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Endurance cycling can be addictive, driving athletes to push their limits constantly. In my case, the moment I started beating my own records and times, it left me hungry for more. This pursuit isn’t just for adults—even teenagers are drawn to the challenge, often adopting strict diets and workout routines to excel. However, the pressure to perform better can lead some to obsess over their body image, which can result in a cycle of underfueling.

Various factors contribute to underfueling, including intense workouts without adjusting food intake and anxieties about weight and performance. Regardless, this behavior can hamper athletic performance and pose health risks. Coaches should prioritize ensuring young endurance cyclists get adequate nutrition to prevent underfueling and safeguard their future well-being. Learn more about the long-term consequences of underfueling and some strategies to help young cyclists reach their full potential.

Underfueling Translates to Higher Risk of RED–S

Proper nutrition is vital for athletes but most crucial among still-growing teens. Those with suboptimal energy intake may be at greater risk of underfueling, which happens when total caloric and macronutrient intake is low.

Inadequate energy intake poses a higher risk of Relative Energy Deficiency in Sport (RED-S), which is defined by the International Olympic Committee (IOC) as “a syndrome of impaired physiological and/or psychological functioning experienced by female and male athletes caused by problematic low energy availability (LEA).”

LEA can be intentional or unintentional. Intentional LEA happens when athletes restrict their dietary intake to control body weight or composition. Pervasive issues around body image and traditional beliefs—such as “eating is cheating”—can result in intentional LEA. One study suggests cycling is a sport with a high prevalence of eating disorders, such as binge eating, anorexia nervosa, and bulimia nervosa. Furthermore, cyclists perceive leanness as vital to their success and can thus manipulate their nutritional intake.

Regardless of the sport and sex, a team’s culture can also contribute to intentional LEA. A culture where people insult other athletes’ body weight and shape can push victims to overexercise and eat less.

Unintentional low energy availability (LEA) happens when cyclists fail to meet the energy requirements of the sport due to a lack of knowledge. Share on X

Consequently, unintentional LEA happens when cyclists fail to meet the energy requirements of the sport due to a lack of knowledge. It can be quite common for young athletes to underfuel since they’re unaware of training demands. Financial problems and low appetite can also contribute to this condition.

Long-Term Implications of Underfueling

According to Rebecca McConville RD, LD, CSSD, CEDS, RED-S-related problems can happen when the body has 250 calories less than its daily requirement over five days. Young endurance cyclists who don’t have enough energy intake could face long-term implications.

Significant fatigue during training sessions conducted after proper rest can indicate inadequate energy levels. According to Jessica Crandall, RDN, CDE, feeling lethargic, weak, and sore are signs of improper fueling, which may lead to a weakened immune system. Coaches can also detect signs of fatigue through body language and other non-verbal communication cues, including mood changes and a lack of willingness to train for long periods. 

Underfueling can delay muscle glycogen replacement and repair of muscle tissue, hindering training. Not getting enough energy requirements may also lead to decreased immunity, increasing susceptibility to injury and illnesses. 

Severe calorie deficiency among women can cause estrogen levels to drop, delaying the menstrual cycle and the onset of puberty. This symptom is a sign of a subcategory of RED-S called “the female athlete triad,” which describes the three interrelated issues of irregular menstruation, bone loss, and disordered eating. Someone can have one, two, or all three parts of the triad. Signs to look out for include missed periods, weaker bones, and low BMI.

Figure 1. Recommended daily carbohydrate intake by weight. Data Source: Gatorade Sports Science Institute.

Most bone density is formed during the teenage years. Reduced bone formation in early adulthood can lead to long-term issues with osteoporosis and bone weakness. The loss of estrogen can lead to a lack of bone density and may put female endurance riders at a higher risk of stress fractures and osteoporosis.

Though the majority of research on underfueling and LEA has been on females, the IOC now recognizes its negative implications among males, including reduced testosterone production. A study shows male endurance athletes who have LEA are at risk of insufficient testosterone production, which may lead to decreased bone mineral density. However, more research is necessary to understand the effects on men better.

Nearly one in three adolescents ages 13 to 18 will experience anxiety disorder in the United States. The pressures of staying fit can affect the mental health of athletes. Stress levels and mood are also affected if the body isn’t fueled enough. For instance, 90% of serotonin is synthesized by enterochromaffin cells in the intestinal epithelium. This chemical is crucial for mood regulation, appetite, and sleep cycle.

Poor energy intake can backfire on the athlete’s performance through decreased endurance, training response, and motivation. Unfortunately, they may respond to decline through more extensive training, which can deplete more of the energy they need to function.

Poor energy intake can backfire on the athlete’s performance through decreased endurance, training response, and motivation. Share on X

Identifying and Managing RED-S

According to a study conducted by Cycling Weekly, 30% of female respondents and 15% of males have RED-S symptoms. Among female cyclists who were not on hormonal contraception, 39% cited menstrual problems.

Athletes and coaches can monitor RED-S if the levels of metabolic hormones and substrates—including 3,3,5-triiodothyronine (T3), growth hormone, leptin, cortisol, and glucose—have been altered. Validated tools such as the RED-S Clinical Assessment Tool can also be used by a trained sports medical physician to assess a young cyclist’s risk of this condition.

This instrument features biochemical markers and functional issues because of LEA, such as recurring bone stress injuries. While physical qualities such as body weight and fat are also assessed, some individuals with RED-S may have standard body mass.

Strategies for Optimizing Energy Balance

Optimal energy intake should be the cornerstone of every athlete’s diet. Nutritional and calorie requirements depend on age, sex, and activity. Since adolescent cyclists are still developing, their consumption should match their activity level and support their growth.

Active teenage males need 2,600–3,200 calories daily, while females in the same age bracket require about 2,200–2,400 calories a day. However, the more active adolescents are, the more calories they need. The body’s required energy is known as basal metabolic rate (BMR), ranging from around 1,200 to more than 3,000 calories per day.

A BMR calculator can help coaches personalize an athlete’s daily caloric requirements for various activity levels. However, this tool only guides coaches when creating a diet plan, not as a prescription for health and nutrition. The BMR formulas for men and women are as follows:

• Men: BMR = 88.362 + (13.397 x weight in kg) + (4.799 x height in cm) – (5.677 x age in years)
• Women: BMR = 447.593 + (9.247 x weight in kg) + (3.098 x height in cm) – (4.330 x age in years)

After identifying the BMR, coaches can help combat LEA by ensuring an athlete’s diet is enough to cover their needs. They can achieve energy balance by computing energy availability (EA) using the equation:

• EA(kcal/kgFFM/day) = [EI(kcal/day)−EEE(kcal/day)] / FFM (kg)

EI = energy intake, EEE = exercise energy expenditure

Nutritional Strategies

Adolescent athletes need appropriate food to fuel their bodies. When creating a nutritional plan, consider including sources that help boost performance and recovery. For instance, one cup of blueberries offers 24% of an individual’s daily value of vitamin K and 22% of manganese, which help boost bone density and reduce proneness to muscular strains. Choosing nutrient-dense foods can help athletes manage a healthy weight and enhance muscle strength.

Carbohydrates are the most essential fuel for an adolescent cyclist. Because carbs are stored as fuel, cyclists need them before training. On the other hand, fats usually get a bad reputation because they are about twice as calorie-dense as carbs and proteins. However, fats are essential for nutrient absorption and hormonal production.

According to exercise physiologist Dr. Tim Podlogar, athletes must utilize fats and carbohydrates efficiently since glycogen stores are limited. Fat stores are larger but only work in aerobic activities, so the body requires oxygen to translate fat into energy. Stores of carbohydrates are smaller, but the body can utilize them in anaerobic processes, meaning it can get energy even without oxygen.

The body needs time to adjust breathing when cycling. During this anaerobic process, the body requires glycogen, so it must get energy from sources that don’t need oxygen.

Figure 2. Recommended carbohydrates in relation to exercise. Data source: Gatorade Sports Science Institute.

Carbohydrate intake should range from 7 to 12 g·kg-¹ body mass (BM) to ensure optimal muscle glycogen availability during competition and intense training. For exercise lasting more than 60 minutes, it is recommended to consume carbohydrates of 1 to 4 g·kg^-1 BM one to four hours before activity.

Endurance athletes should ensure half of their plate consists of carbohydrate sources—rice, bread, oats, and tortillas—on heavy training days. The standard carbohydrate recommendation for high school athletes is 360–500 grams daily.

Junior athletes can struggle to identify thirst during a ride, so starting hydrated is always recommended. Share on X

Good hydration is also crucial for optimal performance and recovery. Junior athletes can struggle to identify thirst during a ride, so starting hydrated is always recommended. Less than 2% dehydration of total body weight can significantly reduce skill, exercise, and mental performance.

Fuel Well for Optimal Health and Performance

RED-S can impact anyone, but its effects are more pronounced in young athletes who are still developing. As a coach, it’s essential to understand cycling is not just a sport—it’s a lifelong pursuit for teens that requires sustainable habits on and off the track.

Help the future generation of cyclists achieve their best health and performance by prioritizing proper nutrition, adequate rest, and long-term health over immediate results. Along with a personalized nutritional plan, regularly monitoring food intake and performance can help ensure proper caloric balance and instill self-care habits that will benefit teens throughout their lives.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Injury prevention programs (IPPs) have been shown to be effective at reducing the risk of injury. The 11+, for example, has been shown to reduce hamstring injuries by 60%, hip and groin injuries by 41%, knee injuries by 48%, and ankle injuries by 32%. It reduces the risk of all injuries by 39% (Thorborg et al., 2017).

According to Arundale et al., 2023, the components of effective injury risk reduction programs include:

• Implementation at the youth level.
• Beginning in the pre-season and continuing through the regular season.
• Being performed multiple times for an overall time of at least 30 minutes per week.
• Being multifaceted and including a combination of strength and plyometric exercises.
• Having a high level of compliance.

Even the best program in the world won’t work if it doesn’t get done.

Unfortunately, implementing IPPs has proven to be challenging. Barriers to implementation are varied and context-dependent.

In elite women’s footballers from the 2019 FIFA World Cup, players identified player motivation and the attitude of coaches as the primary barriers to implementation (Geertsema et al., 2021). A review of IPPs found that motivation, time requirements, skill requirements for program facilitators, compliance, and cost were all barriers to implementation (Bogardus et al., 2019). In my own experience as a youth soccer coach, a lack of confidence in delivering the program, a lack of field space, and limited time seem to prevent coaches from implementing IPPs.

In my experience as a youth soccer coach, a lack of confidence in delivering the program, little field space, and limited time seem to prevent coaches from implementing IPPs, says @NSurdykaPhysio. Share on X

As physical therapists, athletic trainers, performance coaches, and sport scientists, we have access to scientific knowledge on IPPs. However, we are not always the people best positioned to deliver these programs, especially at the youth level, where it is crucial to begin their implementation. While 59% of physical therapists worldwide are aware of IPPs, only 37% actually implement any in their current practice (Al Attar et al., 2021).

Outside of professional academies, how many of us are ever consistently present at training sessions at the youth level? How many of us have access to youth athletes for the recommended 2–3 times per week? To make the most impact and deliver IPPs to the largest number of athletes possible, it has to come from the people who are actually there with them on a regular basis: their coaches (Bizzini and Dvorak, 2015).

Coaching the Coaches

As we all know, it can take years for scientific knowledge to be translated into practice. However, I believe there are ways that we can begin educating coaches on IPPs. Ideally, youth soccer leagues and national federations would mandate that training on IPPs be part of coaching education courses and a requirement to obtain a coaching license.

Outside of governance and policy at the macro level, healthcare and performance professionals can run off-season or pre-season clinics and symposiums to teach local coaches how to run an IPP with their teams. Instead of focusing community outreach on individual teams or clubs, promote a one-day training course for as many youth coaches as possible. Social media can also be a powerful tool for disseminating information to the general public.

If coaches are to be the primary stakeholders responsible for the delivery of IPPs, then the challenges they face in implementing them need to be addressed. One barrier to IPP implementation by youth coaches is a lack of resources and education on what IPPs are, why they’re important, and how exactly to deliver them. Our role, then, as healthcare and performance professionals, needs to shift away from strictly the delivery of these programs to the education of coaches. If we can effectively educate them to deliver IPPs, then more youth athletes might get access to them. When we educate coaches on IPPs, it’s important to highlight their effectiveness in reducing injury risk to increase motivation and buy-in.

In order to enhance buy-in from coaches, the IPP needs to be easy to integrate into the team’s normal training structure. At the youth level, teams might have access to half a pitch for 60–90 minutes twice per week. Coaches perceive that IPPs take too much time (Minnig et al., 2022) and can feel pressure to jump right into the training session to maximize their time on the pitch. There are a couple of ways that we can address this barrier—perceived or real—and help coaches implement IPPs in their training sessions.

Strategies for Implementing IPPs

In 2019, Whalen et al. found that moving part 2 of the 11+ (strength, plyometrics, and balance exercises) was still effective at reducing injury risk while also improving compliance at the semi-professional level. This might be an effective strategy at the youth level because it reduces the time spent performing the 11+ before starting the training session. Coaches can have the athletes perform part 2 of the 11+ while they are wrapping up the session and summarizing key coaching points. They can also perform this part of the 11+ off to the side of the field so they don’t have to worry about going beyond their allotted time slot or being in the way of another team starting their training session.

Another possible method of addressing this time barrier is to integrate components of an IPP more seamlessly into the session. Most youth soccer training sessions begin with some type of technical warm-up, consisting of anything from passing patterns to dribbling in a grid. Why not try to integrate aspects of an IPP into this technical warm-up that coaches are already doing?

Why not try to integrate aspects of an injury prevention program into the technical warm-up that coaches are already doing? asks @NSurdykaPhysio. Share on X

If the team’s technical warm-up is dribbling inside a 20x20m grid and working on individual skills, you can add in the exercises that are part of the 11+. So instead of having the athletes do the running exercises down a straight line of cones, they simply perform them within the 20×20 grid, mixed in with the technical skills. Below is an example of a dribbling and individual ball control technical warm-up performed with components of an IPP for youth soccer players:

Each player has a soccer ball inside a 20×20 grid.

Instructions: Dribble your soccer balls. The only rules right now are don’t stop moving unless I say “freeze,” don’t bump into anyone, and don’t leave the grid unless I tell you to.

Have them do this for about a minute. Then tell them to freeze to listen to the following instructions: Now, every time I say the number 1, I want you to leave your soccer ball, go find another soccer ball, do 10 toe taps, then go back to your ball and start dribbling again. When I say the number 2, I want you to stop your soccer ball, side shuffle to another soccer ball, box the ball 10 times, then side shuffle back to your soccer ball and dribble again. When I say the number 3, I want you to leave your soccer ball, run as fast as you can outside of the grid, and then run back to your soccer ball as fast as you can and start dribbling again.

In this part of the warm-up, the players are getting additional technical work on the ball and have also been introduced to high knees (via the toe taps), side shuffling, changing direction, and scanning the environment for a free soccer ball. I usually do 3–5 rounds of each number randomly before mixing it up again.

Here’s an example set of instructions for the next round of the warm-up:

Now, every time I say the color purple, I want you to stop your soccer ball, jump over it with both feet together, turn around and jump over it again, and then start dribbling again. When I say yellow, I want you to stand on one leg, hop sideways to land on the other leg, hold it for two seconds, then hop back to the other leg and hold for two seconds, then start dribbling again. When I say green, I want you to do fast feet forward for 10 steps and fast feet backward for 10 steps, then start dribbling your soccer ball again.

Again, I’ll randomly call out colors and try to hit 3–5 rounds of each color. In this section of the warm-up, they end up doing double-leg hopping, skater hops, quick changes of direction, and some single-leg balance. In this entire technical warm-up example, the athletes not only perform movements often seen in effective IPPs, but they also get touches on a soccer ball, which helps with their technical skill development and coach and player buy-in.

If the team’s technical warm-up consists of passing patterns, you can also add in the exercises that are part of an IPP. For example, a common passing warm-up in youth soccer is to have four players in a triangular shape with two players at one point (point A) and one player each at the other two points (points B and C) of the triangle.

One of the players at point A has a soccer ball and passes to the player at point B. Player 1 then follows their pass and runs from point A to point B. Player 2 receives the ball, passes to player 3 on point C, and then runs from point B to point C to follow their pass. This continues with players passing the ball to the next player and following their pass on the jog.

Instead of jogging, though, the players can be instructed to perform movements that are part of an IPP. The path from point A to point B can be a jog, point B to point C can be a side shuffle, and point C to point A can be a backpedal. After a couple of rounds, have the players change directions with their passes and change the movements. So now, point A to point C is bounding, point C to point B is a single-leg hop, and point B to point A is a high skip.

The passing pattern can then be varied to mix up the technical component and introduce further IPP movements. Now, have discs set up in a diamond shape with players lined up across from each other at points A and C.

Player 1 has the ball at point A and passes the ball to player 2 at point C. Player 1 then runs to point B and cuts inside to the middle of the diamond, while player 2 passes the ball to player 3 at point A. Player 3 does a short pass to player 1 inside the diamond, who passes it back to player 3 in one touch and then spins out and runs to the end of the line at point C. Player 3 then plays a long pass to player 4 at point C and repeats the same process that player 1 had previously done.

Meanwhile, player 2, who had initially received the ball from player 1 at point C and then played a pass to player 3 at point A, will run to point D, backpedal to point C, and then sprint to the end of the line at point A. From a technical perspective, this warm-up includes one-touch, short, and long passes. From an IPP perspective, it includes changing direction, multidirectional running, and sprinting.

While the athletes do the exercises, I explain which parts of the body the exercises address and why they’re so important to help decrease the risk of injuries in those areas, says @NSurdykaPhysio. Share on X

I mentioned earlier that part 2 of the 11+ can be moved to the end of practice to help with buy-in and still be an effective way to reduce the risk of injury. I also try to do these exercises with the athletes while the parents are there so that the parents can see them, too. While the athletes do the exercises, I explain which parts of the body the exercises address and why they’re so important to help decrease the risk of injuries in those areas. This helps to increase player motivation and gets the parents bought in and educated on what they can potentially do at home as well.

These are the exercises I typically do with the athletes at the end of the session and how I coach them:

• Squats – Keeping your feet flat on the floor, lower down like an elevator, and stand back up. If I notice that athletes have their feet really close together or really far apart, I’ll tell them to stand with their feet on either side of the soccer ball (most kids don’t understand the concept of putting their feet hip-width apart).
• Lunges – Take a step forward, bending both knees, then step back again. Usually, a demonstration works best for a lunge. I also tell them to pretend there’s a laser beam coming out of their kneecap, and I want them to keep that laser beam pointed right in front of them the whole time.
• Heel Raises – Go up onto your toes and then slowly lower down again. I often have them do this while holding a partner’s hands for balance.
• Planks – Make your body as straight as a board and try to freeze in that position. I’ll go around while they do this and kick a soccer ball underneath them to make sure they aren’t sagging their hips down, or I’ll tap on their lower back if they have their hips up in the air too high.
• Copenhagens – Lift the inside of your shoe up to the sky. I always start with Level 1 Copenhagens, in which they are lying on their side.
• Nordics – Make your body as stiff as a board, kick your heels up into your partner’s hands, and lower yourself down to the ground as slowly as you can. It takes kids a couple of sessions to understand how to do this exercise correctly, and they usually need some hands-on guidance. Don’t get discouraged—they can and do learn how to do this pretty well with enough practice.

Where Does Dynamic Stretching Fit In?

So, I covered running exercises, changes of direction, and plyometric exercises within the technical warm-up. I also discussed that strengthening exercises can be done at the end of the session to help improve implementation and explained how I typically do that. One thing I have not yet addressed is stretching.

Some IPPs include dynamic stretches, but they have not been shown to be a vital aspect for effectively reducing injuries. However, there are times that I’ll include a few dynamic stretches if time allows. When I do include some dynamic stretches, I always make sure I add some player education simultaneously. Usually, I’ll include a walking quad stretch, walking calf and hamstring stretch, and lateral lunges.

As the athletes do the stretches, I tell them what part of the body we are focused on (quads, calves, hamstrings, and adductors/groin) and explain that those are the areas used most in soccer. My intention in doing this is simply to educate the athletes on their bodies. Most kids won’t actually feel any stretch, and that’s okay. These are still good movements for youth athletes to do whether they feel a stretch or not (single leg balance, lunging, reaching, etc.).

Most kids won’t actually feel any stretch, and that’s okay. These are still good movements for youth athletes to do whether they feel a stretch or not, says @NSurdykaPhysio. Share on X

The warm-ups I just used as examples are simply that—examples. The exercises that are done are representative of some of the components in IPPs, like the 11+. They can (and should) be varied and progressed as the athletes become more adept at performing them.

Coaches should be educated on how to progress and coach these exercises. It’s helpful to teach principles instead of scripted progressions because coaches can feel comfortable varying and progressing the exercises to suit their team. Here are some general principles that might help coaches progress the exercises in an IPP warm-up:

• Start double leg and progress to single leg.
  • Double-leg jumps over the ball to single-leg jumps over the ball.
• Start with lower hops and progress to higher jumps.
  • Hops over an invisible line on the ground → hops over a disc → hops over a ball.
• Use the first section of the warm-up for running-based movements such as jogging, side shuffling, and some change-of-direction tasks. Use the second part of the warm-up for jumping, hopping, and more challenging change-of-direction activities.
• Simple → Complex
  • For younger kids or novice players, start with simple, one-step instructions. “When I say the color green, jump over the ball.” With older or more experienced athletes, you can add some complexity to the instructions. “When I say the color green, stop your ball, run to a different ball, do five juggles, and then backpedal back to your ball.”
  • Note: You can also add a bit more of a cognitive challenge in your instructions. “When I say something that is the color green (like celery or grass), do five squat jumps.”

It’s also essential that the athletes are not simply given instructions on what to do but are shown and told how to do the movements as well. It’s important for kids to be able to explore various movement patterns and come up with their own solutions to motor challenges, so we don’t want to overcoach them, but we should still give them some cues.

Here are some of the cues I typically use with youth soccer players:

• Jumping and landing exercises: When you land, I don’t want to hear a sound.
• Changing direction: Get low to the ground and look up to make sure you can still see the ball and players around you.
• Side shuffling: Don’t click your heels.
  • Note: I used to say, “Don’t click your heels; you aren’t Dorothy trying to go back to Kansas,” but I’m finding that many kids these days haven’t seen “The Wizard of Oz,” so this cue has been less effective.
• Single-leg balance: Freeze like a statue.

Making a Difference at the Youth Level

In summary, IPPs like the 11+ effectively reduce the risk of injuries, but only when adhered to. It’s important to start IPPs at the youth level; there are, however, several barriers to implementation. Coaches should be the ones delivering IPPs at the youth level, which means our roles as healthcare and performance professionals need to shift away from the delivery of IPPs and toward the education of coaches. The barriers facing youth coaches need to be addressed, including the lack of confidence in knowledge and ability to deliver IPPs, session time, and field space.

Coaches should be the ones delivering IPPs at the youth level, which means our roles as healthcare and performance professionals need to shift toward the education of coaches, says @NSurdykaPhysio. Share on X

Integrating aspects of a successful IPP into a technical warm-up and moving the strengthening exercises to the end of the session are two tactics to help reduce the real and perceived barriers faced by youth coaches. Teaching coaches principles rather than scripted warm-ups might give them more confidence in their ability to program and progress IPPs into their sessions based on their team’s needs and abilities.

Lead Photo by Andy Mead/YCJ/Icon Sportswire

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, and Rathleff MS. “Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes.” British Journal of Sports Medicine. 2017;51(7):562–571. doi:10.1136/bjsports-2016-097066

Al Attar WSA, Yamani SA, Alharbi ES, et al. “283 Sports injury prevention programs: awareness, implementation and opinion of physical therapists worldwide.” British Journal of Sports Medicine. 2021;55:A110.

Minnig MC, Hawkinson L, Root HJ, et al. “Barriers and facilitators to the adoption and implementation of evidence based injury prevention training programmes: a narrative review.” BMJ Open Sport & Exercise Medicine. 2022;8:e001374. doi:10.1136/ bmjsem-2022-001374

Whalan M, Lovell R, Steele JR, and Sampson JA. “Rescheduling Part 2 of the 11+ reduces injury burden and increases compliance in semi-professional football.” Scandinavian Journal of Medicine and Science in Sports. 2019;29(12):1941–1951. doi:10.1111/sms.13532

Bizzini M and Dvorak J. “FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide-a narrative review.” British Journal of Sports Medicine. 2015;49(9):577–579. doi:10.1136/bjsports-2015-094765

Arundale, A.J.H., et al. (2023) “Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention.” The Journal of Orthopaedic and Sports Physical Therapy, 53(1), pp. CPG1–CPG34.

Bogardus, R.L. et al. “Applying the Socio-Ecological Model to barriers to implementation of ACL injury prevention programs: A systematic review,” Journal of Sport and Health Science. 2019:8(1);8–16.

Geertsema, C. et al. “Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women’s World Cup France 2019,” British Journal of Sports Medicine. 2021;55(14):801–806.

With various sports finding ways to play and practice year-round, volleyball continues to drive up practice and tournament demands every year. For a high school volleyball athlete, school season leads right into club after a short break, with club leading into a break of 1–2 months before summer training for school season starts back up again. Add in sand volleyball, which takes place throughout various times of the year, and you get an athlete who is susceptible to overuse injuries and overall burnout. If you’re looking to plan a traditional “off-season,” you’ll find minimal time to reap the benefits and end up leaving potential gains on the table—so finding a more dynamic system ready for anything is the better option.

A good program for an athlete playing so much of the same sport will need to find the balance between performance and health. Share on X

A good program for an athlete playing so much of the same sport will need to find the balance between performance and health. Chasing gains in the weight room with poorly timed and inappropriate methods can build up too much fatigue for optimal volleyball performance, but too much “playing it safe” on the health side of the spectrum, and you can have detrained athletes who won’t see any progress in developing physical outputs.

I’m in the fortunate position to train volleyball players throughout the year and have had zero long-term injuries and achieved numerous PRs on our KPIs (key performance indicators, or things we want to set records in) throughout this past school and club season. Three things have stuck out to me that could help others if they find themselves training high school volleyball athletes.

1. Isometric/Eccentric Methods Are Healthy Add-ins

Unless you somehow don’t have Instagram or X or just haven’t read up on trends within strength and conditioning, you already know about the benefits eccentric and isometric tempo training can have for an athlete. In short, eccentric training is the resisted lengthening of the muscle, and isometric training is producing force where a muscle’s length isn’t changing. Performance benefits from these methods are well known, with eccentric strength always being higher than concentric strength for potential gains, as well as isometrics (primarily overcoming) being able to produce forces much higher than concentric lifting. These are great for a total body vision, but I will look at their use primarily for the lower body here.

Methods of each I prefer include:

Eccentric

• Overloaded eccentrics (80% +) (rarely used)
• Slow eccentrics (60%–75% of 1RM)

Isometric

• Overcoming (pushing against an unmoving object)
• Yielding (holding at various positions)

During competition, the lower body of a volleyball player is constantly asked to perform fast concentric actions in various ranges of motion: front row players jumping and landing constantly at the net, as well as back row players reaching low ranges at high speeds to meet the ball for defensive plays, have their hips, knees, and ankles constantly moving at high speeds to make plays. To get the balance the body likes, these methods will contrast the body’s explosive actions during a volleyball game with slower/yielding lifts that will drive performance on the court with a base of health from the weight room.

The soreness that eccentric training can cause is a well-known factor, and I know some coaches reading this have never considered eccentrics in season, for understandable reasons.

Muscle lengthening has been known to provoke strong delayed-onset muscle soreness and can be a fatiguing stimulus on the nervous system as well; however, I’ve been able to mitigate these effects with proper intensities and volumes (just like any exercise). The best scenario is having athletes who have experienced eccentric training, as their bodies will be ready for it.

Keeping slow eccentrics within the percentage ranges that are away from a maximal stimulus or choosing smaller isolation exercises instead of compound lifts has helped mitigate those effects in my athletes’ training. If it is a worry, then saving it for training periods without as much competition can be great as well, and using isometrics can carry a decent amount of the workload.

2. Know the Right Kind of Jumps to Attack

It can be very easy to refrain from the intensity of jumping with all the jumps that occur in practice and games, but again, if we hold back too much, we cannot grow. Tyler Friedrich’s article, “An Alternative Way to Think about Plyometric Training for Women’s Volleyball,” sheds light on the fact that most of the jumps within practice and games don’t end up being near any personal bests as far as jump heights go.

If we hold back too much, we cannot grow. Share on X

That article was for college players who are among the top female jumpers in the world—so, in the case of high school players who, on average, do not reach that level of height, the jumps can have even less of a nervous system stimulus than what Friedrich highlighted. This is not to downplay the fatigue that comes with jumps happening in practice and games, but when looking to keep plyometric and jump training in the program, this data can help us pick our training methods.

I put this fatigue into an “extensive” category with lots of quick, medium-/low-intensity ground contacts that can wear on the feet, ankles, knees, and entire lower body complex. Filling the extensive bucket means the intensive bucket can have more attention put on it. Lower rep sets for maximum intensity can get the strong nervous system drive we want to tap into high-threshold motor units. This doesn’t mean I don’t plan extensive jump work, as I try to keep in all important qualities all the time, but we know where to put our higher workloads from the data.

Variations of jumps/plyos I like include:

• Resisted jumps (dumbbell, hex bar, barbell, band-resisted)
• Seated jumps for maximal height/distance,
• Broad jumps
• Depth/Drop jumps

Having tools like a jump mat or hurdles for the athletes to try and jump over is key to getting output with direct feedback of jump heights being known right away and helping create a fun, competitive environment. Intent is the key to any training program’s success, and when I can get it, I will go after it. Reps and sets can vary, but 2–4 sets of 3–5 reps for these types of jumps has been a good sweet spot and can be more with an athlete who has a younger training age.

A few other notes:

• Complex training is a great method for potentiating jumps while conserving training time. Heavier lifts/jumps paired with bodyweight/unweighted jumps can be an effective addition.
• Olympic lifting has had a great transfer to jumping for my athletes on their own and in complexes. (I will not waste my time arguing about whether Olympic lifts should be done.)
• Depth/drop jumps and landings are also a strong stimulus on the lower body and, along with all the practice and game jumps, can build fatigue fast. However, these allow the athletes to adapt to landings far higher than their current jumps give them and won’t be a problem when timed and dosed correctly.

3. Build a Strong Base with Variation

A base of physical literacy within core movement patterns is one of the first things I try to increase in an athlete when they begin training with me. The core themes of squatting, hinging, single-leg movement, and upper pushing and pulling will build the movement toolbox that will help them develop over time. When the athletes are first learning, I like to slow-cook their process with foundational movements that can get the point of each across. For example, goblet squats are almost always the first squatting movement I teach, and the athlete will stick with that for two blocks of a couple of weeks. After a good time developing the correct technique and learning the “why” behind the squat, we can move to a barbell.

New athletes to the weight room can get away with making progress from this for a long time, so there isn’t the need to vary the movement approach too much. But I have athletes who have been training for years, and for a lot of them, the weight room is an outlet from the sport of volleyball itself. It offers the physical fulfillment they’re used to in something different than the sport they play at least twice a week, almost year-round. So, for the experienced athlete, I need to look into how I can keep building upon the physical abilities they’ve gained in the weight room and give them something they want to push toward without things becoming less engaging.

In addition to keeping intrigue within the program, variation widens the base of the athletes’ preparedness. Share on X

In addition to keeping intrigue within the program, variation widens the base of the athletes’ preparedness. By keeping the core movement patterns within your program but also switching variations at a good pace, you’re building a base of physical GPP with new tissue developed and movement literacy learned, but also working the fundamentals of the pattern your system has. There are different ways coaches like to teach their squatting movements, but in my system, I’m hoping my athletes can transition front squats to back squats (and vice versa) from one training block to the next. Our squatting pattern is still being trained, but the slightly different physiological benefits these movements have from one another can be just enough to create a change for that athlete.

Louie Simmons was the first to bring the idea of true variation to training with his conjugate method system, looking to avoid the law of accommodation with his powerlifters. Stating that the body will adjust to the stimulus that is continuously put on it, his ideas of max effort variations constantly changing helped him dominate the geared powerlifting world for years.

With all that being said, my volleyball players are the furthest thing from geared powerlifters, so squat suits and bench shirts will not be needed. However, switching between movements within our core movement patterns contributes to the athletes’ overall growth without feeling repetitive and becoming accommodated for no growth. A time frame of 3–4 weeks per training block is the sweet spot to have enough time to squeeze all we can out of those variations without overstaying our welcome.

As for which movements to pick, having a good understanding of what athletes know can guide the process. When there is a stretch of a couple of weeks where the athlete has no tournaments, introducing a brand-new movement can help bring new growth. When we know we are coming to a volleyball-packed couple of weeks, switching to a variation that we know the athlete has literacy with is the better option, considering that brand-new movements can be more fatiguing on the body.

When there is a stretch of a couple of weeks where the athlete has no tournaments, introducing a brand-new movement can help bring new growth. Share on X

Remember, just like the difference between medicine and poison being dosage, the same goes for methods of training. Knowing how much of something to do and when to do it is incredibly important when trying to push athletic development within a competition period.

While this seems like a concept better suited for the more experienced athlete, early variations for accessory movements can be introduced for beginners very well. Even if your goblet squats and push-ups stay as staple movements for a while, making minor adjustments to your lower-tier accessories can go a long way. New core work every block or switching from DB to cable rows keeps things surprisingly fresh for someone new to the iron game.

Along with the exercises used, variation of the movement planes and where you move within space is also important. While every sport has its bias and specific needs, the chaos on the field of play can never be completely accounted for. In the case of volleyball, athletes practice their skill sets for various jumping, blocking, setting, and passing scenarios; awkward setups and reactions to a play can lead the body into positions it’s never seen before, which can ultimately lead to injury. If we are going to do our best to “bulletproof” these athletes, we need to leave no stone unturned.

To fill this need, I have my athletes cover a variety of resistance and movement exercises in the three planes of motion: the sagittal (forward and backward movement), the coronal (lateral), and the transverse (rotational movement). Within these planes, we not only want to build tissue within the primary movers but also work to increase movement speeds and the ability to be fluent within those spaces. Grouping movements for the planes, I look to label them as either “resistance” or “movement” exercises.

These are general terms, but you can get the idea. Examples of each can look like:

• Sagittal: forward or reverse lunges for resistance, linear sprints for movement.
• Coronal: lateral lunges for resistance, shuffling for movement.
• Transverse: Pallof press with rotation for resistance, medicine ball step-in throws for movement.

The more we can build through variability, the higher the chances that an ‘unseen’ position to the body isn’t as unseen as we think, and we will not only survive the position but thrive in it. Share on X

Challenging these plans with new variations, speeds, and tempos allows for a full toolbox of resilient tissue to be built. The more we can build through variability, the higher the chances that an “unseen” position to the body isn’t as unseen as we think, and we will not only survive the position but thrive in it.

Improve Performance While Maintaining Health

We are fighting the battle of fatigue when it comes to training athletes who always have competition going on. With volleyball, I’ve found that there’s always the attraction to playing it safe and getting these players through their season—but there’s too much potential in what they could do to have them skip their training for weeks on end during a competition period. Health is always first and foremost for these athletes and will be considered before anything else, but I believe we can achieve a solid increase in performance throughout their careers while keeping them on the court happy, healthy, and playing the game they love.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

According to the research, maximal running speed can only be maintained for approximately one second, even by the world’s most naturally gifted and best-trained athletes. Depending on the athlete’s level, they can cover anywhere between 10 and 12 meters (approximately) in one second. After that, any further efforts can only briefly maintain the top speed and then attempt to minimize the inevitable deceleration. After about one second of maximal speed, the only question is what the deceleration rate will be.

For that reason, evaluating maximal running speed for more than one second will also include the sprint endurance component. Therefore, the 10-meter (m) fly runs are the only simple and cost-effective way to evaluate maximal running speed. To clarify, flying 20s, 30s, and longer distances also include the sprint endurance evaluation, and absolute speed is no longer achievable.

10m fly runs are the only simple and cost-effective way to measure maximal running speed. Share on X

Based on the maximal speed an athlete can produce, a potential for maintaining and enduring it can be closely estimated. That leads to a conclusion about the direct relationship between maximal running speed and the potential of enduring it; in other words, the higher the maximal speed, the greater the starting point for the speed to be endured. That puts the importance of maximal speed into perspective.

A Speed Experiment

The study I undertook aimed to evaluate the maximal sprint speed in one male college-aged club athlete. The track was marked with cones and athletic tape across the lane at the start of the acceleration. We used the same marking procedure at the beginning and end of the 10m fly zone. In addition, the fly zone was marked at four additional positions, spaced 25 centimeters apart before and after the 10-meter markers, to ensure the step count and timing precision in case the athlete made his first step before or after the designated 10-meter zone.

This track marking method created a 1-meter zone before and after the beginning and end of the 10m fly zone. That made it a 2-meter total distance at the beginning and 2 meters at the end of the 10m fly zone, plenty to ensure the athlete wouldn’t be able to make the initial step outside of the zone. 

The athlete wore sprint spikes and was recorded with a smartphone from about 6m–10m, running perpendicularly to the video-recording camera. The phone was held horizontally, about 1.4–1.5 meters above and parallel to the ground. The camera was set to “slow-mo” mode or 240 frames per second (FPS) video quality. After the videos were recorded, they were transferred to a “Coach My Video” application (CMV), where the 10m flying times and relevant running-quality parameters were calculated within a 0.004/s (four one-thousandths of a second per frame) precision. Each video was analyzed in the CMV app, one at a time.

The maximal sprint speed was measured for 10 meters after a 30-meter approach under four different conditions in the order listed below:

1. Free run.
2. Acceleration assistance with an elastic “overspeed” cord + release approximately 10 meters before the 10-meter fly zone beginning.
3. With half-pound ankle cuffs around each ankle.
4. With 1-pound ankle cuffs around each ankle.

The athlete was instructed to produce maximal effort during the 30-meter acceleration phase and throughout the 10m fly zone. The first run was performed after the athlete was warmed up and fully rested. Each of the three subsequent runs was performed after six minutes of rest, which is considered a full recovery, meaning that each subsequent run began without the presence of fatigue.

Why Are These Results Relevant?

The purpose of this pilot experiment was to measure maximal speed times and their contributing factors precisely to familiarize the reader with the degree of change between each of the four different types of sprints performed.

The most important factors are:

• Ground contact time (GCT).
• Step frequency (rate).
• Distance per step.

Understanding maximal speed and its determinants allows coaches and athletes to reduce or even eliminate the guesswork from training. 

Understanding maximal speed and its determinants allows coaches and athletes to reduce or even eliminate the guesswork from training. Share on X

Compared to the free run, results from the overspeed cord-assisted and half-pound and 1-pound ankle cuff/leg runs provide information on when assistance and resistance types of runs can be applied during preparation. In contrast, free runs can be used almost throughout the year.

Video 1. Free Run.

Figure 1. Abbreviations key: a) (FT) fly time from 30m approach; b) (SN) step number; c) (SL) step length; d) (SR) step rate/10m; e) (GCT 1–4) ground contact time per step; and f) (AVG) average.

*All distances are in meters (m).

**All times are in seconds (s).

***Air times are considered irrelevant and were not calculated.

Figure 2. Differences in 10m sprint assistance and resistance times and distances are calculated from Free Run and expressed as a percentage (%).

*Values are calculated from figure 1 and rounded to the closest .25.

**For FT and GCT, a lower % indicates better values.

***For SL and SR, a higher % indicates better values.

****The abbreviation key is identical to figure 1.

Overspeed Cord-Assisted Run

As expected, the overspeed cord showed a faster 10m time than the free run. The running time/speed improved by 3.75%, and the average four-step length increased by 4.5%. This data shows that the overspeed cord-assisted acceleration is a powerful tool for training those functions.

Video 2. Assisted sprint using overspeed cord.

Simultaneously, the step rate decreased minimally by .5%, while the four-step average GCT did not change. This data indicates that different training methods should be used to train only the GCT and step rate/frequency, the essential contributing factors in maximal speed training.

The overspeed cord training method is typically recommended for advanced athletes during the late-season or competitive training cycle several weeks before the main competition. Also, if an athlete hits the speed plateau or “speed barrier” in training, this method is a well-known strategy to help athletes overcome it.

Caution should be used, as overspeed training arguably poses a greater injury risk than the free run since the running speed becomes artificially enhanced beyond the athlete’s natural ability. Additionally, supramaximal speed sprints dictate that athletes should be monitored even more closely, as they pose a greater risk for the sympathetic overtraining type. Elastic cords should be fully covered with fabric to prevent possible injuries caused by unexpected tearing and snapping back at the athlete or the partner while towing the athlete.

Resistance Runs with Ankle Cuffs

As expected, in comparison to the free run, both resistance runs, with half-pound and 1-pound ankle cuffs per leg, produced slower running times and lower speed-determining factor values.

Resistance runs with a half-pound ankle cuff/leg caused a speed loss of 1.75% from the free run, a 2% longer average step length, a 3.75% reduction in step rate (frequency), and a 7.5% longer four-step average GCT.

Video 3. Sprint with ankle cuffs providing weighted resistance.

Compared to the free run, the 10m fly run with a half-pound ankle cuff/leg showed a steep loss of running speed. When adding another half-pound per leg, an additional loss of speed by 3% followed, making it a total 4.75% difference between the free run and run with a 1-pound ankle cuff/leg. Compared to the free run, while wearing 1-pound ankle cuffs/leg, the average step length dropped by 2%, the AVG step rate dropped by 2.5%, and the AVG four-step GCT plummeted by a staggering 13%.

As the data shows, runs with ankle cuffs do not immediately improve any of the maximal speed components. They should be used primarily during training cycles focused on strength building. Running-specific resistance training is compatible with most types of strength training and can be effectively implemented into the training program during the training cycles emphasizing strength gain.

As the data shows, runs with ankle cuffs do not immediately improve any of the maximal speed components. They should be used primarily during training cycles focused on strength building. Share on X

If weightlifting training is planned for the same day as anaerobic-alactic resistance runs, it should be done as the second part of the practice, not vice versa.

To minimize the risk of injuries, the training effect of preceding general conditioning (GPP) should become relatively stable before advancing to more sprint-specific efforts such as resisted runs. Coaches should carefully plan gradual additional increments of the ankle cuff weight, resisted sprint distance, and volume. They should never use resistance runs in the weeks leading up to competition, as this will slow down the nervous system (CNS) and reduce the athlete’s performance.

By understanding the data from figure 1 and the differences presented in figure 2, coaches can decide on the type of running stimulus most suitable for their athletes’ needs in training.

To accurately select, dose, and effectively fit each type of training stressor into the general training plan, coaches should frequently record their athletes using the video recording method described at the beginning of the article, document data, and analyze how far the athlete’s sprint parameters are from the desired values at any time during preparation.

It is important to mention that too many coaches and athletes rely on auto-timing systems, often with questionable precision. While such timing systems can be practical for large groups or beginner athletes, other than measuring the flying times, they were not designed to measure GCT, step length, rate, or relevant body angles—the essential components of the athlete’s step pattern to be analyzed and trained based on those values. Because of that, when using auto-timing systems in training, it is impossible to pinpoint the exact factor that needs improvement: GCT, step frequency, step length, or the athlete’s mechanics.

Training Ideas

Other sprint-specific resistance and assistance training methods that provide relatively similar types of stress to sprints performed with ankle cuffs and an overspeed cord, respectively, are listed below:

Resistance training:

• Up the hill/stair runs.
• Sled or partner pulls and pushes.
• Weighted vest or weighted shorts.
• In the water (with or without water resistance equipment).
• Against the wind.
• On sand.

Assistance training:

• Downhill to flat.
• Self-propelled, curved treadmill.
• Stick drills (wickets) with sticks spaced closer than the natural stride length (10%, 15%, 20% closer, etc.).
• With the wind.
• Running in the air (hanging off the pull-up bar or gymnastics rings or from the parallel bars).
• Antigravity treadmill.

Running speed-specific training methods that isolate its components from figure 1 and detail how to effectively implement maximal speed, resisted speed, and assisted speed training into a general training plan are beyond the scope of this article. Please consult the references listed or other adequate literature for that purpose.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

Korchemny R and Hoskisson JL (1994). Innovations in speed development, an advanced model. Dr. Remi Korchemny, 6435 Ridgewood Drive, Castro Valley, California 94552.

Mann R and Murphy A (2022). The Mechanics of Sprinting and Hurdling. Independently published.

Walker J, Tucker C, Paradisis G, Bezodis I, and Bissas A. (2019, February). Biomechanical Report for the IAAF World Indoor Championships 2018, 60m Men & 60m Women. Birmingham, UK: International Association of Athletics Federations. www.Worldathletics.com. Retrieved April 1, 2024, from World Athletics.

The pursuit of speed, strength, and all things athletic places intense, repeated physical demands on the human body. With this highly intense demand being a prerequisite for peak athletic performance, athletes are all too familiar with incurring the various musculoskeletal injuries and disorders that can arise—the effective treatment and resolution of the underlying condition impeding performance is then of paramount importance for any serious athlete.

With the world of rehabilitative technology evolving at an ever-quickening rate and athletes looking for the quickest path back to full health, one particular intervention—known as extracorporeal shockwave therapy (ESWT), or shockwave therapy—has created quite the buzz among athletes and practitioners alike.

While this therapeutic intervention has been gaining popularity in recent years, it’s imperative for coaches, athletes, and clinicians who are considering incorporating it into their rehabilitative endeavors to have a rudimentary understanding of this modality. This includes its mechanism of action, the conditions it can treat, and, most importantly, the research behind ESWT’s ability to treat various disorders. This basic understanding is all in the name of ensuring optimal outcomes for those looking to make a full return to their athletic pursuits.

This article will walk you through these various facets pertaining to shockwave therapy, hopefully allowing you to make more informed decisions when it comes to administering or receiving shockwave therapy for your or your athlete’s needs.

How ESWT Works

While the in-depth mechanisms behind shockwave therapy are outside the scope of this article, a basic rundown is warranted for:

• How this therapy is administered.
• What shockwaves are.
• How shockwaves are believed to produce their desired effects on injured tissue.

With that said, don’t get too hung up on the details; for the average reader, knowing the scientific consensus of shockwaves’ effects on human tissue is what truly matters here (and will be discussed after this section).

Shockwave therapy has been used for treating various bone and soft tissue disorders involving the musculoskeletal system for the past 20 years.¹ The process involves a handheld applicator being applied directly onto the skin over the area being treated as a series of shockwaves are administered to elicit their therapeutic effects.

The term ‘shockwave’ is a bit of a misnomer; no electrical activity or ‘shocking’ is involved with shockwave therapy. Shockwaves are acoustic energy waves. Share on X

The term “shockwave” is a bit of a misnomer; no electrical activity or “shocking” is involved with this treatment. Shockwaves are acoustic energy waves (pressure waves) that consist of high peak-pressure amplitudes rising to their peak pressure within nanoseconds and dying out within microseconds (i.e., transient pressure oscillations).² So, once the peak pressure of this sonic energy wave has been reached, its pressure drops to a negative value within microseconds.

As a shockwave passes through tissues within the body, its high-pressure phase can be reflected (bounce off) or absorbed by the tissue(s). As the negative phase of the shockwave interacts with these tissues, air bubbles are created in a process known as cavitation. These microbubbles then implode, leading to direct and indirect effects within the tissue(s) being targeted.³

If that sounds a bit confusing, don’t sweat it. Essentially, it’s a sonic pulse that works in the same way a fast-flying aircraft produces a sonic boom, and it leads to stimulation of human tissue at the cellular level.

More specifically, these “sonic booms” that penetrate the tissue stimulate physiological cellular activity of the targeted tissue through a process known as mechanotransduction.^4,5 This fancy-sounding word simply means that a physical impulse or mechanical force is being converted into cellular activity within the targeted tissue(s).

While the specific biological changes that occur to tissue through ESWT are far outside the scope of this article, tissue regeneration through the delivery of shockwaves has been shown to occur by inducing:^3,4,6,7

• Blood vessel formation (known as neovascularization).
• Growth factor release.
• Inhibition of inflammatory molecules.
• Increased tenocyte proliferation and collagen synthesis.

Additional effects have also been documented; however, the above effects are likely the primary mechanisms involved with optimizing cellular activity and health. Despite the scientific community’s general understanding of these biological changes occurring from ESWT, the exact mechanisms for how these biological and physiological responses occur are not fully understood.

Parameters of ESWT

As with any therapeutic intervention that can be implemented, shockwave therapy relies on a series of parameters that must occur to achieve the overall desired treatment effect. For the average reader, I would advise not to get hung up on these specifics; I have merely (and briefly) included them for clinicians and the curious of mind who like knowing the details of therapeutic interventions.

When treating various orthopedic disorders, shockwave parameters include:⁸

• Pressure distribution.
• Energy flux density.
• Total acoustic energy.

Pressure distribution refers to the area of tissue being stimulated from the shockwave being administered.

Energy flux density refers to the measure of the energy per square area that is being released by the sonic pulse at a specific point. Or, more simply put, it’s the intensity at the focal point of the shockwave. It is measured in joules of energy per area (mJ/mm²).

The extent of energy flux density can be classified as high or low; however, there is no scientific consensus on these particular definitions. It has been proposed as a guideline that low-energy ESWT involves a flux density below 0.12 mJ/mm², while high-energy flux density is above 0.12 mJ/mm².¹

Total acoustic energy refers to the energy flux density within a single shockwave pulse multiplied by the total number of pulses administered.

Focused vs. Radial ESWT

It’s worth noting that when administering ESWT for musculoskeletal conditions, two primary types of shockwave therapy can be administered to injured tissue:

1. Focused shockwave therapy.
2. Radial shockwave therapy. 

Focused shockwave therapy is the more “pure” or established form of shockwave therapy within the medical world. Much of the research involves studying the effects of EWST using this form of treatment.¹ It involves administering shockwaves to a much more focal region of tissue, typically 2–8 millimeters in diameter.

Radial shockwaves are not concentrated directly over the targeted tissue in the same manner as focused shockwaves. Instead, the pressure waves disperse outward from the applicator tip of the device. The primary benefit is that this allows for the treatment of larger areas of tissue with less precision. However, these pressure waves do not penetrate as deep, and their characteristics are different enough that some authors contest they should not be considered true shockwaves.^1,9

The existence of two different forms of shockwave therapy muddies the water when looking at the research and is a potential reason why results can vary differently across studies. Share on X

While both forms of shockwave therapy are employed in literature and clinical settings, the existence of two different forms of ESWT muddies the water when looking at the research (this will be discussed further in the article) and is a potential reason why results can vary differently across studies.

Analyzing the Scientific Research

Enough research on ESWT has been performed that meta-analyses and systematic reviews often exist for specific orthopedic conditions. Despite this, I certainly can’t cover the findings for every condition. Rather, my aim is to skim the surface for the overall scientific findings for conditions most likely to affect the SimpliFaster audience and point those interested in further details in the right direction. For those looking to dive into the specifics of ESWT for specific orthopedic conditions (issues affecting muscles, tendons, bones, and joints), the references listed at the end of this article will serve as a solid starting point.

When analyzing the research behind ESWT’s effectiveness on various orthopedic conditions, I have tried to include findings from results and discussions within meta-analyses and systematic reviews, which offer the highest level of evidence possible within research.

Findings for Tendinopathies

Tendinopathy is one of the most commonly diagnosed conditions within athletic populations, with reports of approximately 30% of all elite athlete injuries.¹⁰ As such, findings of ESWT’s effects on tendon health should be of paramount interest to coaches and clinicians alike who are involved with athletes.

In the lower extremity, the most commonly afflicted tendons are the Achilles tendon, the plantar fascia, gluteal tendons (notably the glute medius and minimus), the patellar tendon (knee tendon), and the tibialis posterior tendon (near the inside of the ankle).¹¹ For athletes involved in running-based sports, tendinopathy in the knee, foot, and ankle appears to be the most common.¹²

In the upper extremity, the rotator cuff and the flexor and extensor tendons of the elbow are most commonly affected, though I am not covering the upper extremities in this article.¹⁰

When looking at ESWT’s effects on tendinopathy, the quick takeaway is that shockwave therapy has been found to have a notable influence on reducing pain and producing health-promoting biological effects. Meta-analyses for the treatment of patellar tendinopathy, Achilles tendinopathy, and rotator cuff tendinopathy have shown statistically significant effects for various aspects of improving tendon health and function.

When looking at ESWT’s effects on tendinopathy, the quick takeaway is shockwave therapy has been found to have a notable influence on reducing pain and producing health-promoting biological effects. Share on X

Critical to this topic, however, is that multiple adjunctive treatments should still be considered and implemented (when appropriate) alongside ESWT to ensure optimal tendon stimulation and subsequent healing. Which specific combined interventions lead to superior outcomes is likely best left to the clinician. The research isn’t entirely clear as to which combined intervention(s), when stacked with ESWT, will offer the best results.⁴

Based on our understanding of the cellular processes that arise and occur with tendon stimulation, it seems that combining ESWT with optimal tendon loading parameters will yield the best possible outcomes, though again, this depends greatly on the athlete’s condition. I have written a detailed article on SimpliFaster for the latest findings for tendon loading when treating tendinopathy, which can help provide a foundation for this approach.

Anecdotally, I will say that my patients experience far better outcomes when ESWT is paired with a loading program suitable for their needs, abilities, and overall condition. I often need to reduce training load, volume, and intensity to an appropriate level as well.

For conciseness and to appeal to the general nature of running- and sprinting-based readers on this site, I’ll only cover lower-body tendinopathy and soft tissue findings here.

Knee Tendinopathies

Overall, the findings for ESWT to produce statistically significant and favorable changes for patellar tendinopathy seem quite promising. A meta-analysis by Mani-Babu et al. reviewed seven papers examining the efficacy of ESWT on characteristics of patellar tendinopathy and found six out of seven of those papers to report significant improvement in symptoms after treatment, concluding it to be a largely successful form of conservative treatment.¹³

As with essentially all other systematic reviews that have analyzed the efficacy of ESWT, the review mentions that each paper utilized different shockwave parameters when providing treatment to the patellar tendon, making it difficult to determine optimal shockwave parameters when treating the condition. (This is a common theme within almost all ESWT meta-analyses dealing with soft-tissue pathologies.) The authors are quick to point out that more research is needed to determine optimal treatment parameters.

A similar meta-analysis by Liao et al. examined the effects of ESWT to reduce pain and improve functional outcomes for individuals with various soft tissue disorders of the knee (such as pes anserine tendinopathy, IT band friction syndrome, and post-traumatic tendon/ligament stiffness, among others) in addition to patellar tendinopathy.⁵ The results of this meta-analysis determined that ESWT showed significant moderate evidence for safety and efficacy for improving overall treatment success, reducing pain, improving functional recovery, and performance-based outcomes.⁵

Readers should note that in this meta-analysis, some studies utilized focused shockwave therapy while others utilized radial shockwave therapy. As such, the authors mention it is unclear whether therapeutic effects on these knee disorders differ from one shockwave form to another. (This is another common theme in many ESWT meta-analyses.)

Achilles Tendinopathy

With the Achilles tendon being one of the most adversely affected tendons in the lower body and the cornerstone of any athletic activity involving jumping and running, the effects of ESWT on this region of the body have been well studied. On the whole, meta-analyses tend to go back and forth on the efficacy of ESWT on different portions of the Achilles tendon. It would seem that some of this is due to examining various studies that largely use different shockwave parameters within each respective study.

Mani-Babu et al. concluded in their analysis that ESWT has moderate evidence for being more effective than eccentric loading for insertional Achilles tendinopathy and equal to eccentric loading for mid-portion tendinopathy. They are quick to point out that combining EWST with eccentric loading may likely produce superior outcomes.¹³

Similarly, a systematic review by Cathy Speed concluded that focused and radial shockwave therapy both have limited evidence to suggest they can be beneficial to insertional and mid-portion Achilles tendinopathy.¹

To cloud the water even more, a meta-analysis by Fan et al. concluded through a subgroup analysis that low- and mid-energy level ESWT led to better functional outcomes and improved pain outcomes than patients who received other treatment interventions.¹⁴ They are quick to note within this paper that further investigation should take place to determine the optimal energy level of shockwave delivery.

Determining the optimal energy level of shockwave therapy is critical as it likely largely influences efficacy and outcomes when treating Achilles tendinopathy. Share on X

This last point regarding the optimal energy level of shockwave therapy is critical to understand, as it likely largely influences efficacy and outcomes when treating Achilles tendinopathy (or other tendinopathies, for that matter). A brief discussion of optimal parameters is given later in this article.

Findings for Plantar Fasciitis

An extensive volume of research on ESWT’s ability to treat plantar fasciitis has been undertaken over the past decade, with results generally finding favor in its ability to reduce pain and improve functional outcomes.

A meta-analysis by Sun et al. examining nine randomized controlled trials of ESWT on 935 patients with plantar fasciitis concluded that focused shockwave therapy could relieve pain in chronic plantar fasciitis but could not draw conclusions about radial shockwave therapy.¹⁵

In a meta-analysis with the same title, Aqil et al. concluded that ESWT produced favorable results for reducing pain in patients with chronic plantar fasciitis and recommended its use for those failing to make improvements after three months of other conservative measures.¹⁶

When determining optimal parameters, a systematic review and network meta-analysis by Chang et al. concluded that optimal delivery parameters when treating plantar fasciitis with focused shockwave therapy should involve selecting the highest tolerable energy output within a medium intensity range.¹⁷ They also concluded that radial shockwave therapy could be an appropriate alternative due to its lower price point and therapeutic effectiveness.

Other Lower Body Conditions

The research and subsequent effects of ESWT extend beyond soft tissue conditions. While not covered in this article, when pertaining to the lower body, favorable findings within meta-analyses have been found for knee osteoarthritis, acute and chronic soft tissue wounds, and medial tibial stress syndrome (shin splints), among others.^18–20

Primary Advantages of ESWT

When considering treatment interventions, coaches and clinicians alike should have a preliminary understanding of the inherent risks and advantages they feel may be warranted for their athlete.

Regarding the use of ESWT for soft tissue disorders, this treatment is largely regarded as safe when used by trained professionals and can, therefore, be considered a first-line treatment option for soft tissue disorders that fail to resolve through traditional interventions. Its non-invasive nature can reduce risks that are inherent with injection-based therapies (such as infection) and surgeries.^1,3,8,21

While it’s disputed whether they produce different outcomes, both focused and radial shockwave therapy are largely considered safe forms of shockwave delivery. Share on X

Additionally, ESWT is becoming more commonplace within clinical practice, adding a convenience factor for those looking to receive this treatment. Radial shockwave is typically found in clinics more often than its focused counterpart due to its more economical price point. While it’s disputed whether they produce different outcomes, both are largely considered safe forms of shockwave delivery.

Shortcoming #1: Lack of Ideal Parameter Usage

For all that we know about the effectiveness of shockwave therapy on various tissues within the body, there is a bit of the Wild West when it comes to a scientific consensus as to the ideal combination of parameters to use.⁴

ESWT treatment parameters often vary across studies, and there is often a surprising lack of recorded parameters (pressure distribution, energy flux density, and total acoustic energy) within studies, causing great frustration to researchers (and clinicians such as myself); a study that shows statistically significant effects on a specific condition without fully listing parameters that were selected is like providing a treasure map without a compass.

As such, it’s often up to clinicians to use anecdotal evidence to select the combination of parameters they believe to be best for the individual whom they’re treating, making for a notable shortcoming at this time when assessing the scientific strength of ESWT.

Shortcoming #2: Focused vs. Radial ESWT

As alluded to earlier, the research regarding the superiority for different orthopedic conditions when comparing focused and radial shockwave therapy is quite unclear. To further complicate matters, it has been suggested that radial shockwave is an inaccurate term and that radial pulse therapy is more accurate for various reasons.¹ It has been noted by the same author that some studies involving “low energy” shockwaves are, in fact, referring to radial pulse therapy.

I make mention of this preceding paragraph to highlight a likely cause for discrepancies between randomized controlled trials examining the effectiveness of ESWT on a particular condition; not only are parameters often not reported, but the type of shockwave administered (i.e., focused versus radial) is not mentioned within certain studies.

In knowing that respective shockwaves have different characteristics (and likely therapeutic effects), treating a particular condition with radial shockwaves might not elicit favorable results, while treating the same condition with focused shockwaves might (and vice versa). This has the potential to lead to conflicting findings within the literature (and likely does).

ESWT Can Be Beneficial

While the research leaves more to be desired as to the precise mechanisms of how shockwave therapy works, which type of shockwave is most effective for a respective condition, and which set of treatment parameters will likely yield the best outcomes possible, it’s nonetheless quite clear that ESWT can offer benefits regarding tissue healing, pain reduction, and functional improvement for various orthopedic conditions.

Athletes, coaches, and clinicians looking for safe, non-invasive treatment for tendinopathies and soft tissue disorders, and potentially for bone healing, will likely experience the best results for what ESWT can offer and should consider combining this treatment with additional intervention such as physical therapy to maximize therapeutic outcomes. 

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

1. Speed C. “A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence.” British Journal of Sports Medicine. 2014;48(21):1538–1542.

2. Ogden JA, Tóth-Kischkat A, and Schultheiss R. “Principles of shock wave therapy.” Clinical Orthopaedics and Related Research 1976-2007. 2001;387:8–17.

3. Wang CJ. “An overview of shock wave therapy in musculoskeletal disorders.” Chang Gung Medical Journal. 2003;26(4):220–232.

4. Ioppolo F, Rompe JD, Furia JP, and Cacchio A. “Clinical application of shock wave therapy (SWT) in musculoskeletal disorders.” European Journal of Physical and Rehabilitation Medicine. 2014;50(2):217–230.

5. Liao CD, Xie GM, Tsauo JY, Chen HC, and Liou TH. “Efficacy of extracorporeal shock wave therapy for knee tendinopathies and other soft tissue disorders: a meta-analysis of randomized controlled trials.” BMC Musculoskeletal Disorders. 208;19(1):278. doi:10.1186/s12891-018-2204-6.

6. Chao YH, Tsuang YH, Sun JS, et al. “Effects of shock waves on tenocyte proliferation and extracellular matrix metabolism.” Ultrasound in Medicine and Biology. 2008;34(5):841–852.

7. Martini L, Fini M, Giavaresi G, et al. “Primary Osteoblasts Response to Shock Wave Therapy Using Different Parameters.” Artificial Cells, Blood Substitutes, and Biotechnology. 2003;31(4):449–466. doi:10.1081/BIO-120025415.

8. Wang CJ. “Extracorporeal shockwave therapy in musculoskeletal disorders.” Journal of Orthopaedic Surgery and Research. 2012;7(1):11. doi:10.1186/1749-799X-7-11.

9. Cleveland RO, Chitnis PV, and McClure SR. “Acoustic field of a ballistic shock wave therapy device.” Ultrasound in Medicine and Biology. 2007;33(8):1327–1335.

10. Millar NL, Silbernagel KG, Thorborg K, et al. “Tendinopathy.” Nature Reviews Disease Primer. 2021;7(1):1–21.

11. Riel H, Lindstrøm CF, Rathleff MS, Jensen MB, and Olesen JL. “Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study.” BMC Musculoskeletal Disorders. 2019;20(1):239. doi:10.1186/s12891-019-2629-6.

12. Francis P, Whatman C, Sheerin K, Hume P, and Johnson MI. “The proportion of lower limb running injuries by gender, anatomical location and specific pathology: a systematic review.” Journal of Sports Science and Medicine. 2019;18(1):21.

13. Mani-Babu S, Morrissey D, Waugh C, Screen H, and Barton C. “The Effectiveness of Extracorporeal Shock Wave Therapy in Lower Limb Tendinopathy: A Systematic Review.” The American Journal of Sports Medicine. 2015;43(3):752–761. doi:10.1177/0363546514531911.

14. Fan Y, Feng Z, Cao J, and Fu W. “Efficacy of Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Meta-analysis.” Orthopaedic Journal of Sports Medicine. 2020;8(2):1–9. doi:10.1177/2325967120903430.

15. Sun J, Gao F, Wang Y, Sun W, Jiang B, and Li Z. “Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs.” Medicine (Baltimore). 2017;96(15). Accessed January 20, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403108/

16. Aqil A, Siddiqui MRS, Solan M, Redfern DJ, Gulati V, and Cobb JP. “Extracorporeal Shock Wave Therapy Is Effective in Treating Chronic Plantar Fasciitis: A Meta-Analysis of RCTs.” Clinical Orthopaedics and Related Research. 2013;471(11):3645–3652. doi:10.1007/s11999-013-3132-2.

17. Chang KV, Chen SY, Chen WS, Tu YK, and Chien KL. “Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis. A systematic review of network meta-analysis.” Archives of Physical Medicine and Rehabilitation. 2012;93(7):1259–1268.

18. Hsieh CK, Chang CJ, Liu ZW, and Tai TW. “Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis.” International Orthopaedics. 2020;44(5):877–884. Doi:10.1007/s00264-020-04489-x.

19. Zhang L, Fu X, Chen S, Zhao Z, Schmitz C, and Weng C. “Efficacy and safety of extracorporeal shock wave therapy for acute and chronic soft tissue wounds: A systematic review and meta-analysis.” International Wound Journal. 2018;15(4):590–599. doi:10.111/iwj.12902

20. Forogh B, Karimzad Y, Babaei-Ghazani A, Janbazi L, Cham MB, and Abdolghaderi S. “Effect of extracorporeal shockwave therapy on medial tibia stress syndrome: A systematic review.” Current Orthopaedic Practice. 2022;33(4):384–392.

21. Dedes V, Stergioulas A, Kipreos G, Dede AM, Mitseas A, and Panoutsopoulos GI. “Effectiveness and safety of shockwave therapy in tendinopathies.” Materia Socio-Medica. 2018;30(2):131.

“The curse of modernity is that we are increasingly populated by a class of people who are better at explaining than understanding, or better at explaining than doing.” – Nassim Taleb

We are blessed to live in the information age, with virtually any bit of information at our fingertips. From countless CEU courses to hard drives filled with e-books, no coach is lacking in information. You can find numerous articles across the internet with Top 10 book lists, and these are all great resources—I have used many of them to fill my own bookshelf and CEU requirements. But I fear they may be incomplete.

I have noticed a trend in young coaches having tremendous book knowledge of training but little understanding of how that training plays out. It’s one thing to know Prilepen’s chart, but a whole other thing to understand the training effects of 15 optimal reps between 80% and 90%. It’s one thing to understand the theory behind accommodating resistance, it’s a whole other thing to understand just how quickly accommodating resistance can wreck a training session. Just like a martial arts master, we must not only know the concepts in theory, but in practice too.

I have noticed a trend in young coaches having tremendous book knowledge of training but little understanding of how that training plays out, says @Tate_Tobiason. Share on X

The following is a list of five programs I believe every young strength coach should run for a training cycle to experience the principles and concepts of these influential programs firsthand—each has a key takeaway that can be learned from running it. Some of these programs I found myself through reading, while others were introduced to me by mentors and others introduced to me through colleagues. So, without further ado, let’s jump in.

Program #1: Jim Wendler’s 5/3/1

5/3/1 is a staple programming approach used by many strength coaches due to its simple yet effective approach to loading the primary lifts. Created by Coach Jim Wendler, 5/3/1 programs calculate percentages based off 90% of the athlete’s one-rep max (1RM). The program then cycles through plus sets each week of 5+, 3+, and 1+, with a de-load in week four.

When I was a young strength coach, I was proud of my squat number and did not follow the prescription of programming off 90% of my 1RM. Experienced coaches know where this is going…and oh, my gosh, I wrecked myself. I was still able to hit good numbers but beat myself up so much with grinding sets that I did not make good progress. I then humbled myself, ran another cycle of 5/3/1 using 90% of my 1RM for calculations, and—what do you know—I started hitting PRs and feeling a ton better.

This helped me understand that submaximal reps can go a long way in an athlete’s training and how 5/3/1 could be easily applied to non-strength sport athletes who shouldn’t get beat up by the barbell, but can still benefit from raising max strength.

Key Takeaway—Athletes can gain substantial strength through submaximal loading parameters.

Program #2: Westside Barbell

Westside training is probably one of the most misunderstood and abused programs out there. From speed sets being too heavy to max effort days taking hours on end, the training looks nothing like the original intent.

Like it or not, Westside Barbell has an enormous impact on strength and conditioning. So do yourself a favor, purchase the Westside Barbell Book of Methods, and run the program to a T. Until you build up to a max-out single in 20 minutes, perform 10 sets of speed squats with max intent on the minute, or do sled pulls for a half mile, you don’t know what Westside training is. Learn what a proper box squat is supposed to not only look like but feel like.

Furthermore, every young coach should experience firsthand the catch-22 that is accommodating resistance. It’s great in theory and when you set it up right, but if you mess up your resistance band setup, you will pay with an uneven barbell or overloaded resistance that crushes the athlete. It was only by running Westside cycles that I truly came to understand what the max effort, dynamic effort, and repetition method were about, along with the purpose of conjugate exercise selection.

Every young coach should experience firsthand the catch-22 that is accommodating resistance, says @Tate_Tobiason. Share on X

Coaches seem to either love or hate Westside, and I’m not here to determine a verdict on it, but before you pass judgment, give it a shot.

Key Takeaway—Running a Westside program creates a better understanding of the max, dynamic, and repetition effort methods.

Program #3: Old School Husker Power

Full disclosure, I was born and raised in Nebraska and had the privilege of interning at the University of Nebraska, learning from Boyd Epley and Mike Arthur. I did not choose this program out of nostalgia or so that young coaches know their history. All of those are good aftereffects, though. I chose this program because, as Mike Arthur told me one day on the floor, “I know my old program might be outdated, but it’s better than half the programs I see nowadays.”

For those who don’t know, the Old School Husker Power program consisted of four training days a week, with two strength days and two power days. Strength days were full body lifts utilizing compound barbell and dumbbell movements, while power days consisted of various Olympic lifts and plyometrics. Each strength day and power day was completed twice in the week, with one being a heavy day and the other being a light day. The heavy–light system provided the athlete exposure to various muscular contraction rates throughout the week, building more than just showy muscle.

There have been many adaptations and tweaks to this original approach, but I believe that young coaches should experience how effective a simple program like this can be. Doing heavy squats on Monday (3 sets of 5 at 60%, 70%, and 80%) and light squats on Thursday (3 sets of 5 at 40%, 50%, and 60%) goes a lot further than you may expect. You can find the original program in Complete Conditioning for Football, written by Mike Arthur and Bryan Bailey.

Doing heavy squats on Monday and light squats on Thursday goes a lot further than you may expect, says @Tate_Tobiason. Share on X

Key Takeaway—The basic concept of heavy and light days can go a long way in physical preparedness.

Program #4: Triphasic

I don’t know about you, but Triphasic to me feels like that program which everyone knows about, but no one has ever done. Cal Dietz is a mad scientist and the theory behind the program is solid—but, until you do it yourself, you won’t understand the group training limitations and coaching constraints you will need to account for. Oh, and let’s not forget how difficult the training can actually be. Overload eccentrics killed me not only in the lifting but in getting the bar back up on the rack. Furthermore, I discovered a newfound respect for isometrics after seeing stars from a pin pull.

Each section of the training plan—eccentrics, concentrics, and isometrics—are fantastic, but require firsthand experience and verbatim adherence the first time around to properly understand the system before one starts to tweak it. Triphasic is a fantastic training reset for coaches coming from Olympic and powerlifting backgrounds, allowing them a chance to better understand muscular contraction rates and how they affect training performance.

Key Takeaway—There are more training parameters than just sets, reps, and weight.

Program #5: 1×20

We all know the joke “anything above five reps is cardio”—which is all for good laughs until our training devolves into nothing but five reps or less. This is one of the reasons I believe every coach should run a 1×20 training cycle. Created by Michael Yessis, 1×20 bucks conventional strength training understanding by exposing the athlete to a wide variety of movement variations at higher rep ranges.

This program is not designed for body building, nor is it designed for strength gain. The byproducts will produce benefits for both, but the goal of the program is to develop increased proprioception and work capacity throughout the system using high-rep sets covering numerous joint actions. One set of 20 reps may not seem like much, but when compounded through multiple exercise selections with minimal rest, these workouts quickly demonstrate their worth.

We all know the joke “anything above five reps is cardio”—which is all for good laughs until our training devolves into nothing but five reps or less, says @Tate_Tobiason. Share on X

This style of training is great for athletes with low training ages and athletes who need the benefits of the weight room. Furthermore, going down a Michael Yessis rabbit hole is great for any coach’s understanding of physical preparedness.

Key Takeaway—Athletes can benefit from rep ranges north of five.

5 Honorable Mentions

1. Dan John: One Lift a Day

K.I.S.S.: keep it simple, stupid. In a world of over-programming, focusing on one lift for 30 minutes with intensity is a breath of fresh air, demonstrating how intent can play a big role in physical preparedness.

2. New Functional Training for Sports

Love him or hate him, Mike Boyle is a leader in strength and conditioning and his methods are far too often straw-manned. Take some time and experience his methods firsthand and see what you like and dislike about them.

3. Juggernaut Training System

This is one of the best adaptations of powerlifting methodologies to physical preparedness I have used. Furthermore, the hypertrophy systems used in Juggernaut help build “functional” muscle mass.

4. Tier System

While not used by many today, the Tier System still stands out as a solid program and one which coaches can easily adapt for general-population clients on the side. Full body workouts with a template that’s easy to remember and won’t harm the client while mixing it up go along way with general population.

5. VBT

Like it or not, technology has made its way into the weight room. Before programming VBT for any group of athletes, a coach should have firsthand experience with how the system works along with the feedback loops it provides.

Writing Your Own Programs

There are countless ways to write a program. Many work. Some are downright awful. But no matter what you do, make sure you know how to do the program firsthand before you consider it, condemn it, or attempt to coach it.

Spend the time reading and learning, but don’t forget about getting under the bar. Weight room calluses, bloody shins, and welts from a poorly set up resistance band can be the best teachers. Get in the weight room, expose yourself to a wide variety of training methodologies, and learn from them. The moment we become closed off and have “our system” is when we start to backslide.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Being a coach, athlete, and human being means being creative. Creativity is a given in the arts: music, film, dance, painting. Coaching has several “artistic” aspects, but the creative application of training means is rarely emphasized.

Perhaps part of this is because so much of what we would call athletic performance is typically “prescriptive” in nature. Strength coaches often tell you about what protocol they run, whether Triphasic, Tier, 1×20, or 5/3/1. Even in speed training, there is often a popular sequence, perhaps with a mechanical sprint device that is prescribed to athletes, and in jump training, a particular depth-jumping protocol.

In some ways, we could say this is the nature of sports performance relative to sport and skill coaching: treating physical qualities—and rudimentary skills—as basic and trainable through a prescription of exercise. No creativity is required, just the general stamp of approval of the coaching community or whatever relevant research or data collection might be available.

To coach is also to create. Complex coaching is to take various colors and brushes and create something new, something that serves the needs of the athletes in front of you, says @JustFlySports. Share on X

Although these prescriptions clearly deliver results, to coach is also to create. Complex coaching is to take a variety of colors and brushes and create something new, something that serves the needs of the athletes in front of you with the equipment you have available (or lack thereof). One of the apexes of creativity in athletic performance, especially when there are a multitude of training means available, is found in complex training. Complex training is the mixture and combination of training means, relying on the synergy of the whole being greater than the sum of the parts.

Video 1. Sample French Contrast sequence for jump power development.

Originally, complex training was defined as alternating heavy strength training with plyometrics. The research threads tend to focus on the specifics of potentiation, how much to lift, and how long to rest. It runs far deeper than “lift heavy weights, rest 10 minutes, and do some plyos.” In reality, complex training is a wide net that can encapsulate anything from wave loading and energy system alternations to purposeful circuits of exercises designed for either a potentiation or coordination challenge (or both). 

The 1980s and the Wellspring of Complex Training Genius

Ironically (or perhaps not so much), the greatest displays of creativity in the realm of complex training came from an era out of the past rather than the present. Music critics claim the 1960s to the 1980s were the richest decades musically, and the 2010s were the most monotonous. If you want to be a good musician, it’s a given to find inspiration from the greats of the past—and a tremendous influence on modern music has been from previous decades.

The material of the past is fundamentally invaluable for a complete understanding of physical training. There is so much training from the 1980s that coaches regularly refer to, such as the work of Charlie Francis. Track and field jumps training, as well as plyometric training, was taking off in this period (literally), and some of the best strength research came from the 1980s as well. This is not to mention the highly funded Soviet research done with actual athletic populations conducted more than 50 years ago.

Regarding complex training, there are two coaches of the past whose work demands our study. Jean Pierre Egger coached from the 1980s (Werner Gunthor) into the 2010s (Valerie Adams). Giles Cometti was not only a track coach but also a professor and performance center director whose work spanned from track coaching in the 1970s and research beginning in the 1980s into books published through to 2010. The more you study them, the more you realize that both were not only ahead of their time, but much of modern training still hasn’t caught up. Between the two, there is also a substantial amount of common material and concepts and a synergy of the developing ideas of the time.

Jean Pierre Egger was a world-class thrower himself and the brains behind the Werner Gunthor training material. The Gunthor training series is one of the most popular by far, and 40 years after its inception, coaches still love watching a 300-pound man perform various feats of complex and explosive training. Egger used a variety of methods, from pre-fatigue to agonist-antagonist pairing to pressurized eccentric overload machines and, of course, creative complex training methods. 

As things progressed through the 1990s into the 2000s, the focus of complex training grew simpler rather than more complex, says @JustFlySports. Share on X

In the time since the 1980s, complex training didn’t seem to accelerate as much as take time to see more rudimentary versions validated by the research. As things progressed through the 1990s into the 2000s, the focus of complex training grew simpler rather than more complex. My graduate school’s focus on complex training in 2007 mentioned nothing of Cometti or Egger. Rather, the focus was simply on the premise of basic potentiation, if a heavy lift could make your vertical jump higher 5–10 minutes afterward.

Much of the training throughout that time (2000–2010) resonated with the powerlifts and perhaps a related regression into more simplistic models. Egger, on the other hand, utilized specific complexes based on the phase of preparation and the plane of muscular motion. In more strength-oriented phases, pre-fatigue, agonist-antagonist work (shown here: 6:28–6:35), and specific eccentric overloading were staples (shown here: 1:58–2:15).

In power phases, strength work was paired with plyometrics in the same plane of motion and joint action. Advanced variations combined plyometric variations in essentially an “obstacle course” format, keeping things highly task-oriented (activating the salience network of the brain) while infusing natural variety. These movements were also high intensity in nature (see more Gunthor here), which differs from much of the watered-down, multi-planar plyometric work seen today, which seems more about the sequence than the stimulus and intensity.

Where contrast training was a centerpiece of the Gunthor training series, a French coach and researcher was simultaneously laying the foundations for modern complex training adaptation. Giles Cometti was the inspiration behind “French Contrast Training” (as per Cal Dietz), the training complexes of Christian Thibaudeau, and methods used by many other coaches.

In studying and translating the works of Cometti, as well as speaking with other influential coaches, I’ve found that his work is inspirational to modern coaches and is foundational and robust in its own right. It may be the language barrier that kept the work of Cometti from really striking the coaching means of the West, but it stands up as both years ahead of its time and highly creative and integrative of multiple athletic performance qualities.

Cometti was listing the pros and cons of the major muscle contractions (concentric, eccentric, isometric, plyometric, electrostimulation) 40 years ago, discussing how to combine these training methods in a way that maximized the positive while diminishing the drawbacks. These pros and cons are rarely discussed today. He also heavily used electromyography and had a deep understanding of the underlying neurological wiring and activation systems of motor units. He understood the nature of muscle twitch, partial and full “tetanic” contraction, and the unique impacts of long-duration isometrics from a motor unit synchronizing perspective. You would see all this at play in his complex training design.

Beyond the basic physiology, a major highlight in Cometti’s work was his emphasis on integrating a relevant sport movement into a complex circuit and being mindful of how various plyometric or special strength pairings could ultimately fit with specific sport skills, such as a volleyball block, soccer kick, or flying header. Few in the training world have so eloquently and creatively combined these specific means as Cometti did back in the 1980s and 1990s or had the extensive library of methods, along with the physiological backing of understanding.

Have We Built on Training of the 1980s?

Watching the Gunthor training series in the 1980s, you would think that modern training would be regularly infused with purposeful and specific creativity, as well as with the potential for task-specific sport efforts. More often than not, however, we see diluted versions rather than work that has truly built on it or integrated it. Part of this may be cultural, in lockstep with what is seen in music and film, but I believe there are also other reasons.

Today, there is an increased separation unfolding in the sports training process. There is the sport coach, the player development coach, the strength coach, the speed coach, the nutrition coach, the mental coach, and the high-performance coordinator. Egger was the coach for Gunthor. Cometti had a prominent sports science position and his own lab/gym. This isn’t to say there isn’t a high level of value in each of these individual positions, but it’s more speaking to the fact that the roles within sport itself have been increasingly specialized, and the container of sports performance doesn’t outright reward creative integration in exercise selection.

The roles within sport itself have been increasingly specialized, and the container of sports performance doesn’t outright reward creative integration in exercise selection, says @JustFlySports. Share on X

Within the silos, much of creativity now focuses more on singular strength training iterations or perhaps plyometric methods in their own capacity. This brings us dozens of iterations of squat, bench, and deadlift variations, unilateral lifts, “functional” training adaptations, and various re-hashes of plyometric movements. Novelty now works more for the individual container than for how movement can be integrated back into sport. The exact emphasis tends to go in waves, with varying strength methods waxing and waning in popularity over the years and decades.

Keeping with the nature of the job, sport coaches are relied on for the motor learning, tactical, and technical processes, which thrive on more “messiness,” non-linearity, and complexity (and those coaches are rarely educated in the subject). Strength coaches, meanwhile, are primarily in charge of “prescriptive tissue enhancement and stress management,” to put it a particular way. Keeping tissues healthy is an incredibly important job, but keeping one’s job tends not to require a creative quest to maximize specific KPIs or athlete movement patterning.

New technology and data collection also give coaches other ways to explore the realm of basic strength training, such as with bar velocity or readiness indicators. Some coaches certainly explore the breadth of complex training in a quest to maximize the athlete’s performance and engagement, but the way success in physical preparation is framed doesn’t facilitate maximizing KPIs as a requirement.

Complex Training in the Modern Era

So, how has complex training moved forward, and who has picked up the baton? What can we learn from the current iterations of complex work, combining strength, plyometrics, and speed for an optimal result? Where is complex training most applicable across the breadth of specific skill training and in general physical preparation?

For this article, I am listing modern iterations of complex training with five coaches who highlight creativity and practicality in building on the giants of the past. Each example points to global principles and strategies that can be taken into a coach’s own unique situation and an understanding of how the nature of sport (individual versus team) has influenced how complex methods have moved forward over time. These break down between the weight room (general preparation) and more skill-specific means (track and pitching/fast-bowling).

Weight Room-Oriented

1. Cal Dietz: French Contrast + Multi-Stage Complexes
2. Christian Thibaudeau: “Insider Complexes”

Speed and Sport Specialty-Oriented

1. Chris Korfist and Dan Fichter: DB Hammer-Inspired Speed Complexes
2. Steffan Jones: Fast-Bowling Specific Complexes

Weight Room-Oriented Complexes

When it comes to the gym, whether it is a strength or speed adaptation, strength coaches throughout history have seen the value of wave loading. Whether it is a Poliquin style “6,1,6,1,6,1” rep scheme, going 3,1,3,1,3,1 on Olympic lifts, or even a basic drop-set of 15–20 reps after a 3×3 heavy set, the value of a wave in the gym is written into general training philosophy.

In “general” preparation, there are more options as to the exact purpose of the wave or complex, but largely, locomotion, sprinting, and jumping are the most transferable KPIs coaches are looking to build. I’ll share here some ideas from Cal Dietz and Christian Thibaudeau, both of whom are inspired by Cometti.

1. Cal Dietz

Many coaches are familiar with Cal Dietz’s “French Contrast” ideation, inspired by the works of Cometti. Cal’s classic version goes as follows:


The above is done for 1–5 sets, with three being most common, and is highly effective. Vertical jump increases of 10% in a short time using this method, and similar increases in acceleration and throwing ability are not uncommon. I’ve written articles about this format in the past, and adapting various exercises to this sequence invites coaches to leverage their own physiological and biomechanical expertise creatively. Not only is this type of contrast effective after several sessions to substantially improve explosive athletic qualities, but it can also provide significant potentiation within the session itself. For example, it is easy to accomplish vertical jump increases of 3+ inches (8 centimeters) from the first set of contrast to the last (after 3–4 sets).

In the time since the original French Contrast, I had a wonderful podcast with Cal where he described moving into contrast work with even more stages—which he called “performance cycling”—with the distinctive purpose of using strength work as a technical amplifier. One low-hanging fruit for creative integration in modern complex work is the connection between exercise selection and movement quality. As Cal stated in the podcast:

“I would start my first set with my quad-dominant athletes at the rear posterior chain exercise and then cycle through everything, which is actually better, Joel, for my weight room functioning.”

This series may look something like the following:

The purpose of more movements in a set is related to washing out the discoordination caused by doing multiple sets of a movement, like a back squat, consecutively while simultaneously using other movements to help bring up weak points (such as a glute-ham raise for a posterior-chain-need individual). The ultimate goal is improved coordination, as evident in the dynamic movements in the series (in the case of the above, the sprint and bound activities). Where the French Contrast is more pure power, this adaptation is more technical, emphasizing the functional movement patterning of the athlete.

2. Christian Thibaudeau: Strength and Power Complexes

I’m not sure there is a modern coach with more complexes in his training toolkit than Christian Thibaudeau. His book Theory and Application of Modern Strength and Power Methods is an absolute classic. Christian speaks of complexes from ascending (light to heavy) to descending (heavy to light), pre-fatigue, post-fatigue, and more. If you are looking for complexes to maximize that strength and power portion found exclusively in the weight room, then understanding Christian’s work is required.

One of the more unique complexes Christian prescribes is “insider contrast,” which he notes is inspired by Cometti’s work. There are many iterations of this, but an example is as follows, all done on short rest in each superset:

This type of “insider” contrast trains many windows of strength on the same training day and in the same set. In a way, it can uncomplicate the process of working out longitudinal periodization as multiple qualities are trained on the day in an interesting and engaging way, and the exact method can be cycled over time.

Speed- and Sport Skill-Oriented Complexes

I believe that in sports where speed is not only desirable but is the sport itself (track) or a massive and direct contributor to success (pitching and fast-bowling), complex training is perhaps the most applicable. There is a reason that Jean-Pierre Egger was a track coach. When it comes to whatever is needed to work out the last few percentage points of performance, it’s nearly a given to look to complex training means.

When it comes to whatever is needed to work out the last few percentage points of performance, it’s nearly a given to look to complex training means, says @JustFlySports. Share on X

1. Chris Korfist and Dan Fichter: Sprint Complexes

In one of the greatest training DVDs (you could call it “old school” at this point), Wannagetfast V.1, Dan and Chris go through many of their sprint-specific complexes, many of which are inspired by a coach with the pen name “DB Hammer.” These combine flying sprints with plyometrics, with more “metabolic” calf and lower leg work. One of their prime complexes, which sticks with me in many of my own programming iterations, is as follows:

In the spirit of the DB Hammer literature, this type of complex would be programmed for rounds until a “drop-off” in the time or quality of key performance markers.

Performing a speed complex in this way trains the body in an incredibly robust manner, with each explosive movement having the capacity to improve the flying 10 and a specific strength adaptation of the body positive to sprinting.

2. Steffan Jones: “Second-Generation” Contrast and Fast-Bowling

The specificity and specific power development of complex training have been used brilliantly toward the outcome of fast-bowling speed by Coach Steffan Jones. Whereas Christian Thibaudeau is a master of creativity in strength complexes, I don’t know of any sports skill performance coach with more extensive complex training in their toolkit than Jones. Jones has included advanced complexes in his fast-bowling regimes, not only through strength overload but also by manipulating the weight of the ball, integrating special developmental work, and working both heavy and light loads in the same complex. The spirit of the “second generation” is plugging deeper into the specificity of a single movement.

Here is a sample of one of Jones’s multi-weight complexes.

Video 2. Steffan Jones has taken complex training in sport skill to a new level in the modern sports world.

Within the skill of a single movement, Jones also puts together complexes that train the coordination of each “node” in the network of the overall throw. While some complexes are more raw power-oriented, there can be complexes meant for coordination and skill as well. (Similar to Cal’s performance cycling, but Cal’s cycling was more driven toward locomotion, a more “general” ability than fast-bowling.)

When athletes experience multiple “shades” of their sport skill, their bandwidth for improvement is greater. When athletes long jump a variety of distances, instead of all maximal efforts (such as in the classic “Rewzon” study), they end up jumping farther at the end of a training phase. By working contrast heavily into a singular sports skill, there is a density of opportunity for both athlete learning and specific power production. This is not dissimilar to experiencing different “shades” of barbell lifting style, as shown in Christian’s version of Cometti’s strength work. Humans are meant to experience different shades and versions of training. 

Integrating Creativity in Complex Training

Although the core of training is simple, complexes are perennial “plateau” busters and chances to integrate multiple “nodes” of the training network in a creative manner. Whether a simple descending power series or a more elaborate adaptation, complex training yields a multifaceted stage for athlete improvement. It also helps satisfy an inherent human need for creativity and novelty in coaching.

Although the core of training is simple, complexes are perennial ‘plateau’ busters and chances to integrate multiple ‘nodes’ of the training network in a creative manner, says @JustFlySports. Share on X

As I have gone through many variations of complex training, I’ve found that the following “ingredients” in a complex can make sense for the corresponding situations:

Strength and Power Priority

• Overcoming or yielding isometrics.
• Heavy strength work.
• Unique strength machines, such as Keiser, kBox, or Supercat.
• Depth and assisted jump variations.
• Resisted and assisted sprinting.
• Medicine ball throws for distance or velocity.

Movement Quality Complexes and Elasticity

• Rhythmic and tempo-oriented movements.
• Proprioceptive challenges (i.e., hard balance discs or physio balls).
• Isometric holds to fatigue or sub-fatigue.
• Locomotive plyometrics (i.e., flexed leg bound).
• Short or long sprinting and locomotive constraints.

Sport-Specific Adaptation

• Relevant isometric positional holds.
• Specific strength drills (“SDE” in the Bondarchuk classification).
• Exploration of basic sports skills such as swinging, kicking, throwing, jumping, sprinting, and changing direction.
• Varying intensities and loads of one’s primary sport skill.
• Tracking and single-object manipulation.

The question is, does this build on what we’ve seen from the giants of the ’80s? Can we really “improve” on Led Zeppelin, Pat Benatar, or Prince? Do we push restart and time warp? Although so much has been done already, we are in a position where we can grab from a variety of methods and apply them to the athlete or group in front of us.

Does the athlete need strength, general power, and confidence? A basic French Contrast circuit can do wonders. Does the athlete desire to connect the gym to a specific skill? Cometti sequences with an actual sport skill iteration on the tail end of the circuit are a great option. Does the athlete seek better movement quality and injury resilience? More of a performance patterning using longer isometrics and proprioceptive challenges can be effective, as I believe the complexity of sport demands more out of preparation than simply: “lift more weight” or “move lighter weights faster.” Simple demands yield simple adaptations, but complex demands need more complex and thoughtful adaptation processes.

The groundwork has been laid, so there has never been a better time to work from the existing sea of knowledge and creatively weave training into your own situation, says @JustFlySports. Share on X

The groundwork has been laid, so there has never been a better time to work from the existing sea of knowledge and creatively weave training into your own situation. If you are interested in learning more about complex training and artistry in performance coaching, then you’ll want to check out the “Escaping the Training Simulation” seminar with Austin Jochum on June 8 in Cincinnati, Ohio.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Strength and conditioning and sports performance coaches earn a living by training their athletes generally with progressive overload, but some already-overloaded athletes need the recovery bucket filled more than they need more training stresses added. I have seen this problem occurring firsthand, training overworked athletes at the middle and high school levels, as well as in the private sector, and consulting with various high school teams that have overworked players and are looking for ways to improve their current strength and conditioning programs.

Some already-overloaded athletes need the recovery bucket filled more than they need more training stresses added, says @DrRaymondTucker. Share on X

Stress and Adaptation

Most strength and conditioning coaches have read either The Essentials of Strength Training and Conditioning by the National Strength and Conditioning Association or another strength and conditioning book that discusses the general adaption syndrome (GAS) model developed by Hans Selye in 1956. The explanation of general adaption syndrome says that any time the body experiences a novel or more intense stress than previously applied (e.g., lifting a heavier training load or a greater volume load), the initial response—or alarm phase—is an accumulation of fatigue, soreness, stiffness, or reduction in energetic stores that results in a reduction in performance capacity.¹

There are two additional extensions to the general adaptation syndrome, and these are:

1. The Stimulus Fatigue Recovery Adaptation theory states that the greater the overall magnitude of the workload encountered, the more fatigue accumulates and the longer the delay before complete recovery can occur.¹
2. The Fitness Fatigue Paradigm states that fatigue dissipates at a faster rate than fitness, thus allowing preparedness to become elevated if appropriate training strategies are used to retain fitness while reducing fatigue.¹

If followed, the general adaption model is a simple prescription for developing strength and conditioning programs that can prevent overtraining, leading to decreased athletic performance and increased risk of injury.

Several years ago, Coach Michael Boyle, a leading expert and sought-after speaker in strength and conditioning, wrote an excellent article called “Abide by the Bucket Hierarchy.” Coach Brendon Rearick, one of the coaches at MBSC, discusses the idea of bucket filling in rules #44 and #45 in his book Coaching Rules. Coach Rearick states that he programs for what he considers to be the four buckets of strength and conditioning:

• Mobility
• Strength
• Power
• Conditioning

As a coach, Rearick aims to ensure each bucket is filled so his clients can reach their goals, and he doesn’t waste time filling already-filled buckets.² The general adaptation syndrome and the bucket hierarchy both feature ways to prevent overtraining. As strength and conditioning coaches, are we applying what we have learned, or are we letting our egos get in the way of good training?

When Buckets Spill Over

The following scenario exemplifies what often occurs in the strength and conditioning profession. Let’s say we are currently training a multi-sport athlete at the high school level: their primary sport is football, and their secondary sport is basketball.

If this athlete is going to play football in the upcoming season, he will have to go through a mandatory off-season football strength and conditioning program during his athletic period at school that could last 75 minutes (depending on the school’s bell schedule), or he could be placed in an athletic period focusing on basketball that will go right into after-school basketball practice. Here in Texas, there is a strong emphasis on playing football, and to ensure multi-sport athletes participate in a football off-season conditioning program, some schools have early morning workouts before school.

Once school is out, the athlete rushes home for a quick bite and then goes to a sports performance center for additional weekly training. The parents believe hard work is the only way to achieve your goals and that more is better. However, reviewing the GAS model by Hans Selye, if the stressors are too high, performance can be further suppressed, and overtraining syndrome can result.¹

Overtraining can be defined as excessive training frequency, volume, or intensity (or some combination of these) without sufficient rest, recovery, and nutrient intake, leading to conditions of extreme fatigue and/or illness.¹ Accumulating this type of training over time will only reduce performance and potentially cause career-ending injuries. 

In the article by Boyle (and his newly released book, Designing Strength Programs and Facilities 2nd edition), he explains the “filling bucket” philosophy to prevent overtraining. His advice is simple:

“I tell coaches to fill the empty buckets. Don’t fill a bucket that’s full. If a bucket is already full, don’t fill it. We want them to get stronger, but when we get greedy, we overflow their recovery capacity and create a mess.”³

In our hypothetical scenario, the athlete goes to a football off-season program, basketball practice, and a personal trainer and plays in two basketball games a week and maybe a weekend tournament. Based on the scenario, the athlete has already filled the buckets of strength, power, mobility, and conditioning during the football off-season program.

If the basketball program performs some basic bodyweight strength exercises, the strength bucket will be filled again; if they are working on plyometrics to improve vertical jumping or even the number of jumps performed during basketball practice, the power bucket will be filled. The football off-season program, basketball practice, and even the personal trainer could require the athlete to do some conditioning to get in shape, and now the conditioning bucket is filled. Several of these buckets could already be full and overflowing.

I want to add another bucket to the bucket hierarchy, the bucket of recovery, which appears empty in the above scenario. Designing a good strength and conditioning program is simple: coaches provide the right stimulus so athletes can respond and adapt. My recommendation for this athlete would be to focus only on basketball. There is no need to attend a football off-season program or even a personal trainer—if the athlete insists, then communication between all of the coaches needs to take place to provide the right stimulus to this athlete so he can properly adapt.

Stacking stressors in a ‘more is better’ mindset will only lead to performance decrement and injury, says @DrRaymondTucker. Share on X

The above example can be reflective of what occurs with any middle or high school athlete, regardless of whether they participate in many sports or a single sport. Stacking stressors in a “more is better” mindset will only lead to performance decrement and injury. I pose this question again: Are we improving athletic performance, or are we part of the overtraining problem in this profession? Are we helping these athletes, or are we so worried about keeping the lights on and building our business that we have forgotten why we are in the profession?

If you think about it, you will see that some coaches are contributing to the problem of overtraining our athletes because their egos are in the way. I do not think we will ever stop this from happening for various reasons, but we can at least make a conscious effort. It starts with communication to build trust between the parents, athletes, and coaches in different environments.

Coaches should take the time to educate the parents on what they are currently doing in their strength and conditioning programs. Coaches in the private sector, high schools, and the collegiate level should build a positive relationship with each other and discuss what they are doing with their athletes in their respective programs. Coaches could also exchange workouts with other coaches to ensure that they are not working on the same buckets during their training sessions—it should also be the responsibility of the athlete to take the time to communicate with the coach prior to the start of each session.

For example, if you are a high school strength and conditioning coach and know one of your athletes is going to a sports performance center for additional training, reach out to the coach at the facility to discuss what you are doing and have done in today’s workout. If you are a coach in the private sector and a high school or collegiate athlete comes to you for additional training, reach out to the coach to see what they are doing. Every strength and conditioning coach should ask three essential questions before developing their training program.

1. Can you explain the reasoning behind what you are doing in your strength and conditioning program? If one of your athletes wants to know why they are performing a specific exercise or drill, can you explain it so they can understand its benefits?
2. Will this program reduce the chance of injury and improve athletic performance or contribute to injuries and overtraining?
3. Am I truly doing what is best for my athlete or what I like to do?

Performance Training for Performance Gains

In conclusion, strength and condition coaches need to understand that there will be some overlap that can be counterproductive, and you do not have total control of the athlete’s strength and conditioning program at the high school level. Coaches need to communicate, be flexible, and recognize how to adjust/adapt to the fact that their athletes will be exposed to stressors that are out of their control but which they have to account for nonetheless.

Coaches need to recognize how to adjust/adapt to the fact that their athletes will be exposed to stressors that are out of their control but which they have to account for nonetheless. Share on X

The strength and conditioning profession is filled with egos, and everyone thinks their program or the way of doing things is better than the next coach. In some cases, this is true, but let’s put our egos aside and learn to work together to ensure the athlete’s success. Isn’t this why we chose this profession in the first place? Our job as strength and conditioning professionals is to develop a program that reduces the chance of injury and enhances athletic performance.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

1. Haff G. and Triplett T. (2000). Essentials of Strength Training and Conditioning (4th ed.). Human Kinetics.

2. Brendon R. (2020). Coaching Rules. Target Publications.

3. Michael B. (2023). Designing Strength Training Programs and Facilities (2nd ed). Target Publications.

The field of sports performance is relatively young, and because of this, I believe it has plenty of room to grow in multiple areas. One such area is the acknowledgment that each athlete is different from a physical and psychological perspective—recognizing those differences and tailoring your program to them at certain times of the year is often overlooked. An individual’s structure will determine what I consider Superpowers versus Kryptonites.

By structure, I am specifically referring to the infrasternal angle (ISA), the angle made just below your sternum that creates a “wide” or “narrow” rib cage. I find that Narrow individuals typically tend to be more elastic or reliant on their connective tissue for movement than on muscle. Wide individuals are the opposite; they generally have more of a muscular reliance.

Referring to the infrasternal angle, ‘narrow’ individuals typically tend to be more elastic or reliant on their connective tissue for movement than on muscle. ‘Wide’ individuals are the opposite. Share on X

In my opinion, strength coaches as a whole typically only cater to one structure—at least in a majority of their programming. Consequently, the Superpower bucket is typically overflowing for some in the program, while the other type of athlete is dosed with far too much Kryptonite.

There’s a reason you’ve heard countless times that an individual in track, football, etc., ran their fastest and jumped their highest in high school. Then they got to college and trained like a powerlifter and actually got slower and less explosive in the things that are most important. And that importance is not found in back squatting and bench pressing but in running fast and jumping high.

This is not to generalize about the entire field, as there are many high-level practitioners who effectively create programming for both types of athletes; however, I still see certain athletes slowed down by an overemphasis on traditional means. I have encountered plenty of athletes in my career who would rather sprint, jump, and play tag—and who’s to say that’s any less potent of a stimulus than back squats and chin-ups?

Throughout this article, I hope to present the differences among athletes that may lend them to being more drawn to certain training modalities than others and how you can recognize these differences to create a program that benefits every athlete to the highest degree.

Avoiding Kryptonite

Early in my career, I often heard the phrase: “We got the skill position guys in this group; they’re so soft.” What did this mean? To some strength coaches, it meant that these individuals didn’t like to back squat or deadlift heavy—these athletes would roll their eyes and be reluctant to add more and more weight to the bar. The perspective of the strength coach (again, not all, but some) comes from their experience, right? Well, what is their experience?

Most S&C coaches enjoy lifting heavy weights and grinding through reps that produce tremendous amounts of internal rotation and compression. This is because their physical structure is built for this type of training. Because they themselves were born with a structure that complements this task of high-intensity powerlifting, they believe that everybody should enjoy that same thing, and those who don’t are “soft.”

What if, however, that wide receiver who avoids loading up the barbell to near-maximal intensities has a different perspective and structure? A structure that lends itself to being springy and elastic, running fast and jumping high, and spending less time on the ground; a structure that excels in quick displays of external rotation. What if their Kryptonite is actually long-duration moments of internal rotation and compression?

No wonder these athletes want to avoid powerlifting! Doesn’t Superman avoid his Kryptonite as well? Because I’ve mentioned this idea of “structures,” let’s dig into this concept in more detail to see how it relates to the differences among athletes.

Infrasternal Angles

As I mentioned earlier, when referring to “structures,” I mean the infrasternal angle (ISA) found at the base of your sternum, which determines the width of your rib cage. This angle spans a spectrum from narrow to wide. Conor Harris describes individuals with an ISA greater than ~110 degrees as “Wides” and less than ~100 degrees as “Narrows.”

Again, referring back to the introduction of the article, from what I’ve seen, the majority of strength coaches are Wides, and the minority are Narrows. I believe this is why most strength coaches hold the bias toward heavy traditional lifting being the most beneficial—because it is the most beneficial to THEIR structure. They enjoy heavy, deep, bilateral squats and typically don’t enjoy short ground contact plyometrics.

Meanwhile, your typical basketball player usually wants to avoid powerlifting but thrives with plyometrics and lighter, more explosive movements in the weight room. Why does the structure create this bias? A wide ISA has just that: a wider structure. This structure is biased toward internal rotation and compression, as stated previously. The compression within their body occurs from front to back.

Imagine the athletes are lying on their backs and being crushed like a pancake. Notice an individual who pursues powerlifting for a prolonged time, and they will begin to compress anteriorly to posteriorly and widen laterally. This leads to these individuals having more space to move in the frontal plane and also contributes to them preferring a bilateral stance, as they lack “space” to move their limbs forward and behind them (i.e., split stance exercises).

That internal rotation is present throughout the lower body, allowing the femurs to “screw into the ground” and create a large duration of force production. This transfers down to the feet as well, while the rest of the chain is biased toward internal rotation, leading the feet to be more biased toward pronation. Pronation is a position that helps drive force down into the ground for prolonged periods, contributing more to powerlifting-type movements.

Wide ISA athletes are typically more “muscular-driven” movers. To elaborate, these people will rely more on their musculature in a traditional eccentric to concentric nature to produce movement. The benefits? They have the potential to create a lot of force. The downside? They take longer to do it, making it less energy efficient.

Wide ISA athletes are more muscle-driven movers. They have the potential to create a lot of force. The downside? They take longer to do it, making it less energy efficient. Share on X

Imagine a standstill countermovement jump performed by a very muscular and wide linebacker at the NFL Combine. This test has no rate-dependent metrics; the instruction is “jump as high as you can.” This equates to a deep countermovement jump where the individual can access the big, powerful musculature of their lower body to achieve a record-breaking jump.

Put a time constraint on the jump, however—“You have to get off the ground in x amount of time”—and they will struggle to achieve that same height. Likewise, accessing all that musculature results in a metabolic cost. Contracting musculature is taxing compared to stretching connective tissue. There is no “free energy” found in relying on musculature for movement like there is with tendons. This idea of “free energy” will make more sense when we look at a Narrow ISA’s movement preferences.

To provide an objective criterion for muscular-driven movers, I begin by utilizing force plates. For a hands-on-hips countermovement jump, a more muscular-driven mover will have a more bimodal force-time curve (figure 1 below), and their rate-dependent metrics (i.e., time to takeoff) will typically be slower. They also will use a deeper countermovement depth.

It is hard to distinguish a muscular-driven athlete from an elastic-driven athlete just by looking at outputs such as jump height, as these metrics may be very similar. However, how they achieve these outputs is much more telling.

It’s hard to distinguish muscular-driven athletes from elastic-driven athletes just by looking at outputs such as jump height. However, how they achieve these outputs is much more telling. Share on X

Another test I use is a multi-rebound, four-jump test. I believe this assessment shows a strategy preference in terms of an elastic- or muscular-driven mover and also the degree to which somebody is able to rely on their connective tissue to produce movement. The Reactive Strength Index (RSI) may be very similar between a Wide and a Narrow; however, Wides typically spend more time on the ground but achieve a greater jump height to execute their RSI score.

Video 1. A four-jump test is easily performed on force plates or a contact mat. I prefer this test to a drop jump because it shows the repeated and coordinated rhythm of elastic-type jumps instead of one singular jump. Coordination and rhythm are essential qualities to consider when determining the level of someone’s elastic system. I want to measure the efficiency, not just the effectiveness, and the repeated nature of a multi-rebound test, like the four-jump, allows me to do just that.

As you can imagine, a Narrow’s structure contributes to the exact opposite; there is an external rotation bias in the lower body found at the femurs, and their feet will be more biased toward supination. All of these things contribute to this type of athlete preferring less grinding through traditional movements in favor of instead getting off the ground quickly and moving lighter weights fast, typically in a staggered or split stance. The bias toward this stance is opposite to the Wide’s preference for bilateral movements, as Narrows usually have more room anterior to posterior but are more compressed laterally.

A bilateral stance is less ideal, as it moves into that frontal plane where their structure affords them less space; a split stance, by contrast, puts limbs in front and back of the center of mass where they have more space. This split position also avoids high amounts of internal rotation. There are many more biomechanical aspects of infrasternal angles that much smarter individuals than me could explain, but this begins to paint the picture of why taking an athlete’s structure into account when determining the best training prescription is important.

From a movement strategy standpoint, Narrow ISAs are usually more elastically driven. This means they are more reliant on their connective tissue (i.e., tendons) to produce movement than their musculature. This is achieved through the musculature acting isometrically, creating a rigid base from which the tendons can stretch and recoil. The benefits? Much more reactive movement, which is actually more energy efficient.

The body is able to use the “free energy” alluded to earlier. This is because there is no metabolic cost to tendons stretching and recoiling. The downside? This movement strategy is typically limited in the long durations of force application some tasks call for (i.e., American football lineman) but great for sports like basketball, especially at the guard position.

From the same objective standpoint as above, a Narrow and elastically driven athlete may actually have lower jump heights in a CMJ test than their Wide and muscularly driven counterparts because a standstill vertical jump is much more biased toward the Wide’s strengths—especially if we don’t take into account the rate-dependent metrics and only focus on jump height.

The elastic nature of their movement strategy is typically reflected in the form of a unimodal peak in the force-time curve of their CMJ test. From a “how” perspective, a Narrow often had a shorter time to takeoff and a shallower countermovement depth.

Considering all of this, how do you create the best training plan possible? This is where my Kryptonite and Superpower program comes in.

Kryptonite Program

As we dig into this section of the article, you may begin to think, “This contradicts everything said in the first portion,” because I believe it would be incorrect to suggest that Narrow ISA athletes should never train with traditional movements at high intensity in bilateral stances. The key is that it is all about the timing and dosage. It would be ignorant to argue that these traditional movements have no benefit to athletic performance—there are qualities that these traditional movements develop that every individual needs regardless of structure.

Just as a Wide ISA individual will be called upon in their sport to elicit short ground contacts and sprint at max velocity, Narrow individuals will be called upon to produce prolonged and high amounts of force. Just ask Ja Morant when he gets switched onto Zion Williamson and must guard him in the post for a possession!

However, it is important to understand the timing and dosage of Kryptonite you give these athletes. That is really the basis for the Superpower and Kryptonite program: dose the athlete with the right amount at the right time to increase robustness and maximize strengths. Instead, though, strength coaches often dose Narrow and elastically driven individuals with these traditional high-intensity means throughout the entire year, thinking they are “peaking” them with one rep max testing right before the in-season begins.

That is really the basis for the Superpower and Kryptonite program: dose the athlete with the right amount at the right time to increase robustness and maximize strengths. Share on X

I typically use the Kryptonite program in earlier portions of the off-season, as there is still a lot of time before competition. This timing is important because training to improve weaknesses may actually decrease your key performance indicators for a short time. This is fine if you know you don’t need your athletes to be at their best for a few months.

I also adjust the dosage of this portion of the program depending on the training age of the individual. A young Narrow may train with traditional means for longer than a Narrow who has trained with me for years. This is because I want to build a large foundation and “raise the floor” with the younger athlete before transitioning to trying to “raise the ceiling.”

I am, however, trying to heighten and “raise the ceiling” of the older individual’s “Superpowers” as much as possible. For example, that younger athlete may train within the Kryptonite program for six weeks of an eight-week off-season, whereas the older individual may only train two weeks out of an eight-week off-season.

So, what does the Kryptonite program entail?

After reading the initial section of this article, I’m sure you can piece it together yourself, but let’s discuss some details. For my Narrow and elastically driven athletes, the Kryptonite program more resembles a traditional training program, and I take time to load them in bilateral stances with increasing intensities. As stated earlier, this may decrease specific KPIs (but in some cases, improve KPIs, especially with younger athletes), and they may be reluctant to dive into this style of training—but after discussing the benefits and the act of improving weaknesses, there is typically much more buy-in.

It’s important to state that these aren’t the only weeks throughout the entire year that you expose these athletes to this traditional style of training; however, this is the highest dosage you should give them. You may dose these methods in small amounts throughout the rest of the year to maintain the “floor” you built during this portion of the annual plan. During this time, you also dive into more traditional powerlifting-type movements, such as deadlifts and bilateral pressing and pulling. Allow your Narrows to develop the foundational strength and hypertrophy that will help them when they aren’t able to rely on their Superpowers.

Throughout this phase, I want to see a couple of things occur with our force plate jumps. First, for the CMJ, I’d like to see jump height go up, but as a product of a greater countermovement depth and even a slightly slower time to takeoff. It is important to remember that jump heights typically decrease during this period because of the intense training; however, the how continues to be important.

You may also begin to see these athletes start to shift their unimodal force-time curve to slightly more bimodal. This is okay! It’s the time of year that we want these things to occur before we begin applying stressors that increase these metrics in an opposite fashion. I’d like to see ground contact time and jump height increase during the four-jump test. The overall RSI may not change, but the strategy is now transitioning to more of a muscular strategy.

Video 2. Remember, the “how” of the CMJ is more important than the absolute outputs. I am less concerned with the jump height than with how that individual achieves that jump height.

The Kryptonite program for Wide ISA and muscular-driven athletes will include the opposite of what the Narrows are doing. I take out all bilateral movements and typically don’t load them with higher intensities. I challenge them to produce as much force as possible in a short time frame, in a shorter range of motion with light loads. I expose these individuals to progressing volume in extensive plyometrics, put them in unilateral positions for both lower and upper body training, and also expose them to movements that involve rotation, such as crawling, rolling, and gymnastic activities.

Objectively, when I go through the Kryptonite phase, I like to see a few things happen that are opposite to what a narrow and elastically driven athlete strives for on the force plates. I am less concerned with jump height scores, and a more rapid decrease in jump height is fine in my view, as long as these athletes are using a shorter time to takeoff and a shallower countermovement depth.

My overall goal with the Kryptonite program is to transition Narrows to behave more like Wides and vice versa. The Superpower program resembles the Kryptonite program, but the groups flip. Share on X

During the four-jump test, I like to see these individuals begin to transition to a shorter ground contact, even if their jump height doesn’t change. My overall goal with the Kryptonite program is to transition Narrows to behave more like Wides and vice versa. Develop the qualities the other excels in before transitioning to the Superpower program in a few weeks.

Superpower Program

The Superpower program resembles the Kryptonite program, but the groups flip. The Narrow and elastically driven athletes now train the way the Wides and muscularly driven athletes did in the Kryptonite phase, and vice versa. While this may be slightly redundant, this looks like:

Narrows and Elastically Driven Superpower Program

• Avoid high-intensity, bilaterally loaded exercises that will force excessive and prolonged exposures to internal rotation.
• Avoid loading in a way that will create increased levels of compression (bilateral, both upper and lower body).
• Rely on staggered and split stances for lower-body movements.
• Focus on the speed of movement rather than the intensity of movement.
• Allow movements to include rotation and freedom, especially with upper-body training.
• Include variation to plyometric training with more elastic-based movements (i.e., fewer “stand still” vertical jumps and more single-leg approach jumps).

Video 3. My time at UC Davis with Men’s Basketball was the first time I unveiled this Superpower program, and it has been under constant refinement since. I considered these athletes to be elastically driven OR so far on the muscularly driven spectrum that I wanted to expose them to more elastic training. It’s important to note that I still include elements of muscular-driven movements, but the overwhelming majority of the program is elastic training.

For objective measurements on the force plates:

CMJ

• Jump height goes up.
• Time to takeoff goes down.
• Countermovement depth becomes shallower.
• Sharp unimodal peak.

Four-Jump

• RSI improves primarily through decreased ground contact time.
• RSI improves secondarily through increased jump height.

Wides and Muscular-Driven Superpower Program

• Allow these athletes to get back under some higher intensity load in bilateral stances and grips from a lower and upper body training perspective.
• Allow for more time to generate force with our faster movements and load them slightly heavier than the Narrow and Elastic Superpower program.
• “Peak” by hitting high-intensity movements (1–3 rep max) close to the season. I believe this not only creates physiological benefits but also psychological benefits, so they “feel” their strongest heading into a season.

Video 4. These individuals were either muscular-driven or young athletes who needed exposure to more traditional training to lay a proper foundation.

For objective measurements on the force plates:

CMJ

• Jump height goes up.
• Time to takeoff goes down.
• Countermovement depth becomes deeper.
  • Ideally, by this point in the year, these individuals have developed enough of the elastic qualities required and heightened their Superpowers so that they are able to achieve a faster time to takeoff with increased countermovement depth. This involves them moving through the loading phase of the CMJ faster and slamming on the brakes rapidly.
• Bimodal peak that transitions from secondary to primary or primary to unimodal.

Four-Jump

• RSI improves primarily through increased jump height while ground contact time holds steady or slightly improves.

It is important to note for this phase of training that we will be getting closer to the preseason period when coaches are given more time for the actual sport, and it is essential to prepare the athletes to withstand that increase in volume as well as try to maximize Superpowers. For example, while Wides may not thrive with excessive amounts of plyometrics, increasing volume in that area is essential to build resiliency in both archetypes for what sports typically entail.

Speed development is also progressed concurrently with this program, and I typically look to touch my highest outputs (velocity) and develop a robust repeat sprint ability through protocols like 10 x 10 (made popular by Derek Hansen), regardless of what program the individual falls within. The next development within the Superpowers program is to begin individualizing the speed development portion of training, tailored to archetypes, strengths and weaknesses, movement strategy preference, and training age.

Incorporating the Concepts with Your Athletes

As I stated in the introduction, alluding to experiences from my past, I don’t believe those strength coaches were trying to be ignorant by saying that certain athletes they were training were inherently “soft” because they didn’t like squatting heavy. It just takes an introspective approach to realize that not every person has the same frame of reference as you.

I’ve heard from multiple individuals within this program, specifically the Elastic Superpower group, that they feel so much better going into a season. They feel light and springy, not stripped of what makes them special by grinding them through heavy bilateral movements.

The idea of ‘peaking’ an athlete by having them ‘PR’ their squat and bench before the season is a completely outdated way of thinking. Share on X

The idea of “peaking” an athlete by having them “PR” their squat and bench before the season is a completely outdated way of thinking. Continue to do this, and these elastically driven athletes will step onto the court for game one, missing their most powerful weapons. This might sound dramatic, and I agree that athletes are highly resilient; however, the goal is to optimize training for every individual.

Everybody is different. Everybody falls somewhere on the Narrow to Wide and elastic-to-muscular-driven spectrum, and it’s important—and, dare I say, imperative—to take that into consideration to create the best possible program for our athletes and get the absolute most out of them. Give structures, Superpowers, and Kryptonites a chance.

As always, with anything I write, please feel free to reach out with feedback, either bad or good, and/or any questions you have! Let’s continue to try moving the needle.

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