unique aspects of competitive weightlifting

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Unique Aspects of Competitive Weightlifting Performance, Training and Physiology Adam Storey and Heather K. Smith Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand Contents Abstract ................................................................................. 769 1. Introduction .......................................................................... 770 2. Literature Reviewed .................................................................... 771 3. Weightlifting Performance .............................................................. 771 3.1 The Snatch ....................................................................... 771 3.2 The Clean and Jerk ................................................................ 771 4. Training .............................................................................. 774 4.1 Exercises ......................................................................... 774 4.2 Annual Training Structure ........................................................... 774 4.3 Application and Variation in Training Load ............................................ 775 4.4 Metabolic Cost of Weightlifting and Nutritional Practices ................................ 776 4.5 Influence of Body Weight Changes on Performance ................................... 777 5. Anthropometric Characteristics of Weightlifters............................................. 777 6. Physiological Responses and Adaptations to Weightlifting ................................... 777 6.1 Skeletal Muscle Structure and Function ............................................... 778 6.1.1 Fibre Type Composition ....................................................... 778 6.1.2 Neuromuscular Function ...................................................... 778 6.1.3 Sex- and Age-Related Differences in Neuromuscular Function ...................... 779 6.2 Bone Mineral Density............................................................... 780 6.3 Cardiovascular Structure and Function ............................................... 780 6.4 Endocrine ........................................................................ 781 6.4.1 Testosterone ................................................................ 781 6.4.2 Testosterone : Cortisol Ratio .................................................... 781 6.4.3 Growth Hormone ............................................................ 782 7. Recommendations and Conclusions ..................................................... 782 Abstract Weightlifting is a dynamic strength and power sport in which two, multi- joint, whole-body lifts are performed in competition; the snatch and clean and jerk. During the performance of these lifts, weightlifters have achieved some of the highest absolute and relative peak power outputs reported in the literature. The training structure of competitive weightlifters is characterized by the frequent use of high-intensity resistance exercise movements. Varied coaching and training philosophies currently exist around the world and fur- ther research is required to substantiate the best type of training programme for male and female weightlifters of various age groups. As competitive REVIEW ARTICLE Sports Med 2012; 42 (9): 769-790 0112-1642/12/0009-0769/$49.95/0 Adis ª 2012 Springer International Publishing AG. All rights reserved.

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Page 1: Unique Aspects of Competitive Weightlifting

Unique Aspects of CompetitiveWeightliftingPerformance, Training and Physiology

Adam Storey and Heather K. Smith

Department of Sport and Exercise Science, The University of Auckland, Auckland, New Zealand

Contents

Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7691. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7702. Literature Reviewed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7713. Weightlifting Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 771

3.1 The Snatch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7713.2 The Clean and Jerk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 771

4. Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7744.1 Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7744.2 Annual Training Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7744.3 Application and Variation in Training Load . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7754.4 Metabolic Cost of Weightlifting and Nutritional Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7764.5 Influence of Body Weight Changes on Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777

5. Anthropometric Characteristics of Weightlifters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7776. Physiological Responses and Adaptations to Weightlifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777

6.1 Skeletal Muscle Structure and Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7786.1.1 Fibre Type Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7786.1.2 Neuromuscular Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7786.1.3 Sex- and Age-Related Differences in Neuromuscular Function . . . . . . . . . . . . . . . . . . . . . . 779

6.2 Bone Mineral Density. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7806.3 Cardiovascular Structure and Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7806.4 Endocrine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 781

6.4.1 Testosterone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7816.4.2 Testosterone : Cortisol Ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7816.4.3 Growth Hormone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 782

7. Recommendations and Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 782

Abstract Weightlifting is a dynamic strength and power sport in which two, multi-joint, whole-body lifts are performed in competition; the snatch and cleanand jerk. During the performance of these lifts, weightlifters have achievedsome of the highest absolute and relative peak power outputs reported in theliterature. The training structure of competitive weightlifters is characterizedby the frequent use of high-intensity resistance exercise movements. Variedcoaching and training philosophies currently exist around the world and fur-ther research is required to substantiate the best type of training programmefor male and female weightlifters of various age groups. As competitive

REVIEW ARTICLESports Med 2012; 42 (9): 769-790

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weightlifting is contested over eight male and seven female body weight ca-tegories, the anthropometric characteristics of the athletes widely ranges. Thebody compositions of weightlifters are similar to that of athletes of compar-able body mass in other strength and power sports. However, the shorterheight and limb lengths of weightlifters provide mechanical advantages whenlifting heavy loads by reducing the mechanical torque and the vertical dis-tance that the barbell must be displaced. Furthermore, the shorter body di-mensions coincide with a greater mean skeletal muscle cross-sectional areathat is advantageous to weightlifting performance. Weightlifting traininginduces a high metabolic cost. Although dietary records demonstrate thatweightlifters typically meet their required daily energy intake, weightliftershave been shown to over consume protein and fat at the expense of adequatecarbohydrate. The resulting macronutrient imbalance may not yield optimalperformance gains. Cross-sectional data suggest that weightlifting traininginduces type IIX to IIA fibre-type transformation. Furthermore, weightliftersexhibit hypertrophy of type II fibres that is advantageous to weightliftingperformance and maximal force production. As such, the isometric peakforce and contractile rate of force development of weightlifters is ~15–20%and ~13–16% greater, respectively, than in other strength and power athletes.In addition, weightlifting training has been shown to reduce the typical sex-related difference in the expression of neuromuscular strength and power.However, this apparent sex-related difference appears to be augmented withincreasing adult age demonstrating that women undergo a greater age-relateddecline in muscle shortening velocity and peak power when compared withmen. Weightlifting training and competition has been shown to induce sig-nificant structural and functional adaptations of the cardiovascular system.The collective evidence shows that these adaptations are physiological asopposed to pathological. Finally, the acute exercise-induced testosterone,cortisol and growth hormone responses of weightlifters have similarities tothat of following conventional strength and hypertrophy protocols involvinglarge muscle mass exercises. The routine assessment of the basal testoster-one : cortisol ratio may be beneficial when attempting to quantify the adaptiveresponses to weightlifting training. As competitive weightlifting is becomingincreasingly popular around the world, further research addressing the phys-iological responses and adaptations of female weightlifters and younger (i.e.£17 years of age) and older (i.e. ‡35 years of age) weightlifters of both sexes isrequired.

1. Introduction

Weightlifting has been a longstanding part of themodern Olympic Games and has wide and growinginternational participation.During the performanceof the two competitive lifts, the snatch and the cleanand jerk (C&J), weightlifters are required to gen-erate extremely high peak forces and contractilerates of force development and, consequently, highpeak power outputs and contractile impulses.[1-6]

This review details the unique performanceand training requirements of competitive weight-lifters with particular emphasis on the movementdemands, training intensities and commonly adopt-ed nutritional practices of these athletes. Furtherattention is directed towards descriptions of thephysiological responses and adaptations of themusculoskeletal, cardiovascular and endocrine sys-tems to weightlifting training and competition. Fi-nally, as weightlifting is becoming increasingly

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popular with females, and younger and older in-dividuals, we highlight potential areas for futureresearch that will enable the development of safe andeffective training guidelines for these populations.

2. Literature Reviewed

The search for scientific literature relevant tothis review was conducted using the US NationalLibrary of Medicine (PubMed), SPORTDiscus�and Google Scholar databases. Key search termsof ‘Olympic weightlifting’, ‘weightlifter/s’, ‘snatch’,‘clean and jerk’, ‘muscular strength’ and ‘muscularpower’ were used. Further literature was obtainedfrom electronic ‘related articles’ searches and bymanually screening the reference lists of includedstudies. The inclusion criteria for all articles were;(i) refereed articles published in English languagejournals and books from the 1970s until February,2012; and (ii) the terms ‘weightlifter’ and ‘weight-lifting’ had to be in context with the sport ofcompetitive weightlifting as opposed to generalweight/resistance training.

3. Weightlifting Performance

The snatch and C&J are complex whole-bodymovements encompassing a series of high-intensitymuscular contractions. During these lifts, weight-lifters achieve power outputs unmatched by anyother athletes.[1] Since 1998, the recognized bodyweight classes are: men £56 kg, £62kg, £69 kg,£77 kg, £85kg, £94 kg, £105kg and >105kg; andwomen £48 kg, £53 kg, £58kg, £63 kg, £69 kg,£75 kg and >75 kg. Athletes must weigh-in duringa 1-hour window that begins 2 hours before thestart of their competition session. The athlete’splacing within their respective body weight class isdetermined by their competition total, which isthe sum of their highest recorded snatch and C&J.

3.1 The Snatch

The snatch requires the weighted barbell to belifted from the floor (using a wide grip) to anoverhead position in one continuousmovement.[7]

The snatch includes six phases (figure 1). The firstpull is initiated when the lifter extends their knees

to raise the barbell off the platform to a positionjust below knee level. A transition period (also re-ferred to as the ‘double-knee bend’) followswherebythe knees are re-bent and are moved under thebarbell whilst the lifter’s trunk is moved to a nearvertical position.[8-10] The ‘double-knee bend’allows the lifter to take advantage of a stretch-shortening cycle during the subsequent secondpull.[10] The second pull requires the lifter to maxi-mally accelerate the barbell by simultaneouslyshrugging the shoulders and extending the hips,knees and ankles. During the performance of nearmaximal to maximal full snatch attempts, the ver-tical velocity of the barbell during the second pullcan range between 1.65m/sec and 2.28m/sec.[4,11-16]During submaximal attempts and snatch-relatedmovements (i.e. power snatch), barbell velocitiesmay exceed 3.00m/sec.[17,18] As the barbell risesin the vertical plane to ~62–78% of the lifter’sheight,[11,13-15] the lifter begins to ‘pull’ their bodyunderneath the barbell; this phase is referred to asthe turnover. The lifter then ‘catches’ the barbell ina straight-arm overhead position whilst flexing atthe knee and hip into a full squat position. Thelifter then ‘recovers’ out of the full squat to astanding position whilst maintaining the barbelloverhead. The duration of effort from the start ofthe first pull until the competition referees signala successful lift is ~3–5 seconds. Each athlete isentitled to three snatch attempts in competition.

3.2 The Clean and Jerk

The C&J is a two-part lift that enables heavierloads (~18–20% greater) to be lifted than duringthe snatch. The clean requires the barbell to beraised from the floor (using a shoulder width grip)to the front of the shoulders in one continuousmovement. There are six phases of the clean(figure 2). The mechanical principles behind thefirst three phases (first pull, transition/double-knee bend and second pull) are the same as thoseof the snatch. During the second pull of nearmaximal to maximal attempt cleans, the verticalvelocity of the barbell can range from 0.88m/secto 1.73m/sec.[3,4] However, during submaximalattempts and clean-related movements (i.e. powerclean), barbell velocitiesmay exceed 2.50m/sec.[19,20]

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As the barbell rises in the vertical plane to ~55–65%of the lifter’s height,[21] the lifter initiates the ‘turn-over’ phase. The lifter then ‘catches’ the barbell ontheir shoulders and descends into a full squat posi-tion. The lifter then ‘recovers’ from the full squatposition to prepare for the jerk.

The jerk also has six phases (figure 2): (i) start;(ii) dip; (iii) jerk drive; (iv) unsupported splitunder the bar; (v) supported split under the bar;and (vi) recovery. During the start phase, the lifterand the barbell must become motionless. The lifterthen begins to dip down by flexing at the kneeand hip, with the barbell held across the should-ers. At the lowest point of the dip, the lifter makesthe transition to the jerk drive where they are re-quired to accelerate the barbell in the verticalplane. During this transition period, the athletemay be exposed to a downward force equivalent

to 17 times their body mass.[22] Reported poweroutputs during maximal attempt jerk drivesrange from 2140 watts (W) for a lifter in men’sunder 56 kg class to 4786 W for a lifter inthe men’s 105kg+ class.[1] At the completion of thejerk drive, the barbell is vertically driven off theshoulders and the lifter’s feet leave the ground.This phase represents the ‘unsupported splitunder the bar’. Once the lifter’s feet are in contactwith the ground and the barbell is held overheadwith fully extended arms, the lifter is in the ‘sup-ported split under the bar’ phase. The lifter mustthen recover and is required to stand motionlesswith their feet parallel to one another. The dura-tion of effort from the start of the first pull tothe signal of a successful lift is ~8–12 seconds.Each athlete is entitled to three C&J attempts incompetition.

a

d e

b

f

c

Fig. 1. The six phases of the snatch: (a) first pull; (b) transition to the start of the second pull; (c) completion of the second pull; (d) turnover;(e) catch; (f) recovery.

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a b c

d e f

g h i

j k l

Fig. 2. The twelve phases of the clean and jerk: (a) first pull; (b) transition to the start of the second pull; (c) completion of the second pull;(d) turnover; (e) catch; (f) recovery from the clean; (g) start position for the jerk; (h) jerk dip; (i) jerk drive; (j) unsupported split under the bar;(k) supported split under the bar; (l) recovery from the jerk.

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4. Training

There is limited evidence comparing the perfor-mance and physiological responses arising fromdifferent weightlifting training programmes.[23-26]

However, the English language coaching literatureand empirical evidence suggests that numerousand varied practices exist amongst internationallycompetitive weightlifters.[21,25-28]

4.1 Exercises

The two competitive lifts form the basis ofthe training programmes for junior and seniorweightlifters. Complementary exercises that havemovement patterns similar to the competitive lifts(e.g. hang/power snatch, hang/power clean, snatchand clean pulls, front and back squats) and sup-plementary exercises (e.g. overhead presses, backextensions and abdominal work) that target sy-nergistic muscle groups are also used. The com-plementary exercises are also incorporated intothe training programmes of other power ath-letes[24,29-31] as follows: (i) kinematic similari-ties exist between the propulsive phases in bothweightlifting and jumping movements;[32-37] and(ii) significant relationships exist between weight-lifting ability and power output during jumping(r = 0.59 to 0.93) and sprinting (r = -0.52 to-0.76)[33,37-40] and tests of agility (-0.41).[37]

However, despite commonalities in the modeof exercise and other acute variables, the trainingprogrammes of weightlifters differ, particularly inthe frequency and volume of high-intensity loads,from that of other power athletes (refer section 4.3).The collective differences in the competitive de-mands and the required physiological adaptationsof other various athletes may account for these dis-crepancies. Furthermore, due to the technically andphysically demanding nature of the snatch andC&J,modified versions are often employed by otherathletes for the enhancement of muscular power.

4.2 Annual Training Structure

Broad descriptions of variations in weightlift-ing training variables have been offered in theliterature.[21,23-26,28,41] More specific details arerarely outlined. Due to the success of many

Eastern European teams, in particular the formerSoviet Union and Bulgaria, a number of the world’straining programmes are variations of the general-ized training models established by these nations.[27]

However, Western coaches were required to makemodifications to these training methods pre-sumably due to the higher prevalence of anabolicsteroid use amongst Eastern Bloc teams;[10,42,43]

since the 1970s, competitive weightlifters havebeen subjected to random drug testing[42] that caninclude both urine and blood assays.

The training programmes from the formerSoviet Union were based upon the classic ‘period-ization’ model[25] consisting of a preparatory phase(generalized and specific conditioning), competitionphase (specific training mimicking the demands ofcompetition), and a transition phase (generalizedconditioning at the end of a training cycle). A widevariety of exercises at varying intensities and vol-umes were incorporated into these programmeswith the belief that this would prevent athletesreaching a state of overtraining due to ‘movementpatternmonotony’.[27] Although international-levelweightlifters would typically perform 20000–25000multijoint exercise repetitions per year, only15–35% of those repetitions were competition liftsperformed at 80–90% of their one-repetition max-imum (1RM) with an additional 4–7% being per-formed at ‡90% of 1RM.[21,25,44]

In contrast, the Bulgarian training approachis characterized by frequent, near-maximal tomaximal-intensity loading[21,27,44-46] and is moreclosely aligned with the demands of competition.It has been reported that Bulgarian lifters per-formed between 1400 and 4000 maximal attempts,and 450 and 460 failed supramaximal attemptseach year in training.[21,44] Approximately 10% ofthe total training time is devoted to warm-up ex-ercises, 45% to competition lifts, 40% to comple-mentary strength exercises, 3% to supplementaryexercises and 2% to other sports and cross-trainingactivities.[21] There is very little variation in train-ing intensity, by comparison with the trainingprogrammes of the former Soviet Union. How-ever, fluctuations in training volume are applied.The training follows a repeated pattern of 2–3weeksof increased loading followed by 1 week of reducedloading. This cyclic pattern of ‘overload’ and

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‘recovery’ is believed to contribute to subsequentlong-term improvements in performance.[41,47]

Although the competitive performances ofweightlifters continue to improve, as evident byincreases in national and world records, furtherresearch needs to be directed towards several as-pects of weightlifting programme design. Theseaspects include (i) effective coaching strate-gies for novice weightlifters; (ii) the influence ofexercise volume and intensity on physiologicaland performance variables in female and youthweightlifters; and (iii) the efficacy of variations intraining techniques (e.g. the incorporation of ec-centric-only exercises).

4.3 Application and Variation in Training Load

International-level weightlifters perform twoor more high-intensity resistance exercise (HIRE)[‡80% 1RM] sessions per day, of the same majormuscle groups, 6 or 7 days per week.[21,25-28] Anextreme example of this high-frequency of train-ing was demonstrated by the Greek weightliftingteam during preparations for the 1996 OlympicGames. Across a 6-day training week, the Greekteam performed 13 snatch, 11 C&J, 11 back squatand 9 front squat sessions.[21] In senior weight-lifters, dividing a given training volume acrosstwo sessions that are performed on the same dayproduces significantly greater increases in muscu-lar strength, hypertrophy and maximal neural ac-tivation of the trained musculature.[48,49] However,as the majority of the exercises that are performedby weightlifters are the competitive lifts and similarmultijoint movements, a large number of musclecontractions are performed by the same majormuscle groups within each training session.

Thus, the frequency of HIRE performed byweightlifters exceeds evidence-based recommenda-tions for improving muscular strength and powerin advanced trained adults. For example, theAmerican College of Sports Medicine (ACSM)propose (i) a training frequency of 4–6 sessionsper week; and (ii) training different muscle groupsduring subsequent strength and power sessions toallow for adequate recovery.[50,51] Previous evi-dence has also shown that repeated HIRE boutsof the same muscle group/s result in the persistent

suppression of key anabolic mediators, prolongedinflammatory signalling and decrements in muscu-lar performance.[52-56] In contrast to these findings,weightlifters demonstrate both acute and long-termimprovements in competitive lifting performancein response to their frequent HIRE trainingstructure.[21,57-60]

Although little evidence exists to suggest thatweightlifting training, under proper supervision,is more injurious to children or adolescents whencompared with other sports,[61-63] considerablecontroversy still surrounds the use of weightliftingexercises in younger populations (i.e. <17 years ofage). As such, definitive biological and/or trainingage appropriate weightlifting training guidelineshave yet to be established. The training age ofa weightlifter greatly influences their ability topositively adapt to the frequent use of HIRE.Over a 10-week training period in competitivejunior (17–20 years of age) weightlifters, moderatevolumes of high-intensity (>90–100% 1RM) load-ing produced significantly greater strength gains(10.5% improvement in C&J and 9.5% improve-ment in back squat) when compared with low(3.0% improvement in C&J and 5.3% improve-ment in back squat) and high (6.9% improvementin back squat performance only) volumes of sim-ilarly high-intensity loading.[23] Furthermore, ithas recently been demonstrated that performingadditional high-intensity training sessions withinthe same day does not lead to significantly greaterperformance improvements in young weightlift-ers.[64] In comparison, international-level seniorweightlifters (20–35 years of age) demonstrate agreater ability to tolerate and adapt to highervolumes of high-intensity loading.[6,21,26,27] How-ever, masters’ weightlifters (‡35 years of age) ex-hibit significant declines in training ability andweightlifting performance,[65-68] which is in accor-dance with the well documented impaired adaptiveresponses to resistance exercise with increasingadult age.[69-71] On the basis of these findings, wepropose that an inverted U-shaped relationshipexists between competitive age and the volumeof high-intensity loading that leads to enhancedweightlifting performance (figure 3).

During ballistic activities such as bench throwsor jump squats, absolute peak power output (PP)

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has been shown to occur between training loadsof 30–50% of 1RM.[72-77] However, more recentresearch suggests that the load required to elicitPP during jump squats may even be as low asbody mass only.[19,78,79] Therefore, the prescrip-tion of relatively low-intensity (i.e. 0–60% 1RM)resistance exercise (inclusive of complementaryweightlifting exercises) is often recommended toimprove muscular power and dynamic athleticperformance.[51,74,80-85] For example, the lighterrelative training loads used for the power snatch,power clean and various pullingmovements result ina greater maximum barbell vertical velocity, con-tractile impulse and thus a greater PP when com-pared with maximal competition lifts.[18-20,36,86,87]

During the snatch and/or C&J, PP has been shownto occur with loads of 70–80% of 1RM[19,30,86,88]

demonstrating that the high-intensity training ofweightlifters results in improved PP under high-load conditions. Therefore, weightlifters will fre-quently train for the competitive lifts at intensities‡70% of 1RM.[21,25-28] Athletes who are requiredto generate high PP against heavy external loads(e.g. wrestlers, bobsledders and rugby union/leagueplayers) are likely to benefit from high-loadweightlifting training.[19,24,35,37,89,90] However, atpresent there is a paucity of research examiningthe efficacy of power training with high- versuslow-load weightlifting exercises in trained strengthand power athletes.

4.4 Metabolic Cost of Weightlifting andNutritional Practices

The metabolic demands of weightlifting train-ing are reflected in the relatively high energy ex-

penditures incurred by the athletes. For example,a mean caloric expenditure of 39.5 kJ/min wasrecorded in male weightlifters during a 1 weekpreparatory phase of training characterized by amoderate- to high-volume of moderate- to high-intensity lifts.[91] This value is comparable withthe metabolic cost incurred by high-volume cir-cuit-style resistance exercise.[92] Furthermore, thetraining stimulus alone produced a weekly energyexpenditure of 16 456 kJ.[91] The reported meandaily energy intakes of male weightlifters rangebetween 13 212 kJ and 19 307 kJ,[93-97] which areconsistent with the values recommended for ‘hardtraining’ male athletes (14 700–23 100 kJ/day).[98]As expected, the corresponding relative daily en-ergy intakes values of 134–244 kJ/kg/day[93,95-97]are comparable with those of other strength andpower athletes.[93,95,97,99] In regards to macro-nutrient consumption, it is reported that weight-lifters consume a greater number of daily servingsof protein-rich sources when compared withother athletes.[93,94,100] As a result, the protein in-take of male weightlifters has been reported torange between 1.6 g/kg/day and 3.2 g/kg/day,[95,96]which is high when compared with the recom-mended 1.2–1.7 g/kg/day for resistance train-ing athletes.[60,93,95,101] Furthermore, weightliftersderive approximately 40–44% of their daily energyintake from dietary fat,[93,95,96,102] which is alsowell above the acceptable range for health andathletic performance of 20–35%.[103,104] This isa possible consequence of their greater intake ofprotein-rich animal products. Conversely, thereported carbohydrate intakes in weightlifters of2.9–6.1 g/kg/day[93,95,105] are insufficient accordingto the current recommended levels of 7–8 g/kg/dayfor athletic individuals.[106] Combined, these reportssuggest that the dietary habits of male weightliftersmay not yield the desired training gains and/orhealth benefits due to the emphasis placed onprotein consumption (with high fat) at the ex-pense of adequate carbohydrate ingestion. As thetraining and competition demands of weightliftersdiffer to those of other strength and power ath-letes, further research is required to (i) documentthe current dietary habits of competitive weight-lifters; and (ii) identify the optimal macronutrientbalance for weightlifting performance.

High

Volume ofhigh-intensity

loadingModerate

Low

Junio

r

Senior

Mas

ters

⎧⎪⎪⎨⎪⎪⎩

Fig. 3. Proposed relationship between the volume of high-intensity(90–100% of one-repetition maximum) loading that leads to enhancedweightlifting performance and competitive age. Junior: 17 to £20 yearsof age; senior: >20 to £35 years of age; masters: ‡35 years of age.

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4.5 Influence of Body Weight Changes onPerformance

Athletes participating in weight-restricted eventswill often train at a body mass that is 5–10% abovetheir required competition weight class.[98] In theweek leading up to competition, a minor reduc-tion in body mass (e.g. a loss of 1–2kg) might beachieved by restricting fluid intake and consuming alow residue diet.[101] To ‘make weight’ and to avoidthe loss of lean muscle mass, it is common forweightlifters to rapidly reduce total body water con-tent prior to competition weigh in. This is achievedvia passive methods including self-limited fluid in-take, acute heat exposure and/or the use of (banned)diuretic agents.[107] Whilst the detrimental effects ofhypohydration on endurance performance are welldocumented,[108-110] less evidence exists regardingthe effects of hypohydration on muscular strengthand power. Evaluations of the effects of short-termhypohydration on maximal force production, mus-cular endurance and PP have demonstrated a de-crease[111-115] or no change[116-119] in these variables.Where mild hypohydration (i.e. £2% reduction inbody mass) techniques have attenuated neuromus-cular performance, rapid rehydration interventionsover a short period of time (i.e. over a 2 hour periodas done in competition) have effectively restoredperformance variables.[111] However, an athlete’sability to overcome the detrimental effects of dehy-dration is severely affected when hypohydration-induced reductions in bodymass reach 3–4%.[107,114]

It is thus tenable that severe hypohydrationwould impair weightlifting performance. Forweight-lifters opting to train at a body mass ‡3% abovetheir competition weight, minor dietary modifica-tions should be introduced in the weeks leading upto competition to achieve a bodymass of£2% abovethat desired/required for competition. Mild hypo-hydration techniques may then be implemented24 hours prior to competition weigh-in, followed byeffective rehydration strategies afterwards.

5. Anthropometric Characteristics ofWeightlifters

The anthropometric characteristics of maleweightlifters have been documented extensive-ly.[10,120-125] Light- to middle-weight male weight-

lifters (i.e. £56 kg to £85 kg) are somatotyped aspredominately ectomorphic or mesomorphic[124]

with body fat percentages of 5–10%.[10,122,123,125]

These compositional characteristics are comparableto weight restricted wrestlers and athletes com-peting in the sprinting and jumping events ofathletics.[10,126,127] Conversely, weightlifters in theheavy to unlimited weight classes (i.e. £94 kg to>105 kg) tend to be more endomorphic meso-morphs[124] with corresponding body fat percentagesof ‡17%.[10,121,125] These individuals possess similarbody compositions to heavyweight wrestlers, pow-erlifters, discus, shot put and hammer throwingathletes.[10,127-131] Although the anthropometric dataon female weightlifters is less comprehensive, thelimited data suggest that the body fat percentages offemale weightlifters may be double that of maleweightlifters of a similar body mass.[10,132,133] How-ever, elite male and female weightlifters exhibit alower body fat percentage when compared withlower level competitors of a similar total bodymass.[122,133] Thus, the resulting differences in leanbody mass becomes a major contributing factorto the divergent neuromuscular responses seenbetween male and female and elite versus non-elite weightlifters (refer section 6.1.3).[122,133-140]

In comparison to other strength and powerathletes of a similar body mass and composition,weightlifters have proportionally shorter arm spanand tibial lengths, larger biacromial breadths andare shorter in height.[120,122,125,136] Such anthro-pometric characteristics provide two mechanicaladvantages when lifting maximal loads: (i) themechanical torque that is required to lift a givenload is less due to shorter lengths of the resistancelever arms; and (ii) the amount of muscular workrequired to lift a given load is decreased via areduction in the vertical distance that the barbellmust be displaced.[129] Furthermore, the shorterbody dimensions coincide with a greater meanskeletal muscle cross-sectional area, which is ad-vantageous to weightlifting performance.[134]

6. Physiological Responses andAdaptations to Weightlifting

The complexity, intensity and brevity of weight-lifting impose great challenges when attempting

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to obtain valid and meaningful physiologicaldata from competitive weightlifters. Furthermore,it is onerous and/or inappropriate to apply sim-ilar exercise protocols in non-weightlifters due tothe technically demanding nature of the specificmovements. As such there is limited data on theacute neuromuscular, cardiovascular and endo-crine responses that occur (especially in femaleweightlifters) during weightlifting training andcompetition. Furthermore, few studies have ex-amined the adaptations of the neuromuscularand endocrine systems that arise from moderate(weeks–months) to long-term (months–years) peri-ods of weightlifting-specific training. However, in-vestigations into the physiological responses andadaptations of masters’ weightlifters do providesome insight into the long-term benefits of weight-lifting training.

6.1 Skeletal Muscle Structure and Function

6.1.1 Fibre Type Composition

The force-velocity properties of a muscle are inpart determined by the relative proportions offast-twitch (type IIA and IIX; formerly identifiedas IIB) and slow-twitch (type I) muscle fibres.[34,141]

Strength and power athletes, including weight-lifters, exhibit mean percentages of fast-twitchfibres in the vastus lateralis ranging from 53% to65%.[60,142-148] Although similar percentages havebeen reported in untrained adults,[144,149,150] thecross-sectional areas of type II fibres are con-siderably larger in weightlifters.[143,144,147,148] Sucha structural difference is advantageous to forceproduction as type II fibres possess a greater ca-pacity to generate power per unit cross-sectionalarea when compared with type I fibres.[141,151-153]

Both the proportion of type IIA fibres and therelative myosin heavy chain IIA isoform contenthave been shown to be greater in weightlifters whencompared with recreationally active adults.[143] Inaddition, weightlifting performance is strongly cor-related to type IIA percent content (r= 0.94) andtype IIA percent fibre area (r= 0.83).[143] Thus,evidence from cross-sectional studies suggests thatthe frequent high-intensity training of weight-lifters results in hypertrophy of type IIA fi-bres.[143,144,147,148] Evidence from longitudinal

HIRE studies in non-weightlifters indicates thatthere may also be a concomitant IIX to IIA fibre-type transformation.[154-158] Conversely, a restora-tion of type IIX content has been shown to occur inother athletes (i.e. swimmers, runners and cyclists)during pre-competition tapers, which involve aplanned reduction in training volume.[159-163] How-ever, the existence of a tapering-induced reshift inthe fibre-type composition of competitive weight-lifters has yet to be quantified.

6.1.2 Neuromuscular Function

Maximal voluntary isometric peak force (PF)and PP are strongly related to weightlifting per-formance.[164-168] During isometric conditions, PF isreached in the vicinity of 300–400msec.[164,169-171]

However, during dynamic weightliftingmovements,weightlifters achieve PF, PP and maximum barbellvelocities in <260msec.[4,12,14,172] Thus, the maximalcontractile rate of force development (RFD) inthe early phase of muscle contraction is of greatimportance to these athletes.[164,173,174]

Improvements in both PF and contractile RFDhave been reported in male and female weight-lifters following moderate- to long-term periodsof training.[23,60,132,145] These findings demonstratethat the frequent high-intensity training used byweightlifters (refer to sections 4.2 and 4.3) effec-tively increases muscular strength and power con-currently.[165,175] As a result, the isometric PF andpeak RFD of male weightlifters is ~15–20% and~13–16% greater, respectively, when comparedwith other strength and power athletes (i.e. footballplayers, sprinters, throwers and jumpers).[176-179]

This improved muscular function may arise dueto an enhanced voluntary and/or reflex-inducedneural activation of motor units[48,49,60,169] and/or a selective recruitment of fast-twitch motorunits.[180,181]

During the performance of the snatch andC&J, weightlifters have demonstrated some ofthe highest absolute and relative PP reported inthe literature.[1,2,4,5] For example, during thesecond pull of maximal snatch and C&J attempts,values as high as 5442W and 6981W, respect-ively, have been reported in male weightlifters.[3,5]

Furthermore, the corresponding relative PP formale and female weightlifters range from 53W/kg

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to 56W/kg and 38W/kg to 40W/kg, respective-ly.[4,5] As a comparison, during maximal benchpress and deadlift exercises performed by malestrength athletes, absolute PP of 415Wand 1274W,respectively, have been reported[4,5] with relativePP ranging from ~4-12W/kg.[1,5] In addition, duringexercise tests that incorporate the lower body (i.e.clean pulls and various jumps) the reported PP ofmale weightlifters is ~13–36% greater when com-paredwith other power athletes.[131,178,179,182] How-ever, during upper body only exercise, no differencesin absolute or relative PP were shown to existbetween weightlifters and handball players.[73]

These findings highlight the important contribu-tion that the lower body makes to power devel-opment in weightlifters. Furthermore, they maybe explained by the specificity of training, as hand-ball players are required to perform repeated high-intensity upper body movements (i.e. throwing)in competition.[73,183] Conversely, the upper bodymusculature of a weightlifter plays a relativelylesser role, in comparison to the legs, during thesnatch and C&J.[73,184]

6.1.3 Sex- and Age-Related Differences inNeuromuscular Function

To compare performances across the differentbody weight classes, Sinclair scores, based uponcurrent world record totals and adjusted eachOlympic year, are used.[185] The lifter’s actualcompetition total is multiplied by the appropriateSinclair coefficient. The resulting score is a projec-

tion of the total the lifter would theoretically achieveif they were in the super heavy-weight class with thesame lifting ability. Various other allometric scalingformulae have been derived.[134,186-188] However,many tend to yield either an overestimation orunderestimation for certain body weights.

In untrained and/or recreationally trained malesand females, reported sex-related differences inabsolute neuromuscular strength and power rangefrom 31% to 48% and 17% to 46%, respective-ly.[139,189-192] However, when comparing the cur-rent under 69 kg (the only common body weightclass between sexes) world record lifts for youth,junior and senior male and female weightlifters,there is a consistent sex-related difference of15–20% (table I). Thus, it is evident that althoughlong-term weightlifting training minimizes the sex-related difference in neuromuscular function, fac-tors such as the distribution and total amount oflean bodymass inmale and female weightlifters willultimately influence the expression of strength andpower across all age and weight categories.[67,134]

As competitive weightlifting is becoming in-creasingly popular in masters’ athletes, a numberof studies have investigated the influence of in-creasing age on competitive weightlifting perfor-mance and neuromuscular function.[65-68,193,194]

Pearson et al.[65] demonstrated that, on average,masters’ weightlifters (aged 40–87 years) were ableto generate 32% more isometric knee extensorforce and lower body explosive power whencompared with age-matched, healthy, untrained

Table I. Sex- and age-related differences in the under 69 kg world recordsa

Category Lift Male Female Percentage of the male record

obtained by a female

Mean – SD (%)

Youth Snatch 142 117 82.4 83.7 – 1.2

C&J 172 145 84.3

Total 310 262 84.5

Junior Snatch 158 123 77.8 80.0 – 2.4

C&J 190 157 82.6

Total 346 275 79.5

Senior Snatch 165 128 77.6 79.2 – 1.4

C&J 197 158 80.2

Total 357 286 79.9

a Current world records as of November, 2011.

C&J = clean and jerk.

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adults. It is likely that neural factors contributedto this enhanced functionality in older weightliftersas no significant differences in lean lower-limbvolume existed between groups.[65] Furthermore,the maximal motor unit discharge rates in therectus femoris of masters’ weightlifters have beenshown to be ~20% greater than in untrained, age-matched adults.[195] Therefore, it appears that long-term weightlifting training and competition has thepotential to attenuate the age-related decline inmotor unit size, number and/or function that be-comes apparent after the age of 60 years.[196,197]

A significant reduction in type II fibre size andcontent is associated with increasing age[198-200]

and is likely to contribute to the annual decline of~1–1.5% in PP and competitive performance thathas been reported in masters’ weightlifters.[65,66]

According to Anton et al.,[68] the rate of decline incompetitive performance is markedly greater inwomen across all weight classes.[68] These pre-vious findings are confirmed when comparing thecurrent under 69kg male and female world recordsacross all age categories (figure 4). Interestingly, nosuch sex-related difference with increasing age hasbeen reported during the expression of maximalstrength in competitive powerlifting.[68] Therefore,it was concluded that only the ability to performcomplex and explosive power-type exercises de-clines at a greater rate in women.[68] These findingsare in accordance with previous investigations,which have demonstrated that women undergo

greater age-related declines in muscle shorteningvelocity and PP than men, which is likely due to adecreased neural drive and a combination ofmuscle fibre loss and atrophy.[201,202]

6.2 Bone Mineral Density

The skeletal structures of weightlifters undergosignificant adaptations in response to the largecompressive and shear forces that are encounteredduring training and competition.[5,22,36,203] Bio-chemical indicators of bone formation are elevatedby up to 35% in actively competitive weight-lifters when compared with age-matched, healthyadults.[204] Furthermore, greater site-specific in-creases in trabecular and cortical bone densitieshave been reported in the vertebrae (13–42%), fem-oral neck/trochanter (12–24%), tibia (9–12%) andradius (10%) of competitive weightlifters whencompared with untrained and recreationally trainedadults.[205-209] Following ~30 years of retirementfrom weightlifting, former weightlifters aged be-tween 50 and 64 years have been shown to exhibita significantly greater bone mass when comparedwith age-matched controls.[209] However, betweenthe ages of 65–79 years, no differences in bonemass existed between groups.[209] Thus, it is evi-dent that weightlifters must maintain an adequatelevel of physical activity past the age of 65 in orderto attenuate age-related declines in bone mass.

6.3 Cardiovascular Structure and Function

High-intensity resistance exercise increasesperipheral vascular resistance, thereby stimulatingconcentric left ventricular (LV) hypertrophy.[210,211]

The increase in myocardial wall thickness arises dueto the parallel addition of new myofibrils and is acompensatory attempt to reduce LV wall stress andsystolic pressure.[211,212] A number of studies haveexamined the ventricular morphology and functionin competitive weightlifters.[121,213-227] Some investi-gations have reported that the absolute LVmass (g)of weightlifters may be ~13–30% larger than that ofage-matched healthy and/or sedentary control sub-jects.[214,219,222,228,229] However, in most instances,the increased LV mass exhibited by weightlifters isproportional to their total body mass, body surfacearea and/or lean body mass, thereby indicating a

60

Sex

-rel

ated

diff

eren

ce (

%)

50

40

30

20R2 = 0.90

10

Age category (years)

Youth

Junio

r

Senior

M 3

5−39

M 4

0−44

M 4

5−49

M 5

0−54

M 5

5−59

M 6

0−64

M 6

5−69

0

Fig. 4. The sex-related differences as a function of age (years)between male and female world record totals in the under 69 kgcategory. World record totals as of November, 2011. M = masters;R2 = coefficient of determination.

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physiological as opposed to a pathological adapta-tion.[219,222,228,229] This is of importance as LV hy-pertrophy is categorized as an independent riskfactor for cardiovascular morbid events.[211] Con-versely, other studies have shown no significantdifferences in absolute or relative measures of car-diac morphology between weightlifters and healthyadults.[215,218,221,224,226] The lack of difference inthese results may be explained by (i) the experi-mental groups being more evenly matched forbody dimensions;[215,218] (ii) differences in thetraining history of the control subjects (e.g. se-dentary/untrained vs recreationally trained);[226]

and (iii) possible sex-related differences in cardiachypertrophy as only one study has examinedcardiac morphology in female weightlifters.[218]

In light of these findings, the consensus of opi-nion is that weightlifting does not induce a trueconcentric enlargement of the left ventricle asseen in pathological conditions.

The cardiorespiratory function of competitivemaleweightlifters, as determined bymaximal oxygenconsumption (

.VO2max), has been reported to range

between 42.0 and 50.7mL/kg/min.[121,226-228,230,231]

As expected, these mean values are similar to thoseof other athletes involved in short-duration high-intensity/power activities.[121] Short-term (8 weeks)weightlifting-style training in active adults hasbeen shown to increase both absolute and relative.VO2max by ~6–7%.[227] However, annual evalua-tions over the course of 3 years of specific weight-lifting training in competitive weightlifters revealedsignificant reductions in both absolute and relative.VO2max of ~4% and 11%, respectively.[232] Withregards to resting haemodynamics, reported valuesfor mean heart rates range between 60 beats perminute (bpm) and 81 bpm, systolic blood pres-sure between 115mmHg and 153mmHg, anddiastolic blood pressure between 71mmHg and93mmHg.[214,221,222,226-228,231,233] These data classi-fy weightlifters as being ‘normal’ or stage 1 hyper-tensive as per the ACSM guidelines.[234]

6.4 Endocrine

Evidence of endocrine responses and adapta-tions in weightlifters and/or related to weightliftingperformance are predominately limited to anabolic

and catabolic hormones for the large part in youngmale weightlifters. Here we include where sub-stantial data have been obtained, the responses oftestosterone, cortisol and growth hormone.

6.4.1 Testosterone

Testosterone is a potent androgenic-anabolichormone that is considered to be a major pro-moter of muscular hypertrophy, strength andpower.[235,236] The reported basal serum total tes-tosterone concentrations in male weightlifters rangefrom ~14.4 nmol/L to 27.7 nmol/L,[60,176,237-241]which is within the normal range for young, healthyuntrained men (12.1–34.7mol/L).[240,242,243] Short-term exercise-induced increases in total serum tes-tosterone of ~17–30% have been reported in maleweightlifters in response to acute weightliftingtraining sessions of moderate to high intensity andvolume.[97,176,241] In addition to the influence of ex-ercise type, volume and intensity, the training age ofan individual also affects the exercise-induced tes-tosterone response. Elite junior weightlifters with >2years training experience exhibit significantly great-er exercise-induced increases in serum testosteronewhen compared with those with £2 years train-ing experience.[241] Combined, these results demon-strate that weightlifting training elicits a responsesimilar to that reported for conventional strengthand hypertrophy protocols involving large musclemass exercises.[244-247]

The available data pertaining to the testosteroneresponse to competition and competition-like set-tings is limited to salivary measures.[57,248] Duringofficial and simulated weightlifting competitions,Passelergue et al.[248] reported no significant changesin salivary total testosterone. From this limiteddata, it appears that competition settings fail tomeet the exercise volume threshold that is requiredto induce a significant testosterone response inweightlifters.[236] This is in accordance with previousinvestigations that have demonstrated no significantchanges in total testosterone following high-intensity, low-volume, moderately long rest periodduration, resistance exercise protocols.[245,247,249,250]

6.4.2 Testosterone : Cortisol Ratio

The basal testosterone : cortisol (T : C) ratio isoften used to represent the physiological strain

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imposed by a training programme,[251-253] as itgenerally exhibits an inverse relationship with ex-ercise volume.[132,238,254-256] For example, acrossa 5-week training period in elite female weight-lifters, a 37.0% reduction in training volume elici-ted a mean increase of 72.5% in basal T : Cratios.[132] Conversely, Wu et al.[256] demonstra-ted that a 54% increase in weightlifting trainingvolume over 2 weeks resulted in a 60% reductionin the basal T :C ratio. However, weightliftingtraining for ‡1 year and prior exposure to increasedtraining volumes appears to attenuate this relation-ship.[59] Furthermore, during extended trainingperiods (i.e. 12–24 weeks) of varying intensity andvolume, experienced weightlifters have demon-strated a positive association between an increasedbasal T :C ratio and maximal voluntary isometricPF and PP.[132,255,257] Thus, the routine assessmentof the basal T :C ratio may provide an effectiveway in which to measure acute and chronic adap-tive responses to weightlifting training.

In competition settings, the T :C ratio is greatlyinfluenced by pre-competition anxiety and maydecrease prior to any form of strenuous physicalactivity.[248] Furthermore, an official weightliftingcompetition has been shown to produce a highersalivary cortisol response and, thus, a greaterdecrease in the salivary T :C ratio, when com-pared with a simulated competition.[58] However,competitors with higher pre-competition salivarycortisol levels also exhibited superior lifting perfor-mances.[58] In stressful situations, salivary cortisollevels have been shown to increase by 230% frombasal values.[258] A pre-competition anticipatory risein circulating catecholamines[220,259] may stimulatethe release of adrenocorticotropic hormone, whichin turn increases cortisol secretion.[260] As a positiveassociation exists between increased catecholaminelevels and force production,[259] it is possible thatthis mechanism may account for the higher cortisollevels and the superior lifting performances thatwere reported during an official competition.[58]

6.4.3 Growth Hormone

Conventional resistance exercise does not appearto affect basal concentrations of growth hormone(GH).[261] In accordance with this contention, sim-ilar basal GH concentrations have been reported

in male and female weightlifters[133,176,241,245,254]

and other strength athletes (i.e. bodybuilders andpowerlifters) when compared with recreationallytrained and untrained adults.[242,244,261,262] Sig-nificant exercise-induced increases in GH occursimilarly in men and women in response to mod-erate-intensity, high-volume and short rest periodresistance exercise protocols (i.e. hypertrophytraining).[245,261,263] Conversely, only minor in-creases in GH have been reported following con-ventional strength and power protocols that usehigh loads, low repetitions and long rest peri-ods.[245,264-266] In contrast to these latter findings,4.5–13-fold increases in GH have been reported inmale weightlifters in response to their high-intensity,high-power training.[176,241,254] However, these con-flicting results may be explained by (i) the differ-ences in the training experience of participants thathas been shown to affect the magnitude of GH re-lease;[244,262,267] and (ii) differences in the absoluteand relative intensity, volume and type of exerciseperformed (i.e. isolation vs multijoint exercise) ineach investigation.[261]

7. Recommendations and Conclusions

The high-intensity, explosive nature of weight-lifting training and competition results in anumber of structural and functional adaptationsof the musculoskeletal and cardiovascular sys-tems. Of particular interest is that the rapid forceand power generating ability of weightlifters ex-ceeds that of other strength and power athletes.Although the use of weightlifting exercises arebecoming increasingly popular across a numberof sports, the frequency of HIRE performed byweightlifters is unmatched by other athletes andexceeds the current ACSM recommendations forstrength and power training. As younger andolder individuals of both sexes are being drawn tothe sport of weightlifting, it is imperative thatfurther research is conducted in these populationsto ensure the development of safe and effectivetraining programmes. Particular focus needs tobe directed towards understanding the acuteresponses and long-term adaptations of femaleweightlifters, as the majority of existing researchhas solely been conducted in male athletes.

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Acknowledgements

The authors have no potential conflicts of interest. Nofunding was received for this review. The authors would liketo thank Jonathan Milne and our athlete model for their as-sistance with supplying the photographs for this publication.

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Correspondence: Adam Storey, Department of Sport andExercise Science, The University of Auckland, Private Bag92019, Auckland Mail Centre, Auckland 1142, New Zealand.E-mail: [email protected]

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