We are excited about our upcoming move to the Barnegat 67 Plaza.¬† We expect to be open for business before the end of January.¬† Our space is in between Dollar Tree and Planet Fitness.¬† Framing is complete and the dry wall is going up this week.¬† We can’t wait to have the larger space for more equipment and greater patient privacy.¬† Stay tuned for news about our open house!¬† In the meantime check out these pictures from last week.
Typically training for power is thought of as something that is more for the younger, athletic population. However, today older adults are trying to stay more active with activities such as tennis, golf, hiking, or dancing.¬† All these activities require some component of power.¬† Are older adults performing any power-based exercise to help with these activities?
What is Power?
First of all, what is power? Power is simply adding speed to a movement. ¬† Power is a combination of strength and speed. ¬† When exercising, we typically encourage slow and controlled movement, but when you are able to control during the exercise, what’s next? We can add resistance to the movement, or sometimes we can add speed. Why would we add speed? Say you are playing tennis and have to move across the court for a drop shot, how do you move to get the ball? Is it slow and controlled or quick? Does it make sense to only strengthen with slow and controlled motions? Or should we think about adding some speed to the movement you are training?
Muscles change with age and they also change with the demands we put on them. As we get older and stop doing fast movements is it fair to expect the body to continue to move quickly to react to a drop shot, field and ground ball, or even jump to catch a ball when playing with grandchildren?
Adding Power Training to an Exercise Program
Adding power to an exercise routine is simple, and can be fun. ¬†You can simply do a movement or exercise that you can do properly and add some speed to it. Another idea can be bouncing a medicine ball or any ball that can bounce onto the ground or a wall. Mini jump hops are also another way to add speed and dynamic movement.
Seniors are continuing to stay active in sports and similar to any athlete, they need to train to play the sport they want to do. A lot of the sports and activities seniors do on a daily basis are not slow and controlled. Power is something to think about with a regular workout routine as we age.¬† If you are not sure how; give your physical therapist a call.
The rear-foot-elevated or Bulgarian, split squat is an excellent exercise to train the lower body for sport or everyday life.¬† It is unclear where how this exercise received it’s name but this is of little importance.¬† The split or asymmetrical stance of the lower body introduces unique deands on the muscles and nervous system.¬† Acceleration, deceleration, change of direction, sprinting and jumping all require stability of the lower body in similar positions. ¬† Elevating the rear foot increases the difficulty by allowing a deeper squat.¬† The Bulgarian split squat trains the hip to support the upper body while also controlling the knee position in an athletic stance.
A traditional squat is performed with the feet placed symmetrically side by side.¬† This creates challenges in primarily one plane.¬† The Bulgarian split squat is performed with a narrow split stance creating challenges in multiple planes.¬† Raising the rear leg on an elevated surface shifts the load to the front leg.¬† The front leg assumes approximately 85% of the total load.
There are many variations to the Bulgarian split squat.¬† Progressions and regressions can be tailored for the beginner or advanced lifter.¬† The purpose of this article is to describe several of these modifications.¬† The Bulgarian split squat can be modified so those new to strength training can incorporate the exercise.¬† The advanced progressions are best suited for athletes or those with several years of training experience. ¬†The exercise can be modified to challenge balance and stability using lighter loads.¬† It can also be performed with heavy loads.¬† Under these conditions, maximal strength development is emphasized similar to training with common multi-joint exercises such as the back squat.
Muscles Involved with the Bulgarian Split Squat
The main lower body muscles involved in the Bulgarian split squat is the quadriceps, hamstrings, and gluteus maximus.¬† The quadriceps is the first muscle to fatigue, especially when heavier loads are used.¬† This then requires the gluteus maximus to compensate.¬† The gluteus medius and minimus are involved to maintain proper positioning of the pelvis and balance. The hip rotators are recruited in order to control the inward or outward movement of the thigh and knee.¬† The ankle muscles are highly active in order to maintain balance in the narrow stance. The abdominals and low back muscles help maintain a neutral spine position and balance.
Set-Up and Positioning
Taking time to position yourself before the movement will allow for proper performance of the exercise.¬† Assume a split squat stance with the trail leg just in front of a support box/bench on the floor. While shifting the weight toward the lead foot, place the top of the trail foot on the support box/bench.¬† The distance from the lead foot to the trail foot support is approximately the length of one leg.¬† Adjust the support box/ bench distance so the lead knee is directly above the toes. The trail leg support can range from approximately 6 inches to knee height.¬† This may require some experimentation.¬† Start with a lower height and adjust as needed.¬† For stability and balance, the top of the trail foot should remain in contact with the support box/bench throughout the exercise.¬† The width between the front and trail leg is approximately hip width.
TRX-Assisted Bulgarian Split Squat
Once proper set-up has been achieved grasp the suspension trainer in both hands.¬† Bend the elbows and hold the straps close to the chest.¬† This will assist with maintaining proper balance and a vertical position of the trunk.¬† Maintain this vertical trunk throughout the exercise. ¬†A forward lean is difficult to control with the split stance and rear foot elevated. ¬†Keep the weight of the lead foot distributed in the middle of the foot or near the heel.¬† Perform the movement by ‚Äúsitting back‚ÄĚ so the trunk remains vertical and the lead knee does not track excessively past the toes. It is acceptable to have the knee pass slightly ahead of the toes.¬† Lower the trail knee only to a position 1-2 inches above the floor.¬† Complete the desired number of repetitions on one leg before switching legs.
Bodyweight Bulgarian Split Squat
For many, the weight of the body is enough to provide a training effect.¬† Progressing away from using the suspension trainer increases balance and stability challenges.¬† Place the hands on the hips or arms across the chest.¬† If you are unable to perform the exercise without the arms in these positions you many lack adequate balance.¬† If this is the case, regress back to the TRX-Assisted exercise or try holding two light dumbbells with the arms at the sides.
Kettlebell (Goblet) Bulgarian Split Squat
There are a few advantages to performing the Bulgarian split squat with a kettlebell held at the chest. ¬†First, this promotes a vertical position of the trunk.¬† Other variations, such as holding dumbbells at the side of the body or a barbell on the back, require the trunk to slightly dip forward.¬† Second, the kettlebell helps activate the core musculature and cue proper positioning of the rib cage on the pelvis.¬† It is important to stack the lower rib cage on top of the pelvis. ¬†The abdominal muscles are primarily responsible for this.
2-Arm Dumbbell Bulgarian Split Squat
Holding two dumbbells to the side of the body lowers the center of mass.¬† For some, this improves balance and stability compared to the bodyweight exercise.¬† Start with light loads and progress as strength improves. If you prefer, try holding two kettlebells instead of the dumbbells.
1-Arm Dumbbell Bulgarian Split Squat
Holding a dumbbell in one hand increases balance and stability challenges.¬† Hold the dumbbell in the hand on the side of the trail leg.¬† This will increase activity to the hip musculature, especially the gluteus medius of the lead leg.¬† This exercise is more challenging than it looks.
TRX Bulgarian Split Squat
This variation is performed with the trail foot placed in the suspension trainer loop. Position the suspension loop so the trail lower leg is parallel to the floor.¬† Maintain the trunk in a vertical position.¬† Maintain the hands on the hips.¬† The knee of the lead leg should not track excessively past the toes.¬† Compared to the bodyweight split squat, this exercise shows greater activation of the hamstrings, adductors, gluteus maximus, and gluteus medius.¬† The suspended position increases stability and balance challenges.¬† This is a more demanding exercise for the hip muscles.¬† It is a progression from the bodyweight Bulgarian split squat.¬† To further increase the challenge, try holding a dumbbell in the hand on the side of trail leg.
Barbell Bulgarian Split Squat
Performing the exercise with a barbell allows for the progression of the load for strength development.¬† The barbell also causes the trunk to angle slightly forward to support the load.¬† Before positioning the bar, pull the shoulder blades back.¬† Place the bar on the base of the neck resting over the trapezius muscles. Tuck the elbows to your side and maintain the retracted shoulder blade position.¬† With barbell training, heavier loads and fewer repetitions are optimal.¬† Start with a weight which allows you to perform 6 to 8 quality repetitions.¬† As always, focus first on proper technique before progressing load on the bar.
The Bulgarian split squat is an excellent exercise for rehabilitation, injury prevention, and strength development.¬† This exercise requires stability in multiple planes and challenges the hip muscles to control the position of the lower limb.¬† Performance in many sports involves lower-body, weight-bearing skills in positions similar to the split squat. Sprinting, change of direction, throwing, and kicking require the transfer of forces from one leg in a similar fashion.¬† If you are unsure about how to best incorporate the Bulgarian split squat, give your physical therapist or strength coach a call.
Loss of muscle with advancing age is referred to as sarcopenia.¬† This process begins in the fifth decade of life and proceeds at a rate of almost 1% each year.¬† Declines in muscle strength usually progress faster than muscle size.¬† Muscle loss with advancing age is associated with many chronic conditions.¬† These include diabetes, cancer, reduced mobility, disability, and mortality.¬†¬† It is estimated that 200 million people worldwide will experience sarcopenia that could affect their health over the next 4 decades.
Muscle loss is quickly becoming a major public health problem with significant clinical, economic, and social consequences.¬† Prevention and treatment strategies are challenging due to the growing number of older adults above 65.¬† Exercise and nutritional strategies are considered the primary treatments for age-related muscle loss.¬† The rest of this article summarizes findings from research on muscle loss in older adults and offers some practical solutions related to exercise.
Diet, Supplements, and Muscle Loss
Muscle is made of proteins.¬† Amino acids are the building blocks of proteins.¬† In younger adults (18-30 years old), eating sufficient protein can stimulate some muscle growth by itself.¬† This can occur with or without exercise in younger adults.¬† However, muscle growth does not come so easily in older adults.¬† Therefore, larger amounts of protein in the diet are needed for older adults to preserve or increase muscle.¬† Younger adults show increased muscle protein rates with the ingestion of 20 grams of protein during a meal.¬† Older adults require about twice this amount, or 40 grams, to stimulate muscle growth.
Recent research has investigated the role of protein and amino acid supplements for older adults.¬† The evidence suggests supplementing with protein or amino acids without engaging in an exercise, does little to preserve muscle mass in older adults.¬† However, increases in muscle size and strength through exercise can be enhanced by certain foods or supplements.¬†¬†¬† Diets rich in dairy and fish containing polyunsaturated fats make the muscle more sensitive to exercise.¬† There is also evidence showing protein supplements and creatine monohydrate is beneficial.¬† Most importantly, research shows that a specific type of exercise, resistance exercise, has powerful positive effects on muscle in older adults. ¬†Resistance exercise is the key to preserving or increasing muscle size and strength as we age.
Exercise is a highly effective strategy to offset muscle loss.¬†¬† Exercising with weights has numerous beneficial effects for older adults.¬† These include increases in muscle mass, strength, power, mood, energy levels, walking speed, balance, and functional performance.¬† Other forms of exercise, such as aerobic exercise, do not confer these same benefits.¬† Aerobic exercise, including regular walking, is not enough to prevent muscle loss in older adults.
Contrary to popular belief, adults older than 75 years old can grow significant muscle through resistance exercise.¬† Heavy weights are not required.¬† Lighter weights with higher repetitions can result in significant improvements in muscle size and strength regardless of age.¬† In all cases, the success of any exercise program depends on adherence and staying committed for the long run.¬† Therefore, it is important to make exercise as enjoyable as possible.¬† Choose resistance exercises you prefer.¬† Exercise with friends.¬† Choose environments (gyms, classes, or in the home) you are most comfortable with.¬†¬† If you are unsure about how to start, work with a personal trainer or physical therapist.
Developing an Exercise Program to Fight Muscle Loss
Many individuals are unsure about how to structure an exercise program.¬† Those without resistance training experience or those recovering from an injury have questions about what is safe and appropriate.¬† How often?¬† Which exercises?¬† How many sets?¬† High or low repetitions? How long should I rest between sets?¬† These are all excellent questions.¬† Below I have outlined a list of recommendations for older adults engaging in resistance exercise.¬† These recommendations are based on research evidence conducted on healthy older adults.
Length of the program
1 year to optimize results but small improvements are often evident after 6-8 weeks.¬† Ideally, a lifetime committment is best.
Frequency per week
2-3 sessions preferably with one day of recovery between sessions (i.e., Monday, Wednesday, Friday).
Duration of each session
Approximately 1 hour including rest periods between sets and exercises.
Exercises per session
6-8 exercises involving the major muscle groups of the upper and lower body.
Sets per exercise
2-3 sets have been shown to result in greater improvements than single set routines.
50-80% of a one-repetition maximum which is the most amount of weight you can perform properly for one repetition.¬† An easier guide is to use the recommendations for repetitions per set below.
Repetitions per set
7-9 repetitions per set have been shown to be optimal for strength and muscle development.¬† This means you should only be able to perform 1-3 more repetitions beyond this range before fatigue becomes limiting.¬† If you can perform more than this amount without requiring a rest break you can increase the weight.
Duration of each repetition
6 seconds or slow controlled movements are recommended.¬† Muscle power development requires faster tempos of movement.
Rest between sets
1-2 minutes is optimal.¬† If this seems like a long time, perform some aerobic activity, such as brisk walking between sets.
Choosing Which Resistance Exercises to Perform
Contrary to the opinions of some, there are no good or bad exercises.¬† The selection of exercises should be based on several considerations.¬† This is where a personal trainer or physical therapist can help you get started.¬† As mentioned, the most important consideration is to choose exercises you enjoy performing.¬† Beyond this idea, I‚Äôll provide some general recommendations and a few examples.
First, incorporate exercises performed in standing positions as opposed to seated or lying down.¬† For example, the body weight squat is preferred over a seated leg press.¬† Second, choose free weights over machines whenever possible.¬† All machines are not bad but using free weights requires greater muscle activation, control, and coordination.¬† Third, exercises using multiple joints are preferred over single-joint movements.¬† For example, the cable row is preferred over a biceps curl.¬†¬† Finally, incorporate at least one exercise for the fundamental movement patterns such as the squat, hip hinge, upper body push (presses), and upper body pull (row).
Aging is accompanied by a decline in physical activity and function.¬† Loss of muscle contributes to these changes and is also a consequence of them.¬† This creates a viscous cycle characterized by muscle loss, weakness, declining function, and developmennt of chronic conditions. Other negative consequences ensue such as osteoporosis and increased body fat. ¬†Exercise can slow down these processes and even reverse them. ¬†In fact, resistance exercise is one of the most effective means to combat the effects of aging and many chronic diseases. ¬†Some have referred to resistance exercise as the, ‚ÄúFountain of Youth.‚ÄĚ¬† Dietary strategies and supplements can enhance the effects of exercise.¬†¬† However, there is no magic pill.¬† Success requires goals, a plan, positive habits, and a commitment. ¬†If you are not sure how to get started, call your physical therapist today.
More than one out of four adults, 65 and older, fall each year.¬† Falling once doubles your chances of falling again.¬† One out of five falls causes a serious injury such as a broken bone or head injury.¬† More than 95% of hip fractures are caused by falling.¬† One in five hip fracture patients dies within a year of their injury.¬† Women fall more often than men and are more likely to break a bone.¬† Over the last 10 years, death from falls has increased by 30% in United States.¬† It is estimated by 2030, falls will result in one death every seven hours.¬† Clearly, fall prevention programs are needed.
Falls are associated with extrinsic and intrinsic factors.¬† The extrinsic causes are related to the home environment such as rugs, stairs, and poor lighting.¬† The intrinsic causes are related to problems with balance or gait, muscle weakness, poor vision, cognitive deficits, the presence of chronic disease, abnormal blood pressure or medications.¬† Research shows the most effective interventions for preventing falls are based on balance and strength training.
Fall Prevention: Lower Body Strength Training
Fall prevention exercise programs for older people not only reduce the rates of falls but also prevent injuries resulting from falls when they do occur.¬† Not only does strength training improve muscle size and strength but it also improves bone density.¬† Therefore, strength training improves an individual‚Äôs protective responses during a fall.¬† The result is a more resilient older adult who is less likely to sustain a debilitating hip fracture from a fall.
Older adults are advised to perform weight-bearing lower body strength training a minimum of 2 to 3 days per week.¬† Most research studies show that a minimum duration of 26 weeks is needed to achieve the best results.¬† Body weight exercises, such as squats, are often performed.¬† However, research shows better improvements in strength and balance when external resistance, such as weights, is used. ¬†Substantial improvements in strength can be achieved with light, moderate, or heavy loads.¬† Multiple sets of each exercise produce greater improvements in strength compared to single set routines.¬† Performing 6 to 12 repetitions per set is a great way to achieve improvements in strength and muscle size.¬† Perhaps most importantly, all strength training exercises initially focus on proper form and then loads are progressively increased over time.
The most frequent exercise utilized in fall prevention exercise programs is the sit-to-stand exercise.¬† This exercise involves an activity which older adults perform frequently in their daily lives.¬† The ability to perform this activity without the assistance of the hands has been linked to fall risk in older adults.¬† It can be easily performed in the physical therapy clinic, any community exercise studio, or in the home.¬† The exercise is progressed by lowering the height of the chair or by holding weighted objects such as a medicine ball or kettle bell.¬† Other lower body exercises commonly prescribed include step-ups, hip, and ankle strengthening exercises.
Fall Prevention: Trunk Muscle Strengthening Exercise
Although an important component of any fall prevention program, performing lower body exercise does not guarantee reduced fall risk.¬† Improvements in lower body muscular strength may not transfer to improved balance if other factors are at play.¬† One such factor which can influence fall risk is core or trunk muscle strength.¬† The trunk muscles are composed of the abdominal, pelvic, hip and low back muscles.¬†¬† These muscles are responsible for transferring forces from the lower to upper body during whole-body movements such as walking or climbing stairs. ¬†¬†The trunk muscles are highly active during a trip suffered while walking.¬† These muscles act in order to stabilize the trunk over the feet when loss of balance occurs.¬† The ability of the trunk muscles to react to unexpected disturbances (i.e., suddenly being thrown off balance) has been shown to be delayed in older adults.¬† Poor ability to activate the trunk muscles has also been linked to an inability to transfer from a chair to standing unassisted.
Trunk muscle exercise focusing on strength and the appropriate timing of contraction can significantly improve balance in older adults.¬† Trunk muscle strengthening programs can be individually prescribed and progressed by doctors of physical therapy.¬† Also, many personal trainers, strength coaches, and Pilates instructors are skilled at instructing older adults in these exercises. Exercise can be performed in various positions such as lying on the back, stomach, side, or in kneeling and standing positions.¬† Trunk strengthening exercises may also be performed using unstable training devices such as exercise balls or balance pads.¬† Often, resistance bands, light weights, and medicine balls are incorporated based on the individual‚Äôs goals.¬† The 90/90 leg lower and Pallof press are two examples of trunk strengthening exercises but there are many more.
Research supports the benefits of both lower body and trunk strengthening exercise for reducing falls in older adults.¬† The importance of the trunk muscles for balance and mobility in older adults has been underestimated and often overlooked.¬†¬† Fall prevention exercise programs are optimized by including individually prescribed lower body and trunk strengthening exercise.¬† ¬†If you are not sure about how to get started, give your physical therapist a call.
The position and mobility of the thoracic spine directly affects the amount of overhead shoulder movement available.¬†¬† A more erect and mobile thoracic spine and rib cage will result in greater overhead range of motion.¬† A slouched posture or stiffness in the thoracic spine and rib cage will result in a loss of range of motion reaching overhead.¬† ¬†Excessive thoracic kyphosis, or a slouched posture, may alter the position of the shoulder blade and impair muscle activation patterns both of which contribute to limited overhead function and shoulder pain.
Approximately 15 degrees of thoracic spine extension mobility is required for full overhead motion when lifting both arms such as when performing a barbell overhead press. Full 1-arm elevation requires approximately 9 degrees of thoracic extension.¬† Thoracic spine rotation is also crucial for rotational sports such as baseball where a large amount of power is transferred through the trunk.¬† ¬†A baseball pitcher who lacks thoracic spine rotation will compensate by increasing movement and stress through the shoulder and elbow joints.
Strength is foundational for optimal shoulder health but thoracic spine mobility is often a neglected area when athletes attempt to maximize their overhead shoulder function.¬† Therefore, exercises targeting thoracic spine extension and rotation mobility should be included in any rehabilitation or performance enhancement program seeking to optimize shoulder function.¬† Instead of jumping to restore shoulder mobility with bands and balls, try these thoracic spine mobility exercises first.
Bench T-Spine Mobilization
This is my favorite exercise for restoring thoracic spine extension. ¬†It also provides a nice stretch to the lattisimus dorsi muscle which can also limit overhead mobility. The exercise begins by assuming a kneeling position facing a bench.¬† Place your elbows on the bench in front of you holding a PVC pipe or dowel with the palms facing up.¬† Sit back, pushing your buttocks towards your heels, keeping your spine relaxed, until you feel a stretch in your upper back. ¬†For an added stretch you can bend your elbows further past your head.¬† Hold this position, and exhale fully. ¬†Reverse the motion to return to the start and repeat the desired number of repetitions.
Thoracic Extension + Rotation (Reach Backs)
Begin this exercise by sitting back on your heels, face down, with one hand behind your head and the opposite forearm resting on the ground in front of you. ¬†This position minimizes available movement in the low back and maximizes movement to the upper back.¬†¬† From this position rotate your elbow up to the sky while exhaling.¬†¬† The opposite forearm remains in contact with the ground.¬† Return to the starting position and repeat for the desired number of repetitions before switching to the opposite side.
Foam Roll Thoracic Extension Mobilization
This exercise can be a challenge to perform correctly.¬† Most end up extending through the lumbar spine and not the thoracic spine.¬† Begin in a lying position over a foam roll.¬† Place the hands behind the neck supporting, but not pulling on, the neck.¬† Raise the buttocks off the ground and roll the upper back up and down the foam roll.¬† Identify a sensitive, stiff, or tender area and then drop the buttocks down to the ground.¬† From this position perform small extension movements by lifting the elbows up towards the ceiling.¬† Be careful not to overextend at the lower back.
Thoracic Spine Windmill
This is my ‚Äúgo to‚ÄĚ exercise to restore thoracic spine rotation.¬† Begin on your side with both arms outstretched in front of you.¬† Place a foam roll under your top leg with the knee and hip bent to 90 degrees.¬† The bottom knee and hip remain extended throughout the exercise.¬† ¬†Reach forward with your top hand and then complete a large circular windmill motion as you rotate your entire upper body.¬† Keep reaching as if you were attempting to lengthen your entire arm.¬† Follow your hand with your eyes to ensure proper thoracic spine and rib cage movement.¬† The top knee and leg should remain in contact with the foam roll throughout the exercise.¬† Perform the desired number of repetitions and then repeat on the opposite side.
Standing Thoracic Rotation Mobilization
The standing rotation exercise is ideal to incorporate into a pre-workout dynamic warm-up.¬† From a standing semi-squat position place one arm between your thighs just above the knees.¬† This position will block unwanted hip and pelvic movement.¬† Next, rotate the body upwards towards the sky by following your open hand with your eyes.¬† At the top of the movement, exhale before returning to the starting position.¬† Perform the desired number of reps and then repeat on the opposite side.
After performing these mobility drills it is important to work on strength and endurance of the thoracic muscles.¬† Also, manual therapy to the thoracic spine and rib cage has been shown to accelerate recovery and reduce shoulder pain immediately and for up to 1 year.¬† Maintaining or improving thoracic spine mobility is imperative for any active individual who regularly functions overhead.¬† Manual therapy, mobility drills, and strength/endurance exercise targeting the thoracic spine can lead to significant gains in overhead function for athletes and the general population.¬† These 5 mobility drills can be easily integrated into any pre-workout warm-up routine or as part of a home exercise program.
Muscular strength is defined as the ability to exert a force on an external object or against some type of resistance.¬†Strength may be expressed when hitting a baseball during sport or when standing up from a low chair during everyday life. Strength is required to press a loaded barbell overhead or strength may be needed to carry groceries from the car into the home.¬†Optimizing strength across the lifespan can have profound effects on athletic performance, quality of life, health, and longevity.
Strength & Sports Performance
During sport, athletes exert large forces against gravity (i.e., sprinting or gymnastics), against an opponent (e.g., football) or when manipulating an object (e.g., throwing a baseball).¬†Muscular performance can be a limiting factor in performing any of these athletic endeavors.¬†Power refers to the rate at which force is produced.¬†Stronger athletes produce more force and often do so in much less time.¬†Power is associated with several important sport variables such as sprinting speed, jumping, change of direction, and throwing velocity.¬†Improving muscular strength through resistance training is a sure fire way to improve power and subsequent sports performance.
An athlete‚Äôs ability to run, jump and change direction is crucial for success in most sports.¬†Enhancing muscular strength improves these characteristics which often transfer to sport specific skills during competition. Stronger athletes jump higher and further than weaker athletes.¬†Strength may be expressed when an athlete elevates for a rebound in basketball, jumps to spike a ball in volleyball, or dives to catch a ground ball in baseball.¬†Athletes, who produce large forces on the ground, are able to jump higher and further than weaker athletes.¬†This results in a true competitive advantage in many sports.
Stronger athletes are also able to accelerate running speeds over short distances.¬†Elite athletes are able to produce greater forces, with short ground contact times, and with greater stride lengths compared to non-elite athletes.¬†Evidence strongly suggests a correlation between maximal strength and running speed1.¬†Athletes who produce greater amounts of force over a shorter period of time are able to change direction at greater velocities.¬†This is important in basketball or football when attempting elude defenders.¬†Becoming stronger is a no-brainer for any athlete looking to jump higher, run faster, or rapidly change direction during their sport. Lateral lunge variations are an excellent way to improve strength in the frontal plane where many athletic injuries occur.
Strength transfers to performance in both strength-power sports and endurance sports.¬†Stronger cyclists are faster than weaker cyclists.¬†Handball players with greater strength outperform weaker handball players.¬†Stronger sprinters have faster 100-meter times than weaker sprinters.¬†Stronger baseball players possess greater bat speeds and throwing velocities than weaker players.¬†Strength alone does not ensure athletic success, but the evidence is compelling that stronger athletes possess a competitive advantage over weaker athletes in most sports.
Strength & Quality of Life
There has been a steady decline in fitness and muscular strength in children and youth across the world.¬†Research shows greater muscular fitness in school-aged youth (4-19 years)is associated with improved body composition (e.g., decreased body fat), and improved risk factor profiles for heart disease and diabetes2.¬†There is also strong evidence for a positive association between muscle strength and bone health and self-esteem in children2.¬†Therefore, youth physical activity programs which promote muscular strength can have many benefits related to overall health and quality of life.
Sarcopenia refers to the age-related loss of muscle size and strength in older adults.¬†Loss of muscle mass begins at approximately age 25 and progresses to a loss of 30% or more by the age of 80.¬†Loss of muscle mass occurs primarily in type II muscle fibers which are highly responsible for muscle strength and power.¬†Therefore, the rate and magnitude of strength loss usually exceed that of muscle mass by 2-5 times.
Age-related loss of muscle strength and bone mass (osteopenia) are associated with impaired functional mobility, compromised balance, and increased risk of arthritis, joint replacement surgeries, falls, and fractures.¬†All of these factors can substantially diminish the quality of life.¬†Nearly 20% of women and 10 % of men over the age of 65 cannot lift a 10-pound weight or kneel down on the floor.¬†The age-related loss of strength is also associated with an inability to live independently and premature death3.
Maintaining muscle strength is a key strategy that leads to healthy aging.¬†Sedentary behavior and physical inactivity are key drivers of sarcopenia and can accelerate the loss of muscle mass and strength. Maintenance of physical activity and engagement in a regular strength training program can diminish or even prevent these age-related changes. Pulling exercises or row variations are great for strengthening the upper body and core musculature.
The Importance of Strength for Optimal Health & Longevity
It is well-known that aerobic fitness is associated with decreased risk for chronic disease and premature death.¬†The health benefits of exercise programs which target muscular strength is less known to the general public.¬†A 2017 study published in the American Journal of Epidemiology showed resistance training reduced the risk of all-cause and cancer-related death to a greater degree than aerobic exercise4. There is now a growing body of evidence suggesting poor muscular strength is associated with death from all causes in both healthy and diseased populations
Another review in the European Journal of Internal Medicine reported a reduced risk for all-cause mortality with increased levels of muscular strength5. This association persists even after controlling for age, body fat, smoking, alcohol intake, medications, other health conditions, physical activity, and levels of cardiorespiratory fitness.¬†Handgrip strength has been associated with survival and long-term outcomes in patients with cancer.¬†Muscular strength has also been shown to be associated with long-term outcomes in patients with heart disease.
The health and mortality benefits of muscular strength appear to be related to multiple physiological mechanisms.¬†This includes improved blood pressure, blood lipids, and body composition.¬†Reduced systemic inflammation and reduction in insulin resistance have also been linked to improved muscular strength and mortality.¬†Based on the available evidence showing a strong association with muscular strength and mortality, adults should perform muscle-strengthening exercises at least 2 days per week in order to reduce mortality risk.¬†For most, basic lower body exercises such as squats and hip hinges are great places to start with a strengthening program.
We continuously perform activities during sport or our daily routine which require the expression of muscular strength.¬†To a certain extent, muscular strength can be inherited.¬†However, strength will never be optimized and will ultimately decline with age unless strength promoting exercises are undertaken.¬†Optimizing or preserving muscular strength is strongly associated with improved sports performance, improved quality of life, improved physical function, reduced risk for chronic disease, and reduced risk for all-cause death.¬†This should be sufficient evidence for all individuals, regardless of age or health status, to engage in some form of resistance training today.
¬†Suchomel TJ, Nimphius S, Stone MH. The importance of muscular strength in athletic performance. Sports Med. 2016;46(10):1419-1449. doi:10.1007/s40279-016-0486-0.
Smith JJ, Eather N, Morgan PJ, Plotnikoff RC, Faigenbaum AD, Lubans DR. The health benefits of muscular fitness for children and adolescents: A systematic review and meta-analysis. Sports Med. 2014;44:1209-1223. doi:10.1007/s40279-014-0196-4.
McLeod M, Breen L, Hamilton DL, Philp A. Live strong and prosper: The importance of skeletal muscle strength for healthy aging. Biogerontology. 2016;17(3):497-510. doi:10.1007/s10522-015-9631-7.
Stamatakis E, Lee I, Bennie J, et al. Does strength promoting exercise confer unique health benefits? A pooled analysis of eleven population cohorts with all-cause, cancer, and cardiovascular mortality endpoints. Eur J Intern Med. 2017; Ahead of P:1-37. doi:10.1093/aje/kwx345/4582884.
Volaklis KA, Halle M, Meisinger C. Muscular strength as a strong predictor of mortality: A narrative review. Eur J Intern Med. 2017;26(5):303-310. doi:10.1016/j.ejim.2015.04.013.
Walk into any gym in the area and you are likely to see people who completely neglect the warm-up.¬†Others spend 45 minutes or more on the foam roller, stretching with bands, or torturing themselves with lacrosse balls.¬†So what is the deal with warming-up before a training session?¬†The purpose of the warm-up is to prepare the body, mentally and physically, for the upcoming training session or for competition.¬†When done properly, the warm-up can improve performance and in some instances, may lessen the risk of injury.
The positive effects of any warm-up are best achieved through an active form rather than passive or static stretching techniques.¬†The positive effects of a warm-up can be achieved through temperature-related and non-temperature-related effects.¬†Temperature-related effects include increased muscle temperature, core temperature, enhanced nervous system function, and improved connective tissue flexibility.¬†Non‚Äďtemperature-related effects include increased blood flow to muscles, improved oxygen consumption, and improved muscle contraction capabilities.
Other physiological and performance benefits of the warm-up include:
Faster muscle contraction and relaxation
Improvements in the rate of force development
Faster reaction time
Improvements in muscle strength and power
Lowered stiffness in muscles and joints
Improved oxygen delivery to working muscles
Increased blood flow to working muscles
Increased psychological preparedness
The Basic Components of an Effective Warm-Up
There are two basic phases to a well-designed warm-up before the start of a training session.¬†These are the general warm-up and the specific warm-up.¬†The general warm-up typically consists of 5 minutes of slow aerobic activity such as jogging, skipping, or cycling. The aim of this phase is to increase heart rate, blood flow, muscle temperature, respiration rate, and joint mobility. This phase is typically followed by a period of general stretching that aims to replicate the ranges of motion required for the upcoming training session.¬†The specific warm-up
Typically incorporates movements similar to the movements of the athlete‚Äôs sport or training session. This should include rehearsal of the skill(s) to be performed.¬†It is recommended the specific warm-up last 10 to 20 minutes with no more than 15 minutes between the end of the warm-up and start of activity (training session or competition).
The warm-up for a game or competition aims to maximize performance in the subsequent event.¬†However, for the training session, in addition to optimizing acute performance during the session, the specific warm-up should contribute to the overall long-term development of the athlete.¬†This is often an ideal time to incorporate individualized corrective exercise into an athlete‚Äôs program. For the baseball pitcher this may include rotator cuff activation exercises such as diagonal patterns with resistance bands.
Structuring the Warm-Up to Optimize Short and Long-Term Performance
Effective warm-ups should be thought of as an integral part of any training session, not as a separate entity.¬† Raise, Activate and Mobilize, and Potentiate (RAMP) is an acronym used to describe a more detailed structure for a warm-up2. This builds on the general and specific structure offering an approach which maximizes both acute and long-term performance.
Raise, refers to increasing the level of several physiological variables and the level of skill of the athlete. This phase is analogous to the general warm-up and aims to elevate body temperature, heart rate, respiration rate, blood flow, and joint mobility through low-intensity activities. General aerobic exercises, such as cycling or the elliptical trainer, are often inserted here.¬†However, it is more beneficial to attempt to simulate the movement patterns of the upcoming activity or develop the movement patterns or skills the athlete will need to utilize within the sport. Instead of treadmill jogging before a squat session, the athlete can perform walking lunges to prepare physically and psychologically.¬†In this way, the training session, from the start of the warm-up, is targeted at key movement patterns and skills and not just aerobic capacity.
Activating and mobilizing refers to the stretching component of a warm-up. Key movement patterns required for athletic performance in both the subsequent session and the athlete‚Äôs long-term development are performed. This might include corrective exercise for core stabilization or specific mobility.¬†Static stretching may be incorporated as corrective exercise if specific deficits are identified.¬†Baseball players can consider inserting static stretches for the lats, forearms, or rotator cuff.¬†Any decrement in subsequent strength or power from static stretching is likely very short-lasting1.
Performing dynamic warm-up activities following static stretching will override any small transient performance decrements. The focus of mobility exercise is always on actively moving through a range of motion not static stretching.¬†Dynamic stretching requires a combination of control, stability, and flexibility and more closely relates to the movement requirements an athlete will face in the training session or their sport.¬†Dynamic stretches are extremely time-efficient compared to single muscle static stretches. Prior to overhead pressing with the bar, try warming-up with 20 reps of a door slide exercise or band external rotation to press.
Potentiation refers to the specific warm-up and focuses on the intensity of activities. This phase incorporates specific activities that progress in intensity until the athlete is performing at the intensity required for the training session. The potentiation phase is often omitted from training sessions.¬†It is common to see an athlete proceed from a stretching exercise directly into their first working set of a squat or Olympic lift. This only compromises strength and power output.
There is strong evidence showing high-load dynamic warm-ups enhance subsequent power and strength performance3. The more power necessary for the exercise or activity, the more important the potentiation phase of the warm-up becomes.¬†The objective is to include high-intensity dynamic exercises in order to prepare the nervous system.¬† Exercises which include short bouts of a high-intensity sprints, jumps or throws are ideal. Again, these warm-up exercises should be targeted to the upcoming session but also address the longer-term requirements of the athlete.¬†A few sets of 2-3 plyometric jumps can be performed before getting under the bar for squats.
Many athletes or fitness enthusiasts are unaware of the optimal structure and performance benefits related to a proper warm-up.¬†The RAMP protocol is a great foundation to structure any warm-up.¬†More importantly, any properly designed warm-up should prepare the body for the subsequent training session and also assist in the long-term development of the athlete.¬†If you are looking for performance gains for your next training sessions and the long-term, get serious about warming-up.
Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2016). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: A systematic review. Applied Physiology, Nutrition, and Metabolism, 41, 1‚Äď11.
Haff, G.G., Triplett, N.T. (2016). Essentials of strength training and conditioning (4th ed). Champaign, Ill: Human Kinetics.
McCrary, J. M., Ackermann, B. J., & Halaki, M. (2015). A systematic review of the effects of upper body warm-up on performance and injury. British Journal of Sports Medicine, 49, 935‚Äď942. https://doi.org/10.1136/bjsports-2014-094228
The winter months are quickly approaching here in the Northeast.¬†For youth baseball players the cold winter is the ideal time to focus on developing muscular strength and explosive power.¬†These physical attributes transfer to the baseball field as quickness, running speed, bat speed, throwing velocity, ball exit velocity, and overall resiliency needed to survive the grind of a full season.¬†Under most circumstances, youth athletes should always be encouraged to participate in multiple sports throughout the year up until about the age of about 15 or 16.¬†Continuing efforts to improve baseball skills, such as hitting, is important for the mature specialized youth athlete.¬†However, baseball performance will never be optimized without a well structured and supervised off-season strength and conditioning program.
Last week I had the unique opportunity to visit the New York Yankees spring training complex in Tampa, Florida.¬†It was a special weekend for a lifelong Yankees fan and strength and conditioning nerd like myself.¬†The Yankees strength and conditioning and sports science staff hosted a group of growth-minded coaches from the National Strength & Conditioning Association. The entire day was tremendous and a humbling learning experience.¬† Topics included leadership, hill running for baseball players, and programming for off-season strength training.¬†The Yankees staff stressed the importance of a well-structured year-round strength and conditioning program for all players from the rookie leagues up through the majors.¬†The Yankees organization fully expects to win many more World Series trophies and developing their athletes is a big part of their winning plan.
What Makes a Great Baseball Player?
Hitting a baseball is a sequence of coordinated muscle activity involving the hips, torso, and arms.¬†Bat speed is an important factor affecting how hard the ball is hit and how far the ball travels. Training baseball players targets the lower body and explosive torso rotational exercises.¬†Exercises which develop upper body power, lower body power, and torso rotational power, all transfer on the field to improved bat speed.¬†Research also indicates lean body mass, lower body power, sprint speed, and grip strength are closely correlated with baseball-specific performance measures such as total bases, slugging percentage, home runs, and stolen bases. The off-season is the ideal time to train these attributes in baseball players because this is typically the period when the least amount of baseball-specific batting or pitching practice is taking place.
In 2010, researchers from Louisiana Tech University investigated the relationship between player variables and bat speed in 2 groups of high-school baseball players before and after completing a 12-week resistance training program.¬†Both groups completed the same upper and lower body resistance training program and took 100 bat swings 3 days per week.¬†However, one group also performed additional full-body rotational medicine ball exercises. Several body composition and physiological variables, along with bat speed, were assessed before and after the training program.
Researchers found bat speed was associated with greater lean body mass and height.¬†This sounds like Aaron Judge to me.¬†Torso rotational strength was even more closely associated with bat speed in these high school athletes. Lower body power, measured by vertical jump, was also closely associated with bat speed.¬†Finally, lower body strength (measured with 3-repetition maximum squat) and upper body strength (measured with 3-repetition ¬†maximum bench press) were also associated with bat speed. From this research, in order to improve bat speed in baseball players, off-season strength and conditioning programs should target improving lean body mass, rotational power, lower body power, lower body strength, and upper body strength.
The Off-Season Baseball Strength & Conditioning Program
Off-season baseball strength and conditioning focuses on improving total body strength, rotational power, and lower body power.¬†Pitchers also focus some of their efforts on arm care programs in order to prepare for the volume of throwing which places unique stresses on the shoulder and elbow.¬†Pitchers must possess adequate strength in order to develop power and throwing velocity.¬†Programs typically last 10 to 12 weeks with training occurring 3 days per week.¬†Volume and intensity of these programs are progressed and tapered down as the athlete gets closer to pre-season when baseball-specific skill training becomes increasingly important.¬†Resistance training with free weights or cables, plyometric training, and medicine ball training are the cornerstones of the off-season program.
Resistance training has been shown to improve both bat speed and throwing velocity in youth baseball players.¬† These exercises seek to build foundational strength through movement patterns such as the squat, hinge, and press.¬†However, as previously mentioned, baseball involves a great deal of rotational and diagonal movement which should be heavily incorporated into training.¬†The cable push-pull exercise is great for improving torso rotational strength in the position player or pitcher.¬†Baseball players often exhibit muscle imbalances where the front of the body (anterior chain) is stronger than the back (posterior chain).¬†Therefore, it is common for programs to include a 2 to 1 ratio of pull to push exercises.¬†Training volume with movements such as rows and lifts targeting the posterior chain should be stressed over movements such as presses.
Baseball is also an asymmetrical one-side dominant sport which involves throwing with one arm or batting from the same side of the plate.¬†Barbell training for the squat, deadlift, and sometimes the bench press can be included in a periodized program to improve bilateral strength.¬†However, it is very important for the baseball player to be training unilaterally with dumbbells or kettlebells.¬†Single arm rows, split-stance squats or lunges, and single-arm kettlebell swings are great examples of unilateral exercises.
Power is the product of strength and speed.¬†Power is expressed when throwing, swinging or jumping during the game of baseball.¬†Strength is trained with resistance exercise using heavy loads at slower speeds. Plyometric training involves drills designed using maximal force as quickly as possible.¬†These exercises are important for training the speed component of power.¬†Research from Arizona State University showed complex training utilizing both heavy resistance training and plyometric jump training improved power in baseball players to a greater degree than either resistance or plyometric training alone.¬†Lower body plyometric drills to improve explosive power for the baseball player include box jumps, lateral jumps, and split squat jumps.
Medicine ball training is a form of explosive exercise using rapid force development and transfer from the lower body and torso through the arms.¬†Medicine ball throws are ideal for developing rotational power which is crucial for any baseball player.¬†Twelve weeks of resistance training plus medicine ball training resulted in greater improvements in rotational strength compared to resistance training without medicine ball drills. In another study, 6 weeks of supervised medicine ball training in high school baseball pitchers was shown to result in a 2% increase in throwing velocity. It is very important that athletes are instructed in proper technique during these drills.¬†Performing explosive medicine ball training with improper technique can result in decreased throwing performance or injury. Common medicine ball drills used with baseball players include the squat and throw, perpendicular throw, and hitter‚Äôs throw.
The baseball player‚Äôs off-season strength and conditioning program should coincide with specialized sports skill practice. However, the off-season is not the time where pitchers should be throwing at high volumes. Youth pitchers should rest from throwing for a minimum of 2 to 4 months per year. The off-season throwing program must be individualized to meet the needs of the athlete. Regardless of the structure of skill practice, the off-season is the ideal time to divert efforts towards improving strength, power, speed, and resiliency.¬†As the off-season progresses and the athlete approaches the pre-season, the focus on strength and conditioning should decrease.¬†At the same time, sport skill training (pitching, hitting, and fielding) increases.
Off-season strength and conditioning for baseball players improves performance through the development of strength, speed, and explosive power. These qualities are the foundation of a long and successful baseball career.¬†Youth athletes should be instructed, supervised, and progressed by trained professionals who have experience with baseball players.¬†The research is clear about how baseball players are built.¬†The New York Yankees have taken notice and put these concepts into practice.¬†Youth baseball players are not miniature professional athletes and should not be trained as such.¬†However, the basic principles used by the Yankees can be applied to youth athletes by trained professionals who understand the science.
Dodd, D. J., & Alvar, B. A. (2007). Analysis of acute explosive training modalities to improve lower-body power in baseball players. Journal of Strength & Conditioning Research, 21(4), 1177‚Äď1182.
Escamilla, R. F., Ionno, M., DeMahy, S., Fleisig, G. S., Wilk, K. E., Yamashiro, K., ‚Ä¶ Andrews, J. R. (2012). Comparison of three baseball-specific 6-week training programs on throwing velocity in high school baseball players. Journal of Strength & Conditioning Research, 26(7), 1767‚Äď1781.
Hoffman, J., Vazquez, J., Pichardo, N., & Tenenbaum, G. (2009). Anthropometric and performance comparisons in professional baseball players. Journal of Strength & Conditioning Research, 23(8), 2173‚Äď2178.
Szymanski, D., Szymanski, J. M., Bradford, J., Schade, R. L., & Pascoe, D. (2007). Effect of twelve weeks of medicine ball training on high school baseball players. Journal of Strength & Conditioning Research, 21(3), 894‚Äď901. https://doi.org/10.1519/R-18415.1
Szymanski, D., Szymanski, J., Schade, R., Bradford, T., McIntyre, J., DeRenne, C., & Madsen, N. (2010). The relation between anthropometric and physiological variables and bat velocity of high school baseball players before and after 12 weeks of training. Journal of Strength & Conditioning Research, 24(11), 2933‚Äď2943.
Static stretching exercises are commonly performed as a method to improve muscle flexibility and overall mobility.¬†Typically, stretches are sustained for 15 to 30 seconds and performed multiple times during an exercise session.¬†Many athletes and fitness enthusiasts perform stretching in preparation for a training session or competition.¬†Others believe regular performance of static stretching can reduce their risk of sustaining an injury.¬†Stretching routines often consume an enormous amount of time for some athletes.¬† Does the current body of research suggest this time is well spent?¬†Or can athletes better spend their time and energy on other types of training in order to reduce injury risk?
Stretching & Injury Risk
A review of the research published in the British Journal of Sports Medicine looked at the role of several forms of exercise in reducing the risk for sports injuries.¬† Twenty-five original studies including over 25,000 athletes looked at the preventative effects of stretching, strength training, and proprioceptive training.¬†Stretching, before or after exercise, was determined to have no preventative effects against acute or chronic sports injuries.¬†The most significant finding from this review was strength training reduced all sports injuries to less than 1/3 and overuse injuries were cut in half.
Other systematic reviews have also concluded no preventative effects for static stretching.¬†One study even suggested that stretching may increase the risk of patellar tendon injuries or ‚Äújumper‚Äôs knee‚ÄĚ.¬†My experience with static stretching leads me to believe there is a neutral effect.¬†In other words, there is no direct preventative or harmful effects to static stretching.¬†Static stretching should be an extremely small part of any training program.¬†In most cases, stretching is not necessary to reduce injury risk or improve performance.
The Acute Effects of Stretching
Static stretching induces range of motion improvements, but these effects are short-term typically lasting less than 30 minutes.¬†Many myths exist with regards to what is actually happening at a physiological level. ¬†Changes in mobility may result from acute reductions in muscle and tendon stiffness or from nervous system adaptations causing an improved stretch tolerance.¬†Stretch tolerance refers to an athlete‚Äôs ability to tolerate the discomfort of the stretch.¬†Athletes with a greater range of motion tend to demonstrate a greater level of stretch tolerance.¬†Thus they are able to tolerate a greater stretch load.¬†Improving stretch tolerance can be achieved through different training methods one of which is static stretching.¬†However, if athletes are looking to reduce their risk of injury, or simply better prepare themselves for training, time can be better spent using more beneficial techniques.
Stretching or Strength Training?
First and foremost, athletes and fitness enthusiasts should build their training routines on a solid foundation of strength training.¬†A comprehensive and proper strength training program may increase flexibility through enhanced stretch tolerance. Strength training also assists in the development of force capacity through the newly gained range of motion.¬†In order to maximize the effect, athletes should perform strength training movements in a controlled fashion through the full available range of motion.
Strength training promotes a sense of resiliency, reduces injury risk, and improves overall performance in many aspects of life.¬†I have written about the benefits of youth strength training for reducing injury risk and performance.¬†Static stretching has no effects on injury reduction or performance, and does not promote resiliency within athletes.¬†Sure, holding hamstring stretches for sustained periods of time feels nice and promotes a sense of relaxation.¬†This may have a time and place but do not confuse the calming effects or short-term increases in mobility gained through static stretching as beneficial for injury risk reduction.
Stretch if You Must
Athletes who insist on performing static stretching should probably do so at the end of their training session or after competition.¬†Prior to training or competition, perform dynamic activities as part of a preparatory warm-up. Performing the warm-up actively in weight bearing positions is the best approach.¬†Also performing the warm-up with multiple joint movements will better prepare the athlete for the complex movements of sport or training.¬†Dynamic stretching, sometimes referred to as mobility drills, places an emphasis on the movement requirements of the sport or activity rather than on individual muscles. An example would be performing body-weight lunge walking prior to a squat training session.¬†There are endless possibilities for one to dynamically prepare the hips prior to squatting.
For athletes looking to improve their mobility and overall performance in the gym, static stretching should play a minimal, if any, role.¬†Instead, try performing dynamic activity-specific preparatory movements with progressive loading.¬†Performing ten minutes of piriformis and calf muscle stretching will do little to improve performance during a squat session.¬†Instead, include some loaded goblet squats or split squats prior to warming up with the barbell. Increase the load progressively until you reach your working set intensity.¬†With this approach, the dynamic warm-up and start of the training session are continuous and optimal for preparing the body for performance. After putting in the work at the end of the training session, feel free to lie down on the floor and stretch those ‚Äútight hamstrings‚ÄĚ.
Contrary to popular belief, stretching has no beneficial effects on reducing injury risk and its role in performance enhancement is questionable at best.¬†Athletes should use static stretching sparingly and focus their time and efforts towards more effective injury reduction strategies such as a well-supervised and progressive strength training program.¬†Lying on the floor to stretch certainly feels good but in order to achieve lasting benefits, nothing can replace hard work and sweat in the gym.
Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2016). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: A systematic review. Applied Physiology, Nutrition, and Metabolism, 41, 1‚Äď11.
Haff, G.G., Triplett, N.T. (2016). Essentials of strength training and conditioning (4th Ed). Champaign, Ill: Human Kinetics.
Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: A systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48, 871‚Äď877. https://doi.org/10.1136/bjsports-2013-092538
Peters, J. A., Zwerver, J., Diercks, R. L., Elferink-Gemser, M. T., & Akker-scheek, I. Van Den. (2016). Preventive interventions for tendinopathy: A systematic review. Journal of Science and Medicine in Sport, 19, 205‚Äď211.