Biomechanics of Muscles

Part III

By
Dr. Marwa Mostafa
IV- Muscle Training
Muscle Training

1- Improving muscle strength (resistance training).

Physiological interaction of muscle conditioning. Effect of sex on muscle

strength.

2- Increasing muscle endurance (endurance training).

3- Improving elasticity.

4- Increasing muscle efficiency.

5- Exercise enhances more smooth forceful contraction with less effort.

Principles of Training

1- Overloading principle

2- Frequency principle

3- Progression principle

4- Overtraining principle

5- Compatibility principle
Muscle Training

1- Improving muscle strength (resistance training).

Physiological interaction of muscle conditioning. Effect of sex on muscle

strength.

2- Increasing muscle endurance (endurance training).

3- Improving elasticity.

4- Increasing muscle efficiency.

5- Exercise enhances more smooth forceful contraction with less effort.

1- Improving muscle strength (resistance training)

Muscle strength is the maximum amount of force exerted by the

muscle and it is directly proportional to physiological cross section

due to physiological hypertrophy. Physiological hypertrophy is the

increase in the muscle size, which is usually additional 30-60% with

training. The stronger muscles are not acting wholly but parts act and

other parts are at rest. This permits early recovery and allows

individual to do more for a longer period of time.

Physiological interaction in muscle conditioning

In strengthening exercises, muscle conditioning passes through two stages

including neural apparatus and muscle tissue itself.

In initial stage of muscle conditioning, an increase in muscle torque occurs due

to neural adaptation and possibly improved force transmission from

individual sarcomere to the skeletal apparatus. An increase in neural activation

is attributed to increase in number of active motor units and their rate of firing at

spinal cord level and supraspinal level. There is also synchronization between

motor units. The recruitment of additional motor units and increased rate of

discharge may serve as stimulus for the second important stage of adaptation.
In later stage of strength conditioning, there is increase in the

physiological cross section of the muscle (hypertrophy). In addition, a

physiological hyperpiesia occurs which is defined as an increase in the

number of fibers. It occurs by splitting of fibers already present as a result of a

forceful muscular contraction. Moreover there is a greater increase in the

area of fast twitch (type II muscle fiber) compared with slow twitch (type I

muscle fiber). Many studies concluded that the muscle hypertrophy

produced by resistance training is a result of the enlargement of the muscle

fiber and not an increased number of fibers.

Effect of sex on muscle strength:

The relative proportion of muscle fiber types are similar in men and women,

but the total cross sectional area of women's muscles is only about 75% that of men,

which accounts for the differences in overall strength. There is little or no

difference in the relative strength of men and women. There is some indication

that men and women can increase strength to a similar degree following

resistance training but muscle hypertrophy seems to be less pronounced in

women. One of the factors that may contribute to the greater hypertrophy in men is

their 20 to 30 times higher levels of testosterone. Strength differences between men

and women are greater in the upper extremities than in the lower extremities.
2- Increasing muscle endurance (endurance training)

Endurance is the ability of the muscle to exert force repeatedly over a period of

time. Endurance training involves the enhancement of the muscle's energy

supply rather than its size. Endurance is related to increase in muscle myoglobin

concentration, capillary number and mitochondrial size and number. The trained

muscle is not easy to fatigue because it utilizes more effective metabolic

reaction and the muscle is oxygenated through the conditioned cardiovascular

and respiratory system. In endurance athlete, type I fibers are the most affected

fibers while in athletes engaged in an explosive activity such as sprinting, type II

fibers are affected.

3- Improving flexibility and elasticity

It is the capacity to lengthen the muscle sufficiently to move the

joint throughout its range of motion. Muscle flexibility can be

improved by decreasing resistance of tight muscles using static or

dynamic stretch techniques or by increasing the strength of the

antagonistic muscles. As the muscle is viscoelastic, the elastic property

permits spring-like behavior and allows the muscle to return to its

original length after stretch. The viscous property helps protect a muscle

from being damaged by a quick and forceful stretch.

4- Increasing muscle efficiency

The efficiency is calculated as the percentage of energy input that is

converted into work instead of heat. When most of energy input is

converted into work instead of heat that means the structure has

high efficiency. The efficiency of the muscle is less than 20-25%. The

reason for this low efficiency is that about half of the energy in the food

stuffs is lost during the formation of ATP. By exercises, maximum

efficiency of the muscle is developed especially when the velocity of

contraction is about 30% of maximum velocity.

5- Exercise enhances more smooth forceful contraction with
less effort

The ability to sustain efforts for longer periods is developed. The

sarcolemma becomes thicker and the connective tissues increase in

the amount. There is also greater amount of glycogen needed to

supply the trained muscle within the muscle itself.

Principles of Training

1- Overloading principle

2- Frequency principle

3- Progression principle

4- Overtraining principle

5- Compatibility principle
1- Overloading principle

The human performance adaptations occur in response to demands applied to the

body at levels beyond a certain threshold value (overload) but within the limit of

tolerance and safety. Overload during exercises can be quantified in terms of

training volume and training intensity. Training volume is the number of repetition

of exercise or the amount of work done while training intensity is the average weight

lifted or the rate of doing work. For example; to strengthen the quadriceps muscle,

the subject can start with 5 kg and is lifted 7 times. The training volume is the

number of repetitions (7 times) which can be increased to10 or 15 times while the

training intensity is the weight lifted (5 kg) which canalso be increased to 7 or 10 or

15 kg.
2- Frequency principle

Frequency between training should be sufficient to allow tissue

growth, good nutrition, biochemical resynthesis and physiological
development to take place. For beginners, 3 days per week causes
excellent progress. For more advanced program, twice a week is
good for training of upper body exercise while alternate days are
necessary for lower body exercise.
3- Progression principle

The amount of overload should be increased gradually and persist

over a long period of time. If this is not done, the training stimulus
soon becomes subminimal. If the increments are made in very
large steps, the exercise becomes either impossible or dangerous.
Progression is achieved by increasing the volume or the intensity of
the overload or both.
4- Overtraining principle

Overtraining is the state of chronic fatigue leading to undesirable

morphologic, systemic and psychological changes. The treatment is
temporary stop or decrease in the volume and intensity of the
training program because overtraining is more dangerous than under
training. Muscle injury resulting from vigorous exercise is called
exercise-induce muscular injury which is referred as delayed onset
muscle soreness (DOMS) as it happens within 24 hours to 72 hours
after vigorous exercise.
5- Compatibility principle

This principle is also called individuality principle. It means

that any exercise program should be compatible with the goals and
the abilities of the trainee. The program should be neither too easy nor
too stressful. Considerations must be given to the person's age,
years of training experience and type of exercise used in the past.
Pathomechanics of Muscles
Muscle injury can take several forms:

1) Acute muscular strain

2) Muscle contusion

3) Exercise induced muscle injury.

4) Muscle cramps

5) Disuse and immobilization

6) Calcaneal (Achilles) tendon rupture

Muscle injuries also may comprise laceration, ruptures, ischemia,

compartment syndromes, and denervation. All these injuries weaken the

muscles and can cause significant disability.

1) Acute muscular strain
typically results from over stretching a passive muscle or from dynamically

overloading an active muscle, either concentrically or eccentrically. The severity

of tissue damage depends on the magnitude of the force, the rate of the force

application and the strength of the musculotendinous structure. Mild strains are

characterized by minimal structural disruption and rapid return to normal

function. Moderate strains are associated with a partial tear in the muscle tissue

often near to the myotendinous junction, pain and some loss of function. Severe

muscle strain are defined by complete or near complete tissue disruption and

functional loss, as well as marked hemorrhage and swelling.

2) Muscle contusion
results from direct compression impact in contact sports e.g. football,
basketball when an athlete's thigh has a violent impact with another
participant's knee. It is distinguished by intramuscular hemorrhage.
3) Exercise induced muscle injury

results from connective and contractile tissue disruption following

exercise. It is characterized by local tenderness, stiffness and
restricted range of motion. This, type of injury is referred as delayed
onset muscle soreness (DOMS) as it happens 24 to 72 hours after
participation in vigorous exercise, especially following eccentric muscle
action in contractile tissue unaccustomed to the activity's demands.
4) Muscle cramps
occur in a shortened muscle and are characterized by abnormal electrical

activity. It is not injury by itself but may be indicative of conditions predisposing

to injury. It may be caused by dehydration, electrolyte imbalances, direct impact,

fatigue, and lowered levels of serum calcium and magnesium. It happens in many

muscles especially gastrocnemuis, semimembranosus, semitendinosus, biceps

femoris, and abdominals and can be relieved by antagonistic muscle activity or

manual stretching of the affected muscle. Care should be considered since

excessive force applied to a muscle in spasm may result in muscle strain.

 Effect of disuse and immobilization

Disuse and immobilization cause loss of endurance and

strength of the muscle and causes muscle atrophy due to decreased
number and size of fibers. Type I fibers (slow twitch) are
the mainly type that atrophies with immobilization more
than type II fibers (fast twitch). Immobilization m a lengthened
position has a less harmful effect than in a shortened position.
Clinical example:

Calcaneal (Achilles) tendon rupture :

The Achilles tendon, the largest and strongest tendon in the body, transmits substantial loads

from the triceps surae group to its attachment on the posterior calcaneus. Forces in the tendon

have been estimated to be as high as 10 times body weight during running. Calcaneal tendon

ruptures typically happen in men between 30 and 40 years old who suddenly exert themselves

in a sporting task that involves rapid change of direction. Tendon rupture seems to be

secondary to degenerative processes rather than a primary injury. It occurs 2 to 6 em

proximal to calcaneal insertion in a region known to be hypovascular. There is a relation

between blood type and increased incidence of tendon rupture. People with type 0 blood

seem to be more likely to suffer from tendon rupture in general and calcaneal tendon

rupture in particular.
Four primary mechanisms cause calcaneal tendon rupture:

1- Sudden dorsiflexion of a plantar flexed foot (e.g. a football player dropping

back and planting his rear foot as he throws).

2- Pushing off the weight bearing foot while extending the ipsilateral knee joint (e.g. a

basketball player executing a rapid change of direction).

3- Sudden excess tension on an already taut tendon (e.g. catching a heavy weight).

4- A taut tendon struck by a blunt object (e.g. baseball bat).

Case study:

A patient with a quadriceps strain returns to physical therapy after the first exercise

session, complaining of muscle soreness that developed later in the evening and

continued into the next day

What is the main cause of this complaint?

How can the therapist minimize the possibility of this happening again?

Answer:

The main cause of patient complaint:

DOMS happens as a result of vigorous exercise or after eccentric exercises, the

soreness begins 12-24 hours after exercise it may last up to 5-7 days

The therapist can minimize the possibility of this happening again:

By using concentric exercises with gradual increasing intensity and duration.

Case study:

A patient presents with difficulty of fast movement speeds and fatigues

easily.

The therapist decides on a strength training program that specifically

focuses on improving fast - twitch fiber function. What is the optimal

exercises prescription to achieve the goal?

Answer:

The optimal exercises prescription to achieve the goal is:

High - intensity workloads for short durations

Case study

While bending in standing position with knees extended, a patient

exhibits decreased spinal flexion and decreased hip flexion.
The most appropriate physical therapy intervention should be
directed to ------

Answer:

The most appropriate physical therapy intervention should be

directed to: Hamstring flexibility