Progressive Loading Part 3: Why the Novice / Intermediate / Advanced Framework Doesn't Work, and What to Do Instead

23:20Dr. Austin Baraki:more background information on their training history and what their kind of expectations have been if that is in fact the case those numbers that you laid out there's actually a good chance that, you know, they started out as most people tending to start out like well below their absolute strength potential on day one. In other words, your early progress might be kind of artificially inflated because it's not like you're working up to your, you know, five rep max on your first day ever training. And then that's what improves by 50 pounds over the subsequent couple months. Most of the time you're starting a little bit artificially light and then you're kind of, you know, developing your neurological adaptations, your technique, your proficiency, your consistency, expectancy getting over the early soreness and things like that and so that early perceived rate of progress might be like artificially fast and so this might not actually be that as dramatic of a quote-unquote slowdown as it seems but if the person's expectations were that they were going to have you know linear progress for a very very very long period of time it might be time for a maybe a hard conversation about those types of expectations now i am also going to be taking a history on like well what does your training look like and how to you know what is the nature of the stimulus that you've been delivering to yourself and then what if the rest of your life looked like outside of the the gym kind of the the recovery aspect the sleep aspect the nutrition things all the things that we know go into generating these adaptations you know sometimes it's a matter of oh this person had some massive life stressors or job changes or various other things and they're wanting the progress to continue but it might not be physiologically realistic or feasible for them so you know getting a sense of where they're coming from what they've been doing where their potential gaps in their game might be and kind of helping to reframe expectations i don't necessarily like the idea of like aggressively resetting expectations like telling them that all your expectations are just like we need to throw them away because that's also a way to like lose somebody but just kind of gently collaboratively massaging those expectations i would say to be more in line with either you know kind of like average data that we're familiar with but also of recognizing that like data are not you the individual right those might give us some like kind of general expectations but at the same time some people are going to be you know above that and some people are going to be below it and more so at this point we need to just treat you as an individual based on what you're showing us rather than you know setting expectations based on how

25:37Dr. Jordan Feigenbaum:somebody else has responded to training yeah yeah well said and i think the programming hopping you know program hopping thing it's i struggle with this because it's like again what defines a program and like when would i definitively recommend somebody change a program versus not and it's like if the bones of your program the reps the sets the exercise selection the total amount of volume proximity to failure all these sort of variables are reasonable i don't know that you need a you know complete program change right and when i say reasonable i I mean, match you, the individual, you know, your current fitness level, your resources that you have, so on and so forth, right?

26:17Dr. Jordan Feigenbaum:If they're not producing the gains that you want, I have less concerns about the sort of formulation of the program and more about the dosing, right? Is that more appropriate for you? But I do see a lot of bad programs. Like it just where almost everything is wrong and anchoring to that particular setup and just tweaking from there is more headache than it's worth. And that's kind of how I feel about the various 5-3-1 permutations, for example. Like, yeah, maybe it was more outspoken previously about 5-3-1 or whatever, but I'm like, I don't know that we need to anchor to what is maybe fundamentally 5-3-1, like changing the rep scheme on a weekly basis or whatever, or even anchoring to fives, threes, and ones.

26:54Dr. Jordan Feigenbaum:Like, why are we doing this? uh and i feel similarly about other programming styles but somebody came up to me and they were like look it's an upper lower split and here's the total training load and i'm i'm mostly doing strength work i want to get stronger and i'm like well this setup seems the bones are fine i would want to iteratively change from there and like what constitutes well now this is a program change like i again this meta conversation about what what is a real change where it's just like a tweak I don't know.

27:22Dr. Austin Baraki:Sure. Uh, I have two thoughts. Um, and, and one of them is a little bit of a pushback and to see your, your thoughts on like a defensive program hopping, so to speak. I mean, depending on the person's goals, obviously from the start, let's say somebody's goals are purely health related, uh, honestly program, how do you, in my opinion that you are sufficiently active with sufficient, you know, level of effort on a sufficiently regular basis. I'm like,

27:48Dr. Jordan Feigenbaum:you're good with the vast majority go ahead the only caveat i would make to that is that we know that exercise works better when it works for you so so that it's not just the participation per se that is like the main thing maybe 80 of the thing the remaining 20 is like it should probably still be making you a little stronger should be getting a little bit of muscle mass getting a fitter cardio fitness but outside of that yes correct i'm like unconcerned if it makes you happy and you're going to keep doing it, do it.

28:16Dr. Austin Baraki:Yeah. If somebody does have performance oriented goals, then obviously the question of specificity comes into play as far as what their program should kind of start to prioritize a little bit more. But even then I can see a degree of like an argument for some amount of program hopping. And the way I'm thinking about this is twofold, I think. One is going back to our prior discussions on like long-term athletic development and how early on in the training lifespan or somebody's training career, sampling can be beneficial for a lot of different reasons. And you think about like the youth kind of recruitment methods that are used, I don't know, I think in like China or something to develop their Olympic athletes.

29:00Dr. Austin Baraki:And they just like bounce them around between different sports to find something that they're good at. And then they select for that. And so that's like the more extreme version where you're literally changing between entirely different disciplines. Although, you know, there's also even an argument for that, you know, in terms of improving, being associated with improved outcomes in single sport athletes down the line is those who have participated in more things early on. Although there's a lot of caveats to that type of interpretation. And then the other thing is even within a narrower range of specificity, not to say that you should be bouncing between powerlifting and weightlifting and then basketball and pickleball and swimming and things like that to get better at 1RM deadlift strength.

29:41Dr. Austin Baraki:But even within a narrower band of specificity, like quote unquote program hopping within the strength training realm, you may happen upon something that either clicks with your psychology a bit better, gets you motivated, gets you training harder in a way that leads to some better outcomes. Or just find something that maybe physiologically resonates or works better for you, your physiology, your, I don't know, tissue tolerance, recovery capacity, whatever the case is. and so some maybe moderate amount of program hopping if it was to happen that might be a reasonable time time to do it kind of a more of a sampling exploratory phase earlier on that I could see an argument for that instead of rigidly adhering to like this has to be the best method for you know everyone who is at this stage of training or who falls under this like call it a novice intermediate advanced type label again an example of like forcing a square peg into a round hole like forcing the client onto the program or the trainee onto the program instead of saying like, we have a lot of options out there.

30:38Dr. Austin Baraki:And then there are some people who maybe you're gonna do great with like a double progression type setup and that gets them motivated. Other people who are really gonna enjoy AMRAPs, other people who are gonna enjoy some aspect of the 5-3-1, maybe somebody else who instead of that enjoys, I don't know, the Fibonacci sequence program where you use different numbers instead of five and three and one. I don't know. So that's kind of a thought that I'm curious what your take would be.

31:00Dr. Jordan Feigenbaum:yeah again i think it just comes back to a definition like what is fundamentally different program like when i think about a strength program right it's like a pretty wide range of things that would be i would consider viable for that goal if we're talking about one rep max strength and so like if you go from primarily you're training in the six to eight rep range right versus primarily training the one to three rep range well both are like in the sort of strength training realm are they different programs right or if one program uses um you know double progression another one is more like repeat sets or percentages like these different programs or just slight tweaks and so again the definition matters if you're calling those program hops like exploring different setups i'm with you a thousand percent if it's more like okay this is definitively like strength and now we've moved so far from that it's hypertrophy and we're doing that for strength game, then I'm less inclined to agree.

31:54Dr. Jordan Feigenbaum:And so I think that's more what I'm getting at. Now, again, all of this is to say, the training, the formulation of the training needs to be relevant to your goals. And if that is out of place, or the setup that you've anchored yourself to is so rigid, that it cannot adapt to you, then I'm in full favor of let's do a full rewrite. But yeah, otherwise, I'm kind of like, I don't know. A lot of programs are reasonable, like starting points, and then tweaking from there is kind of the general thing that we're doing here. Does that seem like something you'd agree with? Fair enough. Yeah, I talked enough that you've got to agree with it.

32:30Dr. Jordan Feigenbaum:It makes sense. So the curve on its own does not kill the framework's biology claim. The same shape is produced by both stories. The NIA framework's biology shifts modes, and the same machinery, less remaining room story, well, it's the same curve. Both produce an asymptote with diminishing returns, and the data on its own can't tell them apart. Where the framework actually breaks down is one level below. When you walk through what each of the four adaptive systems is actually doing across the training career, the cell biology is the same in the new lifter and the four-year lifter. What's different is how much room is left to adapt on each system and how long each one takes to register a change.

33:06Dr. Jordan Feigenbaum:That's the next 30 minutes of this episode. We'll walk through them fastest to slowest and for each one we'll talk about the mechanism, the timeline, and the limit. So let's start off the neurological adaptations. Now the nervous system recruits the muscle through a relatively strict hierarchy called the size principle, Henneman's size principle. At low force demands, the smallest, most fatigue resistant motor units fire first. As force demand increases, larger fast twitch motor units come on. The order doesn't change with training. What training changes is the efficiency of the entire process.

33:42Dr. Jordan Feigenbaum:Lower thresholds to reach those sort of high force motor units, faster firing rates, better coordination between muscles pulling in the same direction, more complete suppression of the muscles that would otherwise oppose the movement. So picture a single nerve cell connected to a small group of muscle fibers. This bundles what physiologists call a motor unit and every contraction is the sum of all of the motor units firing. The bigger the load, the more motor units the nervous system has to recruit, and the faster each one has to fire. Delvecchio and colleagues in 2019 had untrained subjects strength train for four weeks.

34:20Dr. Jordan Feigenbaum:They measured what each motor unit was doing before and after using a technique called high-density EMG that picks up the electrical sort of signature of individual motor units rather than averaging them across the whole muscle. After four weeks, the motor units fired faster and the motor units that previously only came online at high efforts were now showing up at a lower effort. It's the same hardware, but better software. And that's what people mean, I think, when they say the first month of training, those gains are mostly neural. The lifter hasn't really grown any more muscle, not appreciably so anyway.

34:54Dr. Jordan Feigenbaum:The lifter got better at using the muscle they already had. But long term, this sort of story is incomplete. So picture what happens when you try to extend your knee. Your quadriceps on the front of your thigh has to fire. Your hamstrings on the backside of your leg have to relax. If both fired at the same time, the leg doesn't go anywhere. Every coordinated movement requires the muscles on one side of a joint to get out of the way of the muscles on the other side. Now, the spinal cord handles that coordination through a sort of reflex circuit. When a motor signal from the brain goes out to the quadriceps, the same circuit sends an inhibitory signal to the hamstrings, telling them to back off.

35:34Dr. Jordan Feigenbaum:Two synapses, one signal pulls the trigger, one signal lifts the brake. Now, a 2025 review by Lecce and colleagues in the Journal of Physiology pulls the data together on what training does to that circuit, technically called disynaptic reciprocal inhibition. You can use that at the bar later to impress somebody. Long-term strength athletes show that brake lifting signal more strongly and faster than recreationally active people do. In a trained lifter, the quad fires harder because the hamstrings get out of the way more completely. A larger fraction of what the muscle could produce actually reaches the bar, the machine, the dumbbell, whatever.

36:12Dr. Jordan Feigenbaum:Now, adaptations like that take years to develop. They cannot be attributed to muscle size alone either. The trained lifter isn't just stronger because the muscle is bigger, but rather the trained lifter is stronger because the wiring around that muscle is better tuned, better coordinated. Now, we gotta do a few caveats as we want to do here on the Barbell Medicine Podcast. We're talking about EMG or electromyography. This picks up electrical activity that the muscle produces when it contracts. You stick electrodes on the skin over a muscle, you ask the lifter to do something, and the bigger the electrical signal, the more the muscle is firing.

36:46Dr. Jordan Feigenbaum:That's the sort of basic version here. Now, in a study from 2019 by Ball Shaw, they used EMG to compare three groups, untrained subjects, 12-week trained subjects, and a group that had been training consistently for four years. They looked at the electrical signal coming out of the working muscle when each group was pushed as hard as they could. The four-year trained group's signal was 44 % larger than the untrained groups. On the surface, that's a great version of the neural adaptation continues to make differences long after the first month. bigger signal more firing stronger lifter unfortunately it's not that clean scarabot and colleagues in 2021 ran a follow-up that exposed a problem with the measurement bigger muscles produce bigger emg signals on their own so when you correct for that some of the 44 percent goes away the signal that looked like neural adaptation was mostly just more muscle in fact now there are some neural adaptations that take place after the first year but the magnitude is more modest than you know that previous 44 percent number implied the lifter at a year at year four isn't dramatically better at firing the muscle than the lifter at month three they mostly just have more muscle to fire so the point here is that the trained lifter and the untrained lifter aren't running different neural hardware it's the same but the four-year lifter just has less room left to adapt because they're already further along it's the same machinery with less remaining room exactly what the curve predicts austin is there anything practical a lifter can do to get more out of the sort of neural side or is it mostly automatic once you're training consistently

38:20Dr. Austin Baraki:uh no the cool thing is that there is uh there there are things that you can do the main one being that you can try and and that sounds like a like a simplification which it is but we know that at least on the concentric phase of your movement so for example when you're standing up out of the bottom of a squat or you're pressing a bench press off of your chest or you're lifting a deadlift up off the floor that kind of muscle shortening phase to actually move the load when that is done with maximum volitional intent when you are trying as hard as you can to basically accelerate the bar as quickly as you can during that phase even if you're lifting the same load if you're doing that with maximum intent in that way you actually get more adaptations out of the set and out of the training compared with if you move the same load without doing that and certainly more than if you deliberately slowed that component of the movement.

39:13Dr. Austin Baraki:And so I think that this is something that I have felt, I think one of the first times I felt it was definitely when you're going for a load that you're not super certain that you're gonna get early on in your training career and you're like, oh, I'm really gonna have to lock in on this and really maximize my focus. but also when we we've both dabbled with velocity-based training where there are these kind of devices that you can attach to your bar and it'll measure your bar speed and it almost gamified the experience of training in the sense of you wanting to like hit not necessarily like a certain number of reps or a certain weight but rather for the weight that you were lifting you wanted the device to measure the highest bar speed possible and so i would i felt a little bit of a change in how I approached my my lift trying to accelerate things to maximize that speed and then once I got the feel for like how to do that didn't end up like needing the velocity device long term in order to continue doing that in training and that ended up being super useful and something that I've often advised people to do it's almost like you learn how to unlock a different like another level or an additional gear I remember actually noticing the same thing like back in my swimming days.

40:24Dr. Austin Baraki:You know, I was face to face with like a guy who I'd been going back and forth with as a rival for like most of the season. And I was like, so pissed that I was like, I'm going to like bury this guy. And I found in that race, like a new gear that I had never previously accessed before, even though it was the same race, same distance, same stroke, I felt like I was trying before and I was trying certainly afterwards, but there was like this additional gear that I like discovered. And then from then on out, the rest of my training and my racing was fundamentally different and the same applies in strength training so this neurological aspect even if the weight does not actually move very fast because it is very heavy the kind of neurological recruitment that you have to do in order to try even harder to accelerate it will get you better adaptations than you would if you don't do that and certainly better than if you moved it deliberately slowly with a concentric tempo yeah yeah i think the way i think about

41:13Dr. Jordan Feigenbaum:those neurological adaptations is like it's the software if everything else is hardware then this the software and there are multiple ways to kind of update or upgrade your software right unlock a new level um for example or get a better processor and so yeah trying hard trying to move everything uh particularly the concentric as fast as possible there's also some evidence on like bringing the bar down faster on a bench press uh for example can be can be more useful um for for bench press strength faster than you want to most of the time but also just exposure to the test itself there's sort of familiar, you know, becoming more familiar with the test.

41:48Dr. Jordan Feigenbaum:We have pretty interesting data that people like maxing out day after day after day after day after day after day continue to get stronger for a set period of time because they get better at the test, which is mostly neurological. They're not growing, you know, more muscle mass at the time that you're coming, uh, not only better coordinated, uh, but also perhaps some other stuff, whether they're unlocking another gear or whatever. So yeah, you can get more out of this with some programming tweaks, but to your point, even if the program remains the same. Trying as hard as you can on each rep, you're going to get more out of it, generally speaking.

42:21Dr. Jordan Feigenbaum:So those are neural adaptations. The same hardware is running in the new lifter as is in the four-year lifter with less remaining room to adapt in the experienced one. The frameworks claim that neural adaptation is a novice phase phenomenon that hands off to hypertrophy after six weeks is the wrong story. The two overlap from session one and they continue across a training career. It's the same machinery the whole way through with less and less remaining room as the training history accumulates. And that's the whole through line of this episode. Hypertrophy is next, and that's running on a slower clock than the neural side.

42:53Dr. Jordan Feigenbaum:The cleanest study on what early growth is actually made of is actually one of the most elegant things that I've ever read in this literature. Muscle growth happens when individual fibers add contractile protein. Also non-contractile protein too, the muscle will grow. The primary driver here is mechanical tension, which kicks off the mTOR pathway, the mammalian target of rapamycin pathway, which drives muscle protein synthesis, and the muscle fibers will grow over weeks to months. The sort of contemporary or latest synthesis on what drives muscle growth is from Roberts and colleagues in 2023, published in the Physiological Reviews.

43:26Dr. Jordan Feigenbaum:A few popular ideas get dismantled there. One, metabolic stress and muscle damage. They were once framed as these sort of independent drivers of muscle hypertrophy alongside mechanical tension. And they're now mostly understood as downstream correlates of the conditions that produce muscle growth, not independent causes. The second is this sort of post-exercise hormonal milieu, the hormone hypothesis. Your testosterone goes up, your growth hormone bumps every time you train and supplement companies prey on this sort of understanding. Well, they don't predict hypertrophy or strength gains at any meaningful timescale.

44:03Dr. Jordan Feigenbaum:Mechanical tension does the work. The rest is the company you get to keep when you do the work right. Now, the study that earns its place in this particular segment, I think because it changes how you should view hypertrophy, the timescales, and so on and so forth. This is from Domus and colleagues, and it's a deuterium oxide study. It was published in 2016 in the Journal of Physiology. They needed a way to measure how much new muscle protein their subjects were building across weeks of training while the subjects went about their normal lives. Now, most existing methods give you a single snapshot in time, which won't tell you what's actually accumulating across a training blocker cycle.

44:41Dr. Jordan Feigenbaum:Now, deuterium is the heavy version of hydrogen. The same atom that's in regular water is just slightly heavier. Drink water with the heavy version in it for a few weeks, and your body uses that heavy hydrogen to build new proteins, including new muscle. And you can then biopsy a small piece of the muscle, weigh how much heavy hydrogen got built into it and that tells you how much new protein the muscles laid down over the whole window untrained men 10 weeks of training and the researchers tracked muscle protein synthesis the entire time early in the training block the muscle protein synthesis the lifter was generating wasn't correlating to actual muscle growth it was correlating with markers of muscle damage something like ck or creatine kinase the body was building protein, but the protein was repair work, not growth, sort of just keeping your head above water, right?

45:30Dr. Jordan Feigenbaum:At week 10, once the body adapted to the training stimulus and stopped treating each session as a sort of novel insult, the same muscle protein synthesis started correlating with actual growth. The relationship was pretty tight. The R value was 0.94. It's the same machinery the entire time. The body just stopped using it for repair only and got to use it now for building. This was also reflected on imaging studies. So the thigh cross-sectional area, the thigh size at week three, what you see when you take a selfie in the mirror. Well, this was up three to 4 % at week three, but most of that wasn't new muscle.

46:07Dr. Jordan Feigenbaum:It was fluid. The body sent to the area to deal with the training-induced muscle damage, basically inflammation. The thigh got bigger due to that inflammation. Now at week 10, the thigh size was up 7 % to 10%, with most of the inflammation resolved. That's the real growth. And you should probably wait for the gym selfies at that point. The first three weeks of the I'm getting bigger sort of thing you might pick up is mostly water. So before you post those bathroom mirror progress shots, give it a minute. The caveats to this study, of course, as we do here on the podcast, it was untrained men, small sample, the exact percentages are population specific.

46:44Dr. Jordan Feigenbaum:But I think the principle still holds that early visible changes in muscle size, mix repair with growth. But we already knew that trained lifters grow slower. That part's never really been in dispute. The question here is whether they grow slower because they've gotten closer to their ceiling and they have less remaining room, or is it because the underlying machinery has become less responsive per unit of training stimulus? And the current data sets that we have can't really tell which one it is. But why does this even matter, right? Well, the NIA's framework claims that advanced lifters need different programming and that leans on the second answer being true they're just less responsive if the machinery has generally become less responsive you need a different stimulus to get a response if the machinery is the same and the sort of space between where you're at currently and your ceiling has just gotten smaller you don't you apply the same stimulus you get a smaller response and that's what the closing the distance to the ceiling actually looks like so austin to me i think that the window of what works and what you can tolerate just gets narrower.

47:51Dr. Jordan Feigenbaum:Something like the minimum effective dose of training load that you need to actually drive growth and the max recoverable training load, they get closer and closer and closer as people approach their ceiling. What do you think about that?

48:03Dr. Austin Baraki:I think that's a reasonable kind of heuristic or a reasonable paradigm for this, that you are likely to need to do more, but you're gonna start to bump up against some of those physiological limits. And there are ways, obviously beyond a certain point that you can stretch your training tolerance. I think that both of us are able to sustain and tolerate quite high training loads. But if you asked us in any given week or two weeks to bump up our training load or overall training stress by 10 or 15%, I don't think that we would feel awesome on the back end of that if that was done kind of all at once.

48:37Dr. Austin Baraki:And so you're walking a finer and finer line to try to eke out tinier increments of progress as you approach that ceiling. I think this is a reasonable way to look at it. And then the other thing is, you know, fundamentally, if you examine, say, our training, you know, trajectory over time that led up to our peak levels of performance, the nature of what that training looked like was not radically different. In other words, it's, you know, because that also further argues against some sort of like phased response where there's like biology kind of switching or becoming like dramatically more resistant to things.

49:13Dr. Austin Baraki:In general, we did similar styles of training over very long periods of time and we continued responding. It was just slower. It wasn't that we, you know, if the biological gear shifted, we're like, oh, now we need to switch to this, you know, much different style of training. I remember you know leading up to my all-time PRs on all the lifts I think I ran the same more or less the same weekly cycle for like over a year and just kind of as we've talked about rode the wave where some weeks were a little stronger some weeks were a little you know down in performance and then the net trend over a long enough time span was up and up and up and up until those PRs happened and so it was just a matter of trying to find how to thread that needle of like finding a dose that I could tolerate that led to that response and then just being patient and doing it day in and day out for like weeks and weeks and months and months and years and years.

50:04Dr. Jordan Feigenbaum:Yeah, no, it makes sense to me. It's, you know, corroborates my experience for sure, not only personally, but also professionally working with people. And I think, you know, the listener is thinking, well, how come I can't make gains, you know, or like that's the problem they want to solve at the end of the day. Now, now some, look, there's some ceiling, there's some max, right. And people don't like to think about that. They're like, what do you mean I'm limited is how much strength I can gain. I'm like, look, man, if there were no limits here, right? Shout out to Master P. That means that everyone would be able to theoretically squat 1 ,000 pounds or more, right?

50:35Dr. Jordan Feigenbaum:Or everyone should be able to deadlift 700 pounds. And it's like, well, clearly that's not the case, right? There's some limit and there's a lot of things that go in to those limits. Now, one of them is modifiable to some extent, which is how much training load you're willing to expose yourself to. The upper limit there is what can you actually tolerate, right? Right. And so I think as you become more and more trained, those things become closer. Right. And so if you don't have the resources to train as much as you need to, well, that's problem number one. And then problem number two is if you do have those resources, at some point, you're not going to be able to recover from them anyway.

51:12Dr. Jordan Feigenbaum:And right. And so you just you get closer and closer to these things. These things get closer and closer together. And that's what produces that asymptote. That's how I think about it. It's the same answer in the muscle as in the nervous system. The same machinery is running in the new lifter and the four-year lifter with less remaining room to adapt into as training history accumulates. The framework's category-driven prescription is solving for a biology that isn't changing modes in the first place. Now to the system, the framework gets most consequentially wrong, the one where the early training injury story actually lives, which is connective tissue.

51:43Dr. Jordan Feigenbaum:So tendons attach muscle to bone and transmit the force the muscle produces into actual joint movement. They adapt to mechanical loading the same way the rest of the system does, but on a slower clock. This is the system the early training injury story lives in. So how do tendons adapt? Two different things change when a tendon adapts. The first is how stiff it is, meaning how much it resists stretching when force is applied to it or deformation. A stiffer tendon transmits more of the muscle's force to the bone instead of absorbing it. The second is how big the tendon is, meaning the cross-sectional area.

52:20Dr. Jordan Feigenbaum:if you cut it like a piece of rope. The stiffness changes first and size changes later. Both matter, but the lifter sort of feels the stiffness change before the size change because stiffness is what determines how much of the person's muscle contraction, the muscular force, actually reaches the bar, the dumbbell, the machine, the whatever. The tendon adapts most when you load it heavy. Heavy contractions, let's call it 85 to 90 % of the lifter's max, which tends to move relatively slowly each time you lift. for several sets per session, several times a week for at least 12 weeks. That's the protocol that has been shown to drive the largest tendon changes.

52:58Dr. Jordan Feigenbaum:The meta-analysis from 2022, 61 studies, 763 participants. A caveat there, they only mostly recruited untrained individuals. There were only three studies that had well-trained individuals. And those three studies didn't actually see tendon stiffness change much, even with hard training. It's the same machinery, less remaining room, smaller short-term response, which is consistent with the through line of this episode. But the data set on well-trained individuals is pretty thin. The numbers that matter for programming, like what to use this for. Well, Kubo and colleagues ran a study where subjects trained their calves with hard, sustained contractions for several months while researchers tracked both the muscle and the Achilles tendon over time.

53:44Dr. Jordan Feigenbaum:It's in the back of your leg by your ankle. Muscle strength went up by month two, but tendon stiffness didn't catch up until month three. Even when the protocol was specifically designed to drive tendon adaptation, the tendon was still weeks behind the muscle. Think about this like the muscles, the engine in the car, and the tendon is the chassis that transmits the engine's power to the road. In early training, the engine builds faster, gains more horsepower than the chassis. The muscle can produce way more force before the tendon has finished reinforcing itself for it. Now, Austin, you see the consequences of the muscle outpacing tendon mismatch all the time.

54:23Dr. Jordan Feigenbaum:What's the pattern and what does the conversation look like and what's the framing you use with the presumably newer lifter who's sore in the wrong places?

54:31Dr. Austin Baraki:Yeah, this comes up a lot in rehab related conversations, whether relating to somebody who's experiencing, for example, a tendinopathy or a muscle tear or somebody who is post-op from something. So in the context of muscle tears, which are fortunately uncommon, but do sometimes happen for a variety of reasons, whether in the gym or people who got a little too spicy with their, you know, getting excited with high intensity, you know, sprint training on flat ground and pop the hamstring or something like that. And as our friend and colleague, Dr. Miles has said you will often feel better before you are better in terms of the symptoms improving before the tissue is in a state where it's ready to be fully loaded and tolerate that for adaptive purposes.

55:17Dr. Austin Baraki:So there is a little bit of a lag time there that needs to be taken into consideration. When it comes to the tendons, they're even slower. And so a lot of times, you know, the person's muscles and their joints and their bones might all feel quite good. But if they're dealing with a tendinopathy i mean depending on which tendon we're talking about the quote-unquote natural history for recovery of it can be on the order of three or four months for for certain tendons upwards of like a year or more for things like elbow tendinopathy shoulder you know rotator cuff syndrome sometimes things like that that can take even longer to recover and that's you know despite our best efforts in training and sometimes even independent of any training the natural history might be for recovery but just over a very long time span something about the nature of those tissues and you'll hear a lot of hypotheses around you know blood flow and various other things that i don't think it's as worth getting into the weeds on since it's not terribly modifiable in terms of leading to clinical outcomes of like oh now instead we can recover in two weeks instead of like you know two months and so that's a those are some areas of big discrepancies when it comes to post-operative situations again we have to have to respect those tissue healing timelines and load them commensurate with that and then you've talked about this i think i forget which episode we had recently where the question about adaptive capacity of muscle versus tendon in people who are like using anabolic steroids came up and and there's been you know a lot of conversation around that of like do they tend to stimulate more rapid adaptation and muscles than tendons can tolerate and maybe is there an impact on injury risk i think that whole space is still a bit hazy at least at least to me i think that it generally doesn't radically change how i would approach training for somebody in terms of like if they're tending to want to make massive jumps in their loading just because they're, you know, using, then that's generally ill-advised in most situations regardless.

57:02Dr. Austin Baraki:But I would recommend that to anybody, whether they're, you know, enhanced or not, I think.

57:07Dr. Jordan Feigenbaum:Yeah, no, that to me, that's the logical end of this sort of question. Like when the muscles outpace the tendons or the other soft tissues, like what's the predicted response? And so from a macro standpoint, you look at the data on injury risk and people using androgenic anabolic steroids in exercise, they tend to have higher injury rates. And you're like, okay, is this mostly some sort of psychologically mediated thing where they're like, look, I'm on, so I got to push it heavier, right? And so that kind of is the deciding factor, or is that more of the result of a sort of mismatch here between the muscles getting much, much stronger faster than the tendons?

57:46Dr. Jordan Feigenbaum:And the way I think about it always comes back to the racetrack for me, right? Now, at the track, you usually are split up based on the performance of not only your vehicle, but your driving skill. And so, for example, I run the time trial unlimited class, which means there's unlimited horsepower to weight ratio. And you tend to have more advanced drivers in this class compared to TT5, which is one of the entry-level groups. Lower horsepower to weight ratio, a good entry point. The point would be you take somebody from TT5 or somebody who's brand new and you put them now in this race car and you put them on track.

58:26Dr. Jordan Feigenbaum:The car is capable of a lot, right? That's the muscle. But the tendon maybe is the driver here and they're not as capable and they can get themselves into trouble mainly because they're not used to what can this car actually do? And so I think that's reasonable. There's been some hypotheses out there by various researchers that the anabolics themselves have some sort of impact on the tendon, a deleterious impact. That has not really been shown in humans, only in some Petri dish data and some rodent models. And I think the most likely explanation is that, yeah, people just get stronger, which outpaces the sort of longer term scale of the tendon adapting.

59:03Dr. Jordan Feigenbaum:And because they're highly motivated, otherwise, why would they be using this agents? it becomes a more likely outcome that they suffer an injury which to me makes sense but need more data on that before i feel confident and stamping it that makes sense to you there yeah yeah i like the analogies so that's the connective tissue it's the slowest of the fast adapting systems sitting six to eight weeks behind the muscle and it takes the brunt of any loading schedule that was written for the muscles clock the engine builds faster than the chassis the same machinery that was running in the new lifter and the four-year lifter and the chassis on the experienced lifter has just had years to catch up to the engine.

59:39Dr. Jordan Feigenbaum:One more system before we get to the consequence of all this, which is the injury data. The slowest one of all, the background process running underneath everything else, is bone. It's alive. Cue the Frankenstein music. Bone is a living tissue. It's constantly being broken down and rebuilt, and what determines whether it ends up denser or less dense is the load that you put on it, that you expose it to habitually. Heavy load placed in the right places in the right way makes the bone deposit more material there. An absence of loading is an absence of the signal needed to keep the bone around. The same biological process is running at year one and year 10, but the change that you can detect on a scan is small enough that no realistic training block produces a visible difference session to session, but the process is still doing work.

1:00:25Dr. Jordan Feigenbaum:As an example, the LIFT-MORE trial, We talked about this on our direct line for our Barbed by Medicine Plus subscribers. This was done in 2018 by Watson and colleagues. Eight months of twice weekly heavy resistance training plus impact training. They were lifting 85 % of their one rep max for five sets of five. Now, I know listeners are like, dude, you can't do five sets of five with 85 % of your one rep max. Well, if they were using a training max or if they were untrained, it's, you know, squishy. But nevertheless, it's heavy. And then you're like, well, what was the impact training? Well, they were doing jumping pull-ups.

1:00:56Dr. Jordan Feigenbaum:and when they landed from the jumping pull-up, they had straight legs. And so what we think is that both of these things, the heavy resistance training and the landing on straight legs or just landing in general, that the stimulus on the bone is big enough to cause it to remodel. And this is sometimes called the osteogenic index. Now, these were women in their 60s and 70s. They were lifting heavy. The bone density on the scan rose by about 4 % in the lumbar spine and about 2 % at the hip joint compared to the control group. as far as why this matters. Now look, the standard medical advice for women losing bone density is look, you got to take calcium and you should exercise.

1:01:31Dr. Jordan Feigenbaum:But that exercise prescription tends to be just walk on a treadmill. Certainly it's not get under a heavy barbell and do some heavy lifting. And in fact, we had this post go viral about osteoporosis and osteopenia protection. And what I said was, So earlier on in life, women in their 20s and 30s, that is their sort of prime window for building bone mineral density. And that is the time where they should be training heavy. Now look, if you miss that window, you should still be training heavy, lifting weights for bone mineral density, in addition to other health adaptations. But that is your primary window.

1:02:06Dr. Jordan Feigenbaum:And it would be better if you started then. And that's the time you're being advertised to do Pilates and yoga and whatever, which are fine to do as long as you're also lifting weights. Now people push back and they're like, are you saying that I'm because I missed the window, I shouldn't even try? I'm like, well, no, that's not what I'm saying. It's just that it would have been better if you started earlier. It would have been better if you started early. And unfortunately, that advice is not making it into clinical practice. Austin, are you seeing any change in that? Like, do you your colleagues are a little different because they're more up on this stuff.

1:02:33Dr. Jordan Feigenbaum:But what do you think about the broader sort of landscape and primary care? Are women being told habitually to lift heavy weights in practice?

1:02:42Dr. Austin Baraki:uh it's really hard for that's such a very general um you know sort of swath of clinical practice that for me to say confidently that trends are like meaningfully moving there i i don't know um i would like to think so i think that you know younger clinicians i suspect are more open to this um it's just that a lot of the older clinicians or those who are unfamiliar with it or um those who have selection bias meaning uh they they tend to see people who maybe have had a bad experience, they're much less likely to counsel in that way. You know, I talk a lot about how a lot of our like patient selection bias informs a lot of the advice we give and some that that's often actually a bad thing.

1:03:19Dr. Austin Baraki:So like, you know, I'm not here to hate on orthopods, orthopedic surgeons, but they tend to see people who have musculoskeletal pain. And so I remember like when pickleball was taking off, for example, in popularity and of course, you know, overuse syndromes happen when people who are underprepared for the task start jumping in and get excited and play. And then they go to the orthopedic surgeon because they have some shoulder pain or some knee pain. And then all these interviews in the media for the orthopedist saying, you know, it's this horrible injurious activity and you shouldn't do it. And it's like, no, like you're not seeing all the people who aren't going to the hospital for their heart attack or their diabetic amputation because they've gotten more active and weighing those things out is hard to do.

1:03:57Dr. Austin Baraki:It's hard for, you know, you, if you're in a particular silo or niche to recognize that broader thing. And it's also just hard in general to see things that don't happen compared with things that do, right? So if people are training and reducing the risk of osteoporosis and not having fractures that's not something that i see in my day-to-day practice for example in the hospital whereas the person who does have the osteoporotic fracture i would and say they came in and they had a fracture and they did train maybe i'm like oh no like it happened because you're because you're training right so it's easy to draw those wrong conclusions instead of relying on like much broader bases of data and that's why disseminating this type of data these messages can hopefully nudge practice in a more positive direction.

1:04:33Dr. Austin Baraki:So I would definitely like to think that trends are encouraging there. That still is going to have like a little bit of a drop off in terms of like, okay, so we have more people recommending it. What does that mean for uptake? And like, and then once people uptake it, what does that mean for like long-term uptake and consistency? And then what does that mean for like outcomes? So there's like a, I view it as like a waterfall type effect of like, you need more people counseling to lead to more people uptaking, to lead to more people staying consistent, to ultimately impact the things that we care about in terms of outcomes.

1:04:59Dr. Austin Baraki:And that's just really hard for people to, you know, observe or determine based on vibes or their like day-to-day practice compared with like much larger data sets.

1:05:07Dr. Jordan Feigenbaum:Yeah, no, that's exactly right. I mean, we know that doctors, generally speaking in primary care, are not counseling folks on exercise. That's relatively rare, maybe one in 10. Yeah. I suspect that very few of those recommendations involve the specific prescription to lift heavy weights, right? And to the extent that lands, I suspect that the uptake also may be a little less on average there because there's this sort of popular narrative that lifting heavy is more dangerous. And so at all those steps, there are problems. And yeah, I suspect it's just relatively low. All right, well, that covers the four systems, neural, muscle, tendon, bone, same machinery in the trained and untrained lifter.

1:05:47Dr. Jordan Feigenbaum:I think we can reject that part of the claim for the NIA framework. It's just the room that's left to adapt is what's different. Now, the consequence of getting that wrong, which pops up when we talk about injuries, The NIA Framework's progression model says that novices should add weight every session because their biology supports it. The injury data, though, tells us a different story, and the mechanism is the connective tissue lag that we just talked about. Okay, let's zoom out for a second just to make sure that we're not noceboing anybody. Resistance training lifting weights has one of the lowest injury rates of any physical activity.

1:06:21Dr. Jordan Feigenbaum:It's about two to four injuries per thousand participation hours across bodybuilding, powerlifting, Olympic weightlifting, CrossFit, etc. And most gym injuries aren't actual catastrophes. They're overuse presentations. So it's not an acute, I ruptured a pec, I broke a bone, whatever, snapped a tendon. It's more like I've got some tendinopathy. For example, muscle strains, nagging aches that develop over two to three weeks because the training load climbed faster than the tissue could adapt. Also, the average symptom duration for resistance training injuries is less than two weeks on average. Most people can come back from this relatively quickly, which speaks against disc herniations, torn ligaments, et cetera.

1:06:58Dr. Jordan Feigenbaum:Lifting is, in absolute terms, relatively safe, but compared to running, it's even safer. Recreational running has an injury risk of about 10 or more injuries per 1 ,000 participation hours. So if anyone in your life is using injury risk as a reason for you to not lift or for them to not lift, well, it's not really evidence-based. So let's compare newer trainees to older trainees and see if there's a sort of gap there in the injury prevalence data. And one of the best comparisons actually comes from CrossFit data. This is from Predo and Gonzalez in 2020. These people are doing roughly the same movements with the same equipment in the same environment, same general programming approach.

1:07:37Dr. Jordan Feigenbaum:Novice CrossFitters in the first eight weeks had an average injury rate of nine and a half injuries per thousand training hours. Experienced CrossFit participants doing roughly the same training had 0.74 to 3.3 injuries per thousand participation hours. We see the same signal in Olympic weightlifting where more advanced lifters actually have less injuries than newer lifters. A factor of three to 10 in the same sport though in this CrossFit data set. The movements didn't really change. It's just the person's preparation for those movements and their experience did. Now, yeah, that's observational.

1:08:11Dr. Jordan Feigenbaum:It's not randomized. The people who stuck with CrossFit long enough to be experienced trainees are the same people whose bodies sort of tolerated it. A little survivorship bias there. The gap is real, and the mechanism we're about to walk through is consistent with it. But part of the gap, again, is a survivorship bias. Tissue capacity, as we've talked about before in this podcast, kind of behaves like a checking account balance. A training session is a withdrawal. if you've got a thousand dollars in your account an attempted withdrawal of 1200 produces a sort of overdraft fee that's the injury pain soreness that doesn't resolve or even a structural problem the balance isn't fixed it grows with consistent training and any withdrawal that exceeds the current balance produces a problem regardless of how the withdrawal is made a novice might have a thousand dollars in their account but the experienced trainee has ten thousand the same training session might overdraw the novice and barely even show up for the experienced trainee.

1:09:08Dr. Jordan Feigenbaum:The mechanism is similar to what we talked about with anabolic steroids, but what this means for early training injuries, a loading schedule that prescribes session to session weight additions because the trainee is quote still in the novice phase is imposing a muscle pace schedule on top of a connective tissue pace problem. So Austin, walk us through the consult the new lifter they're four months into their to resistance training they've got some knee pain they come in convinced that the program failed them what does that conversation actually

1:09:38Dr. Austin Baraki:look like yeah after an assessment of their symptoms if i am also convinced that this is likely a case of patellar tendinopathy i'm trying to get a sense of a few things really what is the nature of the stimulus that they were trying to apply and then what is their kind of recovery tolerance situation look like so the first would be what's their prior injury history look like because a lot of times the main risk factor for having an injury is like having a prior history of that same injury and then as far as characterizing the stimulus and get meaning getting a sense of what does their training look like the main things that i want to know is what is the frequency of loading what is the volume of loading compared with what they were used to beforehand what is the intensity of that loading and then what is the uh what is the nature of it in terms of specificity versus like variety because those are several of the levers that i'm going to manipulate to help dig them out of this hole from a rehab standpoint.

1:10:30Dr. Austin Baraki:So most of the time when I see this, it's somebody who is using either inappropriately high intensity, inappropriately high training volume for their prior level of fitness when they started out on this. And they are often using too much specificity, meaning the exercises that they're doing are too similar over time, which is another kind of hallmark of developing overuse syndromes instead of having more moderate training volume, more variable intensity some high some medium some low and then having a broader base of exercise variation at least while you're trying to prepare yourself for a phase of higher specificity so this is why for example in our own training we tend to maintain i would say moderate to in certain periods of time high training volume we have a moderate amount of training specificity that when it increases for example it's only for a relatively brief period of time leading into a competition and then it backs off again kind of after that so we are not doing for example exclusively squat bench press deadlift you know three times a week year round or something like that there's a lot more variation even within those main movements they are varied in other ways there's unilateral work there's you know movement in other odd ways that are not characteristic for you know competitive power lifting for example doing other sorts of quote-unquote athletic type movements and activities doing conditioning things like that to build a robust base of physical capacity to tolerate a lot of things that we can then choose to apply more specifically kind of at any point along the way so that's kind of the nature of the conversation is like what is your prior base of fitness what are you trying to do right and then how can i manipulate those levers

1:12:09Dr. Jordan Feigenbaum:to kind of dig you back out of that hole yeah i just think when you have this sort of um rigid progression model that is kind of put forth by again a very literal interpretation of this nia framework that's telling you, you got to add weight here. Got to do it. Can't stop it. Yeah. And we know that the muscle related adaptations outpace the connective tissue ones. To me, this is a predictable response. And so the question then is, well, are there unique advantages for that pacing? And I think some people feel like, well, look, it's prescriptive. I know exactly what to do. Every time I go in the gym, I don't have to think about it.

1:12:47Dr. Jordan Feigenbaum:Right. That's one thing. And I see that because, again, people, maybe they want to turn their brain off and just go exercise. They don't want to, you know, dig into the programming weeds too much. They're not – they don't want to engage in this nerdery. I get that. The other person is like convinced this works better. And so like the first one I don't have a problem with because I can work around that. The second one is, I don't know, more – it's harder to deal with because you have to convince somebody that, look, just adding the weight, particularly before the adaptations that we need have have shown up have come online that is actually working worse for you it's not making you stronger you're just moving the goalposts because the thing got harder and oh by the way you're setting yourself up for this potential injury risk that doesn't need to be there because again it's not working better for you from the adaptations that you're chasing that's and i suspect in your experience that's also been

1:13:37Dr. Austin Baraki:harder to deal with yeah yeah exactly i have little little to add i think that's reflective of our experience collectively.

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1:18:09Dr. Jordan Feigenbaum:The pain lecture also has new cases this year and is built around helping folks make sense of what they're experiencing, not just here's what the research says, but how to use that information in a real conversation with a real person who's frustrated and confused and wants to know what to do next. Spots are limited, so if you wanna learn more and register today, head over to barbellmedicine.com and look for the Bozeman Pain and Rehab Seminar. We also have a link in the show notes below. All right, welcome back to the Barbell Medicine podcast. Now, before we get into what to actually do with all of this, there's one more piece of the framework that needs to get out of the way, and that's fatigue.

1:18:41Dr. Jordan Feigenbaum:Ask any coach why advanced lifters need different programming, and the answer is almost always something about fatigue management. The problem with that answer is that fatigue is at least four different things, and the framework is treating them as one thing. So the four different things that people are calling fatigue. This is a taxonomy that comes from Anoka and Deschateaux in 2016 and a 2023 study by Barron's updated the terminology. So four different buckets here, if you will. First one is performance fatigability. This is what you can measure on the bar. Bar speed, the weight on it, how much the bar speed drops during the set, the force output declining during a sustained contraction.

1:19:17Dr. Jordan Feigenbaum:You can measure all of this. You can also think about this as the engine in your car, the hardware, how much power can you produce? All right. Second bucket here is perceived fatigability, what the set feels like. Two lifters could do the same workout. One feels destroyed while the other one feels fine. It's a different thing from what the bar is doing. This is really the driver of the car. You think about, again, you're on track, the car and its motor and transmission and gearing has, you know, a particular top speed, but the driver, what they're experiencing, I hear the rumble of the engine.

1:19:49Dr. Jordan Feigenbaum:I hear the chassis making noise. I don't want to push it, right? That is the signal that the driver is getting and responding to, okay? So that's the second bucket. The third is called trait or state fatigue. This is what the lifter or individual walks into the gym carrying, the I feel beat up this week. And that exists independent of any specific set, sort of background tiredness, if you will. And the fourth is recovery state. This is really the inverse of the first three. The first three describe fatigue from different angles, whether it's at the, you know, structural level, whether it's from the individual level, right, and what they're responding to.

1:20:25This last one is mainly like, are the tissues able to adapt right

1:20:31Dr. Jordan Feigenbaum:now? Okay, whether the body is currently positioned to turn a training stimulus into an adaptation, and whether the same session will deepen the sort of deficit, put them into a hole. Why this matters. These four different things do not always move together. A lifter can sleep poorly. They're anxious about a one rep max attempt. They are a little hungover, whatever. The perceived fatigability is high. But the actual lift, a one rep max, only takes a few seconds. So the perceived fatigue doesn't have to limit what the bar does. People have PR'd under these situations. You just got to get it together for a few seconds, right?

1:21:05Dr. Jordan Feigenbaum:Right. The lifter feels heavy. The lifter can, you know, lift, perform a one-rep max and do it well. Conversely, if a lifter is overreached, right, they've been doing a really high training load sort of program, the muscles contractile machinery or the engine in the car is subtly impaired. Right. They want to lift more. They want to lift faster. They want to do more, whatever, but they can't because there's something at the structural level that's problematic. They feel fine, but they lift poorly overall. Both patterns are predicted by this framework, and they look like contradictions only if you treat fatigue as one thing, but it's not.

1:21:44Dr. Jordan Feigenbaum:Now, the framework typically claims that experienced lifters can tolerate more, recover faster, or experience fatigue qualitatively differently compared to novices or untrained lifters, as if those are biological facts. But the data doesn't really support that either. What experienced lifters have is a calibrated reference distribution for effort. They know what hard feels like because they've been there enough times. There's actually some really interesting neurophysiology here about your brain basically sends a carbon copy of what they perceive the effort to be downstream, and your body sort of calibrates that.

1:22:20Dr. Jordan Feigenbaum:It's pretty interesting, and it's more refined in advanced lifters. So RPE, how it actually works. rpe in resistance training is typically anchored to repetitions in reserve meaning how many more reps the lifter could have done this is particularly true of multi-rep sets so like a set of five six seven something like that whereas doing a one rep sort of effort single at rpe eight we usually anchor that to other things rather than just how many more reps can you do you can use that but we use a different proxy um the problem is that reps in reserve depends on knowing what failure feels like. And that knowledge is built by kind of going to failure before, paying attention and calibrating that against an actual outcome.

1:23:03Dr. Jordan Feigenbaum:So two lifters who both report RPE9 on a set of eight may have very different actual proximities to failure. For a trained individual, RPE9 might be reasonably close to a true one repetition in reserve set. But for an untrained individual on a three rep max, RP9, might be three to five reps from failure if the novices never genuinely failed. There's been some head-to-head literature here, which I think is interesting. Halperin in 2022 did a scoping review. Lifters of all experience levels under predict reps to failure by two to five reps on average, with only a tendency toward improved accuracy and more experienced trainees.

1:23:44Dr. Jordan Feigenbaum:But a 2025 head-to-head study on the back squat in a Smith machine found no statistically significant difference in repetitions and reserve accuracy between trained and untrained groups. How to square this? I think you can say that the training status effect on repetition and reserve accuracy, RPE accuracy is relatively small and inconsistent. I don't really care about the two to five reps on average difference to be clear, particularly in a new individual, especially because I know it's going to get better over time. This is a skill. with exposure deliberately to things that are closer to failure, maybe even true failure on average, people are going to get better.

1:24:24Dr. Jordan Feigenbaum:And so I'm kind of fine with that. Now, Austin, what do you think about the argument for not using RPE in beginners because they're, quote, too inexperienced to rate it accurately?

1:24:36Dr. Austin Baraki:Yeah, I feel like, I don't know, this is a conversation that's been batted back and forth for many years now. It's not something that raises a great deal of concern for us, I think, especially when we take a very long term perspective on people's training career. I think about this all the time when we get questions from people who say, for example, like, you know, I went on vacation, and I had to shift my training schedule by, you know, a week is, you know, what should I do when I get back? And my first thought is like, if, let's assume that you're going to continue training over the long term, five years from now, is this decision going to have a meaningful impact on where you end up at that time point right and this is contrasted with like lots of other examples in other areas where such decisions may in fact have big enough impact right so you know if you end up choosing to do a deload every other week you know in perpetuity like yeah you're going to probably end up in a different spot because you're training like half the time that you would otherwise or if you choose to control your lipids earlier in life compared with not that is going to lead to more likely different outcomes like a decade from now this type of a thing whether or not you choose to use rpe whether just purely as a descriptive thing or whether you choose to develop that skill early on in your training or or not again at the five-year time point in your training at the 10-year time point in your training not something where i'm terribly concerned about whether you are like not quite accurate enough to within two reps versus three or four reps early on in your first you know three months of training or six months of training or something like that in other words like the the magnitude of impact over the long long uh kind of time frame of training the outcomes that we really care about are not likely to be meaningfully impacted and so given that it is a skill given that this sort of we'll call it an inter interoception which is a fancy way of having this like internal sense of your like physiologic state and your proximity to failure how hard you're trying how much more room you have to go that's something that everybody needs to figure out one way or another it is foolish and you will not find successful long-term lifters who ignore that internal sense and just say well the paper says i have to lift this weight so this weight is going to get lifted and then they like fail reps all the time because they ignored those sorts of signals so learning what those signals feel like and recognizing them correlating them with your actual performance if you can do that collaboratively with a coach even better but the idea that you're too inexperienced to even try to start like paying attention to these things early on.

1:27:07Dr. Austin Baraki:It's just kicking a can down the road that doesn't need to be kicked down the road for like no meaningful benefit. And in fact, just delaying the inevitable in that sense.

1:27:15Dr. Jordan Feigenbaum:Yeah, again, I think this goes back to this very rigidly held NIA framework that, you know, the weight on the bar, the load that you're lifting is so critical that if you miss it, even slightly, you're cooked. Your results, zero. and that is definitively not the case. Even if we accepted this idea that people who are new to training, if they used RPE and reps in reserve only to select the load, that they're gonna be way off, right? Two to five reps in reserve off each single time. Oh my gosh, go crazy. I still don't care. They're close enough, especially for health purposes. Might they get a slightly reduced increase in strength for three months?

1:28:03Dr. Jordan Feigenbaum:Maybe. Sure. I'll say that. Six months? Sure. I'll even be charitable. Six months. I don't care. What I care about in the first six months of training, did somebody get bit by the fitness bug and now it's part of their lifestyle, right? Are they enjoying it? Do they stay injury free? And are they setting themselves up for long-term success? Which means not hyper-specializing in a handful of lifts. It means building a cardiorespiratory fitness base. It means exposing themselves, sampling different exercises and different setups so they kind of get a sense of, I do like this. I don't like this release right now.

1:28:32Dr. Jordan Feigenbaum:And then, um, ultimately being well suited for the rest of their training career, which hopefully lasts for decades and decades and decades. What happens in the first six months in any sport is almost irrelevant outside of like, did the person like it? Did they show some like predilection towards this, which requires some sampling, right? And did they not get hurt? And so they kind of burned out too, too soon. I mean, you've said that before, but I feel like it just bared some repeating here. Yeah, agree. All right. Well, to me, the clearest training status difference in acute recovery in newer lifters compared to more experienced lifters is the repeated bout effect.

1:29:11Dr. Jordan Feigenbaum:First time that you do a new exercise, you get sore for days afterwards. But the second time, a little less. Third time, less still. So we think that roughly after two to six weeks of consistent training, an untrained lifter's recovery from a given session starts to look like what a trained lifter is able to recover from. The novice recovery in any meaningful biological sense lasts about six weeks. It's kind of like they're under recovering basically because the stuff is so new to them. After that, it's the same recovery physiology that runs in the train lifter as running in the new lifter, attenuated only by the absolute loads that they're handling and the lifter's calibration of what hard means.

1:29:52Dr. Jordan Feigenbaum:That's also changing. All of this is to say it's not unusual for a newer trainee to appear to have worse recovery when they're exposed to maybe a lower training load. It's because everything's novel to them, right? But as they are exposed repeatedly, this becomes less. And so it sorts of these things start to converge. Ultimately, I think this is just a short period of time. And again, what happens in the first few months is irrelevant unless you get injured because of an aggressive progression strategy that is kind of the through line of the novice intermediate advanced framework.

1:30:27Dr. Austin Baraki:Yeah, I would just add one thing here that this is not purely a matter of how well trained somebody is in general. but you could take a very highly trained you know even elite powerlifter like hey let's take yourself uh and you've been training very high specificity for a while maybe preparing for a meet and then have you pivot and you do a training week where your lower body training is all like barbell reverse lunges and your upper body some you know you you include some trunk work and you do a bunch of uh you know ghd sit-ups you are going to be very very sore from both of those things because they are very foreign to you big time eccentric components to those movements you're going to have quite a lot of soreness that's going to feel a lot like oh am i a novice or am i a beginner am i untrained it's like yeah on those movements you are right so that's kind of supporting the point that these things are operating all the time or not operating it's not just a, you know, a generalized change in, you know, people's capacity, but rather there is some degree of specificity to that repeated bout effect.

1:31:32Dr. Jordan Feigenbaum:Yeah. And most of that should be stated is in the periphery. The, the sort of experience of the soreness with these novel exercises is mostly in the periphery. And what I mean by that is at the level of the muscle, right? You're getting more muscular damage. And so it's like your engine again, instead of normally producing 500 horsepower, well, now it's only able to do 400 horsepower just because the muscle or in this case the motor itself has some structural damage. But people talk about this other sort of type of fatigue, not at the periphery, but at the level of the brain, this sort of CNS fatigue.

1:32:03Dr. Jordan Feigenbaum:My CNS is fried. That's sort of claimed that advanced lifters are limited by accumulated central nervous system fatigue, CNS fatigue, and therefore require categorically different programming approaches. This has been tested directly by Scarabot and colleagues in 2018. They designed to study to find out where the fatigue from a hard training session actually lies. So here's a setup. Trained men, they did 10 sets of five back squats at 80 % of their one rep max. That's a lot. A session that most people, including your two hosts here, would call hard. The researchers used two tools to localize the fatigue.

1:32:40Dr. Jordan Feigenbaum:The first tool stimulates the nerve in the leg directly with electricity to test the muscle's response, bypassing the brain. The second uses a magnetic pulse over the head to test whether the motor cortex in the brain, this is a part of the brain that drives voluntary movement, is putting out the signal it normally puts out. It sounds like some sci-fi stuff, but this is used in the research, TMS. Comparing those two before and after the session tells you whether the fatigue is in the muscle or in the brain. What they found was that the session produced fatigue that took up to 72 hours to fully resolve.

1:33:15Dr. Jordan Feigenbaum:Real fatigue, that's not really in dispute. The muscle is what showed the fatigue. The brain did not. Motor cortex was firing the same way after the session as before. The fatigue was peripheral, meaning in the muscle and the connective tissue, not central. Of course, this was a single session, so short term. These are entrained men, small sample size, but the study did show that a single hard squat session doesn't produce measurable sort of brain fatigue in the window where lifters claim to be fried. It doesn't rule out a chronic CNS adaptation building up over months. That's a different question, and the data on that is pretty much absent at this time.

1:33:53Dr. Jordan Feigenbaum:Though within session detail, that kind of goes against another popular claim. Lower load sets taken to failure produce more discomfort, more perceived fatigue, and more heart rate variability suppression, and more acute force loss than heavy, low rep work performed further away from failure. That's like doing 12 rep max compared to three reps at RP seven or eight. So for many trained lifters, doing the sets of three is less acutely fatiguing than doing three sets of 12 to failure. So the next time that somebody tells you they need to drop the heavy work because their CNS is fried, the data says the high rep set, you just watch them grind through, actually hit them harder.

1:34:34Dr. Jordan Feigenbaum:Austin, the CNS fatigue framing has some real traction in the lifting community. how do you handle uh somebody that you're talking to who's convinced they need an extended deload

1:34:44Dr. Austin Baraki:because their cns is fried i would definitely want to know what they mean by that like what are they actually experiencing and what are all the potential variables that could be impacting that like how is their sleep and nutrition and again what are they trying to do in the gym compared with their you know level of level of fitness is there a more wholesale overhaul of the program that might be appropriate like are they routinely training and no their average training session, you know, is, uh, you know, 10 singles at near a one rep max level effort, or is it sets of, you know, five, I I've had some, I I'm like thinking of a consult, uh, calls that I've done with folks and some of them who have sent me training programs where in a given session, they're doing anywhere from like, you know, sometimes eight upwards of 10 or more exercises and each exercise itself, they're doing four to six sets.

1:35:36Dr. Austin Baraki:And I'm like, that is a massive amount of work to be doing per session and to be training, say, four to six times a week. And so I'm just like, I just have to pull the reins on you for a bit. And then we need to kind of hone in on like, what are you actually trying to accomplish here and align the program more with your goals? Because a lot of times people who are training in that fashion don't really have very particular goals because if you did, it wouldn't take you very long to notice that the program you're doing is not getting you closer to those goals if it is so so widely distributed in terms of the variety of exercises the super high volume the high recovery requirements things like that so really it's just characterizing like what is the person experiencing what can i modify and then what is the goal that we're trying to work towards and just trying to bring those things into a little bit better alignment it's very unlikely that they need an extended deload very few people in strength training in particular need extended deloads i would say there are some folks maybe in the ultra endurance realm we've talked about this recently issues with like low energy availability to the extent that you know somebody believes reds is a thing uh there's obviously there's been some recent controversy around that although i think it's a justifiable uh thing to be concerned about and a lot of folks those might need a little bit of a longer uh kind of back off period and and uh you know health focusing on health instead of their training but in strength training it's very unlikely that somebody needs like months long deload or something like that they might need to back off for a week or two or something like that but even then there's probably a better formulation of training that can be set up that they would tolerate much better and is likely to be better aligned with their goals if they think they need that much work for hypertrophy they probably don't if they think they need that much work for strength they almost certainly don't and so then it's a matter of like

1:37:16Dr. Jordan Feigenbaum:aligning those things yeah yeah and ultimately this doesn't really matter even if you do accept the NIA framework, if you're a novice, intermediate, advanced, it's all the same, which kind of begs the question, why do we have the framework in the first place? One more thing worth talking about, because the NIA framework leans on it heavily for justifying volume and training load escalation across categories, MRV, maximum recoverable volume. The idea is that each lifter has a specific number of working sets per week per muscle group that they can recover from, and that program should be built around that number.

1:37:51Dr. Jordan Feigenbaum:to me mrv may be useful as coaching shorthand it's never been validated as a number that you can use or you can measure for an individual lifter it's more this abstract concept but it's sensitive to sleep nutrition life stress exercise selection the cumulative load history of the past several weeks whatever the lifters mrv is this month it's probably going to be different the next month so like what's the point it's not stable enough to anchor any sort of prescription. Now, advanced lifters, experienced lifters do tend to tolerate more absolute volume and training load, but the relationship isn't linear.

1:38:28Dr. Jordan Feigenbaum:And it's confounded by the fact that advanced lifters, experienced lifters also need more relative stimulus to adapt their floor and their ceiling, if you will, rise together. Useful as language maybe for auto-regulation, and it may be useful for coaching shorthand, but I don't really think this is like a way to separate people into novices, intermediate or advanced. And I also don't think it's like worth trying to identify again because like it's gonna change next week, next month or whatever. And also I think it's a little limited, max recoverable volume. I can get behind maybe max recoverable training load, but again, how would you identify it?

1:39:07Dr. Jordan Feigenbaum:That's just one factor in training load. I think training load is more important than just volume. So that clears out the main fatigue claims that the NIA framework leans on. Now, what to actually do with all of this? The replacement for the NIA framework isn't a different set of categories. It's really more of a different orientation towards exercise prescription and programming. And we want it to be reactive, driven by what the individual actually demonstrates, rather than proactive, driven by what a category implies should be happening. and the rest of this is what that looks like at each phase in a training career so we've talked about this a number of times on the podcast one of the things we like to do as far as generating reactive reactive approach within a given training session is using the warm-up for what it's telling you to me this is one of the most reliable within session signals a weight that you've performed regularly enough that its feel is sort of well calibrated at your current training level so for example, my last warmup on a squat when I'm, you know, working with relatively heavy weights is usually 455, right?

1:40:16Dr. Jordan Feigenbaum:If it's for singles, it's going to be heavier than that usually 550, but for multi-rep sets, it's usually 455. If the set moves noticeably faster than I expect, it requires less effort than usual, feels light in a way that kind of makes sense to me. I think my performance potential that day is a little higher, so I can add a little bit of weight. On the other hand, if it feels slower, harder, or off in a way that also feels meaningful to me. I'm like, Oh, my performance potential today is not quite what I would hope it would be. So adding weight would be a bad idea. I probably need to actually take weight off the bar.

1:40:48Dr. Jordan Feigenbaum:Um, and then if it feels about the same, maybe I even need to repeat a set. Uh, I think that when things feel lighter to me, what I'm interpreting that is strength is either declared itself or that this is just noise, right? I'm, I'm picking up noise, but I also, So again, I expect my performance to vary day to day. That's human performance in a nutshell. If it feels heavier, I think that doesn't mean I think my strength is going down. It just means, again, I'm within that sort of performance variability. But the logic is the same at year one as it is at year 10. The only thing that changes is the size of the increments, the weight on the bar, and the frequency at which maybe these things show up.

1:41:28Dr. Jordan Feigenbaum:Does that make sense to you, Austin?

1:41:29Dr. Austin Baraki:Yeah, I think that reflects my experience as well. I think that, you know, that are like near maximum efforts have been, you know, essentially near maximum at each stage of our training career. And there were indicators, there were, there were signs on the way towards, towards, towards that effort. But you're right that, you know, I can remember, you know, anybody who's, who's been at this long enough, let's say that you are in a place where you've used like pound plates, for example, in the gym, you know, the first time that you decide that you're going to like skip 95 pounds or skip 185 pounds, you know, and suddenly your increment goes from 135 to 225 that feels like a big deal you know those like quarter plate jumps and you're like ah i can skip that and jump from you know 225 to 315 or you know they become a bigger and bigger deal um the the bigger of jumps i know that you and i historically like you have made some gargantuan jumps before um or at least what what felt like it at the time um and and that's really the thing that's changing but fundamentally the underlying biology and all

1:42:27Dr. Jordan Feigenbaum:that is the same over that period of time i think yeah yeah agreed all right next part what counts as a genuine stall uh because to me it's worth investigating if somebody's really stalled um we call it maybe a lack of demonstrable improvement in a priority lift over three to four weeks with consistent training adequate sleep adequate nutrition and manageable life stress all in place well the window for this detection scales in both directions if somebody with less training history it's generally a shorter window, more training histories, a longer window, but how do you measure it? You have to measure it against a recent anchor, right?

1:43:03Dr. Jordan Feigenbaum:The best performance, maybe in the past six to eight weeks, not a lifetime best, like my lifetime best deadlift right now, 748 pounds, right? And if I looked at my training right now, I'd be like, oh my God, my deadlift is terrible. It's like, well, actually it's going up over the past, you know, 16 weeks or so. It's a good sign, but I'm still not back at my peak level performance because I'm not really prioritizing it. So you have to use a recent anchor that's thing one two you have to compare like to like whether it's an estimated one rep max from sets performed with the same rep range same rpe target that can be useful uh whether it's a rep max set whether it's a single rep something you just can't compare like well i did 10 reps at rp7 what i rated rp7 and this is my estimated one rep max and this is a single rep at rpe8 and i'm just comparing them a lot look i got weaker like those are really two different tasks here.

1:43:50Dr. Jordan Feigenbaum:So one way to also do this is at the beginning and end of each block. So usually the way I program in a lot of our templates program is that the first week of a new training program, if you were to switch programs, is an introduction week. And so new movements, I usually have people do ascending sets. So let's say the first exercise, the back squat, four reps at rp6 four reps at rp7 four reps at rp8 that's all you do it's sort of a calibration thing how strong are you what's the ballpark that you're in right kind of sets your sort of uh expectations as far as your your current performance level well eight weeks later the end of the block let's say it went eight weeks long i'm gonna have you do four reps at six four reps at seven four reps at eight i get you get to sort of compare at the beginning the end did we see demonstrable improvements basically a test with relatively low low stakes here so that's one way that I approach some of our programming here.

1:44:46Dr. Jordan Feigenbaum:Now, Austin, I want you to walk us through this consult to wrap this up. A trainee shows up, squat hasn't moved in four weeks, sleep's been bad, work's been bad. He wants to know if the program is broken or if he needs more volume. What do you do?

1:45:00Dr. Austin Baraki:Take a detailed history and get a sense of what are the sources of biggest concern for the person and basically trying to identify the targets that I can realistically intervene on. so much of this as with many of these sort of scenarios and these are pretty common consults that i'll do through you know people will contact us at barbell medicine for for consults they'll do them with me they'll i know they've done some with you some of our other coaches as well to provide some guidance in this area and really getting a sense of what are their goals and priorities what are their expectations and what sort of modifications are they willing to make so i know that i'm starting out kind of speaking in generalities but and that's mainly because i've seen so many of these consults with so many different actual management strategies that have ended up being appropriate for the person.

1:45:41Dr. Austin Baraki:Sometimes they do need a bit of a deload. Sometimes they do ultimately need a little bit more training volume, but only once we're able to get some of these other, you know, variables like life variables kind of in line. And sometimes they actually have a medical issue that has arisen and that they were not tracking, like maybe you actually need to get some like labs done or some form of testing, maybe something else is going on. And this is kind of the initial declaration of, you know, something pathologic that's happening. Not the most common outcome but certainly something that i'm like very attuned to in the way that i think about things when i'm listening to somebody so really aligning their expectations with the way we're setting up their training program in the short term and then looking for like what i would call red flags red flags being things that need more radical changes in management more of a substantial pullback in training more of a substantial change in their nutrition or or medical evaluation so it's really difficult to pin down like a very specific strategy here because these things can look so different but what is what does that um how does that sound to you compared with your experience or like where do you see these consults typically going in practice yeah i mean i think

1:46:45Dr. Jordan Feigenbaum:ultimately the way you've kind of worked through this systematically is first identifying like okay look this is your experience you validate it right you build a rapport um and then you're kind of looking for uh modifiable levers whether it's a reversible medical cause right or something that's declared itself like you mentioned or in this case the environment is not ripe for gains right right haven't slept works bad stress is high whatever you're like okay well are any of these things modifiable right now right because ultimately you what you are perceiving here or what you're what you're interpreting is that the training load may or may not be appropriate i just don't know because it is being wrecked by the environment in which that training load is being applied and so if we cannot change the environment then the training load has to change it's probably not going to be more volume though yeah not until yeah which i think is a simple answer but yeah ultimately after you establish the relationship looked for other causes that are unrelated to either training load or environment then you can address the training load and whether it should go up or down is more of a function of like uh what happens when the stuffer is resolved right and if it can't resolve then it's like well you only have really one choice and that's going to be to decrease it temporarily yeah yeah agree temporary pullback

1:47:54Dr. Austin Baraki:and then kind of recalibrating the the program beyond that for the person's tolerance and what they're able to do sometimes i make an argument for like an even bigger pivot and i'm like let's have you considered just like taking a few weeks and the horror of like what if we just like didn't touch a barbell for a little bit of time and found some other activities that you might not have so much like prior psychological anchoring to something totally different something that you might actually just like enjoy maybe something that's like outside i don't know um and and finding some other things to play with because again my argument is do you think that let's say we did this for two weeks or four weeks, then fast forward five years.

1:48:31Dr. Austin Baraki:Are you going to be at a certain point five years from now and be like, if only I hadn't done that two week pivot five years ago, right? And so finding ways to dig people out of this hole in the short term so that we can recalibrate, you could do a lot of things in the near term and still end up in a really good place over the long term. So, you know, almost anything is an option.

1:48:51Dr. Jordan Feigenbaum:Yeah. Yeah, I think how this ties into this sort of NIA framework, novice, intermediate, advanced, is that when people are talking about a stall, we have to also make sure that it's not a problem with the sort of detection window or observation window, right? The reason why that framework, I think, resonates with so many people is because that's their lived experience. They got much stronger when they first started compared to later on in their training career. And they're like, well, look, something fundamentally different was happening there. And what I think is they're experiencing is just that the detection window for these adaptations was much, much shorter.

1:49:22Dr. Jordan Feigenbaum:And so it showed up more regularly, right? And that's what they – and the signal-to-noise ratio was also smaller. But as you get more and more trained, the detection window, the observation window has to be longer. Your signal-to-noise ratio is also higher, right? Your 5 % to 10 % swing and strength performance day-to-day is now much larger in absolute terms. And so there's a lot more noise there. But I think overall, we can reject each one of the novice, intermediate, and advanced claims. One, the first claim was that, look, there's different rates at which these underlying adaptive processes are functioning.

1:49:55Dr. Jordan Feigenbaum:I do not think that's true. I don't think the muscle protein synthesis rates are really changing that much. The connective tissue synthesis rates, all of these sort of things are still running at the same rate. There's just bigger difference between where you're at currently and your sort of ceiling. Two, I do not think that these rates are different. And so therefore, I do not think that they require different progression models. I think the progression should be reactive to what the person is actually doing. You can address that within a session using the warm-up sets, for example, also retrospectively after the end of a training block to see how the progression actually went.

1:50:27Dr. Jordan Feigenbaum:But it should still be reactive. What is the person doing? What's their performance potential? Let's match the load, the weight selection, everything else to what the individual is actually telling you in real life. And then claim three, that the program design should different, be different, fundamentally different between novices, intermediate, advanced. I do not think that's true either. I think generally programming heuristics are what they are. And so how the formulation and the dose changes is specific to the individual and is not informed by classifying somebody as novice, intermediate, advanced.

1:50:57Dr. Jordan Feigenbaum:And so I can reject the NIA framework and push even further to say you shouldn't use it prescriptively, which is my real problem with it. If the framework was just, you get faster gains earlier on, slower gains later on, we wouldn't make this episode. But that's not how people are using it in practice. They're using it for progression models and prescriptive stuff for programming. I think both of those things should be stopped. Austin, anything you want to add to this before we wrap up? I think you put a button on it nicely, and I look forward to never having to make this argument again. So that's the case against the novice intermediate advanced framework.

1:51:32Dr. Jordan Feigenbaum:And that's where the practical work starts. Here's what we want you to walk away with. The framework gets the observation right, but the conclusion wrong. Beginners do gain quickly. Advanced lifters do gain slowly. That part really is in dispute. What's wrong is the inference that the rate difference reflects categorically different biology that has to be programmed differently. The same four adaptive systems are running at year one and at year 10. What changes across a training career is the absolute size of each game, the band of noise within the measurement, and how long you've got to watch your results before you know whether the work just done is showing up.

1:52:08Dr. Jordan Feigenbaum:Those four systems are running on four different timescales, and that's the structural reason new lifters get hurt three to ten times more often than experienced lifters in the same sport. Their muscles and nervous systems are responding on a faster clock than their tendons and bones. So a loading schedule built around the muscle's pace tends to overrun the connective tissue underneath it. The framework's prescription, that novices should add weight every session because their biology, quote, supports it, is the same loading schedule that turns into patellar tendinopathy four months in. And most of the cultural language around fatigue, the CNS fried claims, and the max recoverable volume as a number claim, but doesn't survive contact with the data.

1:52:48Dr. Jordan Feigenbaum:Fatigue is at least four dissociable phenomena. The same recovery physiology runs in the new lifter and in the trained lifter once the first few weeks of the repeated bout effect resolve. And RPE is a calibration skill rather than a property that emerges from training years. A single hard squat session, as best as the data can tell us right now, doesn't fry your motor cortex. Which brings us to what to actually do when you're not getting results. The environment comes first. That means sleep, nutrition, and life stress, and if any of those are off, the move is to fix the input before you change anything with the program.

1:53:20Dr. Jordan Feigenbaum:If you can't fix them, yes, then you should adjust the program down because you're not in a good place to train as hard as you want to right now. If the environment is intact and the numbers are still flatlining, the question is whether you're carrying too much fatigue or you're carrying not enough training stress. Too much fatigue tends to look like constant soreness, a session RPE that's constantly above 8, and motivation that's drifting down. And the first move there is to drop a set or two on each exercise for a few training days and to see what happens to performance. Too little stress looks like the opposite.

1:53:52Dr. Jordan Feigenbaum:The soreness is gone, your session RPE is consistently below 6, and the weight on the bar is still flat. First move there is to check your exercise selection to make sure it's specific enough to how you're evaluating strength, and then to consider raising the average intensity and potentially raising volume. The Training Plateau Action Plan walks through this whole sequence with specific decision points, and it's free by the way. A genuine stall is worth investigating, but it's got to be defined by load and environment, not necessarily the calendar. The within-session diagnostic is the reference warm-up set that we talked about earlier.

1:54:26Dr. Jordan Feigenbaum:The across-block diagnostic is a three - to four-week trend in your estimated one rep max against a recent anchor. None of those rules change with training history. what changes is the size of the increment that clears the noise and how long you have to wait to see it. Now if the categories describe a measurement window more cleanly than they describe biology, then most program hopping is a response to a fictional transition. Your training didn't stop working because the program got mismatched to a new physiology, your gain stopped clearing the session-to-session detection threshold, and switching programs is solving a measurement problem with a training intervention.

1:55:02Dr. Jordan Feigenbaum:Two different problems and conflating them is where the NIA framework does its most consistent damage. A question to chew on before next week. If you've ever had a conversation about low testosterone with a doctor or with a friend, did anyone ask about body fat, about sleep, about the signal coming down the chain that tells the testes what to do? Or did the conversation start and end at a number on a lab report? Next week we get into the drivers, the actual reason a man's testosterone ends up where it is, which almost always lives upstream of the testes themselves. The aromatase loop and the inflammatory cytokines from excess body fat are the pieces of the story most readers have probably already run across.

1:55:40Dr. Jordan Feigenbaum:But there's a third piece that almost nobody appreciates and it sits at the very top of the HPG axis. It's a hormone you've probably heard about in the context of appetite, except the appetite story doesn't really hold up the way it's been sold. The rule for that hormone that does hold up tells you why an individual with obesity, while their hypothalamus stops sending the signal, his testes need to do their job. The hormone is leptin, and most clinicians have never connected it to low testosterone at all. That's where we'll be at next week. Everything we covered today, the four-system model, the IPF data, and the warm-up diagnostic comes from work we've been pulling together for our broader progressive loading project.

1:56:18Dr. Jordan Feigenbaum:The three-part article series is on barbellmedicine.com with all of the citations. The Training Plateau Action Plan is the diagnostic walked through step-by-step, and it's a free resource also on our website. Plus, we have the Barbell Medicine programs and one-on-one coaching are there when the answer needs to be more tailored to the individual. Leave us a five-star rating and a review. It's the single best thing that you can do so that we can keep bringing you all the latest nuance in health and fitness. I'm Dr. Jordan Feigenbaum. That's Dr. Austin Baraki. We'll catch you next week and every week right here on the Barbell Medicine Podcast.