Overload: The first thing you need to do to build lean muscle tissue is use more resistance than your muscles are used to. This is important because the more you do, the more your body is capable of doing, so you should increase your workload to avoid plateaus. In plain language, this means you should be lifting enough weight that you can only complete the desired number of reps. You should be able to finish your last rep with difficulty, but also with good form.
Standing with your feet hips distance apart, hold a barbell or free weights at shoulder height (either the barbell resting above your shoulder blades on your back, or free weights resting on top of your shoulder muscles held in front of you). Keeping your spine in a neutral position move into the squat by retracting your hips and pulling them backward. Hinging at your hips, bend your knees until your thighs come almost parallel to the ground (knees should be directly over your feet). Then push back up until your back is straight and repeat 5–10 times depending on the weight you’re using.
Nitrate-rich foods like beets, radishes, and pomegranates are a great way to boost the production of nitric oxide (NO). Although there's very limited research examining the effects of beet root juice and pomegranate extract on resistance training, these ingredients have previously been shown to increase skeletal muscle blood flow and lead to reduced soreness, which may ultimately lead to improvements in strength and performance.[9,10]
If you’re the kind of person who shops for popular dietary supplements like protein or collagen powder, you’ve probably seen another popular bottle on the shelves: creatine. This supplement, which can be taken as a powder or liquid (and usually in some kind of healthy shake), is a staple in the bodybuilding community thanks to its ability to help you pack on muscle and work out longer and harder. (1) While creatine is generally considered safe — and is one of the most researched supplements out there (according to a review published in July 2012 in the Journal of the International Society of Sports Nutrition) — it is still a supplement, which means it’s not regulated by the Food and Drug Administration (FDA) and product claims don’t necessarily need to be substantiated (though the FDA can pull products that are found to be unsafe). (2,3)
Arguably the most influential factor, exercise is what instigates muscle growth. When you exercise, especially if you engage in resistance training, it causes trauma to your muscles. This is exactly what you want because it’s this trauma that triggers a response from your body that grows your muscles. To repair the injury or damage to your muscles, special cells called satellite cells arrive. Typically, your muscle fibers thicken and lengthen in this process. (1)
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.
Another supplement that’s ideal to take pre-workout is protein. Depending on your goals and your workout time, taking protein before your workout can help you keep your energy levels elevated while working out. Make sure you give yourself at least an hour between the time you take your protein and your workout time so that your body has time to digest.
We don’t know as much about the long-term consequences of creatine supplementation. However, creatine use has been associated with reduced risk of injuries like muscle strains. Interestingly, there is also some weak evidence that creatine may protect against dehydration, muscle cramps, and thermoregulatory issues. It’s plausible that this is because creatine affects osmosis, drawing water into muscle tissue. This might be one way by which creatine boosts endurance exercise performance in the heat.
Eat 0.4–0.5 grams of fat per pound of your body weight. Fat is essential for hormone optimization, brain function, and joint health. Now, if you’re following a ketogenic diet (or modified keto diet), or you just feel better with more fat in your diet, you can certainly add more fat and lower your protein and carb intake to accommodate it. The 0.4–0.5 grams per pound recommendation just represents a starting point and a minimum so that you don’t eat too little fat, either out of fear that it will make you fat or damage your heart (both untrue). For more about ketogenic diets, see Onnit’s guide HERE.

Tribulus Terrestris: A fruit from the Mediterranean, this supplement has been used in the Indian traditional medicine of Ayurveda. In addition to helping increase testosterone, many people take it to increase libido and as a cardioprotective aid. (10) Unfortunately, despite the fact that there are claims that tribulus terrestris can increase testosterone levels, studies don’t back up these claims.  There is some evidence, however, that it may improve athletic performance. If you want to choose one of the supplements for men, this should be your pick.
de Salles Painelli V, Alves VT, Ugrinowitsch C, et al. Creatine supplementation prevents acute strength loss induced by concurrent exercise. Eur J Appl Physiol 2014;114(8):1749-55.del Favero S, Roschel H, Artioli G, et al. Creatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performance. Amino Acids 2012;42(6):2299-305. View abstract.
What kind of exercises? Work all major muscle groups, starting with the larger muscles. Always include exercises for opposing muscles: for example, work the biceps and triceps of your arms, and the quadriceps and hamstrings of your thighs. Avoid above-the-shoulder exercises if you have arthritis in your upper body, and talk to your doctor before using leg press machines if you have arthritis in your knees or hips.
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In general, muscle content of creatine tends to be elevated to 15-20% above baseline (more than 20mM increase) in response to oral supplementation. People who get a sufficiently high influx of creatine are known as responders.[150][151][152][153] A phenomena known as “creatine nonresponse” occurs when people have less than a 10mM influx of creatine into muscle after prolonged supplementation.[154] Quasi-responders (10-20mM increase) also exist.[154] Nonresponse is thought to explain instances where people do not benefit from creatine supplementation in trials, since some trials that find no significant effect do find one when only investigating people with high creatine responsiveness.[155] There are clear differences between those who respond and those who do not, in regard to physical performance.[156] People who are creatine responsive tend to be younger, have higher muscle mass and type II muscle fiber content, but this has no correlation with dietary protein intake.[154][157]

“I would really focus on learning how macros work, how your body works and how it reacts to certain foods, and what your body requires each day to maintain your weight,” he advises. “Then you can start playing around with increasing calories [to bulk up], and decreasing calories when you're dieting.” Our beginner's guide to macros will definitely help.
After supplementation of creatine monohydrate (loading phase, followed by 19 weeks maintenance), creatine precursors are decreased by up to 50% (loading) or 30% (maintenance), which suggests a decrease in endogenous creatine synthesis during supplementation.[38] This appears to occur through creatine’s own positive feedback and suppression of the l-arginine:glycine amidinotransferase enzyme, the rate-limiting step in creatine synthesis, as levels of intermediates before this stage are typically elevated by up to 75%.[38]
Listen, I know in the beginning of this post I was sympathetic to your problem, but I am also here to say, Suck It Up. I can tell you that to gain weight, you need to focus on making your meals a habit rather than an afterthought. Your body is pre-programmed with your genetic disposition. And in your case, you have a very fast metabolism that digests and burns calories quickly. Focus on having 5-6 calorie-dense meals a day spaced 2-3 hours apart so that your body is constantly being provided with something to metabolize and build muscle.
And not to drop a truth bomb but, most of us need to be doing glute exercises — and aren’t. “Lack of use is the biggest reason so many people tend to have weak glutes,” says Cassandra York, PhD, MS, RD, CSCS, best-selling fitness author and a professor at Central Connecticut State University. “We don’t walk as much as we used to. We don’t take the stairs. And when we do move, we tend to be quad dominant,” says York.

Homocysteine is produced after S-adenosyl methionine is used up (as donating a methyl group creates S-adenosylhomocysteine, which then produces homocysteine) mostly from phosphatidylcholine synthesis[307] and its reduction (via either methylation from trimethylglycine via betaine:homocysteine methyltransferase, urinary excretion, or convertion into L-cysteine via cystathionine beta-synthase[308]) is thought to be therapeutic for cardiovascular diseases.

It's OK to be a little sore. Your muscles might feel achy or tired the day after a tough training session thanks to DOMS, or delayed onset muscle soreness. When you strength train you're causing microscopic damage to the tissue that will be repaired, that's how you build stronger lean muscle. Speaking of repair and recovery, though, rest days are important. "If you constantly break down muscle without a recovery period, you won’t give the muscle fibers a chance to repair and build back stronger,” explains Davis.
These effects are secondary to creatine being a source of phosphate groups and acting as an energy reserve. The longer a cell has energy, the longer it can preserve the integrity of the cell membrane by preserving integrity of the Na+/K+-ATPase and Ca2+-ATPase enzymes.[241][235][236] Preserving ATP allows creatine to act via a nongenomic response (not requiring the nuclear DNA to transcribe anything), and appears to work secondary to MAPK and PI3K pathways.[226]
Heath bent his legs — each thigh about 32 inches around, bigger than his waist — and lifted the black case. Inside was his latest Mr. Olympia trophy. In bodybuilding, it is called the Sandow, and Heath has won the last six, most recently in Las Vegas in September. Arnold Schwarzenegger, still the world’s most famous bodybuilder, won six in a row, too, and then a seventh a few years later. Two men, Lee Haney and Ronnie Coleman, have won eight.
If you reflect on the effects of creatine supplementation within cells, you can probably come up with numerous conditions in which creatine may help people prevent or overcome morbidity. Sometimes, for example, energy supply to tissues is temporarily compromised, as in the case of impaired blood flow to the brain (cerebrovascular disease) or heart (myocardial ischemia). Sure enough, there’s preliminary evidence that creatine may help in these pathologies.
Generally, you should consume about 20 grams of protein with some carbs shortly after a workout. During the post-workout anabolic window, you’ll also want to limit fats, which can slow the absorption of protein. While there is some recent research that suggests the window may actually extend up to several hours following exercise, there’s no harm in getting nutrients in early as long as you’re sticking to your overall caloric and macronutrient goals.

Negative regulators of the creatine transporter (CrT) are those that, when activated, reduce the activity of the CrT and overall creatine uptake into cells. As noted above, CrT activity is positively regulated by mTOR.[158] Consistent with the well-known role of AMPK as a suppressor mTOR signaling,[177] CrT activity has also been shown to be inhibited in response to AMPK activation in kidney epithelial cells.[178] Since AMPK suppresses mTOR via upstream TSC2 activation,[179] the negative regulation of AMPK on CrT activity in these cells appears to occur through an indirect mechanism. Although indirect, activation of AMPK has been noted to reduce the Vmax of the CrT without altering creatine binding, and is involved in internalizing the receptors.[178] This pathway seems to max out at around 30% suppression, with no combination of mTOR antagonists and AMPK inducers further suppressing creatine uptake.[178]
Without supplementation, approximately 14.6mmol (2g) of creatinine, creatine’s urinary metabolite, is lost on a daily basis in a standard 70kg male ages 20-39. The value is slightly lower in females and the elderly due to a presence of less muscle mass.[35] This amount is considered necessary to obtain in either food or supplemental form to avoid creatine deficiency. Requirements may be increased in people with higher than normal lean mass.[35][198] Creatine excretion rates on a daily basis are correlated with muscle mass, and the value of 2g a day is derived from the aforementioned male population with about 120g creatine storage capacity.[35] Specifically, the rate of daily creatine losses is about 1.6%[199]-1.7%,[25] and mean losses for women are approximately 80% that of men due to less average lean mass.[35] For weight-matched elderly men (70kg, 70-79 years of age) the rate of loss of 7.8mmol/day,[49] or about half (53%) that of younger men.
Stand lunge-length in front of a bench making sure your knee does not extend past your toes. Hold a dumbbell in each hand and rest the top of your left foot on the bench behind you. Lower your body until your rear knee nearly touches the floor and your front thigh is parallel to the floor. Then push through the heel of your front foot to return to standing, keeping the back foot on the bench. Repeat for required reps then switch legs.
Skin degradation is caused by a loss of collagen and degradation of the extracellular matrix,[536] which is enhanced by UV radiation (produces reactive oxygen species which stimulate MMPs[537]) and contributes to skin integrity loss and wrinkling. Due to the stimulation of collagen being associated with a cellular surplus of energy[538] and intracellular stores of energy declining with age,[539][540] creatine has been investigated as a topical anti-aging agent. In vitro, creatine appears to be rapidly absorbed through the skin (52% within an hour, remaining similar at 3 hours) with most creatine found in the stratum corneum (79.6-86.5%) follwed by the epidermis (9-13.2%) and dermis (4.5-7.1%).[541] It is successful in stimulating collagen expression and procollagen secretion in fibroblasts, with the latter increasing to 449+/-204% of control.[541]
While the number of reps you do per set is important, of equal importance is the total number of reps you do per muscle group. The National Strength and Conditioning Association has determined that, to maximize growth, you need approximately 20–70 total reps per muscle group. Depending on which end of a rep range you’re working, this can be done in one session or over a few days (a training week, for instance), but that’s the spread you need to cover to see gains.
The gluteus medius muscle originates on the outer surface of the ilium between the iliac crest and the posterior gluteal line above, and the anterior gluteal line below; the gluteus medius also originates from the gluteal aponeurosis that covers its outer surface. The fibers of the muscle converge into a strong flattened tendon that inserts on the lateral surface of the greater trochanter. More specifically, the muscle's tendon inserts into an oblique ridge that runs downward and forward on the lateral surface of the greater trochanter.

We’ll define the “bigger muscle groups” as being chest, back, quads and hamstrings, and the “smaller muscle groups” as being biceps, triceps and maybe abs. Shoulders are really somewhere in the middle, though I tend to lean more toward the “smaller” guidelines. Calves, while technically small, are another muscle group that is somewhere in the middle, and I can really go either way depending on the needs of the person.
When you’re doing higher reps, focus on the muscle you are trying to build and squeeze every ounce of effort out of it. Yes, cheesie as it may sound, visualizing the muscles working and growing while you train them can be helpful. A 2016 study in the European Journal of Applied Physiology found that, when lifters thought about their pecs and triceps during a workout, they activated them better.

3) Relatively low cholesterol. This is one nutrition category that many people overlook with these supplements, but it's arguable one of the most important. Remember, if you're going to be downing 2 of these a day, you DON'T want to be maxing out your cholesterol intake. Luckily, this whey keeps it down to 30mg per scoop (which is about 10% of your daily intake). I've seen worse and ... full review
A push–pull workout is a method of arranging a weight training routine so that exercises alternate between push motions and pull motions.[28] A push–pull superset is two complementary segments (one pull/one push) done back-to-back. An example is bench press (push) / bent-over row (pull). Another push–pull technique is to arrange workout routines so that one day involves only push (usually chest, shoulders and triceps) exercises, and an alternate day only pull (usually back and biceps) exercises so the body can get adequate rest.[29]
The participants were seen every 4 weeks. Blood was taken to measure hormone levels, and questionnaires were given to assess physical function, health status, vitality, and sexual function. Body fat and muscle measurements were also taken at the beginning and end of the 16 weeks. The study was funded in part by NIH’s National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Results appeared in the September 12, 2013, issue of the New England Journal of Medicine.

Carducci, C., Birarelli, M., Leuzzi, V., Carducci, C., Battini, R., Cioni, G., and Antonozzi, I. Guanidinoacetate and creatine plus creatinine assessment in physiologic fluids: an effective diagnostic tool for the biochemical diagnosis of arginine:glycine amidinotransferase and guanidinoacetate methyltransferase deficiencies. Clin Chem 2002;48(10):1772-1778. View abstract.

The structure of cyclocreatine is fairly flat (planar), which aids in passive diffusion across membranes. It has been used with success in an animal study, where mice suffered from a SLC6A8 (creatine transporter at the blood brain barrier) deficiency, which is not responsive to standard creatine supplementation.[97] This study failed to report increases in creatine stores in the brain, but noted a reduction of mental retardation associated with increased cyclocreatine and phosphorylated cyclocreatine storages.[97] As demonstrated by this animal study and previous ones, cyclocreatine is bioactive after oral ingestion[97][98] and may merely be a creatine mimetic, able to phosphorylate ADP via the creatine kinase system.[97]
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