The complexity and redundancy of the endocrine pathways during recovery related to anabolic function in the body belie an oversimplistic approach to its study. The purpose of this review is to ...examine the role of resistance exercise (RE) on the recovery responses of three major anabolic hormones, testosterone, growth hormone(s), and insulin-like growth factor 1. Each hormone has a complexity related to differential pathways of action as well as interactions with binding proteins and receptor interactions. Testosterone is the primary anabolic hormone, and its concentration changes during the recovery period depending on the upregulation or downregulation of the androgen receptor. Multiple tissues beyond skeletal muscle are targeted under hormonal control and play critical roles in metabolism and physiological function. Growth hormone (GH) demonstrates differential increases in recovery with RE based on the type of GH being assayed and workout being used. IGF-1 shows variable increases in recovery with RE and is intimately linked to a host of binding proteins that are essential to its integrative actions and mediating targeting effects. The RE stress is related to recruitment of muscle tissue with the glandular release of hormones as signals to target tissues to support homeostatic mechanisms for metabolism and tissue repair during the recovery process. Anabolic hormones play a crucial role in the body's response to metabolism, repair, and adaptive capabilities especially in response to anabolic-type RE. Changes of these hormones following RE during recovery in the circulatory biocompartment of blood are reflective of the many mechanisms of action that are in play in the repair and recovery process.
IGF-I stimulates osteoblast proliferation, bone matrix protein synthesis, alkaline phosphatase activity and differentiation. Methods: This presentation will provide an overview of the relationship ...between the IGF-I system and bone health and remodelling, with a particular emphasis toward military relevance and utility of measuring IGF-I during military training2,3. Because the IGF-I system is involved in bone formation, remodelling, and repair, female recruits sustaining stress fractures during military training would be of special interest with regard to differential circulating concentrations of IGF-I system components compared to their uninjured female counterparts. ...serum measurements of the IGF-I system could possibly provide further insight into stress fracture injury risk.
Hormones are largely responsible for the integrated communication of several physiological systems responsible for modulating cellular growth and development. Although the specific hormonal influence ...must be considered within the context of the entire endocrine system and its relationship with other physiological systems, three key hormones are considered the "anabolic giants" in cellular growth and repair: testosterone, the growth hormone superfamily, and the insulin-like growth factor (IGF) superfamily. In addition to these anabolic hormones, glucocorticoids, mainly cortisol must also be considered because of their profound opposing influence on human skeletal muscle anabolism in many instances. This review presents emerging research on: (1) Testosterone signaling pathways, responses, and adaptations to resistance training; (2) Growth hormone: presents new complexity with exercise stress; (3) Current perspectives on IGF-I and physiological adaptations and complexity these hormones as related to training; and (4) Glucocorticoid roles in integrated communication for anabolic/catabolic signaling. Specifically, the review describes (1) Testosterone as the primary anabolic hormone, with an anabolic influence largely dictated primarily by genomic and possible non-genomic signaling, satellite cell activation, interaction with other anabolic signaling pathways, upregulation or downregulation of the androgen receptor, and potential roles in co-activators and transcriptional activity; (2) Differential influences of growth hormones depending on the "type" of the hormone being assayed and the magnitude of the physiological stress; (3) The exquisite regulation of IGF-1 by a family of binding proteins (IGFBPs 1-6), which can either stimulate or inhibit biological action depending on binding; and (4) Circadian patterning and newly discovered variants of glucocorticoid isoforms largely dictating glucocorticoid sensitivity and catabolic, muscle sparing, or pathological influence. The downstream integrated anabolic and catabolic mechanisms of these hormones not only affect the ability of skeletal muscle to generate force; they also have implications for pharmaceutical treatments, aging, and prevalent chronic conditions such as metabolic syndrome, insulin resistance, and hypertension. Thus, advances in our understanding of hormones that impact anabolic: catabolic processes have relevance for athletes and the general population, alike.
ABSTRACTNindl, BC. Physical training strategies for military womenʼs performance optimization in combat-centric occupations. J Strength Cond Res 29(11S)S101–S106, 2015—The physiological differences, ...particularly of upper-body strength and power, between women and men, and the rigors of combat-centric occupational demands would seem to place women at a significant disadvantage, as the U.S. military opens up previously closed combat-arms military occupational specialties (MOSs) to women. This inherent disadvantage can be significantly mitigated by implementing effective and comprehensive physical training (PT) regimens for women targeting those fitness components most critical for those tasks considered most essential for solider warfighting duties (i.e., strength and power). Regrettably, the military historical and legacy overemphasis on aerobic fitness and on “field expediency” as the major criteria for implementing training have limited the extent to which the military has fully operationalized state-of-the-science PT policies. This continued legacy approach could be problematic regarding fully enhancing womenʼs abilities to perform physically demanding combat-centric occupations and could place the successful integration of women into ground combat MOSs at significant risk. Seminal studies from the literature indicate that (a) a minimum of 6 months of periodized combined resistance/endurance training preparedness is recommended for untrained women considering entering combat-arms MOS training; (b) any comprehensive PT program should incorporate and emphasize progressive load carriage training; (c) a greater emphasis on upper body on strength/power development in military women is needed; (d) heavy resistance training in the range of 3–8 repetition maximum sets should be incorporated into training programs to target type II motor units and muscle fibers (those fibers that produce the most force and have the greatest capacity to hypertrophy); (e) low-volume, high-intensity interval training should be considered as a time-efficient training method to improve aerobic fitness while protecting against lower-body musculoskeletal injuries; (f) flexible nonlinear periodized programs should be considered to best accommodate the unpredictability and operational functional needs of the military training environment; and (g) serious consideration should be given to revamping the manner in which the military conducts physical readiness training, with a departure from “field expediency” as the major criteria for determining PT policies. With an increased emphasis on the human dimension of soldiering and concerted strategic, operational, and tactical efforts to maximize individual physical readiness and performance, the science of training physiology exists to leverage and better physically prepare women as they enter more combat-centric occupations.
Whereas there are many varied roles of insulin-like growth factor I (IGF-I), and it exists in different biocompartments, there is abundant scientific evidence demonstrating that IGF-I is an important ...metabolic biomarker associated with a variety of health- and exercise-related outcomes. In most cases (muscle, bone, tendon, body composition, and cognitive function), elevated IGF-I concentrations are considered beneficial; however, cancer remains a notable exception. Although the fact that both increased and decreased IGF-I concentrations can be considered as reflective of favorable and beneficial health outcomes and may seem as a paradox and even contradictory, it is important to emphasize that, in both cases, measured IGF-I concentrations do offer important insight into physiological processes. The precise and relative role of systemic versus locally produced IGF-I in mediating the outcomes of physical activity is still not clearly delineated, but it does seem as though local IGF-I is consistently upregulated with both acute and chronic exercises; whereas in certain situations, circulating IGF-I may actually decrease. Although perhaps counterintuitive to the known anabolic role that IGF-I exerts, positive neuromuscular training adaptations can occur in the presence of decreases or no changes in circulating IGF-I. These observations, however, should not be interpreted to conclude that the role of circulating IGF-I lacks importance or relevance in contributing to enhanced musculoskeletal health as evidenced by the liver IGF-I-deficient mouse model. Because of the ubiquitous nature of IGF-I, prospective experimental approaches involving physical activity that can sample and measure IGF-I in the body's various biocompartments (i.e., blood, interstitial fluid, muscle) with the most biologically relevant assays are encouraged. We believe that such endeavors will provide greater understanding in the complex role that IGF-I possesses in mediating exercise-induced adaptations.
The ability to estimate lower-extremity mechanics in real-world scenarios may untether biomechanics research from a laboratory environment. This is particularly important for military populations ...where outdoor ruck marches over variable terrain and the addition of external load are cited as leading causes of musculoskeletal injury As such, this study aimed to examine (1) the validity of a minimal IMU sensor system for quantifying lower-extremity kinematics during treadmill walking and running compared with optical motion capture (OMC) and (2) the sensitivity of this IMU system to kinematic changes induced by load, grade, or a combination of the two. The IMU system was able to estimate hip and knee range of motion (ROM) with moderate accuracy during walking but not running. However, SPM analyses revealed IMU and OMC kinematic waveforms were significantly different at most gait phases. The IMU system was capable of detecting kinematic differences in knee kinematic waveforms that occur with added load but was not sensitive to changes in grade that influence lower-extremity kinematics when measured with OMC. While IMUs may be able to identify hip and knee ROM during gait, they are not suitable for replicating lab-level kinematic waveforms.
This issue of the European Journal of Sport Science includes 8 invited state-of-the-science narrative reviews by well-established researchers in the area of military performance focused on (a) ...physical training; (b) musculoskeletal injury; (c) adaptive bone formation and stress fracture prevention; (d) sex differences in responses to military stress; (e) load monitoring in military settings; (g) circulating biomarkers related to resilience during military stress; (H) military nutrition research; and (I) development of military exoskeletons. Important historical, current and future scientific and research information and guidance within the context of sustained and improved military physical performance and readiness are provided. Conclusions and recommendations for protecting Soldier health and resiliency include: (1) combined physical training emphasizing higher intensity but lower volume; (2) musculoskeletal injury risk factors most supported from the literature include: female sex, prior injury and low fitness; (3) adequate sleep, vitamin D, calcium, and energy availability are all critical for creating a resilient skeleton protecting against stress fractures; (4) differences between men and women when exposed to military stress include cardiovascular strain, fat oxidation, and psychological health risk; (5) biomarkers (cortisol, epi/norepi, ILs 4, 6, 10, 18 and TNF-alpha, IGF-I, testosterone, DHEA) offer insight for internal stress; (6) monitoring physiological training load should include consideration for multiple inputs, rather than a single measure; (7) nutrition optimization includes determining operational requirements, nutritional practices and nutrient delivery strategies; and (8) future generation exoskeletons will achieve a better balance of intended movement based on individual user and interactions with internal and external constraints.
Bone stress injuries (BSIs) have plagued the military for over 150 years; they afflict around 5 to 10% of military recruits, more so in women, and continue to place a medical and financial burden on ...defence. While the tibia generally adapts to the rigours of basic military training, the putative mechanisms for bone maladaptation are still unclear.
This paper provides a review of the published literature on current risk factors and emerging biomarkers for BSIs in military personnel; the potential for biochemical markers of bone metabolism to monitor the response to military training; and, the association of novel biochemical ‘exerkines’ with bone health.
The primary risk factor for BSI in military (and athletic) populations is too much training, too soon. Appropriate physical preparation before training will likely be most protective, but routine biomarkers will not yet identify those at risk. Nutritional interventions will support a bone anabolic response to training, but exposure to stress, sleep loss, and medication is likely harmful to bone. Monitoring physiology using wearables—ovulation, sleep and stress—offer potential to inform prevention strategies.
The risk factors for BSIs are well described, but their aetiology is very complex particularly in the multi-stressor military environment. Our understanding of the skeletal responses to military training is improving as technology advances, and potential biomarkers are constantly emerging, but sophisticated and integrated approaches to prevention of BSI are warranted.
Decrements in iron status have been reported in female soldiers during military training. Diminished iron status adversely affects physical and cognitive performance.
We wanted to determine whether ...iron supplementation could prevent decrements in iron status and improve measures of physical performance and cognitive status in female soldiers during basic combat training (BCT).
In this 8-wk randomized, double-blind, placebo-controlled trial, soldier volunteers (n = 219) were provided with capsules containing either 100 mg ferrous sulfate or a placebo. Iron status indicator assays were performed pre- and post-BCT. Two-mile running time was assessed post-BCT; mood was assessed by using the Profile of Mood States questionnaire pre- and post-BCT.
The BCT course affected iron status: red blood cell distribution width and soluble transferrin receptor were elevated (P < 0.05), and serum ferritin was lowered (P < 0.05) post-BCT. Iron supplementation attenuated the decrement in iron status; group-by-time interactions (P < 0.01) were observed for serum ferritin and soluble transferrin receptor. Iron supplementation resulted in improved (P < 0.05) vigor scores on the Profile of Mood States post-BCT and in faster running time (P < 0.05) in volunteers reporting to BCT with iron deficiency anemia.
Iron status is affected by BCT, and iron supplementation attenuates the decrement in indicators of iron status in female soldiers. Furthermore, iron supplementation may prove to be beneficial for mood and physical performance during the training period. Future efforts should identify and treat female soldiers or athletes who begin training regimens with iron deficiency or iron deficiency anemia.
Musculoskeletal injuries (MSKI) are a significant burden on the military healthcare system. Movement strategies, genetics, and fitness level have been identified as potential contributors to MSKI ...risk. Screening measures associated with MSKI risk are emerging, including novel technologies, such as markerless motion capture (mMoCap) and force plates (FP) and allow for field expedient measures in dynamic military settings. The aim of the current study was to evaluate movement strategies (i.e., describe variables) of the countermovement jump (CMJ) in Marine officer candidates (MOCs)
mMoCap and FP technology by clustering variables to create distinct movement strategies associated with MSKI sustained during Officer Candidates School (OCS). 728 MOCs were tested and 668 MOCs (Male MOCs = 547, Female MOCs = 121) were used for analysis. MOCs performed 3 maximal CMJs in a mMoCap space with FP embedded into the system. De-identified MSKI data was acquired from internal OCS reports for those who presented to the OCS Physical Therapy department for MSKI treatment during the 10 weeks of OCS training. Three distinct clusters were formed with variables relating to CMJ kinetics and kinematics from the mMoCap and FPs. Proportions of MOCs with a lower extremity and torso MSKI across clusters were significantly different (
< 0.001), with the high-risk cluster having the highest proportions (30.5%), followed by moderate-risk cluster (22.5%) and low-risk cluster (13.8%). Kinetics, including braking rate of force development (BRFD), braking net impulse and propulsive net impulse, were higher in low-risk cluster compared to the high-risk cluster (
< 0.001). Lesser degrees of flexion and shorter CMJ phase durations (braking phase and propulsive phase) were observed in low-risk cluster compared to both moderate-risk and high-risk clusters. Male MOCs were distributed equally across clusters while female MOCs were primarily distributed in the high-risk cluster. Movement strategies (i.e., clusters), as quantified by mMoCap and FPs, were successfully described with MOCs MSKI risk proportions between clusters. These results provide actionable thresholds of key performance indicators for practitioners to use for screening measures in classifying greater MSKI risk. These tools may add value in creating modifiable strength and conditioning training programs before or during military training.