

Effects of Eccentric Strength Training on the CNS
 Effects of Eccentric Strength Training on the CNS

 Greater CNS descending drive

Duclay & Martin, 2008

 Increased spinal motoneuron

excitability Duclay & Martin, 2008
200

150
 Increased EMG during eccentric

Force
100
muscle actions and an upwards 50
shift in FV profile Aagaard et al., 2001 0
-50 0 50 100
Velocity
Where We Are Headed
Injury
Muscle Prevention
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Increased
CNS
Excitability Ecc/Con
Muscle
Strength
Where We Are Headed
Injury
Muscle Prevention
Architectural
Why it matters to
Changes
measure things that
Eccentric Eccentric RFD
Cellular matter
Muscle Strength Signaling

Actions Training Muscle

Case studies on
Power
Increased evaluating eccentric
CNS decel abilities
Excitability Ecc/Con
Muscle
Strength
 Can you make force fast?

Rapid force capacity, explosive strength, RFD

 But being able to put on the brakes by making force fast
eccentrically is key as well, especially for injury prevention
ACL Risk Factors: Transition Zones

 Rapid eccentric deceleration

(landing jumps / changing direction)
high risk sport movement

 Time frame of injury < 50 ms Krosshaug

et al., 2007
(Gio Auletta, Pentaphoto)
Eccentric Deceleration and Injury
INJURY PERIOD (60 ms)
70

60
KNEE JOINT ANGLE

50

40
Knee Flexion
30
Valgus
Internal Rotation
20

10 Rapid increase in knee flexion 26º to 63º

AKA a rapid eccentric deceleration
0
0 80 160
-10
TIME (ms) Barone et al. Skiing Trauma and Safety, 12th Edition (1999): 63-81.
Bere et al. The American journal of sports medicine 41.5 (2013): 1067-1073.
How can we evaluate eccentric deceleration ability?
 Assessing Eccentric Decel Ability 4000

3000

FORCE (N)
2000

1000

0
CONCENTRIC -0,4 0,1 0,6 1,1 1,6
ECCENTRIC
PHASE
DECELERATION -1000
PHASE
4

VELOCITY (m/s)
2

0
-0,4 0,1 0,6 1,1 1,6
-2
Jordan et al., Scan J Med Sci Sports: 2015 TIME( s)
 Assessing Eccentric Decel Ability
4000

3000

FORCE (N)
2000

1000

0
CHANGE OF DIRECTION -0,4 0,1 0,6 1,1 1,6
-1000
4

VELOCITY (m/s)
2

0
-0,4 0,1 0,6 1,1 1,6
-2
Jordan et al., Scan J Med Sci Sports: 2015 TIME( s)
 Assessing Eccentric Decel Ability
4000

3000

FORCE (N)
Eccentric Decel RFD
2000

1000

0
-0,4 0,1 0,6 1,1 1,6
-1000
4

VELOCITY (m/s)
2

0
-0,4 0,1 0,6 1,1 1,6
-2
Thorlund et al., 2008
TIME( s)
 Eccentric Deceleration: Managing Loads > BW
2500
Eccentric Deceleration
Concentric Phase
2000
FORCE (N)

1500
Athlete 1
Athlete 2
1000

500

0
0 0,5 1 1,5 2
TIME (s)
Let’s consider some practical case study examples
Case Study #1: Return to Sport Monitoring
Recovery In Asymmetry Following ACLR
Visualizing the eccentric deceleration phase –
knowledge translation
The Eccentric Deceleration Phase: Stiffness

△ Force
Limb Stiffness =
△ Displacement of BCM
The Eccentric Deceleration Phase

ACLR Limb
Force (N)
Contralateral Limb

△ Force
Limb Stiffness =
△ Displacement of BCM

Athlete Displacement (m)

Recovery in Eccentric Decel Ability After Injury
Assessing injury susceptibility in non-injured athletes
Evaluating Injury Susceptibility In Non-Injured Athletes

66 athletes, Wrestling, Alpine Skiing, Soccer, Rugby

Females: n=49; Males: n=17

Pre-season asymmetry testing (5xCMJs, 5xSJs)

Injury surveillance through four months of training

Asymmetry Monitoring, Injuries, Eccentric Decel Ability
25

ASYMMETRY INDEX CMJ ECC DECEL PHASE (%)

25
ASYMMETRY INDEX CMJ ECC DECEL PHASE (%)

20
20

STATUS
STATUS CONTROL
15 CONTROL
INJURED
15 INJURED
INJURY TYPE
INJURY TYPEUNINJURED
UNINJURED
ACL
10 ACL
Bone
10 Bone
LCL
LCL
MCL
MCL

5
5

0
0
Model χ2(1) = 16.3, P<0.01
INDIVIDUAL SUBJECTS
Asymmetry Monitoring, Injuries, Eccentric Decel Ability
25

ASYMMETRY INDEX CMJ ECC DECEL PHASE (%)

25
ASYMMETRY INDEX CMJ ECC DECEL PHASE (%)
Injury Zone: > 20% asymmetry
20
20

STATUS
STATUS CONTROL
15 CONTROL
INJURED
15 INJURED
INJURY TYPE
INJURY TYPEUNINJURED
UNINJURED
ACL
10 ACL
Bone
10 Bone
LCL
LCL
MCL
MCL

5
5

0
0
Model χ2(1) = 16.3, P<0.01
INDIVIDUAL SUBJECTS
Asymmetries matter in your young athletes
The Eccentric Deceleration Phase

△ Force
Limb Stiffness =
△ Displacement of BCM
Inter-Limb Asymmetries and Deceleration Ability in Development
vs. National Level Alpine Ski Racers

Force (N)
12 Development Level, 12 Elite
Level, 12 Elite ACLR Alpine Ski
Racers

5 CMJs

Limb stiffness

Displacement (m)
Asymmetries and Deceleration Ability: Elite vs. Development

Significant inter-limb
difference in stiffness for
development level athletes
(P<0.001)
 “Coach, I’m feeling weak”

Did you assess eccentric deceleration asymmetry?

Dealing with Eccentric Deceleration Deficits –
Focus on Neuromuscular Coordination

1400
1200 Left
1000
Force (N)

800
600 Right
400
200
0
-200 0 0,5 1 1,5
Time (s)
Dealing with Eccentric Deceleration Deficits –
Focus on Neuromuscular Coordination
Eccentric Deceleration Concentric Phase
Phase
1400
1200
1000
Force (N)

800
600
400
200
0
-200 0 0,5 1 1,5
Time (s)
Dealing with Eccentric Deceleration Deficits –
Focus on Neuromuscular Coordination
Right Left

2000 2000

1500 1500
Force (N)

Force (N)
1000 1000

500 500

0 0
2 3 4 1,5 2,5 3,5
-500
Time (s) Time (s)
Dealing with Eccentric Deceleration Deficits –
Focus on Neuromuscular Coordination
Left Left After Vibration
2000 2000

Force Post-WBV (N)

1500 1500
Force (N)

1000 1000
500 500
0 0
1,5 2,5 3,5 1 2 3
-500 -500
Time (s) Time (s)
Flagging Eccentric Decel Asymmetry
Time to wrap it up
The Path We Took Injury
Muscle Prevention
Architectural
Changes
Eccentric Eccentric RFD
Cellular
Muscle Strength Signaling

Actions Training Muscle

Power
Increased
CNS
Excitability Ecc/Con
Muscle
Strength
Real world examples for assessing eccentric deceleration ability
It matters to measure things that matter
ACKNOWLEDGEMENTS:
Dr. Walter Herzog, Dr. Per Aagaard, Dr. Dave Smith,
,

Dr. Steve Norris, Dr. Mark Heard

The Herzog Group (Azim Jinha)
Stu McMillan, Dan Pfaff, Graeme Challis, Erik Groves,
Tyler Goodale, Jer Barnert, and The CSI Calgary S&C
Team
 Thank You
@JordanStrength
www.jordanstrength.com
 Elite Training 2017
International Meeting on High Performance Sports

Muscle Hypertrophy
Physiology and Training Considerations
Dr. Matt Jordan, PhD, CSCS
Director, Strength and Conditioning, Canadian Sport Institute Calgary
Director, Sport Science/Sport Medicine, Alpine Canada Alpin
Adjunct Professor, Faculty of Kinesiology, University of Calgary

Sao Paolo, Brazil

October, 2017
Key objectives for this seminar
What is the time course of muscle hypertrophy?
What exercise type works best to develop
muscle hypertrophy?
What loading parameters work best to develop
muscle hypertrophy?
Are there special methods for developing
muscle hypertrophy?
Where We Are Headed
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
Where We Are Headed
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
Factors Affecting Muscle Force
MUSCLE GROUP CONTRACTION TYPE FORCE-VELOCITY

MUSCLE MUSCLE
FORCE-LENGTH
FORCE ARCHITECTURE

INTRA-MUSCULAR

PCSA
FIBER TYPE / NEURAL
MUSCLE SIZE INTER-MUSCULAR
MHC COMPOSITION ACTIVATION
CENTRAL
Effects of Resistance Training on Muscle Architecture:
Hypertrophy (PCSA)

` `
 Effects of Muscle Architecture on
Force Generating Capacity
A B

Force Force is proportional

the physiological cross
sectional area (PCSA)

Fiber Length
From: Herzog (2007). Biomechanics of the Musculoskeletal System
 Shifts in FV Relationship Consequent to Hypertrophy
CS HYPERTROPHY
1

NORMALIZED FORCE ` `
0,8

0,6

0,4

0,2

0
0 0,2 0,4 0,6 0,8 1
NORMALIZED VELOCITY
Edgerton et al., 1986
Sarcomere – Acto-Myosin Complex

Increase in contractile proteins

(actin and myosin)
 Regulation of Muscle Size

 Myostatin – down
regulator of muscle
hypertrophy

 Akt/mTOR – key
pathway for protein
synthesis

From: Otto & Patel. Exp Cell Res: 316, 2010

 Anabolic Signaling
Synthesis of muscle protein and collagen tissue (tendon, extracellular matrix)

IGF-1

PI3K

AKT

mTOR
p70S6K

From: West et al. Int J Biochem Cell Biol: 42, 2010

Stimuli for Muscle Protein Synthesis
 Mechanical stress

 Metabolic stress
` `

 Blood flow occlusion

 Bolus of protein
Time Course of Anabolic Signaling

From: West et al. Int J Biochem Cell Biol: 42, 2010

 Additive Effects of Protein Ingestion

Amplification of Protein Synthesis  Exercise + Nutrition

From: Phillips, Sports Medicine: 2014

The Leucine Trigger, Bioavailability, and Protein Synthesis

Whey lowers the leucine trigger

From: Phillips, Sports Medicine: 2014

Protein Synthesis vs. Protein Breakdown
 Protein accretion occurs when MPS > MPB

 Protein Accretion = RT Stimulation + EAA

Ingestion (Leucine Trigger)

 Fiber atrophy (i.e. decrease in muscle cell

size) consequent to aging, disuse, injury ***

 Muscle hypertrophy vs. offsetting of muscle

atrophy (e.g. in the event of injury) Phillips, 2014
Time Course of Anabolic Signaling

From: West et al. Int J Biochem Cell Biol: 42, 2010

 Satellite Cell Proliferation
 Demonstrate plasticity to resistance training
and detraining Kadi et al., 2004

 Essential for muscle repair and regeneration

 Amplify the muscle hypertrophic process

 Altered number of satellite cells concurrent w/

pathology Fry et al., 2017; Mackey et al., 2012

 Satellite cell pool critically important for

pathological states where muscle atrophy is
expected Kadi et al., 2010
From: Nielsen et al. J Physiol: 2012
Satellite Cell Pool Decreases and Fibrosis Increases After ACL Tears

Non Injured
Injured
Reduced
Satellite
Cell Pool

From: Fry et al., J Orthopaedic Research: 2017

Quadriceps Maximal Strength Hamstrings Maximal Strength

# Within Group
* Between Group
# * * # P<0.05
** P<0.01
# **

Jordan et al., Med Sci

Sports Exercise: 2015
Satellite Cell Response to Short-Term Resistance Training

From: Nielsen et al. J Physiol: 2012

Muscle hypertrophy and methods to boost satellite cell pool
may be critical post-injury and pre/post surgery
Where We Are Headed
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
Short Term Adaptations to Resistance Training
50
45

PERCENT CHANGE (%)

40 CSA
EMG
35
MVC
30
25
20
15 Neural and morphological
adaptations
10
5
0
0 10 20 30 40
TRAINING DAYS
From: Seynnes et al. J App Phys: 102, 2007
 Time Course of Muscle Architectural Changes

From: Seynnes et al. J App Phys: 102, 2007

 Fibre Type Specific Hypertrophy TYPE I FIBRES

 Greater potential for hypertrophy in Type II

muscle fibres

 Selective hypertrophy of Type IIx fibres?

(velocity based training not to failure)
QUADS CSA
TYPE II FIBRES

(Aagaard et al., 2001)

 Time Course Of Strength Gains

Both neural and hypertrophic

factors need to be addressed
using specific resistance
MUSCULAR STRENGTH
training methods for long-
term gains in muscle strength
ADAPTATION

Schmidtbleicher et al., 1984

HYPERTROPHY

NEURAL DRIVE

TIME

Adapted from Sale, 2002

 Our Journey Today
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
 Exercise Name

Rest Interval (sec.)

Tempo
(E:P:C) Loading
Parameters
Repetitions
 Repetitions are primary variable dictating physiological
response

 10RM (70% of 1RM) cut off for developing maximal

strength – what about muscle hypertrophy?

 Repetition continuum vs. training effect suggest

optimal gains in strength occur w/ higher intensities
Effects of Intensity

3 Untrained
Trained
Strength Gains 2,5 Athlete
2
1,5
1
0,5
0
40 45 50 55 60 65 70 75 80 85 90 95
Intensity (% of 1RM)

Adapted from Peterson et al., 2005

Repetitions
 Novice athletes will make substantial gains in strength w/ higher
repetition schemes
 Novice athletes may make limited gains w/ very low repetition
schemes
 Scientific evidence supports using a range of repetition schemes
for long-term improvement in strength
 RM Continuum Movement Specific High repetitions in certain
movements (e.g. back squat) may yield substantial increases in
muscle hypertrophy and possibly strength abilities
 1RM Continuum

 1RM continuum athlete Novice Athlete

specific and muscle group
specific

 1RM continuum highly

influenced by training history
Sets
 Number of sets inversely proportional to size of muscle
and to number of repetitions (e.g. biceps can tolerate
greater sets than hip extensors)

 Maximum sets/muscle group typically 8-12

 As repetitions decrease number of sets increase

 Sets key parameter for controlling overtraining

 Effects of Number of Sets
3 Untrained
Trained
2,5 Athlete
Strength Gains
2

1,5

0,5

0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Number of Sets
Adapted from Peterson et al., 2005
Sets
 Beginners can perform much fewer sets and still obtain
improvements in strength (i.e. 1-2 sets)

 Advanced lifters may require 3-8 sets

 Number of sets governed by law of diminishing

returns (i.e. critical drop-off point)
Inter-Set Rest Intervals
Strength End Hypertrophy Max Strength

60-90 Seconds 2-3 Minutes 3-5 Minutes

 Is the goal to load via metabolic stress and build work capacity?

 Is the goal to develop functional hypertrophy and develop neural drive?

 ↑ Intensity of strength training session = ↑ Inter-Set rest interval

Inter-Session Rest Intervals
Strength End Hypertrophy Max Strength

2 Days 3-5 Days 4-6 Days

 Adequate rest is required between workouts exercising the same muscles

 Lack of rest will result in poor adaptation, injury or overtraining

 Excess rest will result in reversibility

 ↑ Intensity of strength training session = ↑ Inter-Session rest interval

Tempo
 Represented in seconds as:
Eccentric:Pause:Concentric:Pause

 TIME UNDER TENSION = Repetitions x TUT/Repetition

 Tempo often overlooked by athletes and coaches

 Slow speed lifting (particularly the eccentric phase)

advantageous for ↑ muscle hypertrophy
Additional Considerations for Tempo
 Slow speed lifting beneficial for training structural
imbalances

 Slow speed lifting well suited for beginners

 Elite athletes may benefit from principle of compensatory

acceleration

 Velocity based training

Exercise Selection
Big mover multi-joint
exercises most
effective for
stimulating muscle
hypertrophy
Exercise Selection
Full range of motion
most effective for
stimulating muscle
hypertrophy
Where We Are Headed
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
 RELATIVE
REPETITION
ZONE TYPE INTENSITY TRAINING EFFECT
RANGE
1RM=100%

SSC 6-10 BW – 20% REACTIVE STRENGTH

EXPLOSIVE STRENGTH /
1 DYNAMIC EFFORT 3-8 30% - 80%
MECHANICAL POWER

MUSCLE HYPERTROPHY /
2 REPEATED EFFORT 6-15 60% - 85%
WORK CAPACITY

MAXIMAL MUSCLE
3 MAXIMAL EFFORT 1-6 85% - 100%
STRENGTH
 TUT (s)
LOAD SETS TEMPO REST
ZONE TYPE GOAL / ABILITY REP RANGE * Sets to
(% of 1RM) Failure
(E:P:C) (min)

Short to
Reactive Strength (Stiffness) Stretch-Shorten-Cycle Ability 6-10 Bodyweight 3-6 Long 1-2
Contact

NEURAL ADAPTATION / NEUROMUSCULAR

Heavy (Power Focus) Mechanical Muscle Power 3-6 50-80% 4-6 Fast 1.5-3
< 10

ZONE 1 Heavy (RFD Focus) Late Rate of Force Development 3-6 60-80% 4-6 Fast 1.5-3

Light (Power Focus) Mechanical Muscle Power 5-8 20-50% 5-8 Fast 1.5-2.5

Light (RFD Focus) Initial Rate of Force Development 5-8 10-60% 5-8 Fast 1.5-2.5

Eccentric Deceleration Deceleration of BCM or Load 3-5 BW-60% 3-5 X:1-3:X 2-3

Maximal Strength Maximum Force 1-5 >90% 3-5 *** 2-4:1-3:X 2.5-5
5– 20

ZONE 3
Maximal Eccentric Strength Eccentric Strength 3-5 90-110% (Very Heavy) 3-5 *** 2-10:0:A 2.5-5

MUSCLE HYPERTROPHY / METABOLIC

Max Rep Exhaustive Muscle Hypertrophy 5-12 70-85% (Heavy) 3-4 *** 2-4:1-3:1-3 2-3
20 - 40

Muscle Hypertrophy /
Max Set Exhaustive 5-12 50-70% (Moderate) 5-10 ** 1-3:1-3:1-2 1-2
Work Capacity

ZONE 2 Structural Balance /

Assistant Strength 8-15 60-80% (Moderate) 2-4 1-3:1-3:1-3 1-2
Work Capacity
30 – 60

Slow Tempo Exhaustive Muscle Hypertrophy 5-8 60-80% (Moderate) 3-5 4-6:1-3:4-6 1-3

Low Load Exhaustive Muscle Hypertrophy / Strength Endurance 15-30 30-60% 2-4 1-2:0:1 2-3

Technical Development Technique 2-5 Light 3-10 N/A 1-2

T
 TUT (s)
LOAD SETS TEMPO REST
ZONE TYPE GOAL / ABILITY REP RANGE * Sets to
(% of 1RM) Failure
(E:P:C) (min)

Short to
Reactive Strength (Stiffness) Stretch-Shorten-Cycle Ability 6-10 Bodyweight 3-6 Long 1-2
Contact

NEURAL ADAPTATION / NEUROMUSCULAR

Heavy (Power Focus) Mechanical Muscle Power 3-6 50-80% 4-6 Fast 1.5-3
EXTENSIFICATION
< 10

ZONE 1 Heavy (RFD Focus) Late Rate of Force Development 3-6 60-80% 4-6 Fast 1.5-3

Light (Power Focus) Mechanical Muscle Power 5-8 20-50% 5-8 Fast 1.5-2.5

Light (RFD Focus) Work Capacity

Initial Rate of Force Development 5-8 10-60% 5-8 Fast 1.5-2.5

Eccentric Deceleration
Muscle Hypertrophy
Deceleration of BCM or Load 3-5 BW-60% 3-5 X:1-3:X 2-3

Maximal Strength Maximum Force 1-5 >90% 3-5 *** 2-4:1-3:X 2.5-5
5– 20

ZONE 3
Maximal Eccentric Strength Eccentric Strength 3-5 90-110% (Very Heavy) 3-5 *** 2-10:0:A 2.5-5

MUSCLE HYPERTROPHY / METABOLIC

Max Rep Exhaustive Muscle Hypertrophy 5-12 70-85% (Heavy) 3-4 *** 2-4:1-3:1-3 2-3
20 - 40

Muscle Hypertrophy /
Max Set Exhaustive 5-12 50-70% (Moderate) 5-10 ** 1-3:1-3:1-2 1-2
Work Capacity

ZONE 2 Structural Balance /

Assistant Strength 8-15 60-80% (Moderate) 2-4 1-3:1-3:1-3 1-2
Work Capacity
30 – 60

Slow Tempo Exhaustive Muscle Hypertrophy 5-8 60-80% (Moderate) 3-5 4-6:1-3:4-6 1-3

Low Load Exhaustive Muscle Hypertrophy / Strength Endurance 15-30 30-60% 2-4 1-2:0:1 2-3

Technical Development Technique 2-5 Light 3-10 N/A 1-2

T
 TUT (s)
LOAD SETS TEMPO REST
ZONE TYPE GOAL / ABILITY REP RANGE * Sets to
(% of 1RM) Failure
(E:P:C) (min)

Short to
Reactive Strength (Stiffness) Stretch-Shorten-Cycle Ability 6-10 Bodyweight 3-6 Long 1-2
Contact

NEURAL ADAPTATION / NEUROMUSCULAR

Heavy (Power Focus) Mechanical Muscle Power 3-6 50-80% 4-6 Fast 1.5-3
< 10

ZONE 1 Heavy (RFD Focus) Late Rate of Force Development 3-6 60-80% 4-6 Fast 1.5-3

Light (Power Focus) Mechanical Muscle Power 5-8 20-50% 5-8 Fast 1.5-2.5

Light (RFD Focus) Initial Rate of Force Development 5-8 10-60% 5-8 Fast 1.5-2.5

Eccentric Deceleration Deceleration of BCM or Load 3-5 BW-60% 3-5 X:1-3:X 2-3

Maximal Strength Maximum Force 1-5 >90% 3-5 *** 2-4:1-3:X 2.5-5
5– 20

ZONE 3
Maximal Eccentric Strength Eccentric Strength 3-5 90-110% (Very Heavy) 3-5 *** 2-10:0:A 2.5-5

MUSCLE HYPERTROPHY / METABOLIC

Max Rep Exhaustive Muscle Hypertrophy 5-12 70-85% (Heavy) 3-4 *** 2-4:1-3:1-3 2-3
20 - 40

Max Set Exhaustive

INTENSIFICATION
Muscle Hypertrophy /
Work Capacity
5-12 50-70% (Moderate) 5-10 ** 1-3:1-3:1-2 1-2

ZONE 2 Structural Balance /

Assistant Strength 8-15 60-80% (Moderate) 2-4 1-3:1-3:1-3 1-2
Work Capacity

Maximal Strength
30 – 60

Slow Tempo Exhaustive Muscle Hypertrophy 5-8 60-80% (Moderate) 3-5 4-6:1-3:4-6 1-3

Low Load Exhaustive Hypertrophy Type IIx Fibres?

Muscle Hypertrophy / Strength Endurance 15-30 30-60% 2-4 1-2:0:1 2-3

Technical Development Technique 2-5 Light 3-10 N/A 1-2

T
 Schmidtbleicher et al., 1984

Undulating mesocycle periodization strategy – cycles

of extensification followed by intensification
Individual and context-specific considerations?
How do we define muscle failure and do we need to
go to muscle failure?
General Principles For Hypertrophy Program Design
1. Keep repetitions between 6RM to 12 RM for Primary Lifts and 10 to
15RM for Assistant Lifts

2. Maximum repetition spread of 2 repetitions e.g. 8-10RM

3. Choose maximum of 1 Primary Lift, 1 Assistant Lift Compound Movement

and 1-2 Assistant Lift Isolation per movement or body part

4. Multiple sets required for overload for optimal stimulation (8-10

Sets/Movement Type)

5. Prescribe 3-4 Sets for Core Lifts and 2-3 Sets for Assistant Lifts
General Principles For Hypertrophy Program Design

7. Set duration (Time Under Tension) between 30 – 60 seconds

8. Short rest intervals (i.e. 60”) vs. moderate rest intervals (i.e 120-
180s/set)

9. Pairing of agonist/antagonist muscle groups to increase workout density

10.Keep workouts to 1 hour or less

11.Take 2 to 4 days rest between workouts

12.Nutrition!!!
Sample Upper Body Hypertrophy Program

EXERCISE SETS RM TEMPO REST

PRIMARY LIFTS
1A) Incline Bench Press 4 6-8 5/0/X 90”
1B) Neutral Grip Pull Up 4 6-8 5/0/X 90”
2A) Parallel Grip Flat Dbell Press 3 10-12 3/0/X 60”

2B) Single Arm Dbell Bent Over Row 3 10-12 3/0/X 60”

ASSISTANT LIFTS
3A) Low Pulley Ext. Rotation 3 8-12 3/0/X 30”
3B) Bent Over Trap 3 3 8-12 3/0/X 30”
Sample Lower Body Hypertrophy Program

EXERCISE SETS RM TEMPO REST

PRIMARY LIFTS
1) Heels Elevated Back Squat 4 6-8 3/2/X 180”

2) Elevated Single Leg Squat 4 8-10 3/1/X 180”

ASSISTANT LIFTS
3A) Partner Resisted Eccentric 3 6-8 5/0/1 60”
Clamshell
3B) Single Leg RDL 3 8-10 3/0/X 60”
Where We Are Headed
Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
Special Methods for Hypertrophy Development

Method 1: Extensive Cluster Training

 Heavy load with short rest breaks followed by large set rest

Example: 3x(6RM, Rest 15s, max reps, Rest 15s, max reps)/ 3’ Rest

Method 2: Volume Training

 Moderate submaximal load lifted for many sets

Example 1: Back Squat 10 x 10 @ 60% 1RM/60s Set Rest

Example 2: 1) Incline Bench Press 5x10 @ 70% 1RM/60s Rest
2) Flat Dbell Press 5x10 @ 70% 1RM/60s Rest
Special Methods for Hypertrophy Development

Method 3: Drop Sets

 Triple set with short rest b/w loads and large set rest

Example: 6RM, Rest 10s, 8RM, Rest 10s,12RM, 3 min Rest

Method 4: Low Load Timed Sets:

 Light load lifted for 30 to 60 seconds

Example 1: 3 x 60s / 120s Rest

Example 2: 3x20s/120s Rest; 3x40s/120s Rest; 4x45s/120s Rest
Special Methods for Hypertrophy Development
Method 5: 8x8 Method

 High volume protocol w/ decreasing rest over the training block at a

submaximal load

Example: Wk 1: 8x8/120s Rest; Wk 2: 8x8/90s Rest; Wk 3: 8x8/60s Rest

Method 6: Final Set to Failure (Metabolic/Mechanical Combined)

 Hypertrophy Protocol followed by one maximal strength endurance

set

Examples: 4x10RM, 20RM; 4x6-8RM, 30RM

Special Methods for Hypertrophy Development

Method 7: Slow Tempo

 Light to moderate load, slow eccentric/concentric

Example: 5x5-6, 5.0.5, 120s R

Method 8: Accentuated Slow Eccentric Tempo

 Slow eccentric with compensatory acceleration

Examples: 4x5-6, 6.0.X, 120s R

Special Methods for Hypertrophy Development

Method 9: Occlusion Training

 Occlusion of venous return with pressure cuff

(100 mmHg) and light load resistance
exercise to failure (20-30 RM)

 Rapid increase in muscle satellite cell pool

Nielsen et al., 2012

 Significant increase in muscle satellite cell

number post-training Nielsen et al., 2012
Satellite Cell Response to Short-Term Resistance Training

From: Nielsen et al. J Physiol: 2012

Special Methods for Hypertrophy Development

Method 9: Occlusion Training (Post Surgery)

 Case report demonstrating efficacy post knee injury Loenneke et al., 2013

 Occlusion training vs. work matched control exercise post knee

arthroscopy Tennent et al., 2016

 30, 15, 15, 15 @ 20-30% 1RM w/ 30s Rest (accumulate 45

repetitions) Tennent et al., 2016

 Significant improvements in strength and muscle circumference

and no reported complications Tennent et al., 2016
 Nick Simpson
CSI Calgary

Case study example – BFR post leg fracture

 How do we prepare athletes before surgery or after
injury to blunt or reverse the effects of injury on muscle?
Time to wrap it up
 The Path We Took Sets x Reps
Loading
Parameters Load
For
Time Hypertrophy Tempo
Physiology
Course
and Rest
Of
Mechanisms
Adaptation
Exercise

Special Occlusion,
Methods for Light Load,
Hypertrophy Metabolic
ACKNOWLEDGEMENTS:
Dr. Walter Herzog, Dr. Per Aagaard, Dr. Dave Smith,
,

Dr. Steve Norris, Dr. Mark Heard

The Herzog Group (Azim Jinha)
Stu McMillan, Dan Pfaff, Graeme Challis, Erik Groves,
Tyler Goodale, Jer Barnert, and The CSI Calgary S&C
Team
 Thank You
@JordanStrength
www.jordanstrength.com