Exacerbated heat strain during consecutive days of repeated exercise sessions in heat.

OBJECTIVES: An exercise session in a hot environment may increase thermal strain during subsequent exercise sessions on the same and consecutive days. Therefore, this study was conducted to determine lasting physiological strain from moderate-high intensity, intermittent exercise in heat on subsequent exercise. DESIGN: Repeated measures laboratory study. METHODS: Seventeen healthy, recreationally active men (age: 22±3 y, maximal oxygen consumption: 54.6±5.3mLkg-1min-1) underwent two intermittent moderate-high intensity aerobic exercise sessions separated by 2h of rest one day, followed by one session 24h later in a 40°C, 40% relative humidity environment. Heart rate, rectal temperature, heat stress perception, and environmental symptoms were assessed. RESULTS: 100%, 35%, and 71% of participants completed the full exercise protocol during the first exercise session, second exercise session, and the following day, respectively. Exercising heart rate and rectal temperature were greater during the second exercise session (189±11bpm, 38.80±0.47°C) than the first identical exercise session (180±17bpm, p=0.004; 38.41±0.52°C, p=0.001), respectively. Immediate post-exercise heart rate, rectal temperature, thirst, thermal sensation, fatigue, and perceived exertion were similar among exercise sessions despite a shorter exercise duration during the second exercise session (93±27min, p=0.001) and the following day (113±12min, p=0.032) than the first exercise session (120±0min). CONCLUSIONS: Moderate-high-intensity intermittent exercise in the heat resulted in greater heat strain during a second exercise session the same day, and exercise the subsequent day.

Intermittent exercise-heat exposures and intense physical activity sustain heat acclimation adaptations.

OBJECTIVES: To determine if intermittent exercise-heat exposures (IHE) every fifth day sustain heat acclimation (HA) adaptations 25 days after initial HA. DESIGN: Randomized control trial. METHODS: Sixteen non-heat acclimatized men heat acclimated during 10-11 days of exercise in the heat (40°C, 40% RH). A heat stress test (120min, 45% V˙O2peak) before (Pre HA) and after HA (Post HA) in similar hot conditions assessed HA status. Pair-matched participants were randomized into a control group (CON; n=7) that exercised in a temperate environment (24°C, 21%RH) or IHE group (n=9) that exercised in a hot environment (40°C, 40%RH) every fifth day for 25 days following HA (+25d) with out-of-laboratory exercise intensity and duration recorded. Both groups completed +25d in the hot condition. RESULTS: Both groups heat acclimated similarly (p>0.05) evidenced by lower heart rate (HR), thermoregulatory, physiological, and perceptual responses (perceived exertion, fatigue, thermal sensation) Pre HA vs. Post HA (p≤0.05). At +25d, post-exercise HR (p=0.01) and physiological strain index (p<0.05) but neither Tre (p=0.18) nor sweat rate (p=0.44) were lower in IHE vs. CON. In IHE only, post-exercise Tre and perceptual responses at Post HA and +25d were lower than Pre HA (p≤0.01). +25d post-exercise epinephrine was higher in CON vs. IHE (p=0.04). Exercise intensity during out-of-lab exercise and +25d post-exercise HR were correlated (r=-0.89, p=0.02) in IHE. CONCLUSIONS: Exercise-heat exposures every fifth day for 25 days and regular intense physical activity after HA sustained HR and Tre adaptations and reduced perceptual and physiological strain during exercise-heat stress ∼1 month later.

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations.

OBJECTIVE: To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations. BACKGROUND: One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment. The critical concern in managing a dislocation is deciding when a joint can be reduced onsite and when the patient should be splinted and transported for reduction to be performed in the hospital or medical setting. Factors that influence the decision-making process include the following: whether the AT possesses a documented protocol that is supported by his or her supervising physician(s), employer documents, and respective state regulations; the AT's qualifications and experience; the dislocated joint; whether the dislocation is first time or recurrent; the patient's age and general health; and whether associated injuries are present. RECOMMENDATIONS: These guidelines are intended to provide considerations for the initial care of specific joint dislocations. They are not intended to represent the standard of care and should not be interpreted as a standard of care for therapeutic or legal discussion.

Metabolic characteristics of keto-adapted ultra-endurance runners.

BACKGROUND: Many successful ultra-endurance athletes have switched from a high-carbohydrate to a low-carbohydrate diet, but they have not previously been studied to determine the extent of metabolic adaptations. METHODS: Twenty elite ultra-marathoners and ironman distance triathletes performed a maximal graded exercise test and a 180 min submaximal run at 64% VO2max on a treadmill to determine metabolic responses. One group habitually consumed a traditional high-carbohydrate (HC: n=10, %carbohydrate:protein:fat=59:14:25) diet, and the other a low-carbohydrate (LC; n=10, 10:19:70) diet for an average of 20 months (range 9 to 36 months). RESULTS: Peak fat oxidation was 2.3-fold higher in the LC group (1.54±0.18 vs 0.67±0.14 g/min; P=0.000) and it occurred at a higher percentage of VO2max (70.3±6.3 vs 54.9±7.8%; P=0.000). Mean fat oxidation during submaximal exercise was 59% higher in the LC group (1.21±0.02 vs 0.76±0.11 g/min; P=0.000) corresponding to a greater relative contribution of fat (88±2 vs 56±8%; P=0.000). Despite these marked differences in fuel use between LC and HC athletes, there were no significant differences in resting muscle glycogen and the level of depletion after 180 min of running (-64% from pre-exercise) and 120 min of recovery (-36% from pre-exercise). CONCLUSION: Compared to highly trained ultra-endurance athletes consuming an HC diet, long-term keto-adaptation results in extraordinarily high rates of fat oxidation, whereas muscle glycogen utilization and repletion patterns during and after a 3 hour run are similar.

Effects of short-term energy deficit on muscle protein breakdown and intramuscular proteolysis in normal-weight young adults.

The effects of short-term energy deficit (ED) on direct measures of muscle proteolysis and the intracellular mechanisms by which muscle proteins are degraded at rest and following aerobic exercise are not well described. This study evaluated the effects of a short-term diet-induced ED, on muscle fractional breakdown rate (FBR), intramuscular 26S proteasome activity, caspase-3 activation, and PSMA2 and MAFbx expression at rest, in the postabsorptive state, and following a single bout of moderate aerobic exercise (45 min at 65% peak oxygen uptake). Six men and 4 women participated in two 10-day diet interventions: weight maintenance (WM) followed by ED (80% estimated energy requirements). Dietary protein (1.5 g·kg(-1)·day(-1)) intake was constant for WM and ED. Mixed muscle FBR, proteasome activity, and intracellular proteolytic factor expression were measured using stable isotope methodology, fluorescent enzyme activity assays, and Western blotting, respectively. Overall, FBR and caspase-3 activation increased 60% and 11%, respectively, in response to ED (P < 0.05), but were not influenced by exercise. During ED, 26S proteasome α-subunit PSMA2 expression was 25% higher (P < 0.05) after exercise compared with rest. Exercise did not influence PSMA2 expression during WM, and MAFbx expression and 26S proteasome activity were not affected by ED or exercise. These data illustrate the effects of short-term, moderate ED on muscle protein degradation. In the context of skeletal muscle integrity during weight loss interventions, this work demonstrates a need for further investigations aimed at mitigating muscle loss associated with energy deficit imposed for intentional reduction of total body weight.

The influence of rehydration mode after exercise dehydration on cardiovascular function.

Our purpose was to compare the common modes of rehydration (REHY) on cardiovascular and fluid regulation recovery after exercise dehydration (EXDE). Twelve nonheat-acclimatized trained subjects (age: 23 ± 4 years, weight: 81.3 ± 3.7 kg, height: 180 ± 6 cm, V[Combining Dot Above]O2max: 56.9 ± 4.4 ml·min·kg , and body fat: 7.8 ± 3.0%) completed 20-hour fluid restriction and 2-hour EXDE to -4% body mass, and then were rehydrated to -2% body mass in a randomized, crossover design. The REHY methods included no fluid (NF), ad libitum, oral (OR), intravenous (IV), and a combination of IV and OR (IV + OR) of 1/2-normal saline (0.45% NaCl). The REHY occurred for 30 minutes, and the subjects were observed during rest for 30 minutes. Seated, standing, and mean arterial pressure (MAP) and blood pressure (BP) were measured every 15 minutes throughout REHY. Heart rate (HR), plasma arginine vasopressin concentration [AVP], and thirst perception were measured throughout REHY. The EXDE resulted in a body mass loss of 4.32 ± 0.22%. The REHY returned the subjects to -2.13 ± 0.47% body mass for controlled trials. Seated systolic BP was greater for IV + OR compared with that for OR (p = 0.015). Seated systolic BP and MAP during REHY showed that IV + OR was greater than OR, independent of time (p ≤ 0.011). Upon standing, IV + OR demonstrated a greater BP than both NF (p = 0.012) and OR (p = 0.031) did. The HR was reduced by IV and IV + OR to a greater extent than NF at REHY30 and REHY60 (p < 0.05). The IV + OR [AVP] demonstrated a strong trend for decreasing over time (p = 0.054) and was significantly less than NF at REHY60 (p = 0.003). Practical application seeking to restore cardiovascular function after EXDE, the combined use of IV + OR rather than a single REHY method seems to be most expedient.

Changes in creatine kinase and cortisol in National Collegiate Athletic Association Division I American football players during a season.

The purpose of this study was to track creatine kinase (CK) and serum cortisol over an American college football season starting with the preseason practice. A secondary purpose was to observe changes in basic clinical chemistries. Twenty-two National Collegiate Athletic Association Division I football players (age: 20.4 ± 1.1 years, height: 188.27 ± 8.3 cm, weight: 115.8 ± 29.7 kg) volunteered to participate in this study. Each of the players had participated in the summer strength and conditioning supervised program. Resting blood samples were obtained just before the start of preseason practice (T-1), 2 weeks later (T-2), and the day after game 2 (T-3), game 4 (T-4), game 6 (T-5), and game 9 (T-6) of a 12-game season. Creatine kinase, a panel of clinical chemistries, cortisol, and testosterone were assayed at each time point. No significant changes in CK concentrations were observed over the season with peak values of each range ≤1,070.0 IU·L(-1), but the largest range was observed at T-6 after game 9 (119-2,834 IU·L(-1). The analysis of covariance analysis demonstrated that the number of plays in the ninth game (T-6) explained the magnitude of the changes in CK. No changes in serum cortisol concentrations were observed yet, again large variations existed with peak values of each range ≤465.0 nmol·L(-1). Clinical chemistries showed various significant changes from T-1, but none were considered clinically relevant changes for any player over the time course of the study. In conclusion, the strength and conditioning program before preseason camp or the structure of summer camp practices and the in-season strength and conditioning appeared to mute muscle damage and the stress response of cortisol. Such data demonstrate that changes in muscle damage and adrenal cortical stress over the season are minimal, yet large individual variations can be observed. Management of these variables appears to be related to optimal strength and conditioning and sports medicine programs. Thus, the greater concerns for student-athlete safety in the sport of American football are related to preventing sudden death, traumatic injury, and managing concussion syndromes.

Betaine supplementation enhances anabolic endocrine and Akt signaling in response to acute bouts of exercise.

Our aim was to examine the effect of betaine supplementation on selected circulating hormonal measures and Akt muscle signaling proteins after an acute exercise session. Twelve trained men (age 19.7 ± 1.23 years) underwent 2 weeks of supplementation with either betaine (B) (1.25 g BID) or placebo (P). Following a 2-week washout period, subjects underwent supplementation with the other treatment (B or P). Before and after each 2-week period, subjects performed an acute exercise session (AES). Circulating GH, IGF-1, cortisol, and insulin were measured. Vastus lateralis samples were analyzed for signaling proteins (Akt, p70 S6k, AMPK). B (vs. P) supplementation approached a significant increase in GH (mean ± SD (Area under the curve, AUC), B: 40.72 ± 6.14, P: 38.28 ± 5.54, p = 0.060) and significantly increased IGF-1 (mean ± SD (AUC), B: 106.19 ± 13.45, P: 95.10 ± 14.23, p = 0.010), but significantly decreased cortisol (mean ± SD (AUC), B: 1,079.18 ± 110.02, P: 1,228.53 ± 130.32, p = 0.007). There was no difference in insulin (AUC). B increased resting Total muscle Akt (p = 0.003). B potentiated phosphorylation (relative to P) of Akt (Ser(473)) and p70 S6 k (Thr(389)) (p = 0.016 and p = 0.005, respectively). Phosphorylation of AMPK (Thr(172)) decreased during both treatments (both p = 0.001). Betaine (vs. placebo) supplementation enhanced both the anabolic endocrine profile and the corresponding anabolic signaling environment, suggesting increased protein synthesis.

IGF-I measurement across blood, interstitial fluid, and muscle biocompartments following explosive, high-power exercise.

Insulin-like growth factor-I (IGF-I) resides across different biocompartments [blood, interstitial fluid (ISF), and muscle]. Whether circulating IGF-I responses to exercise reflect local events remains uncertain. We measured the IGF-I response to plyometric exercise across blood, ISF, and muscle biopsy from the vastus lateralis. Twenty volunteers (8 men, 12 women, 22 ± 1 yr) performed 10 sets of 10 plyometric jump repetitions at a 40% 1-repetition maximum. Blood, ISF, and muscle samples were taken pre- and postexercise. Circulating IGF-I increased postexercise: total IGF-I (preexercise = 546 ± 42, midexercise = 585 ± 43, postexercise = 597 ± 45, +30 = 557 ± 42, +60 = 536 ± 40, +120 = 567 ± 42 ng/ml; midexercise, postexercise, and +120 greater than preexercise, P < 0.05); Free IGF-I (preexercise = 0.83 ± 0.09, midexercise = 0.78 ± 0.10, postexercise = 0.79 ± 0.11, +30 = 0.93 ± 0.10, +60 = 0.88 ± 0.10, + 120 = 0.91 ± 0.11 ng/ml; +30 greater than all other preceding time points, P < 0.05). No exercise-induced changes were observed for ISF IGF-I (preexercise = 2.35 ± 0.29, postexercise = 2.46 ± 0.35 ng/ml). No changes were observed for skeletal muscle IGF-I protein, although IGF-I mRNA content increased ∼40% postexercise. The increase in circulating total and free IGF-I was not correlated with increases in ISF IGF-I or muscle IGF-I protein content. Our data indicate that exercise-induced increases in circulating IGF-I are not reflective of local IGF-I signaling.

Incidence of morphologic changes in asymptomatic Achilles tendons in an active young adult population.

CONTEXT: Achilles tendon rupture is often the result of a long-term degenerative process, frequently occurring asymptomatically. OBJECTIVE: To determine the prevalence of asymptomatic Achilles tendinopathy in an active, asymptomatic, young-adult population and to compare these findings across gender. DESIGN: Convenience sample, cohort study. SETTING: Research laboratory PARTICIPANTS: A sample of 52 (28 male, 24 female) healthy, active subjects were recruited from the student body at the University of Connecticut. Images of 104 Achilles tendons were made. INTERVENTION: Ultrasound images made with a Phillips HD11 with a 15-MHz real-time linear-array transducer were collected on both the longitudinal and transverse axes of the Achilles tendon. Activity level was measured with the International Physical Activity Questionnaire Short Form (IPAQ-SF). MAIN OUTCOME MEASURE: Presence of ultrasound evidence of Achilles tendinopathy as agreed on by 2 blinded assessors highly skilled in ultrasonography. RESULTS: More subjects were categorized as highly active (57.4%) on the IPAQ-SF than moderately active (42.6%). One female and one male subject were found to have ultrasound evidence of asymptomatic Achilles tendinopathy, equaling 3.8% prevalence in this study. CONCLUSION: We found a low prevalence of asymptomatic Achilles tendinopathy in an active, young-adult population. Further work is necessary to identify an optimal group warranting ultrasound screening for asymptomatic tendinopathy.

Sex differences in creatine kinase after acute heavy resistance exercise on circulating granulocyte estradiol receptors.

Previous research has shown reduced tissue disruption and inflammatory responses in women as compared to men following acute strenuous exercise. While the mechanism of this action is not known, estrogen may reduce the inflammatory response through its interaction with granulocytes. The purpose of this study was to determine if estrogen receptor ß expression on granulocytes is related to sex differences in tissue disruption in response to an acute heavy resistance exercise protocol. Seven healthy, resistance-trained, eumenorrheic women (23 ± 3 years, 169 ± 9.1 cm, 66.4 ± 10.5 kg) and 8 healthy, resistance-trained men (25 ± 5 years, 178 ± 6.7 cm, 82.3 ± 9.33 kg) volunteered to participate in the study. Subjects performed an acute resistance exercise test consisting of six sets of five squats at 90% of the subject's one repetition maximum. Blood samples were obtained pre-, mid-, post-, and 1-, 6-, and 24-h postexercise. Blood samples were analyzed for 17-ß-estradiol by ELISA, creatine kinase by colorimetric enzyme immunoassay, and estradiol receptors on circulating granulocytes through flow cytometry. Men had higher CK concentrations than women at baseline/control. Men had significantly higher CK concentrations at 24-h postexercise than women. No significant changes in estradiol ß receptors were expressed on granulocytes after exercise or between sexes. While sex differences occur in CK activity in response to strenuous eccentric exercise, they may not be related to estradiol receptor ß expression on granulocytes. Thus, although there are sex differences in CK expression following acute resistance exercise, the differences may not be attributable to estrogen receptor ß expression on granulocytes.

Chocolate milk and endurance exercise recovery: protein balance, glycogen, and performance.

PURPOSE: This study examined effects of fat-free chocolate milk (MILK) consumption on kinetic and cellular markers of protein turnover, muscle glycogen, and performance during recovery from endurance exercise. METHODS: Male runners participated in two trials separated by 1 wk and consumed either MILK or a nonnitrogenous isocaloric carbohydrate (CHO) control beverage (CON) after a 45-min run at 65% of V˙O(2peak). Postexercise muscle protein fractional synthetic rate (FSR) and whole-body protein turnover were determined during 3 h of recovery using muscle biopsies and primed constant infusions of L-[ring-²H5]phenylalanine and L-[1-¹³C]leucine, respectively. Phosphorylation of translational signaling proteins and activity of proteolytic molecules were determined using Western blotting and enzymatic activity assays. Muscle glycogen was quantified, and treadmill time to exhaustion was determined after the recovery period. RESULTS: Consuming MILK after exercise resulted in higher mixed muscle FSR with lower whole-body proteolysis and synthesis compared with CON (P ≤ 0.05). Phosphorylation of eIF4E-BP1 and FOXO3a was higher for MILK (P < 0.01), whereas Akt phosphorylation was lower during recovery regardless of dietary treatment (P < 0.05). Enzymatic activity assays indicated lower caspase-3 activity during recovery for MILK (P < 0.01) and higher 26S proteasome activity for CON (P < 0.01). Muscle glycogen was not affected by either dietary treatment; however, time to exhaustion was greater for MILK than for CON (P < 0.05). CONCLUSIONS: The effects of consumption of MILK after endurance exercise on FSR, signaling molecules of skeletal muscle protein turnover, leucine kinetics, and performance measures suggest unique benefits of milk compared with a CHO-only beverage.

Timing of lower extremity frontal plane motion differs between female and male athletes during a landing task.

BACKGROUND: Female athletes are at a greater risk for noncontact anterior cruciate ligament injuries than male athletes. Gender differences in frontal plane kinematics (hip adduction, knee valgus, and ankle eversion) and temporal relationships that make up the components of dynamic knee valgus may explain this discrepancy. HYPOTHESIS: The authors hypothesized that women would reach peak frontal plane kinematic values earlier during landing compared with their male counterparts. STUDY DESIGN: Controlled laboratory study. METHODS: Hip, knee, and ankle 3-dimensional kinematics were measured using high-speed motion capture in 10 National Collegiate Athletic Association Division I female athletes and 10 male practice squad athletes during a drop-jump landing. Independent t tests were used to analyze each dependent variable to identify differences between genders. RESULTS: Maximum hip adduction, knee valgus, and ankle eversion occurred earlier in women than in men (mean differences 33.7% of stance [95% CI, 20.2%-47.2%], 41.7% [95% CI, 31.5%-51.6%], 16.5% of stance [95% CI, 7.3%-25.6%], respectively). Maximum hip adduction and knee valgus occurred before maximum knee flexion in women and after in men (mean differences 0.11 seconds [95% CI, 0.05-0.18 seconds], 0.19 seconds [95% CI, 0.13-0.25 seconds], respectively). Maximum ankle eversion occurred earlier in women than in men (mean difference 0.06 seconds [95% CI, 0.01-0.11 seconds]). There was a significant difference between genders for angular velocity of knee valgus (mean difference = 25.53 deg/sec [95% CI, 8.30-42.77 deg/sec]). CONCLUSION: Frontal plane kinematic temporal relationships at the hip, knee, and ankle differ between genders. The components of dynamic knee valgus peak during the deceleration phase in women and during the acceleration phase in men during a drop-jump landing. These data suggest that men and women employ a completely different kinematic landing/jumping strategy and that women land and collapse very rapidly into valgus compared with their male counterparts. CLINICAL RELEVANCE: The differences in timing of the components of dynamic knee valgus between women and men may contribute to the increased risk of noncontact anterior cruciate ligament injuries in female athletes. There may be implications for neuromuscular reeducation training in those at risk for anterior cruciate ligament injury so the components of dynamic valgus occur later in the landing phase of jumping.

Leukocyte ß2-adrenergic receptor expression in response to resistance exercise.

PURPOSE: Epinephrine and norepinephrine mediate interactions between the neuroendocrine and the immune systems to alter immune cell activity. Although both systems respond to exercise stress, less is known about how they interact in response to such stress. The purpose of this investigation was to examine ß2-adrenergic receptor (ß2-ADR) expression on circulating leukocytes to an acute bout of resistance exercise in men and women. METHODS: Resistance-trained men (n = 8; mean ± SD age = 24.63 ± 5.07 yr, body mass index = 26.09 ± 2.21 kg·m(-2)) and women (n = 7; age = 22.13 ± 3.09 yr, body mass index = 22.63 ± 2.03 kg·m(-2)) performed an acute resistance exercise protocol (six sets of five-repetition maximum heavy squats) and a control test (i.e., identical conditions with no exercise) in a balanced, randomized order. Using a within-subject design, ß2-ADR expressions on circulating leukocytes were evaluated with flow cytometry, and plasma epinephrine and norepinephrine were evaluated with high-performance liquid chromatography. RESULTS: Plasma epinephrine and norepinephrine increased during the exercise bout and returned to baseline during recovery. ß2-ADR expression on monocytes was elevated in anticipation of the exercise protocol. ß2-ADR expression on monocytes and granulocytes decreased during the exercise. ß2-ADR expression on lymphocytes was elevated during the recovery time points. CONCLUSIONS: In conclusion, ß2-ADR expression on leukocyte subpopulations changes in response to acute heavy resistance exercise protocol. The present findings provide insights into the potential temporal interactions between the neuroendocrine and the immune systems in response to the physiological stress of acute heavy resistance exercise in men and women.

Glucocorticoid receptor expression on human B cells in response to acute heavy resistance exercise.

OBJECTIVE: To examine glucocorticoid receptor (GCR) expression on B lymphocytes in response to an acute bout of resistance exercise. METHODS: Using a within-subject design, resistance-trained women (n = 7; age: 22.13 ± 3.09 years; height: 1.69 ± 0.084 m; body weight: 65.60 ± 10.01 kg; body mass index: 22.63 ± 2.03 kg/m²; means ± SD) and men (n = 8; age: 23.28 ± 4.26 years; height: 1.73 ± 0.086 m; body weight: 73.93 ± 12.71 kg; body mass index: 24.51 ± 2.61 kg/m²; means ± SD) performed an acute resistance exercise protocol (6 sets of 5 repetition maximum heavy squats) and a control test in a balanced, randomized order. Blood samples were obtained before, during, and immediately after exercise, and after 1, 6, and 24 h of recovery. GCR expression on circulating B lymphocytes was evaluated with flow cytometry, and circulating cortisol was assayed. RESULTS: Resting GCR expression on B lymphocytes was similar between men and women. GCR expression was elevated in anticipation of exercise (p = 0.047), decreased during exercise (p = 0.049), and increased during recovery (p = 0.05 and p = 0.03 after 1 and 6 h of recovery, respectively). Trends for gender differences were apparent before and during exercise, and after 6 h of recovery. Men had significantly higher cortisol responses during (p = 0.002) and after exercise (p = 0.094) compared to before exercise. In women, however, circulating cortisol concentrations did not significantly increase in response to the squat exercise protocol. CONCLUSIONS: GCR expression on B lymphocytes decreased during resistance exercise and increased during recovery. Circulating cortisol increased during exercise in men only. Responses were attenuated in women compared to men. Our data provide insights into the temporal interactions between the endocrine and immune systems in response to acute heavy resistance exercise in men and women.

Evaluating the athlete's claim of an unintentional positive urine drug test.

During a urine drug testing program, an athlete may make a claim that the results of a positive test have arisen from factors that were out of his or her control, and therefore, he or she should not be held responsible for the results. Some of these claims may include classic claims of passive inhalation of marijuana smoke or ingestion of poppy seeds leading to positive tests. In addition, with the proliferation of nutritional supplements on the market, many athletes claim that they accidentally ingested a banned substance contained in one of these. It is important that any sports medicine physician involved with sports drug testing be informed of the data that either support or refute these claims and that he or she contribute to a program wherein adequate education and policy establishment help to limit the likelihood of such claims. This article will review the data to help address these claims.

Caffeine lowers muscle pain during exercise in hot but not cool environments.

Caffeine (CAF) ingestion may enhance endurance exercise by lowering perceived exertion (RPE) and muscle pain. However, exercise in the heat may be detrimental to performance by increasing RPE and pain. The purpose of this study was to examine if caffeine affects pain and related perceptual responses differently in cool and hot ambient conditions. Eleven male cyclists (mean ± SD; age, 25 ± 6 years; mass, 72.6 ± 8.1 kg; VO(2max), 58.7 ± 2.9 ml kg(-1) min(-1)) completed four trials in a randomized, double blind design. While remaining euhydrated, subjects cycled for 90 min at 65 ± 7% VO(2max) followed by a 15-min performance trial. Subjects ingested 3 mg kg(-1) of encapsulated caffeine (CAF) or placebo (PLA) 60 min before and 45 after beginning exercise in 12°C and 33°C (i.e., 12-CAF, 33-CAF, 12-PLA, and 33-PLA trials). Central, local, and overall perceived exertion (C-, L-, and O-RPE) and pain were measured throughout exercise. Throughout submaximal exercise C-, L-, and O-RPE were significantly greater in 33°C (P<0.05) but were not affected by CAF (P>0.05). Using area-under-the-curve analysis, pain in 33-PLA was increased by 74% vs 12-PLA (P<0.05). CAF did not reduce pain in 12°C (P=0.542), but in 33°C, CAF reduced pain by 27% (P=0.032). Despite this apparent advantage, CAF improved performance independent of ambient temperature (i.e., non-significant interaction; P=0.662). This study found that, although caffeine improves exercise capacity, its effect on leg muscle pain is dependent on ambient temperature. Although exercise in the heat increases muscle pain compared to a cooler environment, caffeine reduces this pain.

Effect of ambient temperature on caffeine ergogenicity during endurance exercise.

It is well established that caffeine ingestion during exercise enhances endurance performance. Conversely, the physiological and psychological strain that accompanies increased ambient temperature decreases endurance performance. Little is known about the interaction between environmental temperature and the effects of caffeine on performance. The purpose of this study was to compare the effects of ambient temperature (12 and 33°C) on caffeine ergogenicity during endurance cycling exercise. Eleven male cyclists (mean ± SD; age, 25 ± 6 years; [Formula: see text] 58.7 ± 2.9 ml kg(-1) min(-1)) completed four exercise trials in a randomized, double blind experimental design. After cycling continuously for 90 min (average 65 ± 7% [Formula: see text]) in either a warm (33 ± 1°C, 41 ± 5%rh) or cool (12 ± 1°C, 60 ± 7%rh) environment, subjects completed a 15-min performance trial (PT; based on total work accumulated). Subjects ingested 3 mg kg(-1) of encapsulated caffeine (CAF) or placebo (PLA) 60 min prior to and after 45 min of exercise. Throughout exercise, subjects ingested water so that at the end of exercise, independent of ambient temperature, their body mass was reduced 0.55 ± 0.67%. Two-way (temperature × treatment) repeated-measures ANOVA were conducted with alpha set at 0.05. Total work (kJ) during the PT was greater in 12°C than 33°C [P < 0.001, η(2) = 0.804, confidence interval (CI): 30.51-62.30]. When pooled, CAF increased performance versus PLA independent of temperature (P = 0.006, η(2) = 0.542 CI: 3.60-16.86). However, performance differences with CAF were not dependent on ambient temperature (i.e., non-significant interaction; P = 0.662). CAF versus PLA in 12 and 33°C resulted in few differences in other physiological variables. However, during exercise, rectal temperature (T (re)) increased in the warm environment (peak T (re); 33°C, 39.40 ± 0.45; 12°C, 38.79 ± 0.42°C; P < 0.05) but was not different in CAF versus PLA (P > 0.05). Increased ambient temperature had a detrimental effect on cycling performance in both the CAF and PLA conditions. CAF improved performance independent of environmental temperature. These findings suggest that caffeine at the dosage utilized (6 mg/kg body mass) is a, legal drug that provides an ergogenic benefit in 12 and 33°C.

Testosterone physiology in resistance exercise and training: the up-stream regulatory elements.

Testosterone is one of the most potent naturally secreted androgenic-anabolic hormones, and its biological effects include promotion of muscle growth. In muscle, testosterone stimulates protein synthesis (anabolic effect) and inhibits protein degradation (anti-catabolic effect); combined, these effects account for the promotion of muscle hypertrophy by testosterone. These physiological signals from testosterone are modulated through the interaction of testosterone with the intracellular androgen receptor (AR). Testosterone is important for the desired adaptations to resistance exercise and training; in fact, testosterone is considered the major promoter of muscle growth and subsequent increase in muscle strength in response to resistance training in men. The acute endocrine response to a bout of heavy resistance exercise generally includes increased secretion of various catabolic (breakdown-related) and anabolic (growth-related) hormones including testosterone. The response of testosterone and AR to resistance exercise is largely determined by upper regulatory elements including the acute exercise programme variable domains, sex and age. In general, testosterone concentration is elevated directly following heavy resistance exercise in men. Findings on the testosterone response in women are equivocal with both increases and no changes observed in response to a bout of heavy resistance exercise. Age also significantly affects circulating testosterone concentrations. Until puberty, children do not experience an acute increase in testosterone from a bout of resistance exercise; after puberty some acute increases in testosterone from resistance exercise can be found in boys but not in girls. Aging beyond 35-40 years is associated with a 1-3% decline per year in circulating testosterone concentration in men; this decline eventually results in the condition known as andropause. Similarly, aging results in a reduced acute testosterone response to resistance exercise in men. In women, circulating testosterone concentration also gradually declines until menopause, after which a drastic reduction is found. In summary, testosterone is an important modulator of muscle mass in both men and women and acute increases in testosterone can be induced by resistance exercise. In general, the variables within the acute programme variable domains must be selected such that the resistance exercise session contains high volume and metabolic demand in order to induce an acute testosterone response.