This test measures a participant's ability to stand up from a seated position as many times as possible in a thirty-second period of time.[2] Testing the number of times a person can stand up in a thirty-second period helps assess strength, flexibility, pain, and endurance,[2] which can help determine how far along a person is in rehabilitation, or how much work is still to be done.

Lie on your left side. Rest your head on your left arm. Bend your hips to approximately 45 degrees and bend your knees at 90 degrees. Make sure one hip is lying above the other so your knees are stacked perfectly and your feet are aligned with your back. Now, float the upper leg upwards while keeping your feet in contact with one another, then return. Repeat for required reps, then switch sides.

Although creatine can be bought commercially as a standalone product it is often found in combination with other nutrients. A prime example is the combination of creatine with carbohydrate or protein and carbohydrate for augmenting creatine muscle retention [5] mediated through an insulin response from the pancreas [69]. Steenge et al [70] found that body creatine retention of 5 g CM was increased by 25% with the addition of 50 g of protein and 47 g of carbohydrate or 96 g carbohydrate when compared to a placebo treatment of 5 g carbohydrate. The addition of 10g of creatine to 75 g of dextrose, 2 g of taurine, vitamins and minerals, induced a change in cellular osmolarity which in addition to the expected increase in body mass, seems to produce an up regulation of large scale gene expression (mRNA content of genes and protein content of kinases involved in osmosensing and signal transduction, cytoskeleton remodelling, protein and glycogen synthesis regulation, satellite cell proliferation and differentiation, DNA replication and repair, RNA transcription control, and cell survival) [25]. Similar findings have also been reported for creatine monohydrate supplementation alone when combined with resistance training [71].
Creatine monohydrate is the most common form of creatine, and if not otherwise mentioned is the default form of creatine used in most studies on creatine.[64] It has fairly decent intestinal absorption[65][12] (covered more in depth in the pharmacology section) and is the standard form or “reference” form of creatine, which all other variants are pitted against.

The first thing you need is a weight training program that signals the muscle building process to begin. Research has shown that a well designed program will generate this “signal” via a combination of progressive tension overload (as in, getting stronger over time), metabolic stress (as in, fatiguing the muscle and getting “the pump”), and muscular damage (as in, actual damage to the muscle tissue itself).

An isolation exercise is one where the movement is restricted to one joint only. For example, the leg extension is an isolation exercise for the quadriceps. Specialized types of equipment are used to ensure that other muscle groups are only minimally involved—they just help the individual maintain a stable posture—and movement occurs only around the knee joint. Most isolation exercises involve machines rather than dumbbells and barbells (free weights), though free weights can be used when combined with special positions and joint bracing.
Expert tip: To make it harder, inch yourself close to a wall so your trunk is about a foot away. Bring what would be your “planted” leg on the wall, foot flat against the surface. From here, raise your “non-working leg” up into the air, keeping your knee bent. As you raise up into the glute bridge, you’ll drive your heel against the wall, raising your hips. You can also use a bench. And like the standard bridge, you can up the ante by adding weight. 
COX-2, a pro-inflammatory enzyme, is sometimes a therapeutic target for both muscle soreness and some degenerative diseases that are exacerbated by inflammation. COX-2 inhibitors (in this study, rofecoxib) and creatine monohydrate both appear to protect dopaminergic neurons from being destroyed by toxins, and can protect in an additive manner, suggesting possible usage of both to reduce the risk of Parkinson’s disease.[230]
Mercimek-Mahmutoglu, S., Stoeckler-Ipsiroglu, S., Adami, A., Appleton, R., Araujo, H. C., Duran, M., Ensenauer, R., Fernandez-Alvarez, E., Garcia, P., Grolik, C., Item, C. B., Leuzzi, V., Marquardt, I., Muhl, A., Saelke-Kellermann, R. A., Salomons, G. S., Schulze, A., Surtees, R., van der Knaap, M. S., Vasconcelos, R., Verhoeven, N. M., Vilarinho, L., Wilichowski, E., and Jakobs, C. GAMT deficiency: features, treatment, and outcome in an inborn error of creatine synthesis. Neurology 8-8-2006;67:480-484. View abstract.
Eat 1.5–3 grams of carbs per pound of your body weight. As with fat, this amount can vary greatly, depending on your personal needs and preferences, so consider these numbers only a starting point. If you’re very skinny and feel that you handle carbs well (i.e. you can eat a lot of them without getting fat), go ahead and eat according to the higher end of the spectrum. The same applies if you’re desperate to gain weight—you should increase your carb intake. If you’re prone to weight gain or feel lethargic on higher carbs, you should eat fewer of them. Again, see our keto guide for more details and options.
In addition to directly supporting energy production,  the creatine kinase/phosphocreatine system is also integral to shuttling energy between mitochondria and other sites in cells in need of energy. In this way creatine also helps protect against excessive oxidative stress within mitochondria. (Check out this episode of humanOS Radio for more on why this is important!)
Citrulline Malate is an amino acid also known as L-Citrulline and is taken for many different medical conditions. There is some research that shows that the amino acid may help improve performance while exercising by reducing fatigue. What does that mean for you? In your muscle building efforts, you can use this supplement to help you make it through longer, harder workouts. This will spur more muscle building in response to the trauma your muscles experience in a tough workout. Not only that, but Citrulline Malate can also help reduce soreness after a workout. Who doesn’t want to avoid feeling sore? Reduced soreness means you can get back to the gym the next day with renewed enthusiasm.

Creatine is known to occur in highly concetrated levels in chicken photoreceptors, relative to other parts of the eye (10-15mM[466]) alongside high levels of creatine kinase.[466] The creatine transporter in human eyes also seems to be concentrated in the photoreceptors,[468] which are known to be susceptible to hypoxic cellular death[471][472] which, for humans, usually means retinal detachment.[473]

Older women with knee osteoarthritis given supplemental creatine at 20g for five days followed by 5g for the rest of the twelve week trial experienced improvements in stiffness (52% reduction), pain (45%), and physical function (41%) as assessed by WOMAC, despite no improvements in physical power output relative to placebo.[425] This study paired supplementation and placebo with a mild exercise regimen.[425]
Bodybuilders may supplement their diets with protein for reasons of convenience, lower cost (relative to meat and fish products), ease of preparation, and to avoid the concurrent consumption of carbohydrates and fats. Additionally, some argue that bodybuilders, by virtue of their unique training and goals, require higher-than-average quantities of protein to support maximal muscle growth.[19][20][21][22][23][24][25] However, there is no scientific consensus for bodybuilders to consume more protein than the recommended dietary allowance.[18][26] Protein supplements are sold in ready-to-drink shakes, bars, meal replacement products (see below), bites, oats, gels and powders. Protein powders are the most popular and may have flavoring added for palatability. The powder is usually mixed with water, milk or fruit juice and is generally consumed immediately before and after exercising or in place of a meal. The sources of protein are as follows and differ in protein quality depending on their amino acid profile and digestibility:
Before supplementation, our intramuscular pools of creatine and phosphocreatine are usually at about 70% of their full capacities. The levels of these pools can be raised by increasing dietary creatine. As vegans and vegetarians omit many creatine-rich foods, they tend to have lower creatine pools than omnivores and hence tend to benefit more from creatine supplementation. At the other end of the spectrum, creatine ingestion doesn’t increase creatine stores in a small proportion of people. It follows that these individuals don’t seem to experience the benefits of creatine supplementation.

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.
“Don't get set into one form, adapt it and build your own, and let it grow. Be like water. Empty your mind, be formless, shapeless — like water. Now you put water in a cup, it becomes the cup; You put water into a bottle it becomes the bottle; You put it in a teapot it becomes the teapot. Now water can flow or it can crash. Be water, my friend.” Bruce Lee
Higher percieved effort during heat (or due to elevations in body heat) are thought to be mediated by either the serotonergic system (suppresses performance)[388] or the dopaminergic system (enhances performance),[389][234] and creatine is thought to be involved in percieved effort during heat training since it has been noted previously to interact with neurotransmission by enhancing both serotonergic[253] and dopaminergic[230] neurotransmission.

In nonelite swimmers conducting an intermittent sprint protocol (Six 50m sprints every two minutes), supplementation of a creatine loading period was able to reduce the decrement in speed during the third sprint (2% decrement rather than a 5% decrement) but not the sixth sprint. There were no changes in plasma lactate or other biomarkers of fatigue.[396] When examining a single 50m sprint in amateur swimmers, a creatine loading period is able to reduce the time to complete the sprint by 4.6%, while it had no benefit for the 100m sprint.[397] When the loading phase was followed by three weeks maintenance in youth, there was no apparent benefit to sprint performance (50m sprint with five minutes rest followed by a 100m freestyle) despite benefits to a swim bench test (30s sprints with a five minute break in between).[398]

^ Jump up to: a b c d Brosnan JT, da Silva RP, Brosnan ME (May 2011). "The metabolic burden of creatine synthesis". Amino Acids. 40 (5): 1325–31. doi:10.1007/s00726-011-0853-y. PMID 21387089. Creatinine loss averages approximately 2 g (14.6 mmol) for 70 kg males in the 20- to 39-year age group. ... Table 1 Comparison of rates of creatine synthesis in young adults with dietary intakes of the three precursor amino acids and with the whole body transmethylation flux
The 1960s saw the gradual introduction of exercise machines into the still-rare strength training gyms of the time. Weight training became increasingly popular in the 1970s, following the release of the bodybuilding movie Pumping Iron, and the subsequent popularity of Arnold Schwarzenegger. Since the late 1990s increasing numbers of women have taken up weight training, influenced by programs like Body for Life; currently nearly one in five U.S. women engage in weight training on a regular basis.[4]
Our bodies store creatine in our muscles so that we have quick access to it for fast, high-intensity movements, like sprinting or powerlifting, explains Autumn Bates, a certified clinical nutritionist and sports nutritionist in private practice in Manhattan Beach, California. “It's a nonessential amino acid, meaning your body creates it and you don't need to primarily get it from food.”
Duchenne’s Muscular Dystrophy (DMD) is associated with a reduction in intracellular creatine stores[554] known to only affects males. It is an X-linked progressive myopathy associated with abnormalities in the dystrophin gene.[555] The standard therapy at this moment involves corticosteroids such as prednisone.[556][557] Creatine is thought to be therapeutic since the known targetable abnormalities in DMD (impairment in protein synthesis associated with oxidative stress and increased protein breakdown) is a property of creatine and supplementation showed promise in the first case study[558] and benefit in a group of mixed dystrophinopathies.[559]
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.”
Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.
So, for example, with the moves above you'd do 15 squats followed by 15 push-ups. Take a little breather then repeat that two more times. Then you move on to your walking lunges and lat pull-downs (and repeat those three times total, too). You can really do anywhere from eight reps to 15 (and even just two sets, if you don't have time for three), but "it’s not a bad idea for beginners to start with a 15-rep range to get comfortable with the exercises," says Davis. And while there's some debate over whether three sets of an exercise is really best, "it’s a great beginner model," says Davis. Don't overcomplicate things when you're just getting started.
In complex training, weight training is typically combined with plyometric exercises in an alternating sequence. Ideally, the weight lifting exercise and the plyometric exercise should move through similar ranges of movement i.e. a back squat at 85-95% 1RM followed by a vertical jump. An advantage of this form of training is that it allows the intense activation of the nervous system and increased muscle fibre recruitment from the weight lifting exercise to be utilized in the subsequent plyometric exercise; thereby improving the power with which it can be performed. Over a period of training, this may enhance the athlete's ability to apply power.[39] The plyometric exercise may be replaced with a sports specific action. The intention being to utilize the neural and muscular activation from the heavy lift in the sports specific action, in order to be able to perform it more powerfully. Over a period of training this may enhance the athlete's ability to perform that sports specific action more powerfully, without a precursory heavy lift being required.

These protective effects are similar to those seen with trimethylglycine, since they both cause an increase in liver concentrations of phosphatidylcholine (PC, causing an increase in vLDL production and efflux of triglycerides from the liver).[497] Both TMG and creatine are thought to work indirectly by preserving SAMe concentrations,[125][498] since PC synthesis requires SAMe as well (via PEMT[499]) and genes involved in fatty acid metabolism in the liver that were not affected by the diet (VLCAD and CD36) were unaffected by creatine.[125]
In addition to the proper amount of sleep, do not overdo your training regimen. While you might be tempted to think that "more is better," in fact the opposite is true. You can reach a point known as "over-training", in which you'll lose the ability to "pump" (engorge the muscles with oxygen-rich blood) your muscles, and this can even lead to muscle wasting—exactly the opposite of what you are trying to achieve. Here are some symptoms to be aware of if you think you may be falling into the over-training zone:
There appears to be some potential for creatine supplementation. However, many questions remain. Are there any long-term harmful effects from supplementation? Is there a point where enhanced performance levels off from long-term supplement usage? What effect does "stacking" or taking two ergogenic aids simultaneously have on the body? What happens if you immediately stop taking the creatine supplement? Is the enhanced performance great enough to warrant the expense of the supplement? Until further research answers these questions, creatine is not recommended for the average athlete.
Some bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[42][43][44] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH), which can cause acromegaly.
Are you sitting right now? Squeeze your buttocks, then release them: You should feel them tighten, then slacken. While slack muscles aren’t necessarily a bad thing—all of our muscles shouldn’t be firing at all times, after all—resting all of your body weight on your slack glute muscles (as you do when you sit) creates a lengthening of the fascial tissues within and surrounding the glutes, which weakens the gluteals’ natural tension. When the buttocks are excessively weak, the quadriceps and hip flexors have to work harder to compensate, and these muscular imbalances often sneakily follow us onto our mats to cause problems and pain. Want help? Try these poses:
The creatine kinase system appears to be detectable in endothelial cells.[314][315] Under basal conditions, creatine itself is expressed at around 2.85+/-0.62μM[316] (three-fold higher than HUVEC cells[314]). When incubating the medium with 0.5mM creatine, endothelial cells can take up creatine via the creatine transporter (SLC6A8) and increase both creatine (almost doubling) and phosphocreatine (nearly 2.5-fold) concentrations.[316]
In competitive bodybuilding, bodybuilders aspire to develop and maintain an aesthetically pleasing body and balanced physique.[16][17] In prejudging, competitors do a series of mandatory poses: the front lat spread, rear lat spread, front double biceps, back double biceps, side chest, side triceps, Most Muscular (men only), abdominals and thighs. Each competitor also performs a personal choregraphed routine to display their physique. A posedown is usually held at the end of a posing round, while judges are finishing their scoring. Bodybuilders usually spend a lot of time practising their posing in front of mirrors or under the guidance of their coach.
After the ingestion of 5g creatine in otherwise healthy humans, serum levels of creatine were elevated from fasting levels (50-100µM) to 600-800µM within one hour after consumption.[135] The receptor follows Michaelis-Menten kinetics with a Vmax obtained at concentrations higher than 0.3-0.4mmol/L,[136] with prolonged serum concentrations above this amount exerting most of its saturation within two days.[137]
When you’re planning your high-protein meals, 20 grams of protein is the optimal amount generally accepted for muscle growth. Research has found that the body doesn’t use much more than 20 grams for muscle-building at any one sitting. Around 80 grams of protein per day (or, four meals containing 20-grams of protein each) is about right for most people.

Another double-blind study supplemented with 18.75 g/day of creatine monohydrate for 5 days prior to high-intensity intermittent work to exhaustion, and then 2.25 g/day during testing. The workouts consisted of cycling to exhaustion using several protocols: (a) nonstop, (b) 60 seconds work/120 seconds rest, (c) 20 seconds work/40 seconds rest, and (d) 10 seconds work/20 seconds rest. Creatine supplementation significantly increased the total work time for all four protocols [13].
Lifters who follow high-volume or high-intensity resistance-training programs, as many bodybuilders do, may also benefit from carbohydrate intake immediately post-workout. Compared with a placebo, carbohydrates combined with protein immediately post-workout and one hour after a bout of resistance exercise have been shown to increase insulin levels and rates of glycogen resynthesis.[19]
When looking for a whey protein powder to purchase, seek out powders that offer at least 20 g of protein per serving (one scoop) and are low in carbohydrates (aim for 5 g per serving or less). You may run into whey protein isolate, which looks attractive because it’s a higher concentration of protein. However, avoid this one as in the extreme processing, proteins are denatured that can render them less effective. In addition, these formulas are also often chock full of artificial sweeteners. Instead, look for powders from grass-fed cows that aren’t pumped with hormones.
You may be wondering what conditions and medications contraindicate the use of creatine supplements. Creatine is contraindicated in people with kidney insufficiency or kidney disease. If you take diabetes medication, diuretics or acetaminophen, do not take a creatine supplement. Use caution if you regularly consume caffeine while taking a creatine supplement. Overall, if you are healthy and have gotten clearance from your doctor, consider this non-GMO creatine supplement.

Few supplements have the solid scientific foundation that creatine has. Studies show that it's effective for 80 percent of those who use it. Since creatine is found naturally in meat, the more meat you eat, the less likely you'll need creatine supplementation. Vegetarians or those who rarely eat meat, however, can get huge boosts from most creatine supplements.