Category Archives: Muscle Physiology

“You’re All a Bunch of Pathetic Weaklings,” Says the Steroid Using Powerlifter

“Why is it, that weak lifters always have to make the claim that stronger people are using steroids?”

Recently, an anabolic steroid using powerlifting poked fun of me (a natural lifter) for being weak. When I asked him if he used steroids (I already knew the answer to the question), rather than answer me, the anabolic steroid using powerlifter replied with the question above.

I would now like to take the time to answer this question. Here’s why.

Anabolic steroids make the average lifter WAY stronger and more muscular. When steroids are added to the mix, it changes the rules.


For the record, I have no problem with lifters who use anabolic steroids. Dozens of lifting partners of mine over the years have used them, and I honestly couldn’t care less, as long as they went about it in a wise and safe manner. However, I have a HUGE problem with anabolic steroid using lifters who poke fun of natural lifters for being weak. In fact, I believe it’s one of the most deplorable things I see on the internet. Think about it – these individuals are taking substances that artificially make them bigger and stronger, then going around and bullying lifters who are natural. If you do this, it makes you absolutely pathetic.

Lately, I’ve seen an onslaught of comments from steroid-using powerlifters that are quite puzzling to say the least. Here are two of them: “Steroids don’t do the work for you, sure they help you recover faster but you still have to put in the work,” and, “Natural lifters love to play the steroid card, but 90% of it is hard work, nutrition, and consistency.” WHO DO THEY THINK THEY’RE KIDDING? Do these guys really believe this? Steroid-using powerlifters and bodybuilders don’t work any harder than natural powerlifters and bodybuilders. We all put in the work, it’s just that steroid-users have drastically altered physiology which causes them to see much greater gains.

In my experience, many steroid-users grossly underestimate the role that steroids play in their strength development. I’d have a lot more respect for the lifter who admitted that without steroids, he’d be pretty ordinary in terms of strength and physique. In fact, one of my lifting friends openly admits this, and it cracks me up. He’s a jacked cop (ironic, I know), and he’s said on numerous occasions that, “Man, before I took roids, you could barely tell I lifted weights. Now guys envy my physique and women flock to me.” This guy is honest to a fault, but he makes us all laugh.

Many steroid-using powerlifters don’t have a good grip on what transfers best for the natural lifter, and they don’t optimally understand program design for the natural lifter. Why? Because many of them have never controlled variables. Fluctuating drug cycles confound training/nutrition cycles. Because when the going got tough, many of them simply took more steroids. Many figure out quickly that taking another gram of testosterone or adding in trenbolone transferred very well to strength and got them through their training ruts. Because it came too easy for many of them. Most never spent 8 months hammering the bench press, only to gain a meager 10 lbs of strength. Many never took the time to learn the effects of different protocols. When they were stagnating, many simply took more juice.

It reminds me of this Robert DeNiro speech in Limitless.

As a consequence, I’ve found that many training programs written by steroid users are too harsh for natural lifters; some of these programs contain excessive volume which the average natural lifter could not recover from. This is why it’s important for lifters and coaches working with natural lifters to train naturally themselves (or at least cycle on and off for ample amounts of time) and to train or train with natural lifters.

Now that I’ve gotten that off of my chest, I’d like to discuss some aspects of testosterone and androgen usage. There are several articles that I will call upon, which are linked below. Please click on them if you’d like to download the full papers.


Testosterone dose-response relationships in healthy young men


Testosterone Concentrations in Women Aged 25–50 Years: Associations with Lifestyle, Body Composition, and Ovarian Status

Testosterone Facts

The first thing you should know about testosterone is how much a normal person makes. Healthy men produce approximately 4.0–9.0 mg of testosterone per day, with blood concentrations ranging from 300 to 1,000 ng/dL (10.4–34.7 nmol/L). Females typically make 1/10 to 1/20 of this amount and have blood concentrations in the range of 15 to 65 ng/dL (0.5–2.3 nmol/L).

So, if you’re a male, your testicles pump out approximately 7 mgs/day of testosterone. In males, around 95% of this testosterone is made in the Leydig cells of the testis, whereas 5% is made via conversion in the adrenal cortex. Around 2% of this testosterone is free (unbound) in the bloodstream, whereas 35-38% is bound to albumin and 60-63% is bound to sex-hormone-binding-globulin (SHBG). In women, around 50% of testosterone is produced through peripheral conversion of androstenedione, with the remainder of production concentrated in the ovary (25 percent) and adrenal cortex (25 percent).

Quantities Taken by Elite Lifters

Now let’s look at what amounts the top lifters are taking. Here is a quote from a recent Ryan Kennelly video. For those of you who don’t know who Ryan Kennelly is, he used to be the strongest geared bench presser in the world, until he got put behind bars for selling steroids and other drugs. Here’s what Ryan had to say about steroid use and strength development.

“Basically later on in life instead of getting steroids from my friends and having to buy them, I got on the internet and realized that they can be purchased on the Internet in raw form. Basically testosterone powder and all the raw forms of the ingredients and it was much cheaper. So I invested in that because in 2003 when I benched eight hundred and knew I had to go for 900 I knew I needed a large amount of steroids.


The amount that I was taking like I referenced earlier, waking up to three syringes which was nine cc’s pointing up in the air in the bathroom when I woke up each morning. I also ended up going to the ranch home store because, why have three needles when you can buy a large syringe that were used for horses that had like 25 CC’s/25 milliliters and just fill that up? So the amount of steroids that I had were for personal use and not for resale or distribution.

Let me make a point, the amount that I was taking in 2003 consisted of at that time, going for 900 pounds, I was taking twenty five hundred milligrams of testosterone a week, eight hundred milligrams of nandrolone deconate a week, 75 milligrams of dbol a day and there was also fast-acting testosterones that I was taking upwards of a hundred milligrams of those a day.

The long-acting testosterone from my calculations the plasma half-life is about 14 days they kick in in about seven days but seven days wasted I need some that’s kicking in now. I would take testosterone propionate or testosterone no ester that I would make up myself in oil with sterile alcohol, sterile needles, sterile syringe filters. I would make bottles of it because I was going through upwards (bottle holds pan 10-13 milliliters of liquid) through roughly 10 bottles every 10 days at the time.


At that point it didn’t seem like a lot because if you know anything about injecting and how steroids work in the body, there are things your body called receptors. They are like flowers and after a while your flower start to will, meaning the amount you’re taking to 1500 milligrams and you’re not getting the desired effect. This is because your body is not accepting it so in return you take more. Or you take more of a different ester like testosterone cypionate is one ester.  You take twenty five hundred milligrams. Once your body gets used to that, you change to testosterone enanthate, which can attach it to a different receptor.

By juggling these things at the time you learn that you can only inject so much. Your body can only handle so much injected into itself. Then you start consuming these oral powders and using insulin as a transport drug. What insulin does is it unlocks the cells in your muscle and it is very dangerous taking insulin. People could die and it’s something you go to your local Walmart and buy a bottle of humulin-r insulin for twenty-five dollars. Basically what insulin does is it shuttle’s all what you consume in your body into your muscle.

So basically I was taking the steroid powders, taking a tablespoon of certain ones adding it with orange flavored tang and I would drink these throughout the course the day. I would inject this medium acting insulin that in my mind, according to other athletes I spoke with at the Arnold classic and other athletes from overseas, this a technique that they are using now. They claimed increased water retention increased size and increase strength.

images (1)

So on top of injecting 3- 4,000 milligrams a week I was also consuming orally as time went on. This upset my stomach, made me pale, and made me puke. That didn’t last very long because you cannot lift and gain weight when your pale sick and puking. In my mind that’s not going to be what benefits you in the long run.”

Ignoring the fact that Ryan was wrong about some of his steroid knowledge, he confesses to taking the following amounts of steroids:

  • 2,500 mgs testosterone enanthate per week
  • 800 mgs of deca durabolin per week
  • 75 mgs of dianabol per day (525 mgs/wk)
  • 100 mgs of testosterone propionate per day (700 mgs/wk)
  • 4,525 mgs of anabolic steroids per week

6dc6c_ORIG-Ryan_Kennelly_Double_BicepsWhen Ryan wanted to get to a 1,000 lb bench press, he knew he needed even more steroids. He didn’t mention that he needed another two years of solid training, where he’d periodize his training and implement strategic assistance lifts at various time points. It was all about the steroids. He knew that this amount would take him to this level, and to get to the next level, he’d need to take this amount. At any rate, let’s compare the milligrams of androgens for a natural lifter and world class bench presser:

Natural Lifter: 7 mgs testosterone/day
Ryan Kennelly: 646 mgs androgens/day

It has been reported that many top bodybuilders will take between 1,000-2,000 mgs/wk of anabolic steroids per week, with some reaching up to 5,000 mgs/wk (see HERE, HERE, and HERE). I’ve heard rumors of powerlifting gyms bragging that their main lifters take a minimum of 3,000 mgs/wk of testosterone as a base, while adding orals on top of it. As I mentioned earlier, normal blood levels of testosterone range from 300-1,000 ng/dL. It has been reported that pro bodybuilders tend to have testosterone levels of around 3,500 ng/dL, with a maximum of 21,000 ng/dL (see HERE), but keep in mind that they’re taking a lot more than just testosterone (they also might be taking steroids with names such as Deca-Durabolin, Dianabol, Winstrol, Primobolan, Equipoise, or Trenbolone, along with other drugs such as IGF-1, Cytomel, Human Growth Hormone, and Clenbuterol).

What Does Testosterone Do? 

Here are the various effects of testosterone:

  • Increases lean body mass
  • Increases cardiac tissue mass
  • Decreases body fat percentage
  • Increases isometric and dynamic muscle strength and power
  • Enhances recovery ability between workouts
  • Increases protein synthesis, accretion, and nitrogen retention
  • Decreases catabolism
  • Increases muscle cross-sectional area
  • Stimulates growth of the epiphyseal plate
  • Increases erythropoiesis, hemoglobin, and hematocrit
  • Increased vasodilation
  • Increases bone mineral content, density, and markers of bone growth
  • Regulation of osteoblasts, bone matrix production, and organization
  • Increases glycogen and creatine phosphate storage
  • Increases lipolysis and low-density lipoproteins and decreases high-density lipoproteins
  • Increases neural transmission, neurotransmitter release, myelinization, and regrowth of damaged peripheral nerves
  • Repression of myostatin
  • Behavior modification (i.e., aggression)
  • Acute elevations in skeletal intramuscular calcium concentrations
  • Decreases sex hormone binding globulin (SHBG)
  • Increased androgen receptor density (depending on the androgen, the dose, the duration, the muscle, and the tissue)
  • Increased satellite cells and androgen receptors in satellite cells

Many are aware of some of these effects, but most aren’t aware of all of them. Testosterone works through a variety of anabolic, anti-catabolic, neural, and psychological mechanisms.

How Does Testosterone Effect Strength, Hypertrophy, and Body Composition?

Hopefully you downloaded the articles that I linked earlier and can explore the studies to a greater extent, but here are a couple of highlights from two of those papers:

In the following study, subjects were given either 25 mg, 50 mg, 125 mg, 300 mg, or 600 mgs of testosterone per week. The graphs below illustrate that testosterone’s effects on hypertrophy are fairly linear.


In the study below, subjects were given 600 mgs/wk of testosterone. In the group that exercised, this caused total testosterone levels to raise by approximately 800%, and free-testosterone levels to raise by over 600%. As you can see below, taking ample testosterone is better for hypertrophy than lifting weights, and taking testosterone on top of exercising is markedly better for strength than exercising-alone.


Anabolic Steroids are Used with Females Too

Most people assume that anabolic steroids are used only by males, but many top female powerlifters, top female bodybuilders, top female figure competitors, and even top female bikini competitors take anabolic steroids too. They do not openly discuss this, as they would be judged and ridiculed too extensively, but nevertheless it’s happening all over the world.

In this case, they don’t take testosterone as it’s more harsh for women and leads to too many undesirable side effects. Therefore, they’ll often take oxandralone (aka Anavar), which has a favorable anabolic: androgenic ratio for women. Because women typically possess 5-10% of the blood levels of testosterone that men do, they tend to respond very well to small doses of androgens such as oxandralone.

For this reason, often the routines espoused by steroid-using female lifters tend to not be progressive enough for natural lifting women.

It Goes Both Ways

While the steroid-using lifters need to be sympathetic of the natural lifters, the natural lifters also need to be sympathetic of the steroid-using lifters. Many natural guys tend to assume that if they did a steroid cycle, they’d blow up and be just like Dan Green. First of all, just like with natural lifting, there’s a large inter-individual variation in the response to steroids. Some guys blow up and other guys don’t grow too much. Second, these guys should certainly be respected as they’re putting a boatload of weight on their backs or in their hands every day. One minor mistake can lead to Snap City. When you’re squatting 3 hundy, you have more wiggle room with improper form, but with a grand, your form better be spot on. This is why bodybuilders often adjust their programs so they’re not using so much weight on big lifts, for example utilizing pre-exhaustion techniques, high reps, drop sets, ultra-strict form, and pause reps.

Finally, the life of a steroid-user is not as glamorous as it seems. Steroids are expensive and illegal. They can do jail time if caught, and there are a lot of ancillary drugs and supplements that must also be taken to minimize the damage to their organs or to keep certain hormones in normal ranges (ex: Nolvadex). Their bloodwork (hematocrit, cholesterol profile, etc.) and blood pressure is often atrocious. They battle with sleep apnea and fluctuating moods and sex-drives, and many have trouble performing simple daily task such as wiping their butts or washing their backs. Last, their caloric intake is much higher (and expensive), and it becomes a chore to meet calorie and protein requirements day in and day out. The grass is not always greener on the other side.



Most of us lifters couldn’t care less if our colleagues experiment with anabolic steroids. Personally, I don’t judge lifters who take roids. However, I do have a problem with steroid-using lifters who surf the net and poke fun of natural lifters, and with steroid-using lifters who deny or attempt to understate their efficacy. If you take anabolic steroids, remain humble and enjoy your expedited strength and hypertrophic gains. Ripping on natural lifters when you take steroids make you a pathetic, mentally-fragile bully.

Ten years ago, I did some MMA training for a couple of years. We had around a dozen gym rats come through our doors during this time, and most of them only lasted a day. They’d get choked out or pounded around by guys half their size, and the vast majority had egos that got the best of them which enticed them to quit on the spot. I can’t help but wonder if some of these same bullying powerlifters would poke fun of the much weaker MMA fighters if they were face-to-face. If so, they’d get their butts handed to them. I respect powerlifting strength very much, but I respect humility even more. At any rate, I hope this article sheds some light on why natural lifters “play the steroid card” when steroid-using lifters are talking smack.


How Does Foam Rolling Work? And Why “SMR” Should be Called “SMT”

Today, I’m going to share a discussion on Facebook that I recently had with Todd Hargrove and Greg Lehman. I’m not always confident with my understanding of things, but I’ve developed great “go-to guys” over the years when I’m seeking answers in various topics, and Todd and Greg are well-versed in areas pertaining to manual therapy.

I lift weights every day with a ton of strong dudes. Nearly all of them foam roll. I foam roll and use the stick and a lacrosse ball too. Are we all just a bunch of dumb meatheads falling prey to The Placebo Effect? Or is there more to foam rolling than meats the eye? Are we changing mechanical properties in the fascia? Or are there other mechanisms at play?

Over the past decade, strength coaches have come up with a number of potential mechanisms to explain how and why foam rolling is working. Though these theories made sense at the time, most of them are now outdated. I hope you appreciate the conversation.

foam rolling


Hey Todd and Greg, I want to write a blogpost about “How Foam Rolling Works” and pretty much repeat what Todd wrote about DNIC. I’m going to link to blogposts that you have written. But I wanted to ask you all whether or not you think there’s any merit in Schleip’s thoughts here:

And, do each of you agree that DNIC makes the most sense in regards to how foam rolling works? Thank you very much for your time, Bret


Hi Bret, I think there is some merit in Schleip’s ideas, and I discussed them briefly in my paragraph titled “4. Does Foam Rolling Work by Proprioceptive Stimulation?” My answer is that stimulation of mechanoreceptors is probably part of the story, but I think DNIC is a better explanation.

Someone pointed out in the comments to my post that Schleip has new proposed mechanism – something like squeezing water from a sponge. (See the comment by Margy) I never looked into it, but I noticed Chaitow referenced it recently in an FB post.


Thanks Todd! Greg, I would appreciate your thoughts. All of my lifting partners swear that foam rolling has made their muscles more pliable over time. I’m inclined to think that they’re full of it and that they’re just imagining things, but if Schleip’s theory is correct then it could make sense.


Two thoughts:

1. I would guess there is a transient increase in stretch tolerance and ROM after foam rolling. Your friends might then go train a little easier at end ROM and it is this new training and confidence at end ROM that ends up increasing their extensibility or comfort with new ROMs.

2. Pain reduction: I would not put this solely on DNIC. People will certainly report pain relief without having to mash the shit out of their tissues. I would guess that the pain relief mechanism is the same as every other pain relief mechanism from manual therapy or movement. Meaning we probably don’t know but its a lot of little things that deal with the resolution of our pain output. This could be all the non-specific effects we talk about: fuzzy homunculus, refreshing the sensory cortex, beliefs about treatment and satisfying an expectation, paying attention to the area etc. If someone can tell me what manual therapy does then we can probably say that that is what foam rolling does.

I certainly don’t think scar tissue or mechanical adhesions are being removed.

As for long-term changes I suppose it is possible that the tissue might change via mechanotransduction if the load is consistent and frequent over time. I don’t know why this would make some more pliable it seems just as likely to make the tissue more robust.

Sorry, no good answers there.


BTW, Chaitow recently referenced Schelip’s research on water extrusion, which I haven’t read. Here’s a good quote, which supports my idea that if foam rolling has any benefit, it is temporary, but opens up a “window of opportunity”:

“Schleip and Klingler observe temporary easing of stiffness after water is extruded from fascial tissues, returning to stiffness as it is resorbed (after 20-30 minutes)…this window of reduced stiffness offers chance for mobilization etc, but does not seem to account for sustained reduction in stiffness.”


Let’s try to form a current consensus between us:

Theories that are out are:

1. Pizoelectricity – liquid crystals spark and realign tissues

2. Thixotropy – fluid-like flow from agitation

3. Fuzz – unsolidification of loose connective tissue

4. Scar tissue and adhesion removal – breaking down scar tissue and removing adhesions

5. Trigger point therapy – releasing trigger points

6. Myofascial meridians – affecting one part of the body’s fascia impacts the whole chain

But still on the plate are:

1. Increased stretch tolerance – transient decrease in stretch-related pain sensation

2. DNIC – pain distraction

3. Placebo effect – believing makes it real

4. Refreshing the somatosensory cortex – clearing pain-related “defaults” in the brain/body

5. Proprioceptive stimulation – transient decrease in muscle tone due to mechanotransduction

6. Spongy window – dehydrating tissue followed by a subsequent rehydration, with a window of opportunity in between

Are these correct?

What else is in, or out?

Should self-myofascial release be given a new name? If so, what 3 letter acronym?


With #3. Placebo isn’t really the right word. Use it. But clarify that there are really effects behind it. Expectation and satisfying that expectation being one of them. I don’t know this stuff off the top of my head but that paper by A Louw on A neuroscience approach to low back pain in athletes would probably touch on it.

But honestly, if we solve why manual therapy works then I bet we can say why foam rolling helps with pain.


Hi Bret, those look good. Here are a few comments, each of which are pretty trivial.

First, in reference to the meridians idea, I would not disagree that causing structural changes to the fascia in one area would have mechanical effects in another area. I just disagree with the idea that foam rolling could affect the fascia.

Second, I might somehow combine numbers four and five of the second list. In other words, the effects on the somatosensory cortex are due mostly to proprioceptive stimulation.

Third, the “window of opportunity” applies to more than just the sponge. It would also apply to any other mechanisms (e.g. DNIC) which would create temporary benefits in mobility or pain reduction.

Fourth, I haven’t read anything at all about the water/sponge theory so I have no idea whether it “holds water.” Ouch!

Oh, and in regard to your question about the term “myofascial release”, I don’t like that term at all as applied to foam rolling or any manual technique. It is describing a theoretical and implausible mechanism of effect, as opposed to the actual technique.

Therefore, it’s confusing and causes people to assume that when you are foam rolling, you are releasing fascia, even though there are many other ways that foam rolling might cause changes to your movement that have nothing to do with fascia.

Calling foam rolling MFR is like calling sit ups “ab shredding.”


Awesome stuff guys! So it should be called…..wait for the drumroll…..Self Manual Therapy (SMT)?


SMT sounds great. That way, no one will be confused about what you are taking about.


If you find this interview to be interesting, here are some more links you can check out:

Paul Ingraham on trigger points

Todd Hargrove on the mechanisms of how foam rolling works (and how it doesn’t work)

Greg Lehman on fascia science

Todd Hargrove on fascia

Alice Sanvito on how we can’t stretch fascia

Paul Ingraham on fascial neurobiology

Chris Beardsley summarizing current research on foam rolling

foam rolling

Glute Science

Last week I made an appointment with a PhD Anatomy professor to visit his laboratory and examine the muscular anatomy of cadavers. I’ve seen cadavers in the past, but now that I’m much more knowledgeable, I got much more out of the experience. Seeing the glutes in this state really allows you to envision their functional roles and capacities. Here are six glute facts that I’d like to share with you today:

1. The gluteus maximus does its thang through myofascial force transmission

Having actually felt the fiber insertions of multiple cadavers, this is what stood out to me the most. The vast majority of glute fibers insert into fascia. Textbooks say 70-85% but it might be even higher. Only a small percentage insert onto the gluteal tuberosity of the femur. See the pic below – the red insertion portion shows how much of the glute max inserts onto the leg – the rest (blue) inserts into the fascia lata (especially the iliotibal tract).

gluteus maximus

The fascia lata wraps around the entire leg. When muscles such as the gluteus maximus and tensor fascia lata contract, they “tense” the fascia lata which compresses the entire thigh region, which influences muscular contractile biomechanics. See THIS article – the fascia lata is more than just a stocking. In this manner, the gluteus maximus will influence the biomechanics of the entire leg musculature through myofascial force transmission

Last year I showed you how the gluteus maximus greatly enhances knee stability during the lunge exercise HERE, through its influence on the tibia via the iliotibial band. The gluteus maximus has far-reaching influences across the body due to its fascial connections.

2. The deep sacral fibers of the gluteus maximus stabilize the sacroiliac joint

Having read THIS article on the deep sacral fibers of the gluteus maximus a couple of years ago, I was on the lookout to see this in the cadavers. The gluteus maximus contains short fibers deep into the muscle that cross the sacroiliac joint (SIJ) and most likely contribute to the stability of the structure (some fibers attach to the sacrotuberous ligament and can influence stability through this route too), thereby preventing low back pain. The SIJ appears to be implicated in approximately 25% of low back pain incidents according to THIS and THIS review, so this is quite important!

sacrotuberous ligament

3. The gluteus maximus is well-built for hip external rotation

When you examine the fibers of the gluteus maximus, you can envision how they’d be well-suited for hip extension. However, it’s also quite apparent how effective their design is for hip external rotation. My EMG studies show that the gluteus maximus is HIGHLY recruited during band hip rotations and Pallof presses, and other research shows that the gluteus maximus is highly recruited in throwing, swinging, and striking actions in sports. To quote Professor Neumann in Kinesiology of the hip: a focus on muscular actions:

“The gluteus maximus is the most potent external rotator muscle of the hip. This suitably named muscle is the largest muscle of the hip, accounting for about 16% of the total cross-sectional area of all hip musulature. Assuming that the gluteus maximus muscle’s line of force is directed approximately 45° with respect to the frontal plane, maximal-effort activation would theoretically generate 71% of its total force within the horizontal plane (based on the sine or cosine of 45°). All of this force could theoretically be used to generate an external rotation torque.”

gluteus maximus2

Basic trigonometry shows that 71% of the muscle force created by gluteal contraction can translate to external rotation torque! Here’s a good beginner movement for teaching the gluteus maximus of the rear leg to produce hip external rotation torque in order to counteract (stabilize) the hip internal rotation torque induced by the band.

4. The lower gluteus maximus fibers don’t adduct the hip; electromyography (EMG) trumps functional anatomy  

I’ve seen dozens of textbooks and articles claiming that the lower fibers of the gluteus maximus produce hip adduction. For example, see HERE, HERE, HERE, HERE, and HERE.

When examining the fibers, it looks like the lower gluteus maximus fibers would indeed aid in adduction. Some of the fibers insert into fascia located near the medial side of the femur, which would make it seem that they’d be capable of producing adduction. However, herein lies the problem with just relying on functional anatomy for knowledge of biomechanics. In order to produce the movement, the lower fibers of the gluteus maximus would need to be activated during adduction movements.

In my experiments, I’ve been unable to detect any lower gluteus maximus activation in all the subjects I’ve tested during adduction maneuvers. Karlsson & Jonsson reported the same findings 48 years ago in 1965. To quote the authors,

“Accordingly the results to not seem to bear out Kopsch’s (1955) hypothesis that the distal portion of the gluteus maximus can act as an adductor of the thigh.”

So it appears that this misconception arose 58 years ago in some German textbook as a hypothesis via examining anatomy. But if theories don’t jive with experimental findings, then they need to be dropped.

adductor machine

Ain’t no gluteus maximus activity goin’ on here!

5. Gluteus maximus moment arms in the literature are highly underestimated  

A moment arm is an measurement of a muscle’s leverage (in this case it would be deemed a muscle moment arm or an internal moment arm). This is important data in biomechanics, as it allows one to estimate a muscle’s torque capacity. To quote Channon et al.,

“Muscles facilitate skeletal movement via the production of a torque or moment about a joint. The magnitude of the moment produced depends on both the force of muscular contraction and the size of the moment arm used to rotate the joint. Hence, larger muscle moment arms generate larger joint torques and forces at the point of application.”

When researchers measure the moment arms of muscles, they utilize different techniques. Sometimes they use cadavers, often of frail or older individuals (cadavers are dried up and flat). Sometimes they use CT scans, but the subjects are typically positioned supine which flattens out their glutes.

Check out the picture below. Look how close the glute max is going to be positioned to the hip in the saggital plane. This will yield a small moment arm measurement.

gluteus maximus3

The gluteus maximus moment arm of an upright, athletic individual will be greater, and this will be even more pronounced when the gluteus maximus is contracting. Check out the picture below – the gluteus maximus moment arm is going to be markedly larger in this situation.

Glute moment arm

There is currently no research examining gluteus maximus torque capabilities in athletic subjects during athletic endeavors. For example, I bet that sprinters’ glutei maximi during sprinting or powerlifters’ glutei maximi during hip thrusting (or simply during MVC’s) would yield considerably greater gluteus maximus moment arm measurements, and the PCSA is affected too due to changes in pennation angle during muscle contractions.

If this is the case, and I’m pretty sure it is, then the strength and power potential of the gluteus maximus is underestimated in the literature. Sure you could say the same for other muscles, but I suspect that it’s underestimated to a greater degree in the gluteus maximus compared to other muscles.

Carmelita Jeter, second fastest woman of all-time

Carmelita Jeter, second fastest woman of all-time

6. Genetics Highly Influences Glute Size  

The anatomy professor insisted that I inspect the smallest gluteus maximus specimen (belonging to a cadaver of a frail, elderly individual), as well as the largest gluteus maximus specimen (belonging to a middle-aged mammoth of a man).  A few months ago I wrote about glute genetics HERE and reported that there is an inter-individual variation of 500% in terms of gluteus maximus volume, meaning that some folks have 5X the glute size of others. In inspecting the specimens, this became apparent. For the unlucky individuals with poor glute genetics, luckily they now have Strong Curves and Get Glutes for some guidance and hope!

bikini glutes

What You Need to Know About Rhabdomyolysis: Insights from the University of Iowa Incident

In the last Strength of Evidence Podcast Episode, Ms. Jenny Sinkler, Jon Fass and I discussed exertional rhabdomyolysis. I confessed to not being comfortable with my familiarity of creatine kinase levels following various training protocols. Just recently I stumbled across a brand new study involving the infamous University of Iowa incident from 2011. I decided to review the study along with a couple dozen others in order to educate myself on the topic. I’d like to share with you my findings. Near the bottom of this article is the information from the new study involving the University of Iowa.

What is Exertional Rhabdomyolysis (ER)? 

Here’s a chart from THIS paper that summarizes ER:


What is the Best Indicator of ER?

There are several things that doctors will look at, including creatine kinase (CK) levels, creatinine, myoglobin, and various ratios of these. CK appears to be the gold standard, but as you’ll see below, there’s more to the big picture than just examining CK.

High Variability with CK Levels Following Exercise

While CK is the most commonly used indicator for ER, there is high variability between subjects. In fact, there are “high-responders” and “low responders,” in terms of CK output following damaging exercise.

For example, THIS study ran two experiments: one where subjects did 20 minutes of stepping exercise (one leg did concentric step ups and the other did eccentric step downs), and another where subjects kept exercising until failure. There were three subjects in the latter group, with one lasting 50 minutes, another lasting 60 minutes, and the other lasting 120 minutes. The subject who lasted 50 minutes had a CK level of 34,500 mU/mL, the subject who lasted 60 minutes had a CK level of 1,698 mU/mL, and the subject who lasted 120 minutes had a CK level of 2,643 mU/mL. This shows that the same workout produced 20X higher CK levels in one subject than another.

Moreover, THIS paper reported a subject who experienced ER who had a CK level of only 700 IU/L, so high CK levels aren’t necessary for ER diagnosis. Finally, THIS paper showed that 9/12 football players exhibited over 10 times their baseline levels of CK (average of 5,125 IU/L) during ten days of 2 practice/day sessions over the preseason, yet none were hospitalized for ER, complained about symptoms, or had to suspend activity.

Therefore, it’s important to look at other criteria for ER such as urine color, muscle pain, nausea, weakness, headaches, difficulty with movement, decreased joint ROM, cramping, and swelling.


Estradiol and CK

THIS study shows that estradiol exerts a protective effect on muscle damage and can decrease elevations in CK, indicating that women will experience different results depending on where they are in their menstrual cycle. THIS paper states that based on the available evidence, women don’t experience less muscle damage than men, but their inflammatory response may differ.

What are Normal Creatine Kinase Levels, and How do Gender and Race Affect These Levels?

In THIS study, normal creatine kinase levels were shown to range from 19-155 IU/L in adult women. It appears that gender race affect CK levels, with men showing higher values than women and blacks showing higher values than Asians, Hispanics, and whites.

THIS paper shows that black men had levels of 147 IU/L, white men 61 IU/L, and Hispanic men 85 IU/L. For women it was 66 IU/L, 37 IU/L, and 42 IU/L for black, white, and Hispanic women, respectively.

THIS paper involving a huge sample size showed that within each ethnic group, men had higher median creatine kinase levels than women: African Americans, 135 versus 73 IU/L; whites, 64 versus 42 IU/L; Hispanics, 69 versus 48 IU/L; and South Asians, 74 versus 50 IU/L.

What are Typical Creatine Kinase Level Increases Following Exercise?

Now I’ll point out some studies that have been conducted in the literature.

THIS study showed that 30 hours post marathon, average CK values were 2,213 IU/L with one person showing a maximum of 12,950 IU/L. 

In a 246 kilometer continuous race lasting under 36 hours, THIS study showed that CK levels were 43,763 IU/L (before the race they were 178 IU/L). Ranges appear to be between 10,000 and 170,000 IU/L.

THIS paper showcased a 16-year old boy who did 62 crunches in 3-5 minutes as part of a physical screening and got ER. His CK values were 13,180. It also showcased a 17-year old boy who played soccer, got ER, and experienced CK levels of 9,056 IU/L. 

THIS 12-year old boy was punished for talking in class and had to perform 250 squat jumps. He experienced ER, and four days later his CK levels peaked at 244,006 IU/L.

THIS bodybuilder with ER had CK levels of 76,080 IU/L. THIS bodybuilder with ER had CL levels of 70,962 IU/L.

THIS bodybuilder decided to take 80 grams/day (16 times the daily amount) of creatine for four months and ramp up his training to 2 daily sessions for 10 days prior to a competition. He experienced ER and had CK levels of 39,900 IU/L.

In THIS paper, a personal trainer chose to keep pushing a female client to train harder despite having to help her walk to a machine and her requesting to quit. She experienced ER and her CK levels peaked at 234,000 IU/L. This same paper showed another example of a personal trainer prescribing a new sedentary client three sets of four rowing movements, three sets of two biceps exercises, and abdominals, then the following session he trained chest and triceps in a similar manner. He vomited after the sessions, experienced ER, and had CK levels that peaked at 70,158 IU/L.

THIS paper had subjects perform 2 sets of 25 maximal eccentric biceps curls done in rest-pause fashion with a 3 second repetition followed by 12 seconds of rest in between reps (and five minutes in between sets). This is pretty crazy – it wasn’t until 5 days later that extreme swelling was noticed. Isometric force continued to drop until the 6th day, where he only exhibited 11% of his original strength. Nineteen days later he still had a 55% loss of force, and by day 47, he still hadn’t regained his original strength (9% loss after 47 days).

HERE is a study done on swimmers – subjects alternated between a minute of push-ups and a minute of squats for 10 straight minutes. The next day they did a 40-minute upper body circuit, and the day after that they did a max pull-up test and abs. Seven of the swimmers experienced ER, and CK levels ranged from 14,417 IU/L to 157,700 IU/L.

In THIS paper military recruit had been sedentary for 6 months and then performed a 5 kilometer march while wearing an 18 kilogram rucksack, then did 50 push-ups and 50 sit-ups. He experienced ER and his CK levels peaked at 296,000 IU/L.

THIS paper showcased a 16-year old wrestler who performed 60 min of wall-sits, squats, sit-ups, push-ups, lunges, and plyometric jumps. The next day, the athlete performed a bunch of running drills. His was hospitalized with ER and experienced peak CK levels of 146,000 IU/L.

In THIS article, 8 female lacrosse players performed 3 x 20 rep dumbbell curls with 15 lbs in each hand (one player used 10 lbs). All 8 athletes experienced ER and had CK levels ranging from 4,287 to 28,247 U/L.

THIS football player was fine until he did a cold-water plunge, which set of severe muscle cramps. His was hospitalized with ER but only had CK levels of 2,545 IU/L.

THIS study showed that an American football player with ER had CK levels at 130,899 IU/L. The training session that led to the ER was 10 sets of 30 rep band-resisted squats with one-minute rest in between sets, followed by 30 reps of RDLs, shrugs, and curls.

In THIS paper, a high school football team in Oregon was told by their coach to perform a 4-5 minute partner drill where subjects supersetted chair dips with push-ups. Twelve players were hospitalized with ER, 6 of the players had CK levels over 10,000 IU/L, and the other 6 had CK levels over 20,000 IU/L.

Wild Card Game: Tennessee Titans v San Diego Chargers

When to Return to Training

THIS paper recommends waiting until CK levels drop below 5,000 IU/L to gradually start participating in training again.

The Infamous University of Iowa Incident

And now I’m going to review the recent study HERE invoving the University of Iowa.

Essentially, after a 3-week break following a bowl game, the players performed their first week of workouts consisting of the following:

Jan 20, 2011

  • 15 min warm-up
  • Snatches 3 x 3 with 65, 70, and 75% 1RM
  • Parallel squats 100 reps with 50% of 1RM (as many sets as needed to complete)
  • Sled pushes 5 x 20 yds with 180-240 lbs
  • Pull-ups – max reps with body weight
  • Dumbbell rows 3 x 12 with 65% of 1RM
  • Cable push-aways 10 reps
  • Abdominal cable pulldowns 2 x 10 reps
  • Blast strap rollouts 2 x 10 reps

Jan 21, 2011

  • 15 min warm-up
  • Bench presses 100 reps @ 50% of 1RM (as many sets as needed to complete)
  • Back extensions 5 x 10 reps with body weight
  • Abdominal cable pulldowns 15 reps

Jan 24, 2011

  • 15 min warm-up
  • Hurdle hops 3 x 3
  • Hang cleans 1 x 2 with 70% 1RM, 1 x 2 with 75% 1RM, 3 x 2 with 80% of 1RM
  • Incline presses 1 x 5 with 70% 1RM, 4 x 5 with 75% of 1RM
  • Romanian deadlifts 5 x 5 with 75% of 1RM
  • Pull-ups 3 x 10 reps with body weight
  • Overhead press 3 x 10 reps with 60% of 1RM

On this day (Jan 24), several players visited the athletic training staff presenting dark urine, severe muscle soreness and swelling, and abnormal gait. The trainers sent out a mass text encouraging any affected players to report to medical staff. Nine players were admitted to the hospital for ER, and ten volunteered data for this particular article. The ten players’ CK levels were as follows:

  • 96,986
  • 115,819
  • 127,413
  • 143,055
  • 166,991
  • 179,509
  • 227,821
  • 233,167
  • 264,363
  • 331,044

Average CK levels were 188,617 IU/L, with a min of 96,986 and a max of 331,044. Players were treated with IV’s and were released 4-6 days later, their CK values were still approximately 10,000 IU/L upon discharge. Two weeks later, players were asymptomatic and had CK levels between 100-700 IU/L. Around 14-24 days following discharge from hospitalization, players gradually began training again. All players reported that the squat workout was the most difficult workout they’d ever performed.


Take-Away Points

Ironically, I wrote much of the same advice I’m about to mention two and a half years ago (before the Iowa incident occurred) HERE. If you’re a coach or personal trainer:

  • Do not have your athletes do insane workouts without gradually familiarizing them with it first. For example, let’s say you want them to do four sets of 20 rep squats with a load equal to their own body weight. Have them do one set of 20 the first week, two sets the second week, three sets the third week, and four sets the fourth week. Or, have them do four sets of 20 with 25% body weight the first week, 50% body weight the second, 75% the third, and 100% body weight loads the fourth. 
  • Ease athletes into any new methodology or exercise. This goes for cardio, HIIT, endurance, max strength, power, and speed work.
  • Do not use exercise as punishment. Prescribe the amount that you planned for (training sessions should be planned) and no more. Feel free to do less though depending on athlete biofeedback.
  • Don’t start off your season with 2X/days practices. Start off the first week with one session per day and ramp up to two per day the following week.
  • Don’t assume that your athletes stayed conditioned over the off-season or during breaks, or that they performed “homework” exercise as prescribed.
  • Listen to athletes and clients – if they feel like something is wrong or “off” during the training session, they’re probably right.
  • Build your athletes and clients up gradually. Don’t be overzealous and push them too hard too soon.
  • Make sure you can rationalize your programming. There’s nothing wrong with just doing 3 sets of 5-10 rep squats with heavier loads; most sports don’t require 60 seconds of non-stop squatting (or push-up) endurance.
  • Pay attention to the eccentric component to your programming as it takes a greater toll on the muscles than the concentric component.  
  • Small muscle groups can get compartment syndrome and isolation movements can trigger ER. Don’t assume that “smaller” movements aren’t dangerous – biceps, triceps, and ab exercises have each shown to produce incredibly high CK levels following damaging workouts.
  • Crazy eccentric workouts can cause so much damage that it takes over a month to return to baseline strength levels.
  • Excessive damage is overrated and causes stagnation. Err on the side of caution.
  • Some athletes are more prone to muscle damage than others – it’s your job to learn this about your athletes and adjust programs accordingly.
  • High-rep resistance training and high-rep plyometrics appear to be the most risky forms of exercise for ER; higher than heavier training and endurance training.
  • Before ever prescribing a workout, do the workout yourself.
  • Educate players about ER so they know to report symptoms right away.

I’ll leave you with a quote from the late, great Dr. Mel Siff:

To me, the sign of a really excellent routine is one which places great demands on the athlete, yet produces progressive long-term improvement without soreness, injury or the athlete ever feeling thoroughly depleted. Any fool can create a program that is so demanding that it would virtually kill the toughest Marine or hardiest of elite athletes, but not any fool can create a tough program that produces progress without unnecessary pain.