Isometrics: Static Holds and Static Contraction Training

The term isometrics refers to exercise protocols during which no shortening or lengthening of the muscle occurs. Traditional isometric protocols typically involve the sudden application of a maximal contraction lasting 10 to 15 seconds, usually performed against an immovable object or another muscle group. Some protocols involve holding a posture for a longer period of time using the subject’s own body weight as resistance (wall squats, planks, various yoga postures).

Over the past few decades various high intensity training isometric protocols have been developed. These vary considerably in duration, from less than 6 seconds in John Little’s Max Contraction training, to 90 seconds in Ken Hutchins’ Timed Static Contraction protocol. Some popular high intensity training methods, such as the late Mike Mentzer’s Static Holds and John Little’s Omega Sets, incorporate both an isometric and dynamic or “isotonic” component, usually involving an isometric contraction followed by a partial or full range negative.

Basic Descriptions of Popular High Intensity Training Isometric Protocols

Mike Mentzer’s static holds involve an isometric contraction in the “fully-contracted” position of a single-joint or compound pulling exercise or the mid-range position of a compound pushing exercise, using a weight the subject can hold for between 8 and 12 seconds for the upper body, or 15 to 30 seconds for the lower body. When the subject can no longer hold the weight motionless, they perform a slow negative.

John Little’s Max Contraction protocol is similar to Mike Mentzer’s static hold, but involves a much shorter (0.25 to 6 second) isometric contraction, and is only used in the fully-contracted position of a single-joint or rotary exercise. When performed as part of an Omega Set, the Max Contraction may be repeated for several repetitions.

Ken Hutchins’ timed static contraction protocol involves a 90-second isometric contraction against a fixed or immobile source of resistance, consisting of three 30-second segments of gradually increasing effort. Subjects are instructed to exert a “moderate” effort during the first 30 seconds, an effort that is almost as hard as they dare during the second 30 seconds, and to contract as hard as they dare for the last 30 seconds, then to gradually reduce effort after the full 90 sec0nds.

The subject is instructed to contract as hard as they dare rather than as hard as they can to remind them to be cautious since it is possible to produce very high levels of force.

Advantages

If a subject is unable to perform an exercise dynamically due to an injury or joint deformities or if they experience pain or irritation in certain portions of the range of movement, an isometric contraction performed in a position where the subject does not experience pain or irritation is an effective alternative.

Subjects suffering from neck problems which are exacerbated by various dynamic exercises for the upper body can often perform those exercises using timed static contraction with little or no irritation to the neck.

Since very little skill or motor control is necessary, subjects with too poor a level of motor ability to perform dynamic exercise in a controlled manner can safely perform isometrics.

Many timed static contraction exercises require no special equipment and can be performed using one’s own body, a wall, or common items such as chairs, balls and belts. Such exercises make it possible for those without access to exercise equipment to directly address certain muscular structures that are only indirectly addressed using traditional bodyweight exercises, possibly as a pre-exhaust for those exercises. One example of this would be to perform a timed static contraction chest fly, contracting against a ball held between the elbows to address the pectorals, which could be performed as a pre-exhaust for push-ups.

Isometric protocols can often be performed effectively on equipment which possesses too much friction or improper resistance curves for use with dynamic protocols.

Disadvantages

Isometric protocols provide no stretching and do little to improve the flexibility of the muscles worked. This problem is easily solved by performing separate stretching exercises for those muscles if required (only a few muscles can actually be stretched).

Due to the greater blood pressure (BP) elevation possible with isometric exercise and especially during exercises involving gripping, extra caution is necessary for subjects with high BP or conditions that may be exacerbated by significant BP elevation. Proper breathing is absolutely essential to minimize BP elevation, specifically not performing Val Salva’s maneuver.

Isometric exercise protocols may produce strength increases specific to the position or joint angle trained, and not over the full range of motion (ROM). This depends upon several factors, which will be discussed in more detail under the section on Compound Movements below.

Another disadvantage is the need for strong training partners to lift the weight into position for the subject when performing static holds. Most people can use significantly more weight for static holds for the durations recommended than for normal dynamic training, so this can quickly become very demanding for the training partners or trainer as well as present a greater risk of injury if interpersonal transfer is not performed correctly. Stronger subjects will also quickly “max out” most common selectorized machines. Because of these disadvantages timed static contractions are a safer and more practical alternative.

Timed Static Contraction

During timed static contraction, the subject contracts against an effectively immobile source of resistance such as a movement arm that has been locked into a fixed position or is held motionless by an instructor or training partner. This is different than a static hold where the subject holds and attempts to resist the negative movement of a barbell or machine’s movement arm.

Timed static contraction is best performed on exercise machines whose movement arms can be locked into position at any point over the ROM or using a power rack. It also possible using selectorized machines with conventional weight stacks that allow an adequate amount of resistance to be pinned with the movement arm in the desired position, preventing further positive movement. Some training facilities have incorporated adjustable lengths of chain into their equipment which can be used to limit range of motion for the performance of timed static contraction. When using machines that do not provide a means of locking the movement arm into position it can be held motionless by an instructor or training partner if they have adequate leverage. It can also be performed using manual resistance for many exercises. Timed static contraction may be safer than static holds for some subjects since the use of a fixed rather than moveable resistance requires no inter or intrapersonal transfer of a movement arm or barbell.

Starting with a minimal effort, the subject gradually increases the amount of force they are applying until they’re exerting an approximate 50% effort, and continues to contract against the resistance at this level of effort for approximately 30 seconds. After 30 seconds they gradually increase their effort to 75%. After another 30 seconds they gradually increase their effort to “near maximal”. Finally, after 30 seconds of “near maximal” effort, the subject exerts a maximal effort for 30 more seconds. After this the subject should very gradually reduce the intensity of contraction over the period of a couple of seconds, rather than suddenly let off. It is just as important to gradually reduce the intensity of contraction as it is to apply it in a gradual and controlled manner.

Ken Hutchins’s protocol for timed static contraction is as follows:

  1. Gradual increase of contraction from 0% to perceived 50% effort: ~5 seconds
  2. Contraction against resistance at perceived 50% effort: 30 seconds
  3. Contraction against resistance at perceived 75% effort: 30 seconds
  4. Contraction against resistance at perceived near maximal effort: 30 seconds
  5. Contraction against resistance at maximal effort: 30 seconds
  6. Gradual decrease of contraction from maximal to 0% effort: ~ 5 seconds

Although this may sound easy, when properly performed it is incredibly intense and capable of producing a very deep level of muscular inroad.

A disadvantage of timed static contraction is that unless it is performed on equipment with a force gauge, there is no objective or accurate means of measuring exercise performance or progress. Since the subject is contracting against a fixed object rather than resisting the pull of gravity on a barbell or the back pressure of a machine’s movement arm there is no way to quantify resistance.

Static Holds

During a static hold a barbell or the movement arm of a machine is transferred from the instructor or training partner to the subject in either the fully contracted position or end-point of a simple exercise, or in the mid-range of a compound movement. The subject then contracts against the resistance, attempting to hold it motionless as long as possible. After the muscles are inroaded to the point where it is impossible to prevent the downward movement of the resistance, the subject continues to contract against the resistance, performing the negative as slowly as possible.

Most subjects require approximately 20% more resistance for static hold than they would use for a set of dynamic exercise of similar duration. This will vary somewhat between individuals and muscle groups, and when using barbells or equipment with incorrect resistance curves the increase in resistance necessary depends on the position or joint angle at which the exercise is performed.

Mike Mentzer’s protocol for a static hold is as follows:

  1. The instructor or training partner assists in raising the resistance to the desired position, or in the case of bodyweight exercises such as chins or dips, using a step the subject lifts himself into the starting position with his legs.
  2. The resistance is transferred from the trainer to the subject or the subject transfers the resistance from the legs to the upper body.
  3. The resistance is held motionless until static muscular failure occurs – the point at which the muscles no longer possess adequate strength to prevent negative movement of the resistance.
  4. The resistance is then lowered slowly under strict control.

Static holds require considerably more caution than timed static contraction due to the requirement for a relatively high amount of resistance and the need for inter or intrapersonal transfer of resistance in many exercises. static hold may not be appropriate for some subjects who can not tolerate dynamic exercise due to injuries or joint deformities, in which case timed static contraction should be used.

The only advantage of static holds over timed static contraction is that it allows for measurement of exercise performance and progress in terms of resistance x set duration. If a subject performs a static hold for the prescribed duration before muscular failure occurs, the resistance should be increased the following workout.

Interpersonal Resistance Transfer

It is extremely important that interpersonal transfer of resistance be performed properly. When handing the bar or movement arm to the subject it is important not to suddenly let go, abruptly loading the subject, as this may cause injury. When the bar or movement arm is in the desired position and the subject indicates that he is ready the instructor or training partner should inform the subject that he is going to begin to transfer the resistance. While the subject holds the bar or movement arm motionless, the training partner should very gradually reduce the amount of force he is applying as the subject gradually increases the amount of force he is applying until the subject is supporting all of the load. At the point where the training partner has completely transferred the weight to the subject, he should indicate that he has done so, and begin timing the set.

Exercises requiring interpersonal transfer should be performed using machines with fused rather than independent movement arms, and barbells rather than dumbbells, as this allows both the subject and the training partner better control over the weight during the transfer and is therefore much safer.

Intrapersonal Resistance Transfer

During intrapersonal transfer, rather than the transfer of resistance being between the instructor or training partner and the subject, the subject is transferring the resistance from one of his muscle groups to another. For example, when performing static or negative only chins on the Nautilus Multi Exercise, the subject would set the machine’s carriage so that while standing on the top step the chinning bar is level with the top of his chest. He would then gradually raise his feet off of the step transferring his bodyweight from his legs to his arms and torso. This can also be performed with a regular chinning bar using a stepladder or tall chair.

Position Specific vs. Full Range Strength Increases

Isometric exercises should be performed near the middle of the range of motion for most exercises where the overlap of myofibrils allows for optimal force production and greater tension in the targeted muscles. Positions at or near the end point may be more effective in some exercises as long as active insufficiency of the targeted muscles is avoided. Isometrics should not be performed at or near the end point of compound pushing exercises where little meaningful resistance is encountered by the target muscles while the joints may be subject to large compressive forces due to the lever advantage.

Arthur Jones, the founder of Nautilus, has often stated that the only position in which one is capable of contracting and thus stimulating all of the fibers in a particular muscle is the position of full muscular contraction. This is incorrect. While positions or ranges of motion involving a lesser degree of shortening may not be as ideal, motor unit recruitment (contraction) and thus the possibility of stimulation, does not require moving into the “fully-contracted” position. Motor unit recruitment depends on the force requirements of the exercise. If the force requirements are high enough all motor units will be recruited regardless of where in the ROM the exercise is performed.

Based on this it would appear that isometric exercise protocols such as timed static contraction and static hold should result in full-range rather than position or range specific strength increases. However, the fact that many exercises involve multiple muscles or groups of muscles whose relative involvement may vary considerably over the full ROM complicates the issue somewhat.

Compound (Multi-Joint or Linear) Movements

Isometric exercise protocols may not produce full range strength gains in some compound movements. Unlike many simple or single joint exercises, during compound exercises significantly more muscles are involved and the relative involvement of those muscles changes continuously from position to position throughout the range of movement. Depending on the degree of change in muscular involvement from position to position, isometric exercise in some positions of a compound movement may provide inadequate loading and stimulation for muscles that are not involved to some minimal necessary degree at that position, but may be involved to a greater degree in other portions of the ROM. As a result, there would be a disproportionately low strength increase in those parts of the ROM.

For example, during the front grip pull down, the chest is involved in shoulder extension during the first 30 to 45 degrees of movement. If a person performs timed static contraction or static hold on the front grip pull down in a position past that portion of the ROM involving the chest, the resulting strength increases will not be proportional over the full range of the exercise. They will be lower over the ROM involving the chest.

Realize that in such a situation although strength increases may not be proportional over the full ROM, they would not be limited to the specific position trained either.

In exercises where this is a problem, one should either perform the exercise at a position in which all of the muscular structures involved in the dynamic version of the exercise are meaningfully loaded or address the inadequately loaded muscles with a different exercise.

Weight vs. Resistance

During compound pushing movements such as squats, chest press and overhead press, none of the muscles involved in the exercise are meaningfully loaded near the position of full extension due to changes in leverage. In positions at or near full extension the bones support the majority of the load and the muscles encounter significantly less resistance. This lever advantage is the reason a person can perform partial repetitions in these exercises over the portion of the ROM near extension with much more weight than they can use to perform the exercise over the full ROM.

Weight and resistance are not the same thing. Weight is a scalar quantity, a measure of an object’s mass. Resistance is a vector quantity, a type of force, which in the case of exercise is a product of weight and leverage. Depending on leverage, one can have a tremendous amount of weight with very little resistance in some positions, as in the above compound exercises, or a tremendous amount of resistance with very little weight. It is the resistance the muscle encounters during exercise that is important.

When used with compound pushing movements static holds should be performed in the position where the target muscles encounter the greatest resistance, not where the most weight can be handled. This position will vary depending on the equipment used. An exception to this would be cases where these techniques are being used to work around an injury or physical condition which prevents dynamic, full range exercise, in which case the position depends upon the subjects physical limitations.

Strength Testing

Comparisons of the relative effectiveness of different exercise protocols using a dynamic test to measure changes in strength are grossly inaccurate due to several factors. These include the effects of skill, apparatus friction, body and apparatus torque variation, momentum and problems with positional reference, etc. Performing static testing solves most of these problems and minimizes others. Static testing involves no significant friction, no momentum, no torque variation, and minimizes the influence of skill from dynamic training protocols. MedX medical machines also make it possible to accurately counterbalance body torque and factor for torque produced by stored energy during isometric testing.

Explosive Training

The following article is published here with the permission of the author, Ken Mannie, Head Strength & Conditioning Coach at Michigan State University

The subject of explosive weight training is one that has been in the center of a maelstrom among strength and conditioning practitioners for quite some time. Many individuals and some associations advocate the use of so-called explosive weight training movements, which purportedly offer trainees a distinct advantage in speed and power development over those who choose to incorporate more controlled movements.

It is also suggested by some that explosive weight training movements prepare the body for the exorbitant, potentially traumatic forces of competition more so than other strength training techniques.

For the purpose of this article, only the explosive lifts will be discussed. These include-but are not solely restricted to-the Olympic lifts (i.e., the snatch and clean and jerk), power clean, speed-squats, push jerks and any variations of these movements. Basically any movement performed in a rapid, jerky manner where momentum plays a key role in the execution and or completion of the movement would be included. [continue reading…]

Muscular Development May 2001In May of 2001, Muscular Development magazine ran a feature on SuperSlow® training , in which contributing editor Bob Lefavi, PhD. interviewed Dr. Wayne Westcott, Dr. William Kraemer, Dr. Robert Newton, and myself. The following is the portion of the article with my interview, followed by my current thoughts on the subject.

Drew Baye

May 2001

I still think the TUL’s [time under load; beginning to end] that people use with SuperSlow® are too high. But, it’s not so much a problem with SuperSlow as it is with the way it’s being applied. My personal experience has shown that the six to eight rep range, while producing significant improvements in other trainable areas of fitness, is less than ideal for someone trying to gain muscle mass, for a few reasons.

First, obviously, if you’re spending 120 to 180 seconds performing an exercise, you’re not going to use nearly as much weight as you would if you were trying to fail in a lower TUL. Second, it unnecessarily increases the overall volume of the workout.

Ken’s [Hutchins] experience with rehabilitation and training osteoporotics has led him to be more acutely aware of the potential for injury in some subjects during exercise when poor form and typical movement speeds are used. It’s an irrefutable fact that when a material is exposed to a level of force that exceeds it’s structural strength, it fails, and that force = mass x acceleration. The principle, that slower movements are safer, is a given.

The principles behind SuperSlow are sound. If there are any problems, it’s in the application. Obviously, younger, stronger athletes are structurally far more sound than the elderly and injured that Ken has spent much time working with. I believe a moderate, but not quite as slow rep speed would still be safe, but more efficient in terms of keeping TUL lower, while still providing enough reps per set to be safe.

In any case, slower is safer, and slow movement loads the muscles more efficiently because there’s less momentum. He’s right about that. How much slower? I would have to say that like everything else, it’s an individual thing. In my opinion, a big part of the problem with a lot of things is that people want instructions, not understanding. They want to be told exactly what to do, but not have to think too hard about it. Problem is, in so many endeavors, the proper action is context sensitive. while the same principles apply, their applications will be different for each person’s unique situation.

It is true that there’s no one program to fit everybody, if you define “program” as a specific set of actions (do this X number of times, Y days per week, at Z cadence, etc.). But, if you define a program as a set of principles to be applied based on each individual, then there can only be one program for everybody since we’re all physiologically pretty much the same (with much variation in form, but not in basic function). And we are all subject to the same laws of physics. The individuals simply have to do the work and experiment and find out how to best apply those principles within the context of how their bodies respond to training.

Is it important to move slowly during exercise? Yes, slowly enough that you are using your muscles to do the work and not exposing your body to excessive force. Is it necessary to move so slowly as 10/10? Probably not. It’s got a built-in margin of safety to compensate for those on the low end of the bell curve of structural integrity. There are other considerations, such as motor skills, but these are not fixed either. While it may be necessary for someone with poor motor control to move more slowly to really be able to focus on what muscles they’re using, someone with better motor control may not. Like the RDA is more than what the average person needs, so as to compensate for those on the higher end of the bell curve where nutritional requirements are concerned, I think the SuperSlow recommendation of a 10/10 rep is the same type of thing. My body’s daily requirement for vitamin B might be X, but if I take in a little more, it’s not going to hurt anything. My body may be structurally strong enough to withstand X amount of force, but it doesn’t hurt to reduce the force a little more, for safety’s sake.

Of course, continuing with the vitamin analogy, as you know, too much of some vitamins can be a bad thing. If a particular individual is using a particular rep cadence and some minimal rep range guideline for the sake of safety, but it results in a TUL/volume of exercise that is beyond what is ideal for that individual based on his tolerance for, and ability to recover from and adapt to the stress of exercise, then he may be going too slow. There are also motor control problems involved.

In any case, I think SuperSlow is based on sound principles, but individuals have to determine how to best apply them based on their particular goals and needs. In the case of a bodybuilding application of the protocol, I recommend using a much lower rep range and TUL than what the general, non-bodybuilding fitness-minded individual would use.

In short, I believe the SuperSlow exercise protocol, like HIT [High Intensity Training] in general, is not so much a fixed “program” as it is a set of principles, the application of which must take into consideration individual differences. I agree that change in a workout is necessary, but those changes should be in accordance with how one’s body is responding to the training, and in accordance with the principles of the protocol, which I believe to be absolutely correct.”

Decades ago, Nautilus founder Arthur Jones theorized muscular friction was the source of differences observed between positive (lifting, concentric) and negative (lowering, eccentric) strength, reducing positive efficiency while increasing negative efficiency. On several occasions Arthur has stated the following,

“Everything in the known universe that has both mass and motion also has friction, and muscles are no exception. Whether it is an automobile, an airplane, a snake or a human muscle, friction acts the same way: inhibits positive function while enhancing negative function, thus reduces your positive strength while increasing your negative strength”.

While the levels of friction in most exercise machines have this effect, research has shown muscular friction is practically non-existent. Although the exact mechanism isn’t yet fully understood, current scientific consensus is the differences in positive and negative strength are due to differences in cross-bridge mechanics. Dr. Michael Reedy of the Duke University Cell Biology department provided me with the following explanation,

“In a nutshell – more crossbridges attach and hang on tightly – due to to either or both causes of recruitment:

1) backbending distortion of one-headed crossbridges allows the second head of each myosin to attach, and they backwalk a few steps, smoothing the plateau of force that develops in phase 2 of ramp-stretch. (I love this idea, inspired from the Linari paper, but good evidence for it is not available yet.)

2) all weak-binding M*ADP*Pi heads of myosins that collide with backsliding actin hang on tightly to resist lengthening– and the more generous interface geometry for braking attachments by M*ADP*Pi allows more myosins to attach and evolve into brakes than are able to attach and evolve into purely isometric or shortening motors.

Much of my structural research over the next couple of years will focus on getting evidence for or against 1) and 2). We get snapshots of muscle structure by x-ray diffraction, and by 3D EM tomography of thin sections from fibers quick-frozen during mechanical actions and responses of interest.”

The Linari paper Dr. Reedy mentioned is A combined mechanical and X-ray diffraction study of stretch potentiation in single frog muscle fibres. M. Linari, L. Lucii, M. Reconditi, M. E. Vannicelli Casoni, H. Amenitsch, S. Bernstorff, G. Piazzesi and V. Lombardi, J. Physiol. 2000;526;589-596.

In addition to Arthur Jones’ friction theory being wrong, I believe his recommendation to emphasize the negative portion of the repetition by taking longer to perform it is also incorrect. Since negative work has been shown to be more metabolically efficient, if the negative phase of the repetition is too long relative to the positive, inroading may be less efficient and it may take longer to recruit and stimulate all the target muscles’  motor units. Spending more time performing the easier part of the repetition reduces the intensity of the exercise rather than increasing it.

The following article is published here with the permission of the author, Danny Thompson

I am not a Physical Therapist (although I did stay in a Holiday Inn Express once). Through trial and error, I have found that these ideas work fairly well.

During some exercises, especially certain compound pulling, some subjects experience an uncomfortable sensation in their elbow. They feel a minor “popping” after a few repetitions. Other subjects experience a much more dramatic sensation. The elbow feels like it will actually “catch”, and the subject perceives their elbow is locking up. Many personal trainers, and even some doctors, have misconstrued that this is an indication that the subject will not be able to use that exercise. This simply isn’t true.

What exactly causes the elbow problem isn’t fully understood at this time. I have heard an explanation that does make some sense:

Between the bones of the elbow joint is a bursa sac filled with sinovial fluid that cushions and lubricates the joint. The fluid moves around the sac to cushion the joint depending on the movement. On some people, the lower arm extends out away from the upper arm at a greater angle than usual (this is termed “valgus”). When the arm is extended out in certain positions, the fluid in the bursa sac is trapped on one side of the sac. In an arm where valgus isn’t very dramatic, the elbow fluid will rush to fill the whole sac, causing the popping sound. Most often, once the elbow has popped, the elbow will not have the problem again for the rest of the exercise. In an arm where the valgus is much more dramatic, the fluid is trapped, and cannot get to the other side of the sac. This is what gives the subject the sensation that the elbow has “locked up”.

This usually occurs on the negative portion of the repetition, and usually in the first stages of a training program. As the subject strength increases, the weight becomes significant, the problem is less frequent and will usually disappear. I’ve also found that in the most dramatic cases, subjects have an imbalance in flexibility of their pronator and supinator muscles in the forearm musculature.

This condition, while surprising and alarming to some subjects (and some trainers) is not dangerous, and can usually be worked through or worked around.

To be forewarned is to be “forearmed.”

The first order of business to warn the client of what might happen, and what to do if it does. This should be done before the client learns how the exercise is to be performed. I use a format something like this:

“This is the _______ exercise.” (Have the client sit down on the exercise to explain). “Some clients experience a popping in their elbows, and possibly even a sensation of the elbow locking up. This is not dangerous, but it can be alarming. When you first feel it, you might panic, but if you do, try to immediately remember it’s not dangerous. Let me know if you do experience this, and I’ll show you how to work through it”

Treatments

Exercise order

The first prescription for this problem is to put a pushing exercise immediately before the pulling exercise. I’ve found the Overhead Press is the best choice. Seated Dip or Self-Assisted Dip does not seem to help the problem. It is important to get into the pulling exercise as soon as possible after the pushing exercise is completed.

Partial Repetitions

In this procedure, the client notes the position of the arm when the locking position is perceived. The client is instructed to continue the exercise in the range just before the sensation occurs. Have the client challenge the locking position each repetition, returning to the contracted position each time the sensation occurs. Usually within a few repetitions, the subject will be able to perform the full range with no locking sensation.

The Push-Through

If the above solutions are not effective, the “push-through”, will usually help. Some subject become so cautious that they move too slowly in the negative, causing the “locking” sensation to feel much more intense. This procedure should be used in the initial learning stages of a program when the resistance level is not yet significant. This procedure should be explained fully before the subject begins the exercise.

Once the subject perceives the elbow locking during the negative, instruct them to return to the contracted position. As the lower the weight again, instead of resisting the weight on the locking arm, the subject will actually push on the handle. The arm will push through the locking position, and the elbow will usually pop.

The Drop

This procedure is a last resort. It is used only when the other options do not help. I do not advise its use with experienced clients, as their levels of resistance would not be appropriate for this.

Once the subject perceives the locking sensation, instruct the subject return to the contracted position. Instruct the client to maintain their grasp on the bar or handles, and virtually drop the weight to the starting position.

This procedure usually works because the muscles are not contracted during the negative. It seems that the contracted musculature during the exercise forces the bones into a position that will not allow the sinovial fluid to disperse evenly in the bursa sac. Allowing the movement to occur without the musculature being contracted lets the fluid move.

I would recommend that this procedure be performed only with clients that you are confident of their coordination skills.

Long Term “Treatment”

In some clients, the forearm supinators and pronators are too tight, thereby restricting the elbow joint from moving naturally through the range of motion of some exercises. I’ve found that these simple stretches done immediately before and after the exercise for a few sessions will help. In most cases, they will instantly alleviate the problem.

90° supinator and pronator stretch

Have the client sit in the exercise seat, and raise their upper arm to about a 90° angle from the body. It doesn’t seem to be important which angle the arm is in the transverse plan, but I usually try to keep it in the same plane that the exercise will be performed in. Hold the clients lower arm at a 90° angle from the upper arm. Grasp the clients’ hand, and instruct the client to attempt to supinate the hand as far as possible. Assist the client by supinating the hand just a little further. Hold for 2-3 seconds. Repeat the stretch about 8 times, then perform the same procedure pronating the hand.

Straight-arm supinator and pronator stretch

Instruct the subject to straighten the elbow as hard as possible. Grasp the subjects upper arm bone with one hand, and the subjects’ hand with the other. Stabilize the subjects’ upper arm as best as possible, and repeat the stretches as described above.

Experiences with Meditation and High Intensity Training

High intensity training is not only one of the most physically demanding activities a person can perform, it also requires considerable mental effort. In addition to focusing on intensely contracting the target musculature throughout each exercise, one must concentrate on using proper body mechanics, correct breathing, a controlled speed of movement, etc., all while experiencing rapidly intensifying physical discomfort. It can be difficult to focus on one thing, much less two or three or more, when your muscles are burning, you’re breathing hard and your heart is pounding through your chest.

Those who work out in commercial gyms must also deal with various external sources of distraction which make concentration even more difficult. Scheduling workouts during non-peak hours helps, but may not be practical for everyone. Home gyms can be designed to provide an environment more conducive to concentration, but often have their own sources of distraction, especially if young children are present. Even personal training centers which strive to provide an ideal exercise environment – private or semi-private and devoid of music, mirrors, windows, and other distractions – are not always perfect.

Although the physical discomfort associated with productive exercise is unavoidable and it is impossible to completely eliminate distractions from the training environment, the ability to focus during exercise can be greatly improved through concentrative meditation. During concentrative meditation one trains their mind to be able to focus their attention more completely and to be more resistant to distraction and wandering. In his article How to Meditate, Joshua Zader writes,

“Through meditation, many people find they can make their attention more stable, strong, and wieldy. You do this by learning to isolate awareness from its alternatives—just as you would isolate one muscle from another—and then exercising it.”

A friend introduced me to Vipassana meditation, a Buddhist system of meditation that uses the breath as the object of focus. He claimed it  improved his concentration and his overall sense of well-being, and suggested I try it. Although I do not practice it as regularly as recommended, I have experienced a considerable improvement in focus during my workouts. I am able to concentrate better on the target musculature during each exercise, and on avoiding form discrepancies I have had trouble with such as tensing of the neck and facial muscles.

More recently, I have been experimenting with shorter meditation sessions performed immediately prior to my workouts. While my regular meditation sessions are performed to strengthen my ability to focus, these pre-workout sessions are performed only long enough to relax slightly and quiet my mind, clearing it of distracting thoughts and allowing me to mentally prepare for the workout. After a few minutes of concentrative meditation during which I focus on breathing, I mentally rehearse the workout, visualizing the performance of each exercise in perfect form. In addition to further improving my ability to focus during workouts, I have also found the visualization portion of the pre-workout meditation to be highly motivating.

In addition to enabling one to train in a safer and more productive manner by improving focus during workouts, regular meditation may also contribute to improved recovery between workouts since it reduces stress. A study on the effects of Buddhist meditation found that it significantly reduced serum cortisol levels as well as blood pressure and heart rate. Various other studies have also shown reduced cortisol levels with different types of meditation. Reducing the level of cortisol, a major catabolic hormone, creates a state more favorable to muscle growth.

Based on my experiences, discussions and reading on the subject I believe that regular meditation practice provides valuable benefits to those performing high intensity training, and would like to see more research done in this area.

For instructions on basic meditation practice, I recommend reading How to Meditate, by Joshua Zader.

For a more detailed text on Vipassana meditation, I recommend reading Mindfullness in Plain English by Henepola Gunaratana, available for free online at vipassana.com

References:

Sudsuang R, Chentanez V, Veluvan K. Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time. Physiol Behav. 1991 Sep;50(3):543-8.

Jevning R, Wilson AF, Davidson JM. Adrenocortical activity during meditation. Horm Behav. 1978 Feb;10(1):54-60.

Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004 May;29(4):448-74.

MacLean CR, Walton KG, Wenneberg SR, Levitsky DK, Mandarino JP, Waziri R, Hillis SL, Schneider RH. Effects of the Transcendental Meditation program on adaptive mechanisms: changes in hormone levels and responses to stress after 4 months of practice. Psychoneuroendocrinology. 1997 May;22(4):277-95.

Warming Up

When performing high intensity strength training using proper form and a slow, controlled speed of motion additional warm up sets are almost never necessary. In most cases they provide little or no benefit while wasting time and energy that could otherwise be devoted to the “work” sets.

Most of the physical benefits of a warm up – increased blood flow to the muscles, enhanced metabolic reactions, reduced muscle viscosity, increased extensibility of connective tissue, improved conduction velocity of action potentials, etc. – are obtained during the first few repetitions of an exercise. Additionally, each exercise performed helps prepare the muscles and joints for subsequent exercises they’re involved in.

I do not warm up for my workout or any specific exercises, and do not have the people I train warm up with only a few rare exceptions. I’ve been training people this way for two decades and none have been injured as a result. Like most aspects of exercise, whether to perform a warm up or not depends on the individual and the specifics of the workout being performed.

People with some physical conditions or joint problems may find they tolerate certain exercises better or experience noticeably reduced joint discomfort if they perform a warm up set prior to exercises involving the affected joints or body areas. When this is the case only a single warm up set is required, and it should be performed with half or less of the resistance to be used for the work set to provide the previously mentioned benefits while wasting as little energy as possible.

In some of these cases they can perform certain exercises better by first performing a different exercise that involves the same joints. For example, some people’s knees tolerate exercises involving extension better if they warm them up with a knee flexion exercise, and some people whose elbows tend to lock during pulling movements find it helps to perform a pushing movement first.

Some trainers still recommend stretching as part of a warm up, however stretching prior to a workout does not prevent injury, and should not be performed since it can reduce the muscles’ ability to produce force. Stretching is highly overrated and with a few exceptions there is no need to do it at all. Regularly performing exercises for all the major muscle groups over a normal range of motion will help achieve and maintain a functional, healthy level of flexibility adequate for the majority of activities a person would participate in. If stretching is performed at all it should only be performed after the workout.

References:

Darden, Ellington. The Nautilus Book: An Illustrated Guide to Physical Fitness The Nautilus Way. Chicago, IL: Contemporary Books, Inc., 1981

Hutchins, Ken. SuperSlow: The Ultimate Exercise Protocol, 2nd Edition. Casselberry, FL: Media Support. 1992

Enoka, Roger. Neuromechanics of Human Movement, 3rd Edition. Champaign, IL: Human Kinetics. 2002

Herbert RD, Gabriel M. Effects of stretching before and after exercise on muscle soreness and risk of injury: systematic review. BMJ 2002; 325: 468-470

Shrier I. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clin J Sports Med 1999; 9: 221-227

MacAuley, D., Best, T. M (2002). Reducing risk of injury due to exercise. BMJ 325: 451-452

Fowles, JR. Sale, DG. MacDougal, JD. Reduced strength after passive stretch of the human plantarflexors. J Appl Physiol 2000 Sep;89(3):1179-88.

In books and articles on fat loss it is common to see arbitrary recommendations for daily calorie intake or deficit, such as 1,200 calories per day for women and 1,500 calories per day for men, or a deficit of 500 to 1000 calories per day to lose 1 to 2 pounds of fat per week. The problem with arbitrary calorie intakes is obvious – not everybody has the same daily calorie expenditure so the resulting deficit will vary significantly between people. Apparently the problem with arbitrary deficits is not so obvious – many personal trainers and health professionals routinely recommend a daily calorie deficit of 500 to 1000 calories for everybody – a range that is too low for some and too high for others.

A few months back I read about a paper from the March 2005 Journal of Theoretical Biology in an article by Lyle Mcdonald. The paper by Alpert et al, which examined data from various sources including the Minnesota Starvation Experiment, concluded the rate at which the body can get energy from it’s fat stores is about 31.4 calories per pound per day.

“A limit on the maximum energy transfer rate from the human fat store in hypophagia is deduced from experimental data of underfed subjects maintaining moderate activity levels and is found to have a value of (290 ± 25) kJ/kg d. A dietary restriction which exceeds the limited capability of the fat store to compensate for the energy deficiency results in an immediate decrease in the fat free mass (FFM). In cases of a less severe dietary deficiency, the FFM will not be depleted.”

290 kilojoules = 69.31 kilocalories and 1 kilogram = 2.2 pounds, so 290 kJ/kg = 31.4 kcals/lb

In other words, the authors claim the maximal daily calorie deficit for fat loss is approximately 31.4 cals per pound of fat, give or take about three calories, and if your daily calorie deficit exceeds this the difference is going to come from other tissues, including your hard-earned muscle. Keep in mind the specific foods and macronutrient ratios consumed by the subjects were far from optimal for fat loss, and that “moderate activity levels” is not the same as regular, high intensity strength training. The maximum rate is most likely higher for someone eating adequate protein and not overdoing carbohydrate intake and strength training would also contributes to maintenance of lean body mass when calorie intake is below maintenance level.

Since the maximal deficit would change in proportion to your fat stores, as fat is lost the calorie deficit would need to be decreased. However, even if you were losing over three pounds of fat per week this would only reduce the maximal deficit by about 90 calories each week, so it would be unnecessary to re-adjust daily as long as the deficit accounted for the reduction in body fat.

For example, a 200 pound man at 15% body fat would have 30 pounds of fat, enough to provide about 940 calories of energy over the course of a day. Assuming he reduced his calories intake to 940 below maintenance for a day, by the end of the day he would have lost about a quarter pound of fat, which would require the deficit to be reduced by about eight calories the next day.

Nobody can estimate their body composition or daily calorie expenditure, or measure and record their food intake accurately enough for eight calories to make a difference. Additionally, metabolic rate may decrease slightly over time while on a below-maintenance calorie intake due to reduced thermal effect of food and hormonal changes. Rounding down the daily calorie deficit to 30 calories per pound of fat and re-adjusting the deficit every other week based on changes in weight should be more than adequate to maintain a near-maximal rate of fat loss with little or no loss of lean tissue. Body composition should be re-measured monthly to ensure only fat is being lost and calorie intake adjusted accordingly. Very lean individuals may want to re-measure body composition more frequently.

Calculating Daily Calorie Deficit For Maximum Fat Loss

  1. Measure body weight and composition.
  2. Multiply body weight in pounds by percent body fat to determine pounds of fat.
  3. Multiply pounds of fat by 30.

If the above formula is used to determine the daily calorie deficit, assuming body fat measurements and daily calorie expenditure estimates are reasonably accurate, the following formula can be used to estimate the number of days required to lose a certain amount of fat. This would not include refeed or “cheat” days.

FS = starting body fat in pounds

FE = ending body fat in pounds

[(FS – FE) x 3,500] / [(FS + FE) x 15] = Approximate days of calorie restriction required to reach FE when daily calorie deficit equals current bodyfat level x 30.

The above is far from perfect, but provides a rough estimate that can be used for planning a diet or establishing time frames for short and long term fat loss goals. Also consider this is based on a theoretical maximum rate of fat loss. Substituting 13 for 15 in the formula may provide a more realistic time frame for most people.

Exceptions

As I mentioned in Basic Guidelines for Fat Loss, severely obese individuals may have enough body fat to provide more energy than they expend per day. Regardless of the amount of energy obtainable from the fat stores, daily calorie intake must be high enough to at least allow for adequate protein and fat intake and for as much carbohydrate as the individual requires to function adequately – some people handle lower carb intakes better than others. Daily calorie intakes for fat loss for those very over-fat or obese should be calculated based on macronutrient requirements rather than amount of body fat.

While steady-state activities are generally highly overrated for fat loss for the majority of people, the obese are an exception. For most people who are only moderately over-fat or leaner, an increase in activity is not necessary to achieve the calorie deficit required for maximum possible fat loss – a reduced calorie intake can accomplish this while still providing adequate nutrition. If someone has enough fat to provide more energy than they expend per day, however, their daily calorie deficit will fall far short of their potential maximum for fat loss unless activity level is increased significantly. In addition to a program of high intensity strength training, one or two hours per day of walking or a shorter period of a low-force, low-impact activity performed at moderate intensity may increase the rate of fat loss significantly for those who are very over-fat or obese.

References:

Alpert SS. A limit on the energy transfer rate from the human fat store in hypophagia. J Theor Biol. 2005 Mar 7;233(1):1-13.

Exercise is an Absolute Requirement for Life

Exercise is not merely important. It is absolutely essential. Most people, however, do not realize this, because the time factor of the cause-effect relationship between lack of exercise and the resulting decline in functional ability is so great. To further elaborate on this point, Arthur Jones once used the following example during a Nautilus seminar:

“If I were to grab you by the throat, and choke off your air supply, it would immediately become apparent to you that oxygen is absolutely essential for life. If I were to lock you in a room with no water, after several hours, the degree of thirst you would experience would indicate to you that water is a requirement for life. If I were to lock you in that room with water, but no food, it would take a little longer, a matter of a couple of days, before you would be ravenously hungry, and there would be no question in your mind that food was absolutely essential for life. However, it often takes years before ones body begins to show the harm done by a lack of proper exercise.”

If nothing is done to prevent it, we gradually lose muscle tissue as we age, becoming weaker, and less flexible as a result. There are several problems associated with this, the most obvious being a decrease in metabolism resulting in increased body fat, which is a primary risk factor for heart disease and several other serious health conditions such as diabetes. Not so obvious though, are the effects of a lack of exercise on one’s bones.

We often hear about elderly people falling and breaking their hips, an injury which often turns out to be fatal. It is often assumed that these people break their hips as a result of having fallen. In a large number of cases, the opposite is true: they suffer a fall because their hip breaks. Each year, an average of 80,000 men suffer a hip fracture and one-third of these men die within a year. The cause: osteoporosis.

Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. In the U.S. today, over 10 million individuals already have osteoporosis and 18 million more have low bone mass, placing them at increased risk for this disease. What can be done about it? Exercise. What kind of exercise? Low-force, high-intensity strength training is the only safe and productive means of effectively addressing this disease. Some studies have shown increases in bone density as high as 1% per week with high intensity strength training. The SuperSlow exercise protocol was developed by Ken Hutchins as a result of his need to provide a safe method of high intensity training for the elderly women who’s training he supervised during the Nautilus funded Osteoporosis Study at the University of Florida (1982-1986).

Keep in mind that by “exercise” I mean high intensity strength training. Many of the activities that have been recommended as exercise by so-called “experts” in this field will do little or nothing to help anyone, and in some cases may even cause serious harm. Jogging, dance aerobics, and other high-impact steady-state activities are examples of this. Even Michael Pollock, PhD, a former member of Kenneth Cooper’s Aerobics Clinic, and past president of the American College of Sports Medicine agreed with Ellington Darden, PhD when he said “…all the aerobics activity and interest promoted within the fitness industry since the late 1960’s has not fostered any long-term vascular health. Instead, it has caused an epidemic of joint and spine injury.”

While proper exercise can be of tremendous potential benefit to anyone who performs it, one would be far worse off performing activities such as jogging, plyometrics, and various ballistic or “explosive” strength training protocols, than if they had never exercised at all. Not only are these activities not relatively effective means of stimulating meaningful improvements in any factor of functional ability, they can be downright dangerous. Often, the injuries and degenerative joint conditions which result from such activities will force a person to become much less active earlier in life, and may even reduce their ability to perform proper exercise, accelerating their loss of muscular strength and functional ability. If as a result of such activities one’s mobility begins to decrease earlier in life, then that activity has effectively shortened that person’s life. Loss of mobility is the first step towards loss of all other factors of functional ability, and eventually death.

There are many people out there who do not exercise either due to motivational problems or ignorance of what is actually required in terms of time invested to achieve meaningful results. They rationalize for this by making excuses about not having enough time or not being able to afford a gym membership or exercise equipment.

This simply is not true.

The amount of training time necessary to dramatically improve ones physical condition is far less than what most people have been led to believe; at the most an hour to an hour and a half per week, and in many cases considerably less. There are few people, if any, who can not schedule 30 to 90 minutes of their time each week for something so important.

Can’t afford it?

Wrong. You can’t afford not to exercise.

The cost of not exercising can be far greater than a lifetime of gym dues or one-on-one personal training. Heart surgeries can cost well over $200,000, and one must often spend as much as $5,000 per year on medication afterwards for the rest of their life. If, due to lack of exercise, your mobility prematurely decreases to the point where you can’t care for yourself, you may end up spending over $3,000 per month for the last 5 to 10 years of your life wasting away in a nursing home.

So, would you rather spend a few hundred per year on a gym membership or home exercise equipment or a few thousand a year on personal training and make the effort to stay fit? Or end up spending upwards of $30,000 per year to stay in a nursing home and have somebody else dress, feed, and bathe you, because you no longer possess the necessary level of functional ability to do so yourself?

Like the old saying goes, use it or lose it. If you can’t move, you can’t do anything but lie there and wait to die. If you value your life, proper exercise should be one of your highest priorities.

Estimating Daily Calorie Expenditure

Whether you’re trying to maintain your current bodyweight, gain muscle or lose fat, it is necessary to estimate daily calorie expenditure as a starting point for determining the calorie intake appropriate to your goals. The key words here are estimate and starting point. No formula or method of measurement is perfect. No matter how good something looks on paper, what ultimately matters is practical results. Whatever your initial estimate, you will need to keep records of calorie intake and goal-relevant measurements and adjust your intake accordingly.

Your body burns a number of calories every day just to sustain vital organ function – called basal metabolic rate (BMR) or basal energy expenditure (BEE).This can either be directly measured using indirect calorimetry or estimated using various formulas. Additional calories are burned during physical activity and during digestion, which is also referred to as the thermic effect of food (TEF). Total daily calorie expenditure can be estimated by multiplying BMR by an “activity factor”, which also takes TEF into account.

Estimating Basal Metabolic Rate

If measurement through indirect calorimetry is available to you, this is the best option. You may be able to find a local gym, training studio or university that provides this service. If not, there are several formulas that can be used to estimate BMR. I recommend using the Katch-McArdle Formula since it is based on lean mass rather than total body weight.

Katch-McArdle Formula:

  • For men and women (metric): 370 + (21.6 x lean mass in kg)
  • For men and women (standard): 370 + (9.82 x lean mass in lbs)

Many books and web sites recommend the more popular Harris-Benedict equation, however there are several problems with it, the biggest being a failure to account for body composition. There is a big difference between the basal metabolic rate of a 200 pound man with 10% bodyfat and 200 pound man with 25% bodyfat due to the difference in lean body mass. While the age factor may be intended to account for age-related decline in metabolic rate related to loss of muscle mass, this makes assumptions that are flat-out wrong when applied to people who regularly strength train and probably have better-than-average body composition for their age.

Also, the methods used when the Harris-Benedict equation was developed also failed to account for TEF, so it tends to overstate BMR slightly. Rather than BMR, the result is closer to resting metabolic rate (RMR)/resting energy expenditure (REE). In addition to calories burned sustaining vital organ functions, RMR also includes calories burned due to TEF, which can vary depending on the time between the last meal and testing as well as the macronutrient composition of the meal. If the subject does not fast for an adequate period of time before testing what is being measured is RMR and not BMR.

Harris-Benedict Equation:

  • For men (metric): (13.75 x weight in kg) + (5 x height in cm) – (6.76 x age) + 66
  • For men (standard): (6.25 x weight in lbs) + (12.7 x height in inches) – (6.76 x age) + 66
  • For women (metric): (9.56 x weight in kg) + (1.85 x height in cm) – 4.68 x age) + 655
  • For women (standard): (4.35 x weight in lbs) + (4.7 x height in inches) – 4.68 x age) + 655

The biggest downside of the Katch-McArdle formula is most methods of measuring body composition are off by at least a few percent, typically overstating the body fat percentage of very lean individuals and understating the body fat percentage of people with a high amount of body fat. However, the typical 3-4% error in body composition measurements when properly performed is lower than the potential error when using formulas based on total body weight as opposed to lean body mass.

For example, if we apply the Katch-McArdle formula to two 200 pound men – one with 10% body fat, one with 25% bodyfat – we get the following BMR estimates:

  • 200 lbs at 10% body fat with 180 pounds lean mass: 2138
  • 200 lbs at 25% body fat with 150 pounds of lean mass: 1843

Even if bodyfat percentage was off by 4 percent – high for the leaner man and low for the fatter man, the BMR estimates would be:

  • 200 lbs at 14% body fat with 172 pounds lean mass: 2059 (79 lower)
  • 200 lbs at 21% body fat with 158 pounds of lean mass: 1922 (79 higher)

Assuming both men are 30 years old and 5’10”, the Harris-Benedict equation would give each an estimated BMR of 2002, despite a significant difference in lean body mass. This results in an estimate that is off by an average of almost twice as much for both the leaner and fatter man (147.5 ± 11.5) than would result from a significant error in body composition measurement. The Harris-Benedict equation should only be used if you are unable to get your body composition tested.

Estimating Calories Burned Due to Activity and Thermal Effect of Food

After estimating your BMR you would need to determine the additional calories burned by activity and digestion. In Exercise Physiology: Energy, Nutrition and Human Performance, the authors provide several “activity factors” to multiply by your BMR to estimate your average daily calorie expenditure. These also account for TEF:

  • 1.2 – Sedentary: Little or no physical activity.
  • 1.375 – Lightly Active: Light exercise or activity 1-3 days per week.
  • 1.55 – Moderately Active: Moderate exercise or activity 3-5 days per week.
  • 1.725 – Very Active: Hard exercise or activity 6-7 days per week.
  • 1.9 – Extremely Active: Hard daily exercise or activity and physical work

While these activity factors are pretty vague to say the least, keep in mind this is intended as a starting point, and that some adjustment is going to be required based on your results. If unsure of where you fit, it is better to err lower and gradually increase calories, especially if your goal is fat loss. Even if your goal is increased muscle mass, which requires a calorie surplus, it is better to err low at first and gradually adjust it upwards than to start high and find you’re gaining more body fat than muscle.

Making Adjustments

Although the above should provide a reasonably good estimate of your daily calorie expenditure, you will still need to track daily calorie intake and take skin fold or circumference measurements regularly and adjust accordingly. If the estimate is accurate and you are measuring and recording food intake accurately and consuming your estimated daily maintenance calorie level, your skin fold and circumference measurements should not change significantly.

If your goal is to lose fat and you have properly calculated your daily calorie deficit (the difference between your daily calorie expenditure and intake), your weekly fat loss should equal roughly your weekly calorie deficit (daily calorie deficit x 7) divided by 3,500 (the approximate number of calories stored in a pound of body fat). Keep in mind there are many factors such as muscle glycogen levels and hydration that can affect weight loss and gain, so don’t worry too much if you’re off a pound one way or the other as long as your measurements are consistently moving in the right direction.

If your goal is to gain muscle with minimal fat gain, I recommend first reducing your bodyfat to at least the low teens if it is not already there or lower. This will make it easier to determine whether weight being gained is coming from muscle or if you’re consuming too many calories and simply putting on fat. Start with maintenance calories and increase your daily calorie intake every week by 100 to 200 calories per day until your weight begins to increase. Take regular skin fold measurements at your fattest spot – usually the abdomen for men and the suprailiac or mid-thigh for women – and reduce your daily calorie intake to the previous level if the skinfolds go up over a few millimeters. Plan on gaining at least a little bit of fat while trying to increase muscle mass significantly, but do not allow yourself to become too fat.

References

Harris J, Benedict F. A biometric study of basal metabolism in man. Washington D.C. Carnegie Institute of Washington. 1919.

Katch, Frank, Katch, Victor, McArdle, William. Exercise Physiology: Energy, Nutrition, and Human Performance, 4th edition. Williams & Wilkins, 1996.

Alpert SS. A limit on the energy transfer rate from the human fat store in hypophagia. J Theor Biol. 2005 Mar 7;233(1):1-13.