AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
Ballistic training incorporates weight training in such a way that the acceleration phase of the movement is maximized and the deceleration phase minimized; thereby increasing the power of the movement overall. For example, throwing a weight or jumping whilst holding a weight. This can be contrasted with a standard weight lifting exercise where there is a distinct deceleration phase at the end of the repetition which stops the weight from moving.[40]

As scientific research progressed, it became apparent that the best types of protein came from milk and eggs. That led to the next great revolution in sports nutrition, namely the engineered food, pioneered by Scott Connelly, M.D., a critical care specialist from Northern California who teamed with a young entrepreneur named Bill Phillips from Golden, Colorado.
One study on 27 otherwise healthy men supplementing creatine (0.3g/kg loading for a week, 0.05g/kg thereafter for 8 weeks) with a thrice weekly exercise regiment noted that alongside greater increase in lean mass and power relative to placebo at 4 and 8 weeks, myostatin in serum decreased to a greater extent with creatine (around 17% at 8 weeks, derived from graph) than it did with placebo (approximately 7%).[356] Increases in GASP-1, a serum protein that inhibits the actions of myostatin by directly binding to it,[357] were not different between groups.[356]
Kilduff, L. P., Georgiades, E., James, N., Minnion, R. H., Mitchell, M., Kingsmore, D., Hadjicharlambous, M., and Pitsiladis, Y. P. The effects of creatine supplementation on cardiovascular, metabolic, and thermoregulatory responses during exercise in the heat in endurance-trained humans. Int J Sport Nutr Exerc Metab 2004;14(4):443-460. View abstract.

SAMe is the primary methyl donor in the human body, and supplements that preserve SAMe (such as trimethylglycine; TMG) promote a variety of benefits in the human body, like a reduction in homocysteine and reduced risk of fatty liver. Creatine has been implicated in both reducing homocysteine[124] and preventing fatty liver in rodents[125], thought to be secondary to preserving SAMe.

In addition to the HIIT sessions, it’s always a good idea to go for a 30–60-minute walk as many days per week as you can. I recommend getting a minimum of 10,000 steps every day. Use a phone app to track them. If you’re into jogging, swimming, hiking, or some other form of long-duration, fairly low-intensity cardio, that is fine to do as well, and as often as you like.
One of the biggest goals of bodybuilders is to increase their muscle size and strength. Bodybuilding supplements often contain many ingredients that help to encourage this. Branched-chain amino acids are a common ingredient that can significantly increase muscle growth. Other ingredients help to increase the levels of hormones, such as growth hormone and testosterone, that can also stimulate muscle growth.
So how does that play out in the real world? Well, if, for example, a woman adds 10 pounds of muscle and loses 10 pounds of fat, she’ll burn 40 extra calories per day. Forty calories a day isn’t nearly as significant as a dietary change could be, but for people who are looking to lose weight, it can still make a minor difference over the long term.
It’s important to remember that since everybody is different, these estimates are just that. How the numbers work out for each person will definitely vary. So many factors—like genetics, hormones, sleep, and diet—can change the rate at which our bodies burn calories. And some people may have a harder time than others when it comes losing fat or gaining muscle—again, there are so many factors at play and our body chemistries are all different. Strength training is important for many, many, many other reasons (more on that later), but if you’re looking to increase your metabolism, it’s important to have realistic expectations and know that strength training can make a difference, but probably won’t drastically affect how many calories you burn from one day to the next.
The bulking and cutting strategy is effective because there is a well-established link between muscle hypertrophy and being in a state of positive energy balance.[19] A sustained period of caloric surplus will allow the athlete to gain more fat-free mass than they could otherwise gain under eucaloric conditions. Some gain in fat mass is expected, which athletes seek to oxidize in a cutting period while maintaining as much lean mass as possible.
How to maximize its effects: Take 20 grams of whey protein powder in the 30 minutes before working out, and take 40 grams within 60 minutes after training. Also consider taking 20-40 grams of whey immediately upon waking every morning to kick-start muscle growth. Your best bet is to choose a whey powder that contains whey protein hydrolysates (whey protein broken down into smaller fragments for faster digestion) or whey protein isolate.
Heath suggests incorporating dropsets into your training routine by immediately decreasing the weight and repping out again to failure. “Dropsets overload the muscle with shorter rest periods and increasing volume which you need to grow,” says Heath. “That overload improves your body’s abilities to utilize more nutrients, natural growth hormone, and natural testosterone into those areas and makes the supplements you take more effective.” Heath’s favorite way to do dropsets is on a pin-loaded machine since it’s faster to switch weights.
Forbes, S. C., Sletten, N., Durrer, C., Myette-Côté, E , Candow, D., & Little, J. P. (2017, June). Creatine monohydrate supplementation does not augment fitness, performance, or body composition adaptations in response to four weeks of high-intensity interval training in young females. Human Kinetics Journals, 27(3), 285-292. Retrieved from http://journals.humankinetics.com/doi/abs/10.1123/ijsnem.2016-0129
It’s true—your genes can play a role when it comes to building muscle. In general, there are two types of muscle fibers: Type I, which are slow twitch, and Type II, which are fast twitch. Depending on which you have more of, you may have an easier or harder time gaining muscle. “Fast twitch muscle fibers are two times as thick as slow twitch muscle fibers, lending to the overall thickness of the muscle without any activity,” explains Lovitt. “Those people with a genetic predisposition of a high percentage of these fibers can increase muscle size very easily while the people with a higher percentage of slow twitch muscle fibers have to work really hard to put on mass.” It’s the reason why a world-class sprinter genetically has more fast twitch muscle fibers than a world-class marathoner—it comes down to what we’re born with.
Entry into neural tissues in general is mediated by the secondary creatine transporter (CrT-2) known as SLC6A10,[186] which is the same transporter that is active in a male’s testicles.[145] CrT-2 belongs to the family of SLC6 transporters that act to move solutes across the membrane by coupling transport with sodium and chloride.[187][188] Genetic deletions in the 16p11.2 region, which encodes both SLC6A8[189] and SLC6A10[186] can result in severe mental retardation in humans and is one of the causes of “Creatine Deficiency Syndrome.” Creatine Deficiency Syndrome is not only caused by lack creatine transporter expression, however, as creatine synthesis is also critical for neural function.[190].[189] Retardation caused by defective creatine synthesis[31] can be reversed with creatine supplementation and dietary changes.[191]
Macrophages are known to express creatine kinase[290] and take creatine up from a medium through a sodium dependent mechanism (likely the creatine transporter) in a saturable manner,[435] with a second component that requires there to be no concentration gradient to work against (likely passive diffusion) but this effect tends to only account for up to 10% of total uptake in the physiological range (20-60µM).[435] Supraphysiological range was not tested.

Bodybuilders have THE BEST mind to muscle connection of any resistance-training athletes. Ask a seasoned bodybuilder to flex their lats or their rhomboids or their hamstrings and they will do it with ease. Ask other strength athletes and you will see them struggle and although they may tense up the target muscle they will also tense up about 15 other surrounding muscles. This is because strength athletes train MOVEMENTS. They don’t care about targeting their lats. They just want to do the most pull ups. They don’t worry about feeling their quads. They just want to squat maximum weight. Although this is an expected and positive thing for the most part, there are real benefits to being able to isolate and target muscles.
In addition to the BBB, SLC6A8 is also expressed on neurons and oligodendrocytes,[192] but is relatively absent from astrocytes, including the astrocytic feet[193][194] which line 98% of the BBB.[195] Creatine can still be transported into astrocytes (as well as cerebellar granule cells) via SLC6A8, as incubation with an SLC6A8 inhibitor prevents accumulation in vitro. It seems to be less active in a whole brain model, relative to other brain cells.[196]
Still, any supplement should be used carefully and after discussion with a dietitian or doctor. There are some potential health risks and side effects that you should be aware of before taking creatine. Muscle cramping, nausea, diarrhea, dizziness, gastrointestinal pain, dehydration, weight gain, water retention, heat intolerance, and fever have all been linked to the supplement. (13)
Different forms of creatine in combination with other sports supplements as well as varying doses and supplementation methodology should continue to be researched in an attempt to understand further application of creatine to increase sports and exercise performance of varying disciplines. It is important to remain impartial when evaluating the safety of creatine ingested as a natural supplement. The available evidence indicates that creatine consumption is safe. This perception of safety cannot be guaranteed especially that of the long term safety of creatine supplementation and the various forms of creatine which are administered to different populations (athletes, sedentary, patient, active, young or elderly) throughout the globe.
It is suggested [16,37] that another mechanism for the effect of creatine could be enhanced muscle glycogen accumulation and GLUT4 expression, when creatine supplementation is combined with a glycogen depleting exercise. Whereas it has been observed [38] that creatine supplementation alone does not enhance muscle glycogen storage. Hickner et al [15] observed positive effects of creatine supplementation for enhancing initial and maintaining a higher level of muscle glycogen during 2 hours of cycling. In general, it is accepted that glycogen depleting exercises, such as high intensity or long duration exercise should combine high carbohydrate diets with creatine supplementation to achieve heightened muscle glycogen stores [39].
The US FDA reports 50,000 health problems a year due to dietary supplements [14] and these often involve bodybuilding supplements.[15] For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, widely sold in stores such as Walmart and Amazon, was found to contain N,alpha-Diethylphenylethylamine, a methamphetamine analog.[16] Other products by Matt Cahill have contained dangerous substances causing blindness or liver damage, and experts say that Cahill is emblematic for the whole industry.[17]
If you stop getting the results you want after several weeks of working out, it's time to mix things up. You need to challenge or "confuse" your muscles often to keep them growing. You can do this by putting a twist on your basic moves. Do a biceps curl with a reverse grip, for example. Or find a bench for the step-up move shown here. Change up your workout at least every 4 to 6 weeks for the best results.
Bodybuilders spend years and years of their lives focused on perfecting the human body through proper training and nutrition. You, on the other hand, might not have an interest in the sport of bodybuilding, but do want to know the secrets to six-pack abs, a wide back, and rounded shoulders. And what better place to score the tricks of the trade than from 3-time Mr. Olympia Phil Heath. 
In fact, in one new study comparing the effects of aerobic exercise versus resistance training on the psychological health of obese adolescents, researchers found that people in the resistance group experienced significantly greater self-esteem and perceived strength over four weeks. But what’s most interesting is that the feeling of getting stronger — rather than any measurable gains — was all it took to give them a boost.
Peirano, R. I., Achterberg, V., Dusing, H. J., Akhiani, M., Koop, U., Jaspers, S., Kruger, A., Schwengler, H., Hamann, T., Wenck, H., Stab, F., Gallinat, S., and Blatt, T. Dermal penetration of creatine from a face-care formulation containing creatine, guarana and glycerol is linked to effective antiwrinkle and antisagging efficacy in male subjects. J.Cosmet.Dermatol. 2011;10(4):273-281. View abstract.
Transparent Labs’ Creatine HMB really did their homework. The HMB, which stands for hydroxymethylbutyrate, is the main metablite in the branched chain amino acid leucine that prevents the breakdown of muscle protein. Translation: it helps you to retain muscle, and it appears to do so more effectively than leucine alone. One bonus is that combining HMB with creatine also appears to increase strength better than taking either supplement alone. Plus, the blue raspberry flavor is delicious and contains no artificial sweeteners.
However, not all proteins are created equal in the muscle building stakes. Always remember the better the quality (biological value) of protein consumed, the more of it will be used for muscle building. To maximise muscle growth, stick to high-quality proteins, such as whey, milk, eggs, fish or lean meats. However, combining lower quality or incomplete protein from plant-based sources, such as nuts and beans, can still be a valuable protein source for muscle building.
^ "The History of Weightlifting". USA Weightlifting. United States Olympic Committee. Archived from the original on 7 July 2013. Retrieved 3 September 2018. The genealogy of lifting traces back to the beginning of recorded history where man's fascination with physical prowess can be found among numerous ancient writings. A 5,000-year-old Chinese text tells of prospective soldiers having to pass lifting tests.
Preparation – If you have physique or aesthetic goals then you’re going to have monitor your nutrition. That being said, it will require a bit of work to prepare some healthy meals and ensuring you’re getting enough calories. Not only that, you must approach training in the same way. If you don’t have your gym bag essentials prepped, you’ll end up wasting time looking for your belt and wrist wraps which should already be packed.

More specifically, you can expect to end up in the upper half of these ranges ONLY if you are a beginner, younger, and/or have amazing genetics. You can expect to end up in the lower half of these ranges if you are an intermediate or advanced trainee, older, and/or have poor genetics. The average person can expect to end up somewhere in the middle. Additional details here: How Much Muscle Can You Gain?
Creatine, the amino acid, naturally helps your body produce more adenosine triphosphate, or ATP, a small molecule that’s actually your body's primary energy source. But research shows that your body is only capable of storing enough ATP for 8 to 10 seconds of high-intensity exercise — and after that, it needs to produce new ATP for you to continue. (9)
One of the biggest goals of bodybuilders is to increase their muscle size and strength. Bodybuilding supplements often contain many ingredients that help to encourage this. Branched-chain amino acids are a common ingredient that can significantly increase muscle growth. Other ingredients help to increase the levels of hormones, such as growth hormone and testosterone, that can also stimulate muscle growth.
A: Start with the calculations above but don’t be afraid to adjust up or down. Your metabolism and physiology will adapt to more food by trying to maintain homeostasis and regulate your bodyweight. Some may have to increase more than others but the number on the scale doesn’t lie. If it’s not going up, then you probably need to increase your calories.

Bodybuilders do cardio training such as running and using a StairMaster StepMill to burn fat and make their muscles more visible. “Do cardio throughout the year at least three days a week for at least 30-40 minutes, whether it be first thing in the morning on an empty stomach or after a post-workout protein shake,” says Heath. “Cardio won’t kill your gains as much as you think, you’ll see how much muscle you really have.” Break a sweat to stay lean ’round the clock.
Now, while all three are definitely beneficial to the process, I’d consider metabolic stress and muscular damage to be of secondary and tertiary importance, respectively. In addition, they are also things that will pretty much take care of themselves when implementing the workout guidelines and recommendations we’ve already covered (namely for volume, rep ranges, rest periods and exercise selection).

Using clinically effective doses of potent ingredients, Transparent Labs' StrengthSeries Creatine HMB combines creatine monohydrate with HMB in order to boost strength, lengthen endurance, and reduce fat. Along with the addition of BioPerine, StrengthSeries Creatine HMB is able to increase the rate of absorption and dispersion of this powerful creatine formula. Each serving of Creatine HMB contains 5g of Creatine, 2 g of HMB, and 5mg of BioPerine! Keep Reading »
Stash away your scale for several weeks — and set a strength training goal instead. That’s the advice of Lisette Cifaldi, director of behavioral health at Hilton Head Health weight loss resort who counsels patients. “I think strength training shifts your perspective,” she says. “The happiness doesn’t come from achieving a certain number [on the scale]. It comes from the process of getting stronger and feeling empowered that you’re navigating your own success.”
One study investigating the effects of creatine supplementation on people with osteoarthritis undergoing knee arthroplasty (surgical procedure for osteoarthritis), who received creatine at 10g daily for 10 days prior to surgery and 5g daily for a month afterward, failed to find benefit with supplementation.[424] This study failed to find any differences in muscular creatine stores or weight changes.[424]
So it was popular then, but is it effective now? Just because something is popular doesn’t mean it works. In the case of creatine supplementation, however, you can be confident that increased muscle strength and less fatigue is possible. All thanks to a critical chemical reaction taking place in your muscle cells. Read on and learn how creatine works and why it lives up to that nostalgic ‘90s hype.

The last survivors of the pro-hormone supplements, which were removed from sale last January, estrogen-blocking supplements aren't pro-hormones but do inhibit the enzyme aromatase, which converts androgens into estrogens. In normal men that enzyme is ubiquitous, being present in such tissues as muscle, brain and skin. About 20 percent of the free testosterone circulating in the blood is converted into estrogen by way of aromatase.


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