Boston Sports Medicine and Performance Group, LLC Blog

Fatigue is just an untapped reserve tank

Posted by Guest Blogger on Mon, May 3, 2010 @ 13:05 PM

As strength and conditioning coaches, it is imperative that we have a good understanding of what fatigue really is. A dictionary definition might be a decrease in energy, but most of us would say that fatigue is a decrease in force production. That might be acceptable to tell your athletes, but do you really understand what is going on? Let’s take a close look into what fatigue really is and it’s untapped potential.

There are two classes of fatigue: “peripheral” and “central”. The more commonly known and understood is peripheral fatigue. Peripheral fatigue is what is happening in the extremities, more specifically the muscles. This is usually due to action potential failure or impairment in the cross-bridge cycle. Studies have shown that there is an increase in lactic acid concentration and a decrease in pH, ATP, and creatine phosphate. Also, there is a decrease in muscle or liver glycogen stores during sub maximal exercise which is all believed to cause fatigue. These metabolic processes add up together to prevent the muscle from a forceful contraction. Essentially, you can look at peripheral fatigue as the muscle no longer capable of producing the force that it is being asked to produce. An example would be doing 1,000 bicep curls and getting the “BURN”.

Less commonly known is central fatigue. Central fatigue is a decrease in neural drive or a disruption in the efferent fibers. In more simple terms, central fatigue originates in the brain. There is limited research on this phenomenon, but studies show that during exercise there is a change in neurotransmitters, such as increase in serotonin, which can regulate muscle contraction among other things, and a decrease in dopamine and acetylcholine which play a role in voluntary movement, motivation, attention, working memory, and learning; and then opens ligand-gated sodium channels in skeletal muscle to produce muscle activation, respectively. Now, I know neurology wasn’t my favorite class either so to develop the big picture, let's just say when there is increase in neural drive, there is an increase in neurotransmitter activity which results in a decrease in brain capacity to recruit motor neurons. This is that feeling of your body just not doing what you ask it to do although your muscles aren’t on fire, that “I just don’t have it today” feeling.

The debate on central fatigue is that I mentioned it being a disruption in efferent fibers. Proponents of peripheral fatigue will argue that it is just the opposite, and that it is the afferent fibers that cause a change in the neurotransmitters. Meaning that muscles, by way of the mentioned metabolic processes, are sending sensory information to the brain that then activate the change in the neurotransmitters to stop exercise. But then studies have shown that fatigue doesn’t start in the motor cortex but even further up in cortical regions, as in the prefrontal and cingulate cortex. So what comes first, the chicken or the egg?
No studies have shown a physiological change with no change on perceived fatigue. Actually, just the opposite has been shown.   Perceived fatigue has been expressed with no physiological change. Chronic fatigue syndrome is just that; patients express fatigue at rest when there is no impairment of the metabolic processes that we discussed. . Consider the fact you can produce more force during an eccentric lift than a concentric lift, which would suggest different neural drives. Studies show that at most during maximal voluntary contraction (MVC) one can only recruit 70% of motor units and some suggest that 100% recruitment would tear tendons right off the bone. On the other side perhaps central fatigue takes place as a protective mechanism. By changing neurotransmitter activity your brain will not allow 100% MVC. So what are your muscles actually capable of and what can you do about it?

Whether you believe it is the chicken or the egg that comes first, you can’t argue that they both have a role in fatigue. Metabolic processes do take place and your brain does prevent 100% MVC. So how do decrease the protective threshold? For the sake of this article, we will save the idea of over training for another time and just focus on a single training session. In order to get more out of our athletes, we need to engage their brain. Increase dopamine and acetylcholine. Studies have shown that verbal encouragement during activity will increase the duration of the contraction. Others have shown that yelling during a lift actually can increase force production. Another study showed that when subjects were asked to give maximal effort during a cycling sprint their power output decreased over the reps except it increased on their last rep, indicating a “reserve tank”. Perhaps the brain protects less knowing that it is your last rep. Perhaps this developed during the pre-historic era when our ancestors had to hunt for their food, but maintain a reserve tank of energy in case they became the hunted. Either way, we need to tap into that reserve tank. One way to achieve this is by including open looped activities. Doing 10 reps or sprinting for 1 minute is a closed loop activity because you know when it will stop allowing you to pace yourself. So including an open loop activity is one way to do short maximal effort without pacing yourself, such as having your athlete sprint for an unknown time stopping when you decide to blow the whistle. Challenge yourself to develop ways for the conscious brain to control the unconscious brain. Don’t allow your athletes to pace themselves. Training is not about surviving, it is about DESTROYING.

If a mother is able to lift a car to save her child, find a way for your athlete to lift a bus, because they can.

Keke Lyles is a DPT student at Northeastern University and has worked directly with both the Men’s and Women’s Basketball teams.


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Topics: Strength Training, basketball conference, boston hockey summit, athletic training, boston hockey conference, sports performance, strength coach, mental toughness, sports conference

What do you make?

Posted by Boston Sports Medicine and Performance Group on Wed, Apr 14, 2010 @ 08:04 AM

Uncle Sam did it again.

After another year of working countless hours, waking up early every weekend, and of course working on Christmas day… Uncle Sam showed no compassion.

I just returned from doing my taxes at the local HR Block where I get them done each year. It’s just a block away which I guess makes the pain of writing that check to the government a wee bit easier.

Reviewing my W-2 sheet made me think about one of Seth Godin's articles and exactly what I make.

I make kids better,

I make kids walk after surgery and I make parents feel good about the care their kid gets when they’re a thousand miles away,

I make push-ups feel easy,

I make shy kids walk with pride and I make bike sprints enjoyable,

I make spin, glide and roll move as they should,

I make slap shots harder, jump shots easier and high jumping higher.

So the next time your Wall Street brother-in-law rubs his thumb and fingers together and asks, “what do you make?”, just smile and say, “I make athletic dreams come true.”

Now get back to work.

Art Horne
is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at


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Topics: Strength Training, basketball conference, athletic training conference, boston hockey conference, athletic trainer, sports performance, strength coach, sports conference

To Fail or Not to Fail? – That is the Question

Posted by Boston Sports Medicine and Performance Group on Wed, Apr 14, 2010 @ 08:04 AM

“To fail is a natural consequence of trying, to succeed takes time and prolonged effort in the face of unfriendly odds. To think it will be any other way, no matter what you do, is to invite yourself to be hurt and limit your enthusiasm for trying”
-    David Viscott

I remember coming home after failing a fifth grade geography test and showing my parents the results of my effort.  To avoid a long detailed explanation of what happened next let’s just say I wasn’t able to sit down for the rest of the day.  So failure’s bad right? But what about failure in the weight room? Is pushing yourself or your athletes past the discomfort associated with the last few reps a good thing?

I asked Northeastern University’s legendary throwing coach for his insight and the below is a summary of our interaction.

So Joe, is failing good?

Well this depends on several factors such as, how often the event takes place within a general workout or particular exercise.  
If it is a regular occurrence then:
•    it might be symptomatic of a load that is too heavy for the reps,
•    poor technique,
•    poor fitness.
•    It also can be a sign of over training or
•    It can also be a sign of oncoming poor health.

For a particular exercise, failure might be just a random event. (which is why many top lifters use a daily note log) Technique breaks down when the load becomes too heavy for the current capacity of the athlete.

If you constantly push to failure the system adapts to failure as a goal and feeds back into the athlete with more failure.  The technique of the exercise begins to disintegrate. It is a system of negative follow through where the last motor event in the sequence is the goal. Olympic shooters, for instance, are taught to site-hold on the target after the shot is gone ensuring that the pathway stays on target. What you practice is what you will get and I deal with this all the time in throwing. In baseball Ted Williams used to emphasize 'follow through'. Failure done regularly is a form of 'follow through'.

Can you have a micro-cycle where push to failure is OK?

 Yes you can, but the exercises should be ambiguous in nature and not closely related to the sport movement. In that way the technique can be undisturbed but the work effort to push CNS and increased body load capacity is affected.  Sometimes you need to 'blast' the system to make it more alert to change. It's the motor systems equivalent of a loud yell!

'Push to failure' in weight training must not impede other sport preparation. Sufficient recovery is necessary. Each athlete is different in this and recovery rates vary. This is why 'One workout for All' does not work for 'all'. You start with a general workout then customize based on developmental ability.

On the flip side, should athletes always experience "success" on each set or rep?

If they are, then they are not pushing hard enough. There is a time for high intensity and a time for general development and maintenance. High intensity in the sport event usually requires a reduced load in the wt room but there are anomalies. Some athletes get a psychological boost when training hard and a significant reduction of load or intensity raises their anxiety. What you believe is as important as what really works which is why education in the latter is so important.

When the failure occurs you can;
1. Do nothing and move on to the next set
2. Adjust the rest of the sets (ie: poundage down)
3. Adjust the reps
4. Adjust reps and poundage
5. Correct the technique

In conclusion, I would say push to fail is OK if done when needed, the cycle is short and does not interfere with the sport skill.  It is not the poundage in the weight room that decides whether a workout plan is effective. It is the sport skill result that is the final arbiter. The knowledge we gain is scientific but the application is still art.

Sometimes a good loud yell is what we all need but not in an airport security line!

*Thanks to Joe Donahue (Northeastern University Legendary Throwing Coach) for his thoughts and contribution.

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at


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Topics: Strength Training, basketball conference, athletic training conference, boston hockey summit, boston hockey conference, sports performance, strength coach, mental toughness

A Bigger Box

Posted by Boston Sports Medicine and Performance Group on Mon, Apr 5, 2010 @ 09:04 AM

I hate when people say, “You need to think outside the box,” like they’ve just discovered the world was round.

Since when was reading articles or attending conferences “thinking outside the box”?  When did practicing evidence-based medicine or implementing strength programming other than 3 sets of 10 on bench press every Monday become novel thinking?

Some people just need to get a bigger box.

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at


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Topics: Strength Training, basketball conference, athletic training conference, boston hockey summit, boston hockey conference, Mike Boyle, barefoot running, mental toughness, northeastern

Give Up Control: Build a Great Athlete

Posted by Guest Blogger on Sun, Mar 28, 2010 @ 14:03 PM

Dr. Adam Naylor, AASP-CC and Matt Shaw, MS

Strength and conditioning programs are written and, ideally, followed by athletes. Often time’s athletes record weights and reps on workout cards. When it is time to condition, the strength coach shouts out times and, occasionally, encouragement (or sometimes just let the "beeps" do their motivating best). This is all a quite reasonable approach to building faster and stronger athletes. The question however that must be asked is, "Does it build better athletes?"

Better athletes being one's that bring enthusiasm to the gym, make optimal performance gains, and can execute basic principles of preparing the body for play away from a coach's watchful eye... empowered athletes that learn better, sustain gains longer, and perform at their peak potential. Writing programs and closely directing athletes' workouts lead to physical gains, but will this approach alone lead to excellent performances?

How the strength coach directs his or her weight room can be the difference between good and great athletic performances. The art of this performance difference is in being less a director of conditioning programs and more of an empowerer of athletes. The key to this transformation is understanding the coaching nuances that encourage and teach "mindfulness."

This lies in giving athletes both choice and voice. Ellen Langer, psychologist at Harvard has spent decades examining how developing cultures of mindfulness creates greater learning in classrooms and better health in wellness settings.  Individuals who are regularly encouraged to engage their mind (not just their body) and have direct responsibility in their activities, have sustained health, better attitude, and greater ability to commit knowledge to memory. This mental engagement can be fostered by giving athletes choices on a regular basis... encouraging them to make decisions and consider the details of their training.

Similar to creating a mindful approach to the gym in your athletes is “questioning” athletes.  It has been found that "questioning" during the coaching process leads to superior long-term athlete development and greater athletic self-competence (Chambers & Vickers, 2006). Questioning involves asking questions to stimulate the athlete's analyzing of their own technique. This cognitive stimulation leads to improved self-awareness ultimately increasing autonomy and learning.  Asking questions as simple as, "Wow, how'd you do to that?" or "Tell me the keys to a good front squat?" make a better athlete and a better teacher-coach.

It is important to note, not all athletes are created equal when taking this coaching approach. A tightly structured coaching environment helps novice athletes learn fundamental techniques. As an athlete skill level increases, overly structured coaching may decrease motivation and prevent continuous improvement. Lack of cognitive freedom can produce boredom and unchallenged individuals. Experienced athletes reap benefits from mental engagement and freedom of choice. They are more motivated and progress in training most efficiently.

The two most common challenges/criticisms to this approach are time and patience. A coach might complain, "I only have a limited amount of time to make a large number of athletes stronger. Where will I find opportunity to have intellectual discussions with my athletes?" Finding time is simply about building new coaching habits and realizing, as illustrated above, it is about quick thought provoking questions not extended debate. As for patience... simply find it. Seeing a skill performed perfectly the first time is nice, watching an athlete master a technique after a bit of struggle is most rewarding. A little extra time and patience are worthwhile investments that pay dividends in long term learning and high performance.

A comprehensive way of considering combining technical teaching with athlete engagement is by:  1. Taking sufficient time to educate athletes on the form and the purpose of exercises; 2. Encouraging an environment where athletes may begin to help coach fellow teammates or freshmen.  This will actually create a more efficient training environment.  There will be greater consistency in form when the strength coach’s eyes are elsewhere. Furthermore, team communication and cohesion will be improved. This creates a win-win situation, where the coach can be most efficient, while the athletes can learn the most and make the greatest gains athletically.  Ultimately a strong, trusting bond is created between coach and athlete.

It is unfortunate when the coach of collegiate and elite athletes teach solely through direct instruction and feedback. This creates an athlete that is over-reliant on the coach and ultimately decreases motivation. Without the necessary cognitive challenge and stimulation, an athlete may become stagnant. We often we find the name of the strength coach on the doors of the gym, in reality however it ought to be the athletes' names there, claiming ownership over the gym and what goes on within. Encourage a mindful approach to strength training you will find athletes reaching their maximum potential.

Chambers, K. & Vickers, J. (2006). Effects of Bandwidth Feedback and Questioning on the Performance of Competitive Swimmers. The Sport Psychologist, 20, 184-197.

Dr. Adam Naylor, AASP-CC. is the Director of the Boston University Athletic Enhancement Center (  He has serves as a mental conditioning and player development resource for players at all stages of their sports career.  More reflections on player development and sport psychology can be found at and Dr. Naylor can be reached at
Matt Shaw, BS is a Graduate Assistant Strength & Conditioning Coach at the Boston University Varsity weight room.  He has been coached athletes from youth to adult at Boston University, Harvard University, the BU Athletic Enhancement Center, and elsewhere in the greater-Boston community.  He is currently working on his masters degree in coach education at Boston University.



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Topics: Strength Training, basketball conference, athletic training conference, boston hockey summit, boston hockey conference, sports performance, strength and conditioning tips

Must Reads That Have Nothing To Do With Strength

Posted by Boston Sports Medicine and Performance Group on Mon, Feb 15, 2010 @ 19:02 PM

     Shortly after the First Annual Boston Hockey Summit in the summer of 2009, I received an email from one of Mike Boyle’s interns and strength and conditioning coach for the Worester Sharks, Jamie Rodriquez.  Just as I did in my younger years, Jamie was asking local-area strength coaches which books he should be reading to improve his craft. He stated that he had either already read or was planning on purchasing what I would consider must-haves in any strength coaches library (see below) but was searching for additional ones that would provide him a “professional edge”.  (On a side note, Mike Boyle has a nice list of professional books I would also recommend you check out on
The list of strength coach must-haves include:

Diagnosis and Treatment of Movement Impairments by Shirley Sharman
Supertraining by Mel Siff
Physical Examination of the Spine and Extremities by Hoppenfeld
Athletic Body in Balance by Gray Cook
Low Back Disorders by Dr. Stuart McGill
Anatomy Trains by Thomas Myers
Designing Strength Training Programs and Facilities by coach Boyle himself

     Jamie came to me and asked the same question as to what books he should be reading.  The two books that I recommended to Jamie however, may have surprised him.  As important as it is to read as much research and information as you can in your specialty, I believe it is just as important to become a master in communication and leadership if you hope to rise to the top of your chosen profession.  With that said, the two non-sports medicine or strength and conditioning books that have had the greatest impact on my career and the two that I recommended to this young coach were Good to Great by Jim Collins and Never Eat Alone by Keith Ferrazzi.  Here is a short review of each book:

Good to Great by Jim Collins (the following contains excerpts from Jim Collins Website,

     Jim’s research shows that building great organizations (yes, even training facilities and college sports medicine departments) proceeds in four stages.  (Some of the most important points are briefly outlined below; however this list is not complete and I recommend that you read this book in its entirety)

First Who … Then What.  Whether you just opened a new training facility or were promoted to lead a new team, the most important first step is getting the right people on the bus (your team), the wrong people off the bus, and the right people in the right seats before you decide to drive the bus anywhere.  This goes for the hiring process.  It's better to move forward and do some extra work and not hire someone for a while, than to make a rushed decision and hire someone that really isn’t interested in being on your bus.

Confront the Brutal Facts—Nothing is worse then putting off the truth because it's more convenient to keep doing “business as usual.”  Ask yourself and your team tough questions and engage in furious debates in search of the truth and brutal facts.  You might find out that the success you thought you were headed for won’t happen in a particular area, but it's better confronting that fact initially than to invest in a product or idea that leads you to a dead end later on.

The Flywheel.  When building a business or a department (say within an athletic department) that you wish to reach the level of greatness, there is never a single moment in which people will turn to you and say “That was it! That’s what caused you to be great!" There is no distinct program, no miracle exercise or hiring.  Instead, greatness is a relentless and never ending daily push against a “flywheel.”  Then, without any one particular moment being credited for it, the flywheel begins turning on its own; turning faster and faster until its moving on its own.   Many organizations go years upon years, sometimes for decades prior to experiencing success, but their actions each and every day was setting the groundwork for greatness.

Preserve the Core and Stimulate Progress. Collins talks about two really important points here that are worth sharing.
i)    Sticking to your core values no matter what, while having a “willingness to challenge and change everything except those core values.”  For example, a core value for your sports medicine department should be to practice Evidence Based Medicine, but then willing to challenge and change for example the best way to provide auxiliary services such as hours of operation or compensation time for team travel; but NEVER move away from or at the expense of the core value(s).
ii)    In order to stimulate progress, Collins suggests setting a BHAG, or a Big Hairy Audacious Goal.  Now I’m sure you’ve all heard of SMART goal setting, and although I agree with these and continue to set them, no one gets excited about a SMART goal. By setting a goal so large and exciting (BHAG) you’ll be sure that those that work alongside you will be excited about your vision and working towards that end.

Never Eat Alone by Keith Ferrazzi

Farrazzi opens his book with a quote worth sharing here:

“Relationships are all there is.  Everything in the universe only exists because it is in a relationship with everything else.  Nothing exists in isolation.  We have to stop pretending we are individuals that can go it alone.”
-    Margaret Wheatley

     If the above quote didn’t quite set it, here is a story that I often share with students and young interns.  I originally met Henry at a John Berardi Seminar that Eric Cressey was putting on several summers ago.  A couple of coaches in attendance, including myself, jolted to Uno Chicago Grill during lunch break to discuss the morning's lecture and grab a quick bite.   As I was walking out the door, a young student approached me and asked if he could sit with us during lunch.  Not knowing who he was, but impressed by his bravado, we pulled him into our group and enjoyed his company that day.  Long story short, Henry continued to stay in touch with myself and other members of that group and ended up eventually interning and spending time at some of the best strength venues in the nation including Cressey Performance,  Boston College Strength and Conditioning and USC Football Strength and Conditioning, all prior to graduating from Springfield College.  After graduation, Henry was accepted and started his Master’s degree program at the University of Connecticut but soon found himself at the University of Washington as the assistant strength coach for its football program under former USC strength coach, Ivan Lewis.  
     Without even knowing it, and even prior to me reading the book, Henry did exactly what Farrazzi preaches: He never ate alone.  Henry thanked those that offered advice and always stayed in touch with those same people – constantly expanding his network and thus expanding the opportunities that were available to him; this of course all happened, because he didn’t want to eat alone.

Final Takeaway: As this coming summer quickly approaches, and you’re putting together your leisure reading list, continue to read and develop your skills in your particular field, but when given the chance to step outside the traditional books of your craft, a weekend with either of these two books might just be the read you’ve been waiting for.

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at



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Topics: Strength Training, athletic training conference, strength and conditioning books, athletic training books

Seeing the world through the hole in a 45 pound plate

Posted by Boston Sports Medicine and Performance Group on Sun, Feb 7, 2010 @ 10:02 AM

It was first described to me during the summer of 2005 when I visited my good friend Mike Potenza, who was working at the time as the S&C coach at the University of Wisconsin for both the men’s and women’s ice hockey teams (by the way, both teams won national championships that year).  He introduced me to Steve Myrland, a former strength and conditioning coach at both the professional and collegiate level and a guy that I now describe to others as simply “the strength Zen master.”  While having coffee one morning, Steve was describing to Mike and I the frustration he was having with a college strength coach who only “saw the world through the hole in a 45 pound plate,” and the coach’s inability to see and embrace the importance of movement, function and anatomy.  Now, all of us have taken a 45 pound plate from the rack, lifted it to squat bar height, peered through the tiny 2 inch hole and loaded it up onto the bar.  The view just prior to loading is exactly what Steve was talking to me about.  The world, (or weight room or even more simply your athlete’s performance continuum) has a very limited offering if only viewed through this hole, compared to the massive area that the plate encompasses, which basically equates to the entire rest of his or her development.

Up until that point in my very young career, I considered myself a “strength” guy.  If it wasn’t heavy, it wasn’t training. If it didn’t have chains hanging off of it, or if your training partner didn’t have to pull the bar off your throat, then you simply weren’t working hard enough.  About two minutes into our conversation I realized that I was one of the strength coaches that Steve was talking about.  I guess the hole in the plate which I was coaching through at the time never allowed me to see the epidural injections that some of our athletes were getting due to their back pain, or the multiple ACL injuries our female athletes were incurring on a yearly basis.  Steve challenged me to remove the dense piece of iron that obscured my vision and allowed me to evaluate and prescribe a training program that reflected the whole athlete (with respect to his/her sport, previous injury, movement impairments, volume at practice or games, current and future goals and yes, even strength development) and not just the athlete I once saw through the hole in the 45 pound plate.

Now, I’m still a strength guy, but my view on strength development (what really matters – a future blog) vs. numbers improvement (by any means necessary) has changed dramatically.  The next time you load the bar and you peer through that tiny hole, I simply challenge you to think about athletic development in its totality.  If all you have is a hammer then everything looks like a nail; if all you do is load plates, then the window in which you have viewed the world, and the development of your athletes have been limited.  Believe me, the world looks a hole lot different when you begin to look at it with a pair of fresh eyes; or at least a pair not obscured by only iron.

Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at



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Topics: Strength Training, basketball conference, boston hockey summit, boston hockey conference, sports performance, strength and conditioning tips