ABSTRACT The goals of increasing muscle mass or losing weight tend to use opposing nutrition strategies—hypercaloric intake for the former and hypocaloric intake for the latter—but it remains unclear whether a strategy exists to achieve both goals simultaneously, that is, body recomposition. The aim of this review was to determine whether the literature supports body recomposition, particularly regarding energy balance and protein intake to support resistance training outcomes. Body recomposition was observed in several studies; however, strategies were mixed, results were inconsistent, and populations varied widely regarding age, sex, body composition, health status, and training history. A caloric surplus appears essential, whereas a deficit, although effective at reducing body weight and fat mass, tends to result in a loss of fat-free mass. Maintaining high protein intake (≥1.6 g/kg/d) in support of resistance training was often found to be crucial for achieving body recomposition; however, evidence regarding meal distribution, macronutrient distribution, and total energy intake is equivocal. (See the Video Abstract, Supplemental Digital Content 1, for more insights from this review.)
ABSTRACT Hamstring strain injuries (HSI) are highly prevalent in team sports and often result in muscle atrophy, shortened fascicle length, and reduced eccentric strength. Addressing these deficits is crucial for both injury prevention and rehabilitation, and for enhancing performance. Flywheel resistance training has gained attention in recent years as an effective modality because of its capacity to potentially elicit eccentric overload. The flywheel hip extension (FWHE) is a hip-dominant hamstring exercise that can promote muscle hypertrophy, increase fascicle length, and improve eccentric strength, thereby targeting key HSI modifiable risk factors. Training adaptations can occur within 6 weeks, with recommended prescription involving 1–3 weekly sessions, 4–10 weeks in duration, and individualized inertial loading to optimize outcomes. In rehabilitation, FWHE offers a controlled, progressive eccentric stimulus, particularly valuable in the late stages of rehabilitation. FWHE represents a practical tool to reduce HSI risk, accelerate return-to-play, and improve sport performance.
ABSTRACT All athletes should engage in injury prevention programs (IPPs). However, real-world constraints prevent targeted prevention for every possible injury and require prioritization based on sport-specific injury burden, athlete-specific risk, or a combination thereof. Accordingly, IPPs are commonly designed in 1 of 3 ways. Generic IPPs apply a one-size-fits-all approach to reduce the risk of the most burdensome injuries in a sport. Individualized IPPs are tailored to athletes' unique risk profiles, often identified through injury histories and preparticipation screening. Hybrid IPPs include a mix of generic and individualized components. Despite evidence for all 3 approaches, it remains unclear which offers the optimal balance of effectiveness and practicality under real-world constraints. To guide IPP design, this narrative review explores the advantages and disadvantages of each approach. Generic IPPs are broad-reaching and well-supported but may not address individual athletes' needs. They are a simple, viable option when development and delivery resources are limited. Individualized IPPs are targeted but resource-intensive to develop and deliver. Hybrid IPPs balance broad reach with personalization. There is a critical need for intervention research comparing the real-world impact of the 3 approaches. Ultimately, the best-fitting IPP depends on contextual factors such as time, staffing, buy-in, and practicality of preparticipation screening.
ABSTRACT Combat sport athletes frequently compete in multiple high-intensity matches within a single day, leading to progressive acute fatigue that compromises neuromuscular and physiological performance. This review aimed to describe the methodological approaches used to assess fatigue and performance during simulated and official combat sport competitions. Simulated match protocols, predominantly applied in grappling disciplines, such as judo, wrestling, and Brazilian jiu-jitsu, enable greater experimental control and facilitate comprehensive physiological and performance monitoring, including physiological markers (e.g., heart rate, blood lactate concentration, and cortisol) and strength and power performance. Conversely, assessments conducted during official competitions are limited by logistical constraints and typically rely on noninvasive or rapid measures, such as handgrip strength, jump tests, heart rate, and subjective ratings. The evidence indicates that simulated environments allow for a broader and more complex range of measurements, while official contexts provide higher ecological validity but reduced methodological control. A synthesis of the literature highlights the importance of selecting assessment strategies according to research goals and competitive context. These perspectives contribute to optimizing training monitoring and fatigue management strategies in combat sports, supporting the integration of reliable physiological and subjective indicators into both experimental and applied performance settings.
ABSTRACT This review examines physiological limits, longitudinal projections, and best practices for muscle hypertrophy with a focus on bodybuilding and physique sport. Recurring body composition assessments using multicompartment models are recommended for monitoring short-term fat-free mass (FFM) changes and long-term muscular development. Normative data indicate that drug-free male athletes typically gain roughly 1.4 kg of FFM over 12 weeks of resistance training, with an interquartile range of 1–2 kg. A practical upper limit for FFM index in drug-free male athletes is approximately 28.5, although higher values have been observed in the context of elevated adiposity or anabolic androgenic steroid use. Female athletes tend to have roughly 70% less FFM at baseline but make proportionally similar FFM gains in response to resistance training. The present review models plausible short-term and long-term growth trajectories for both male and female lifters. Training practices that optimize hypertrophy include moderate loads (6–12 repetition maximum), training near muscular failure, and sufficient weekly volume (12–30 fractional sets per muscle group). Nutritional factors include maintaining modest caloric surpluses (0.1–0.25% body weight gain weekly), adequate protein intake (1.6–2.2 g/kg/d), sufficient carbohydrate intake (≥3 g/kg/d), and moderate fat intake (0.5–1.5 g/kg/d). Creatine and protein supplementation provide established hypertrophic benefits, while evidence for other supplements remains inconclusive.
ABSTRACT Clinical exercise physiology curricula build foundational knowledge effectively, yet a persistent gap remains between content mastery and clinical decision-making competence. After the July 10, 2025 transition to examinations aligned with the 12th edition of the Guidelines for Exercise Testing and Prescription (GETP 12), the ACSM Certified Clinical Exercise Physiologist (ACSM-CEP) first-attempt pass rate declined from 65% (2024) to 55% (July–December 2025), a multifactorial pattern consistent with increased difficulty at the synthesis level of clinical reasoning. Existing pedagogical tools address content recall; few train the reasoning process itself. This article presents a conceptual, pedagogical framework, proposed rather than empirically validated, for designing clinical scenarios that target specific cognitive errors. Drawing on cognitive psychology and medical education, we introduce a 7-step design process, a 12-point design checklist, and a complexity-scaling framework. Two fully worked clinical examples illustrate the method: one addresses chronic low back pain within a biopsychosocial framework; the other involves sodium-glucose cotransporter 2 inhibitor pharmacology and seated-to-standing orthostatic hypotension. Implementation strategies for educators, including collaborative case-bank construction and exploratory cognitive-error pattern mapping, are discussed. The framework is modular and platform-flexible; empirical validation of its impact on learning outcomes and certification performance remains an open direction for future research.
ABSTRACT Tennis tournaments impose fluctuating match times, consecutive-day play, and occasional same-day doubles, creating a need for preparation strategies that boost explosive performance while preserving freshness. This article integrates tennis-specific post-activation performance enhancement evidence with the broader priming literature to propose a practical, schedule-driven framework for neuromuscular preparation. Four time windows are outlined: (a) 2–3 hours “micro-priming” between matches, emphasizing minimal ballistic work, short accelerations, joint-specific isometrics and high-intent strokes to restore neural readiness; (b) 3–12 hours within-day priming under uncertain start times, using low-volume, high-intent strength–power exercises and sport-relevant sprints/throws while safeguarding against schedule compression; (c) 12–24 hours next-day (MD-1) priming, combining compact strength–power work with small doses of tennis-specific serving/rotational actions to leverage overnight recovery; and (d) 24–48 hours primers on rest days/cancellations, using low-volume maintenance strength–power sessions to preserve neuromuscular qualities. Across windows, recommended principles are low total volume, high movement intent, sport-relevant patterns and sufficient recovery, with strong emphasis on individualization (training status, strength level, accumulated fatigue, age, and sex). Key research gaps include ecologically valid tennis trials, dose–response profiling and studies in women and youth players.
ABSTRACT In high-performance sport settings, multidisciplinary teams operate to provide support for the holistic development of athletic performance qualities, the mitigation of injury risk, and overarching health and well-being of their athletes. Although strength and conditioning is now a well-recognized part of the multidisciplinary team, historically, this profession has been viewed predominantly through a lens of enhancing and optimizing athlete and sporting performance. However, our ability to objectively showcase this sport-specific improvement is more challenging in some sports than others, raising the question of how we objectively quantify our worth and value as both an individual practitioner and profession as a whole. Further to this, although the roles of physical therapists and athletic trainers are typically more aligned to working with injured athletes, there is an emerging scientific evidence base, showcasing the beneficial effects of strength and conditioning training methods (especially strength training) on the reduction of noncontact injuries and in the treatment of chronic medical conditions. Therefore, this brief review offers a narrative, practice-focused opinion addressing some of the ways that strength and conditioning can directly influence sport performance outcomes, but also some of the concurrent challenges that our profession may face, in addition to the impact it may have mitigating injury risk for athlete populations and the benefits toward some chronic medical conditions.
ABSTRACT Assessing muscular fitness is critical for exercise professionals to evaluate performance, monitor progress, and design effective resistance training programs for athletes and nonathletes. Traditional methods, such as 1 repetition maximum (1-RM), multiple-repetition maximum (multiple-RM), and load-velocity profile (LVP), are widely used for these purposes. However, these methods present significant challenges, including time consumption, complexity, and potential safety concerns, particularly when working with large groups or individuals with specific needs. This article addresses these challenges by reviewing the strengths and limitations of 1-RM, multiple-RM, and LVP methodologies and introducing practical and user-friendly spreadsheets intended to simplify the creation of individualized testing protocols, allowing professionals to perform efficient and accurate assessments. In addition, the spreadsheets provide immediate data analysis, facilitating the determination of key training parameters such as estimated 1-RM, training intensity, and volume. By streamlining the testing and analysis process, this approach enhances both the efficiency and accuracy of resistance training prescriptions. Ultimately, the proposed spreadsheets improve the effectiveness and customization of training programs for athletes and clients while offering exercise professionals a time-saving solution to optimize their everyday practice.
ABSTRACT Adaptive sports are for individuals with disabilities, such as spinal cord injuries, with wheelchair basketball (WB) being one of the most popular globally. Although a strength and conditioning program is a fundamental component of athlete development in nondisabled sports, this approach is not as well implemented in WB. Several key components are necessary for strength and conditioning coaches working with WB athletes to improve health and athletic performance. These include the implementation of athlete needs analyses (e.g., energy system, biomechanical, competition demands, health and injury prevention), body composition, nutritional intake analysis, and the management of training loads. The goal of this narrative review was to compile scientific evidence and comprehensive information regarding the critical components that assist coaches in developing training programs for WB athletes. Furthermore, although WB athletes may not be able to utilize strength and conditioning training regimes designed for nondisabled athletes owing to their preexisting conditions, these training regimes (e.g., traditional weight training exercises) can still be implemented with modifications. A well-rounded strength and conditioning program will provide the necessary foundation for WB athletes' need for optimal performance in sports.
ABSTRACT Interval training is a regimen that consists of systematic repetitions of high-intensity efforts (above the second ventilatory threshold [VT 2 ]) with recovery periods. Several meta-analyses have summarized the benefits of interval training for human performance and health, with an optimal time-efficient relationship compared with moderate-intensity continuous training. There are 2 effective traditional ways of implementing interval training: (a) high-intensity interval training, which consists of repeating submaximal efforts, and (b) sprint interval training, which consists of repeating supramaximal efforts. A style of interval training that has emerged in recent years is high-intensity functional training, which promotes cardiorespiratory and neuromuscular adaptations. Nevertheless, many protocols prescribe volumes that exceed the recommended minimum of 75 min/wk of physical activity—a level not reached by a large portion of the population. In other cases, regimens have induced severe fatigue and discomfort, making them unfeasible for most adults. Currently, it has been shown that low-volume interval training (≤15 min/session) that includes short efforts does not attenuate physiological adaptations (e.g., maximum oxygen consumption [V̇ o 2 max]) and is better tolerated. This review aimed to describe the acute and chronic physiological/psychological effects of different interval training styles, focusing on short efforts and low-volume sessions.
ABSTRACT Long-term athletic development (LTAD), which traditionally has been a framework for youth strength and conditioning and sports participation, can be applied as a holistic framework for tactical athletes, which includes military personnel, law enforcement officers, and firefighters. Tactical athletes, whose careers may extend from age 17 to age 42 and beyond, face unique physical and psychological demands different from sport athletes, across the tactical athlete lifespan of foundational development, occupational readiness, and lifelong engagement. LTAD, as a “cradle-to-grave” framework, is influenced by multidimensional wellness to inform strength and conditioning professionals how to optimize performance, sustain readiness, mitigate injuries, and support long-term health and operational capacity for tactical athletes.
ABSTRACT The increased practice of sport specialization by young athletes and the plethora of competitive sport opportunities is staggering. Girls' volleyball is a sport that is experiencing high sport specialization rates and is the most popular team sport in the United States. This narrative review explored the literature surrounding girls' volleyball sport specialization, programming, and training load management in context to gathered national data on volleyball matches played throughout a calendar year. The publicly available data were collected from schools and clubs across the United States. These data provided the framework in which principals of programming for the highly specialized volleyball athletes were applied. This process created a macrocycle that starts in July and continues until the following July. This macrocycle includes both the high school and club sports and provides a suggested length and progression of the transition, preparation, precompetition, competitive, and tapering phases of mesocycles. Within each phase, recommended goals are given based on the length and training load intensity of the high school and club volleyball season. Finally, special considerations for programming club volleyball athletes are presented given the length and variability of training load during the club volleyball season for highly specialized volleyball players.
ABSTRACT For many athletes, being agile is the end goal of physical performance training. It represents their capacity to change velocity and direction in response to the actions of their opponent and the opportunities and constraints of their environment. The aim of this article was to describe the pitch-based development of agility, focusing on 60–180° turns. This ensures all turns have the demand of deceleration, turning, and reacceleration, requiring both outside leg turns (60°) and inside leg turns (180°). To enable the effective coaching of these, coaches must understand movement mechanics and thus the fundamental principles that underpin good technique. Within agility training, a detailed appreciation of how the center of mass and base of support interact to affect the direction of force is fundamental to this. This understanding and the ensuing technical models ensure athletes have the best chance of executing the task optimally and ensure coaches can effectively instruct athletes and adapt drills accordingly.
ABSTRACT Despite the widely recognized importance of long-term athletic development (LTAD) by scholars and practitioners who work with youth in a physical activity setting (e.g., physical education, sports, strength and conditioning, sport coaches, program directors), there is a gap between research and real-world application. In this study, we aim to address this gap by better understanding what practitioners who work with youth know and do in relation to applying LTAD, specifically developing motor skill competency. In this narrative review, we summarize three studies from our research group that evaluated the knowledge, practices, and challenges of practitioners responsible for developing motor skill competency and implementing LTAD programs. Overall, practitioners reported that it is important to develop a broad range of motor skills; however, physical education teachers did not emphasize resistance training movements until puberty. Practitioners recognized their responsibility to enhance health, fitness, and physical performance and reduce the risk of injury. However, the ability of practitioners to define athleticism and LTAD along with their familiarity with existing models was variable. Practitioners reported good adherence toward delivering LTAD programs, in spite of a range of challenges. Overall, continued mutual collaboration is warranted between scholars and practitioners related to education, knowledge translation, and implementation toward LTAD and motor skill competency.
ABSTRACT After infection with SARS-CoV-2, up to 50% of individuals experience post-acute sequelae of COVID-19 (PASC) including symptoms such as fatigue, postexertional malaise, and autonomic dysfunction that can disrupt engagement in physical activity. Exercise physiologists, personal trainers, and fitness instructors need evidence-based practical training approaches to help individuals with PASC safely and effectively resume a physically active lifestyle. In this paper, we propose the Adapted Flexible Nonlinear Periodization model (AFNLP), a novel individualized approach to supporting recovery for people with PASC seeking training guidance in a fitness environment. The model, guided by emerging literature and interdisciplinary clinical experience, was developed to improve symptom management and physical recovery from PASC while reducing risk of exacerbating underlying conditions. The AFNLP framework provides a practical and flexible structure for supporting gradual return to activity and emphasizes readiness over fixed timelines. AFNLP enables symptom-responsive exercise programming that integrates physiological monitoring, nutritional support, psychological readiness, and multidisciplinary oversight. Key considerations include symptom tracking, pacing strategies, mental health, nutrition, and use of wearable technology to guide readiness-based exercise adjustments. This paper outlines the AFNLP framework and provides practitioner-oriented guidance for implementing symptom-responsive training strategies in individuals with PASC. A video abstract is available as Supplemental Digital Content 1, which provides an overview of the AFNLP framework and its application in individuals with PASC.
ABSTRACT This review examined how power profiling has been implemented in flywheel resistance training. Power profiling was defined as assessment of the load-power or force-velocity-power relationship across multiple inertial loads using concentric and/or eccentric peak or mean outputs, and the reliability of existing protocols was evaluated. The aims were to (a) summarize methodologies used to assess flywheel load-power characteristics; (b) clarify the rationale for, and reliability of, current profiling approaches; and (c) provide a framework for practical implementation. A comprehensive literature search was conducted using Google Scholar, PubMed, ScienceDirect, and SportDiscus. Of 33 studies identified, 17 met the inclusion criteria. Most protocols used 1 submaximal repetition to generate momentum, followed by 3–12 maximal repetitions. The most common approach involved 1 submaximal repetition followed by 3, 5, or 7 maximal efforts, although few directly assessed profiling reliability. Peak concentric and eccentric power were most frequently reported, whereas average power metrics were inconsistently included. Only a minority of studies directly assessed reliability; most used power outputs to guide load prescription rather than evaluate consistency. Flywheel power profiling appears logical for characterizing power output across exercises and inertial loads, but reliability is dependent on methodological factors.
