Abstract
Skeletal muscle loss poses significant health issues to both the general clinical population, but also athletes recovering from musculoskeletal (MSK) injury. Whilst resistance training is known to induce skeletal muscle hypertrophy (SMH), 70% of an individual’s one repetition maximum (1RM) is required to elicit such changes. This is not always feasible for the abovementioned populations due to rheumatic limitations and thus, targeting metabolic stress as a stimulus for skeletal muscle hypertrophy may be more favourable than that of mechanical tension. Blood Flow Restriction (BFR) training occludes venous out-flow, whilst sustaining arterial in-flow to the working muscle resulting in a pooling of anaerobic metabolites. As a result, resistance training loads as low as 20% 1RM are capable of eliciting hypertrophic effects equivalent to training at heavier loads, and this is mediated through both endocrine and intramuscular mechanisms. Safe administration of BFR is paramount, especially when prescribing to post-surgical athletes. As such, the coach or clinician in question must take careful consideration regarding pressure application, rest periods and various patient characteristics such as post-surgical timeframe and overall health status.
Highlights
With over 10% of all Olympians facing MSK injury based on data from the last three events (Vasta et al, 2018), it is crucial that coaches and clinicians involved in high-level sport are understanding of the impacts this has on an individual
This is a necessary requirement for muscle homeostasis, whereby the body maintains its internal regularity through a delicate balance between synthesis and degradation of cellular proteins, complementary to the environment it faces (Scicchitano et al, 2018)
Does sarcopenia increase the likelihood of falls and fractures as a secondary complication, but falls and fractures may accelerate the onset of sarcopenia via reduction in physical activity and mobility driven by a fear of re-falling and hospitalisation
Summary
Muscle loss typically occurs in response to chronic periods of immobility such as post-surgical or postinjury (Parry and Puthucheary, 2015) This is due to skeletal muscle displaying high levels of plasticity, whereby it responds and adapts to both increased and decreased usage (Aguilar‐Agon et al, 2019). Seeing as sarcopenia is an issue frequently faced by aging individuals, hypertrophy training should be a major focal point within their weekly physical activity or, in the case of aging athletes, their training plan This may reduce the effects of sarcopenia and decrease the likelihood of subsequent injury. Whilst it is arguably not essential for a coach or clinician to understand these pathways in great depth, it is of value for such professionals to consider them in order to develop a rounded knowledge of skeletal muscle physiology These pathways are mediators of the effects of metabolic stress and BFR training which will be discussed.
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