Hooper, DR, Szivak, TK, Comstock, BA, Dunn-Lewis, C, Apicella, JM, Kelly, NA, Creighton, BC, Flanagan, SD, Looney, DP, Volek, JS, Maresh, CM, and Kraemer, WJ. Effects of fatigue from resistance training on barbell back squat biomechanics. J Strength Cond Res 28(4): 1127–1134, 2014—Exhaustive resistance training programs that have been previously referred to as extreme conditioning protocols have increased in popularity in military and civilian populations in recent years. However, because of their highly fatiguing nature, proprioception is likely altered during such programs that would significantly affect the safety and efficacy of such programs. Therefore, the purpose of this study was to assess the alterations in movement patterns that result from extreme conditioning protocols and to evaluate if these protocols can be deemed safe and effective. Twelve men (age 24 ± 4.2 years, height 173.1 ± 3.6 cm, weight 76.9 ± 7.8 kg, body fat percentage 9.0 ± 2.2%) and 13 women (age 24.5 ± 3.8 years, height 166.9 ± 8.5 cm, weight 66.1 ± 9.2 kg, body fat percentage 18.6 ± 4.0%) with at least 6 months of resistance training experience involving barbell bench press, barbell deadlift, and barbell back squat performed a highly fatiguing resistance training workout. During the barbell back squat, a 2-dimensional analysis was performed where the knee and hip angles were recorded throughout the 55 repetitions of the workout. At the early stages of the protocol, knee angle was significantly lower in men and in women demonstrating less knee flexion. Also, hip angle was significantly lower early in the program in men and in women, demonstrating a greater forward lean. The technique changes that occur in high repetition sets do not favor optimal strength development and may increase the risk of injury, clearly questioning the safety and efficacy of such resistance training programming. This is likely a display of self-preservation by individuals who are faced with high repetition programs.