Mixed martial arts (MMA) is a new combat sport that combines boxing, Muay Thai kickboxing, wrestling, and Brazilian Jiu-Jitsu (BJJ). The growing sport of MMA gained mainstream attention on November 12, 1993, when Royce Gracie, an accomplished BJJ expert, dominated the Ultimate Fighting Championship (UFC) in Denver, Colorado (61). Gracie's opponents during his tenure as 3-time UFC champion were practitioners of other styles of martial arts such as boxing, shootfighting, kickboxing, karate, judo, and taekwondo. Competitors during the early days of the UFC were specialists in their trade and, unlike today, did not train in other martial arts. The introduction of MMA into mainstream consequently attracted countless participants in the United States (61).
Although the majority of mixed martial artists are male, there are also female athletes who train and compete in this male-dominated combat sport. The number of participants in women's MMA is continuously growing partly because of 2 reasons: first, MMA is a means for female wrestlers to participate in combat sports after their collegiate wrestling careers. Second, the implementation of Title IX in 1972 led to a large increase of female participation in sports at the high school and collegiate level (11). According to a longitudinal study, the number of women in high school sports increased by a factor of 9, whereas the number of women in college sports increased by more than 450% since Title IX (11). In fact, according to a 2011 report by the National Federation of State High School Associations, the 2010–11 wrestling season saw women's participation increase 19.8 percent from the previous year (33).
Male and female mixed martial artists have different needs to address regarding physical fitness and athletic performance. Although men and women increase strength at the same rate, performance can be enhanced by the application of a female-specific training program that addresses physical limitations while being contoured to the unique sport of MMA. Two areas that must be emphasized when designing resistance training programs for women are increasing upper-body strength and preventing injuries, especially in the knee. MMA is physically demanding and uses both anaerobic and aerobic energy systems. There is limited peer-reviewed research regarding the best possible training methods for the MMA fighter and none on the subject of women fighters. The aim of this article is to assess the physiological demands of MMA, discuss available peer-reviewed research concerning combat sport-specific training methods, and suggest proper training structures that will optimize performance and reduce the risk of injury for female fighters.
STRENGTH AND CONDITIONING CONSIDERATIONS FOR FEMALE MIXED MARTIAL ARTISTS
Designing a program specifically for female MMA fighters is essential because of the physiological and anatomical differences between men and women. One of the most significant physiological differences is the disparity in testosterone. This lack of testosterone explains why men have a greater amount of lean body mass (LBM) than women. Testosterone plays a significant role in determining the extent to which the body adapts to strength training because it is perhaps the most potent promoter of cell growth and muscular hypertrophy (57,58). For example, an average male between 20 and 29 years has 15.9% body fat, whereas his female counterpart has 22.1% (45). Women in combat sports need to focus on increasing LBM because of its direct relationship with strength and anaerobic capacity, to physiological measures that women tend to lack compared with men (21,30,31,37). Female combat athletes must improve their anaerobic power because it is an essential component for technique execution (39). Furthermore, Kubo et al (41) investigated the sport of Judo, which is a common discipline in MMA, and found that across all performance levels, judo athletes (judokas) with greater LBM had a physical advantage over their opponents.
Female fighters can increase LBM by following a structured weight training program that focuses on increasing circulating testosterone (59). Testosterone release can be manipulated by performing multijoint lifts (squat, power clean, deadlift, etc.), decreasing rest periods in between sets, increasing the number of sets (at least 3), and increasing intensity (10RM range) (16). Multijoint and power exercises must be completed before single-joint lifts because they stimulate circulating testosterone serum level throughout the workout (12).
METABOLIC COSTS OF MIXED MARTIAL ARTS
Strength and conditioning professionals must design a training regimen that accurately reflects the metabolic demand of the sport. A women's MMA fight is typically made of three 3-minute rounds compared with men's nontitle fights of three 5-minute rounds. All 3 bioenergetic pathways (phosphagen, glycolytic, and oxidative) can be taxed within a full 9-minute fight (42). Exercise intensity is the most important variable in determining which energy system is activated the most to produce adenosine triphosphate (ATP) for muscular work (12). Each fight contains periods of recovery and rest between intermittent bursts of high-intensity movements. For example, fighters may actively rest on the mat after a successful takedown or circle each other after a series of strikes. The ATP-phosphocreatine and glycolytic energy systems produce ATP anaerobically at a very high rate and are the predominant sources of ATP in an MMA fight when the fighter attempts a quick movement like a takedown (12). These high-intensity movements are counterbalanced by low-intensity periods that allow a fighter to actively recover. During these periods of recovery, the supply of ATP to previously active tissue must be slower and more continuous. In these instances ATP is produced aerobically, allowing the anaerobic energy pathways to restore for the next high-intensity energy movement (12). Thus, the more aerobically fit the athlete, the better she will be able to recover quickly between rounds and between high intensity bursts.
The principle of specificity states that sports training must be similar and appropriate to the activity to produce a positive training effect (47). Because MMA is both anaerobic and aerobic in nature, interval training needs to be implemented to mirror the demands of the sport. Since the metabolic demand of the training sessions must be similar to the fight, female MMA fighters should partake in 3 sets of high-intensity interval training (HIIT) for 3 minutes followed by rest for 1 minute. HIIT is characterized by alternating high-intensity exercise bouts with relatively longer active recovery periods (23). Benefits of HIIT include increasing V̇o2 max while delaying muscular fatigue (60), improving body composition, increasing anaerobic power (38), and increasing oxidative capacity in skeletal muscle faster than continuous exercise (23). Compared with traditional circuit training, which is done at a lower intensity at a greater total volume, HIIT must be performed at a minimum of 90% of V̇o2 max (24).
An example interval workout could include a circuit where the athlete would cycle through stations and perform exercises back to back without rest (Table 1). She would perform a predetermined number of repetitions of jump squats, medicine ball slams, kettle bell swings, push-ups, medicine ball rotations, and shoulder presses consecutively until all exercises have been completed. An example of a HIIT workout could include MMA-specific exercises (Table 2), where the work and rest periods replicate a competitive fight. For example, the fighter can shadow box for 1 minute, kick the heavy bag for 30 seconds, do takedown drills with a partner for 1 minute, perform a shrimping drill for 30 seconds (Figure 1a and 1b), and finish with guard passing drills for another. The fighter will then rest for 1 minute before starting the circuit again because rest periods in between sets reflect the duration used in a real fight. The magnitude of acute growth hormone responses in strength-trained women is greater with shorter rest intervals between sets compared with longer rest periods (8). Interval training in the form of HIIT and circuit training would be extremely beneficial to mixed martial artists because it is both metabolically and biomechanically specific to MMA.
Static strength is essential in MMA because fighters use isometric muscle actions constantly during the course of a fight. They use static strength when holding each other in position on the ground to maintain control, grasp opponents above and below the waist, and to pin down their opponent on the mat after a takedown. It is also imperative in kickboxing when the fighters perform a clinch (2 hands behind opponent's neck) when throwing knees. Female MMA fighters can implement isometric exercises in their strength training routine by performing isometric push-ups (lower body half way down and hold the position for 10–30 seconds), isometric squats (back against the wall with hips at or below 90 degrees, hold for 10–30 seconds), or performing pull-ups with a towel to develop grip strength (Figure 2). These exercises will develop isometric strength and endurance, vital abilities fighters must have in MMA.
McGuigan et al (44) examined the relationships between isometric maximal strength (PF), rate of force development (RFD), and 1 repetition maximum (1RM) strength with other variables that contribute to successful performance in college wrestling. Eight division III college wrestlers participated in the study and were tested for PF and RFD using isometric mid-thigh pull exercise, 1RM using squat, bench press, and power clean exercises as well as vertical jump for explosive muscular power. Results indicated strong correlations between measures of PF and 1RM (r = 0.72–0.97). According to McGuigan, RFD may not be as important as maximum strength for collegiate wrestlers because he did not find any correlations between RFD and measures of strength and performance. Female MMA fighters, like wrestlers, may benefit from heavy strength training to increase isometric maximal strength. Although heavy strength training benefits isometric maximal strength, because of the principle of specificity, the best way to increase isometric maximal strength is to regularly perform isometric strength exercises.
Mixed martial artists are required to have exceptional cervical muscular strength due to the loads placed on the cervical spine. The neck is constantly under strain when being pulled down in a clinch or when the fighter is in a contorted position on the ground. MMA fighters must bridge on the neck to escape an unfavorable position from the bottom. For instance, in executing a technique called “the can opener,” which is performed when the fighter is in their opponent's guard (opponent's legs wrapped around the waist), the fighter grabs her opponent's head and pulls hard to force the opponent to submit. The nature of MMA places athletes at risk for cervical injury because of the unnatural contorted positions (36); therefore, having a strong neck reduces the risk of injury and decreases the level of discomfort for the athlete. Neck exercises should target all major motions including neck flexion, extension, and lateral flexion. Female MMA fighters can add isometric neck exercises, bridges (Figure 3), or a face down/face up plate neck resistance exercises to their routine in addition to concentric and eccentric exercises.
Upper-body strength is paramount to the physically well-rounded MMA fighter because much of the sport involves engaging by striking or holding the opponent with the upper limbs. Women lack strength compared with men particularly in the upper body (21,31,37), thereby making it a necessary area of focus in strength training. Upper-body lifts, such as bench press, bent-over rows, lat pull-down, and shoulder presses, must be a regular part of the training routine. Women can incorporate these exercises into their HIIT, circuit training, and strength training programs, placing focus on the multijoint exercises at the beginning of the workout. When completing a heavy strength training day, female MMA fighters will benefit from large multijoint exercises like the military press, bench press, push press, and weighted pull-ups done at high intensity (75–85% 1RM). The female fighter can also integrate a number of upper-body exercises into their warm-up by completing a set number of push-ups and pull-ups before martial arts practice. Thus, women MMA fighters will gain an advantage over their opponent through incorporating intense upper-body training.
LOWER-EXTREMITY INJURY PREVENTION
Jarret et al (36) evaluated the data of the National Collegiate Athletic Association Injury Surveillance System on collegiate wrestling to report musculoskeletal issues. The knee, shoulder, and ankle were the most commonly injured regions. The mechanism of injury was the rotation about a planted foot, one of the main causes of anterior cruciate ligament (ACL) injuries in female athletes. Previous literature has shown that a neuromuscular training program using plyometrics and speed, agility, and quickness (SAQ) training can improve athletic performance and reduce the risk of injury in female athletes (17,48-50,53,55). Women are up to 8 times more likely than their male counterparts to injure their ACL in the same sport (2). Combat styles that involve striking, like boxing (7) and kickboxing (22), have been shown to have a higher incidence of injury compared with grappling styles (36), possibly due to giving and receiving high velocity blows. Notwithstanding, grappling also poses a high risk for women because of the distorted positions the limbs can be forcibly placed in (36). There are also many submissions used in MMA, like the knee bar and heel hook, which are used to specifically damage an opponent's knee (3). Accordingly, female MMA fighters need to develop explosiveness and proprioceptive awareness to avoid injury in training and competition (48).
Myer et al (51) examined the effects of a comprehensive neuromuscular training program on measures of performance and lower-extremity movement biomechanics in female athletes. Forty-one female basketball, soccer, and volleyball players underwent 6 weeks of training that included plyometrics, core strengthening and balance, resistance training, and speed training. At the end of the protocol, subjects were able to improve measures of vertical jump, single-leg hop distance, speed, bench press, squat, knee ROM, and knee varus and valgus torques compared with their pretrained values and control group. The improvements were statistically (P > 0.05) and clinically (functionally) significant, displaying up to a 92% improvement (51). Hewett et al (28) used the same neuromuscular training program and evaluated the effects on serious knee injury rates and female athletes. Results demonstrated that plyometrics supplemented with resistance training reduced serious knee injuries in adolescent volleyball, soccer, and basketball players.
Mandelbaum et al (43) investigated whether a neuromuscular and proprioceptive performance program was effective in decreasing the incidence of anterior cruciate ligament injury within competitive female soccer players. Soccer is transferable to MMA because both sports require athletes to quickly change direction, pivot, and perform intermittent explosive movements. All 844 female athletes participated in either their traditional warm-up or a sports-specific training intervention over a 2-year period. The intervention consisted of education, stretching, strengthening, plyometrics, and sports-specific agility drills designed to replace the traditional warm-up. Anterior cruciate ligament injuries decreased by 88% compared with the control group in the following year. In the year after, there was a 74% reduction in ACL tears in the treatment group compared with age- and skill-matched controls. Hence, the neuromuscular and proprioceptive program was effective in decreasing ACL injuries in female athletes.
Neuromuscular training protocols that combine plyometrics and dynamic balance exercises can significantly improve biomechanics and neuromuscular performance and reduce lower-extremity injury in women. Myer et al (49) compared the effects of plyometrics versus dynamic stabilization and balance training on power, balance, strength, and landing force in female athletes. Nineteen high-school female athletes trained 3 times a week for 7 weeks, either in the plyometric or in the balance group. The results of the study suggest that both plyometric and balance training are effective methods of increasing neuromuscular power and control and must be combined to maximize its effectiveness. Women combat athletes are at high risk of lower-body injury from kicking, decelerating, pivoting, abruptly changing direction, and having their joints in compromised positions (6). They will benefit from a combination of power, balance, and SAQ training (Table 3).
Proper conditioning will help female mixed martial artists remain injury-free in training and competition. Women have specific anatomical characteristics that contribute to the increased risk of injury: larger Q angles (46), excessively valgus knee angles (28), narrow femoral intercondylar notches (52), and an inability to optimally activate hamstrings during deceleration (15,48). Incidences of noncontact ACL injuries are greater in women than men in the same sport (55), but the risk of injury can be considerably reduced with proper power, balance, and posterior chain training. Since strength is the basis for power, athletes are required to be adequately strength trained before undertaking a power-based training program (12).
SAQ training uses speed, agility, and quickness drills to develop straight ahead speed, lateral speed, change of direction, and deceleration. Strength and conditioning coaches design SAQ programs to improve their athlete's ability to execute precise movements at high speeds. Female athletes are known to have anatomical and biomechanical issues that impair their ability to change direction and decelerate (15,48). Decreased ability to decelerate and control dynamic knee valgus may be related to the muscular imbalance of the hamstrings to quadriceps in females (29). Thus, drills such as shuttle runs, speed ladder drills, speed skaters (Figure 4) and dot drills are beneficial for female athletes to develop dynamic leg strength while increasing knee and ankle strength and stability.
Nutritional ergogenic aids are useful tools for female athletes to enhance performance, speed recovery, and reduce fatigue. Although some ergogenic aids can be harmful, there are many that are safe and have a positive effect on performance (9,10,14,34,35,62). Supplements that would be beneficial for female fighters include whey protein and creatine. Whey protein is a thoroughly researched supplement that has been shown to be effective in building muscle and decreasing recovery time (32,35). Also rigorously investigated, creatine is primarily used to improve power and performance during short bursts of activity (4,40). Whey protein and creatine may be functional instruments to boost the female fighter's performance.
Many studies suggest that ingestion of protein and branched chain amino acids after strength training can enhance skeletal muscle hypertrophy in response to chronic resistance training (1,5,9,10,14,26,34,62). Supplementation with protein can also reduce postexercise muscle soreness after high-intensity workouts (32). Hoffman et al (32) examined the efficacy of pre-exercise and postexercise protein ingestion on recovery from an acute resistance training session. Fifteen male strength/power athletes were randomly divided into a supplement (SUP) or placebo (PL) group and were tested for maximal strength. Blood draws occurred at baseline, immediate, and 15 minutes postexercise to determine testosterone, cortical, and creatine kinase (CK) concentrations. Subjects reported back to the laboratory 24 and 48 hours later for a baseline blood draw and to perform 4 sets of 10 repetitions with 80% of 1RM for squat exercise. As a result, CK concentrations were significantly (P < 0.05) elevated at the post–24-hour blood draw for both groups but continued to elevate (P < 0.05) at 48 h for PL only. These results indicate that protein supplementation before and after a resistance training session significantly contribute to recovery 24 and 48 hours postexercise.
Creatine is most commonly used to improve power and performance during short bursts of activity. It is a naturally occurring nitrogenous compound made in the liver, kidneys, and pancreas and found in red meat. Creatine supplementation may enhance the effects of intense interval endurance training (38) and has been shown to increase muscle strength, power output, and muscle mass (4,18,40). It is most useful in high-intensity short-duration exercises because it may enhance intramuscular phosphocreatine synthesis, thereby improving the cell's potential for rapid ATP production (20). Cox et al (13) observed that acute creatine supplementation improved elite female soccer players' performance in repeated sprint and agility tasks. Creatine has been shown to improve anaerobic working capacity in both men and women (18) and is a viable option for female mixed martial artists seeking to increase anaerobic power.
In addition to losing large amounts of important minerals during a menstrual cycle, research shows that female athletes often display poor dietary behavior (27). Since MMA is a weight class–based sport, fighters usually undergo a drastic weight-loss process that can be detrimental to performance. Female mixed martial artists can benefit from consuming whey supplementation immediately post-workout to increase muscular hypertrophy and reduce the effects of delayed onset muscle soreness, and creatine will be useful in increasing power output.
Since whey protein can enhance muscle hypertrophy response to resistance exercise in healthy adults (10,34,35,62) and decrease muscle damage and soreness (32), female mixed martial artists can benefit from consuming whey supplementation immediately post-workout to increase muscular hypertrophy and reduce the effects of delayed onset muscle soreness. They must consume a protein–carbohydrate beverage immediately post-exercise, which can be easily accomplished by drinking chocolate milk infused with whey protein after practice. Recommended daily whey protein consumption is 1.5–2.0 g/kg of body weight to increase LBM and anaerobic capacity (12). Effective supplementation may allow the female fighter to retain muscle and recover faster during this strenuous weight loss process.
The purpose of periodization is to transfer a variety of performance variables (power, strength, and endurance) to their highest rate of development with the goal of peaking at the right time while avoiding stagnation, injury, and overtraining (19). The 2 major models of periodization are linear and nonlinear (undulating) (56). Linear periodization (LP) is characterized by slow but progressive increases of intensity over time, whereas non-LP is varied and includes large daily fluctuations in intensity (56).
A properly periodized program can prevent the risk of injury by altering intensity, exercise selection, and volume, effectively increase strength and LBM and prevent plateaus from occurring (54). Successful female MMA fighters devote countless hours to MMA training because of the sport's multifaceted qualities, consequently spending ample training time in several different martial arts styles. Female fighters will benefit from a properly structured training program that clearly presents detailed workouts that allow sufficient recovery time in between. Periodization will also allow the female fighter to gain muscular strength, power, and endurance simultaneously (25).
Undulating periodization is more beneficial to MMA fighters than LP because it has been shown to induce greater increases in maximal strength than the linear model (54,56). Since a disadvantage of LP is the increased chance of training stagnation (54), MMA fighters need to vary their daily intensity and volume variations to maximize strength increases. For instance, she may perform sets of 12–15RM on Tuesday and 6–8RM on Friday (Table 4). Tuesday strength training workouts should be performed 60–70% 1RM with rest periods of 45 seconds to 1 minute and Friday workouts performed at 80–85% 1RM with rest periods of 2–4 minutes. Manipulating rest period, exercises, volume, and intensity can vary circuit training workouts. A lower-intensity circuit training workout will contain longer rest periods between exercises and will not use plyometrics or power movements. An effective training program will gradually increase training intensity and decrease volume while including daily and weekly fluctuations in both variables. This will prevent the neuromuscular system from fully adapting to training by continuously changing physiological demand, thereby placing greater stress on the neurological components of the neuromuscular system.
When a female fighter trains twice a day, it is important for her to recover adequately to decrease the chance of overtraining and getting injured. A full day of rest in a week would be beneficial especially when workouts are strenuous and intense. The most strenuous workouts, such as HIIT training, must be performed after a full day of rest so the athlete is properly recovered. Since most MMA fighters condition in the day and train martial arts in the evening, it is best to pair the light conditioning day with the more physically demanding martial art.
Designing strength and conditioning programs for mixed martial artists is challenging because of the complex and diverse nature of the sport. Women clearly have physical, anatomical, and biomechanical differences from men and must consider those distinctions when training. Strength and conditioning for female MMA fighters must consist of HIIT and sport-specific power exercises, with a focus on SAQ training and posterior chain development to prevent injuries. Special attention must be directed to increasing upper-body strength and developing total body explosiveness. The training program must be periodized in an undulating fashion for maximal physiological benefit and to be best prepared for last-minute fights.
- Take 2 full days of recovery between heavy resistance training days (Table 4) to avoid overtraining
- Incorporate circuit training (Table 1) and HIIT (Table 2) into workouts with low rest periods
- Design programs in a nonlinear periodized fashion to anticipate a last-minute fight and avoid overtraining
- Incorporate lower-extremity injury prevention training (Table 3) that contains agility, balance, and proprioceptive neuromuscular exercises
- Consume 1.5–2.0 g/kg daily of whey protein and 3–5 g of creatine to increase LBM
1. Andersen LL, Tufekovic G, Zebis MK, Crameri RM, Verlaan G, Kjaer M, Suetta C, Magnusson P, and Aagaard P. The effect of resistance training combined with timed ingestion of protein on muscle fiber size and muscle strength. Metabolism 54: 151–156, 2005.
2. Arendt EA. Musculoskeletal injuries of the knee: Are females at greater risk? Minn Med
90: 38–40, 2007.
3. Baker JF, Devitt BM, and Moran R. Anterior cruciate ligament rupture secondary to a ‘heel hook’: A dangerous martial arts technique. Knee Surg Sports Traumatol Arthrosc
18: 115–116, 2010.
4. Becque MD, Lochmann JD, and Melrose DR. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc
32: 654–658, 2000.
5. Bird SP, Tarpenning KM, and Marino FE. Independent and combined effects of liquid carbohydrate/essential amino acid ingestion on hormonal and muscular adaptations following resistance training in untrained men. Eur J Appl Physiol
97: 225–238, 2006.
6. Bledsoe GH, Hsu EB, Grabowski JG, Brill JD, and Li G. Incidence of injury in professional mixed martial arts competitions. J Sports Med Phys Fitness
7. Bledsoe GH, Li G, and Levy F. Injury risk in professional boxing. South Med J
98: 994–998, 2005.
8. Bottaro M, Martins B, Gentil P, and Wagner D. Effects of rest duration between sets of resistance training on acute hormonal responses in trained women. J Sci Med Sport
12: 73–78, 2009.
9. Burke DG, Chilibeck PD, Davidson KS, Candow DG, Farthing J, and Smith-Palmer T. The effect of whey protein supplementation with and without creatine monohydrate combined with resistance training on lean tissue mass and muscle strength. Int J Sport Nutr Exerc Metab
11: 349–364, 2001.
10. Candow DG, Burke NC, Smith-Palmer T, and Burke DG. Effect of whey and soy protein supplementation combined with resistance training in young adults. Int J Sport Nutr Exerc Metab
16: 233–244, 2006.
11. Carpenter L and Acosta R. Women in Intercollegiate Sport: A Longitudinal, National Study—Twenty-Nine Year Update
. West Brookfield, MA: Brooklyn College of the City University of New York, 2006. pp. 1–33.
12. Chandler T and Brown L. Conditioning for Strength and Human Performance
. Philadelphia, PA: Lippincott Williams & Wilkins, 2007.
13. Cox G, Mujika I, Tumilty D, and Burke L. Acute creatine supplementation and performance during a field test simulating match play in elite female soccer players. Int J Sport Nutr Exerc Metab
12: 33–46, 2002.
14. Cribb PJ, Williams AD, Stathis CG, Carey MF, and Hayes A. Effects of whey isolate, creatine, and resistance training on muscle hypertrophy. Med Sci Sports Exerc
39: 298–307, 2007.
15. DeMorat G, Weinhold P, Blackburn T, Chudik S, and Garrett W. Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. Am J Sports Med
32: 477–483, 2004.
16. Deschenes MR and Kraemer WJ. Performance and physiologic adaptations to resistance training. Am J Phys Med Rehabil
81: S3–S16, 2002.
17. Ducher G, Turner AI, Kukuljan S, Pantano KJ, Carlson JL, Williams NI, and De Souza MJ. Obstacles in the optimization of bone health outcomes in the female athlete triad. Sports Med
41: 587–607, 2011.
18. Eckerson JM, Stout JR, Moore GA, Stone NJ, Nishimura K, and Tamura K. Effect of two and five days of creatine loading on anaerobic working capacity in women. J Strength Cond Res
18: 168–173, 2004.
19. Fleck SJ and Kraemer WJ. Designing Resistance Training Programs
. Champaign, IL: Human Kinetics, 2004.
20. Forbes SC, Paganini AT, Slade JM, Towse TF, and Meyer RA. Phosphocreatine recovery kinetics following low- and high-intensity exercise in human triceps surae and rat posterior hindlimb muscles. Am J Physiol Regul Integr Comp Physiol
296: R161–R170, 2009.
21. Frontera WR, Hughes VA, Lutz KJ, and Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol
71: 644–650, 1991.
22. Gartland S, Malik MH, and Lovell M. A prospective study of injuries sustained during competitive Muay Thai kickboxing. Clin J Sport Med
15: 34–36, 2005.
23. Gibala MJ and McGee SL. Metabolic adaptations to short-term high-intensity interval training: A little pain for a lot of gain? Exerc Sport Sci Rev
36: 58–63, 2008.
24. Guidetti L, Musulin A, and Baldari C. Physiological factors in middleweight boxing performance. J Sports Med Phys Fitness
42: 309–314, 2002.
25. Hartmann H, Bob A, Wirth K, and Schmidtbleicher D. Effects of different periodization models on rate of force development and power ability of the upper extremity. J Strength Cond Res
23: 1921–1932, 2009.
26. Hartman JW, Tang JE, Wilkinson SB, Tarnopolsky MA, Lawrence RL, Fullerton AV, and Phillips SM. Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters. Am J Clin Nutr
86: 373–381, 2007.
27. Hassapidou MN and Manstrantoni A. Dietary intakes of elite female athletes in Greece. J Hum Nutr Diet
14: 391–396, 2001.
28. Hewett TE, Lindenfeld TN, Riccobene JV, and Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med
27: 699–706, 1999.
29. Hewett TE, Stroupe AL, Nance TA, and Noyes FR. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med
24: 765–773, 1996.
30. Hill DW and Smith JC. Gender difference in anaerobic capacity: Role of aerobic contribution. Br J Sports Med
27: 45–48, 1993.
31. Hoeger WWK, David R, Barette SL, and Hale DF. Relationship between repetitions and selected percentages of one repetition maximum: A comparison between untrained and trained males and females. J Strength Cond Res
4: 47–54, 1990.
32. Hoffman JR, Ratamess NA, Tranchina CP, Rashti SL, Kang J, and Faigenbaum AD. Effect of a proprietary protein supplement on recovery indices following resistance exercise in strength/power athletes. Amino Acids
38: 771–778, 2010.
33. High School Sports Participation Continues Upward Climb. In: High School Today (2011). Howard B, ed. Available at: http://www.nfhs.org/content.aspx
?id=5752. Accessed: November 16, 2011.
34. Hulmi JJ, Kovanen V, Selanne H, Kraemer WJ, Häkkinen K, and Mero AA. Acute and long-term effects of resistance exercise with or without protein ingestion on muscle hypertrophy and gene expression. Amino Acids
37: 297–308, 2009.
35. Hulmi JJ, Lockwood CM, and Stout JR. Effect of protein/essential amino acids and resistance training on skeletal muscle hypertrophy: A case for whey protein. Nutr Metab (Lond)
7: 51, 2010.
36. Jarret GJ, Orwin JF, and Dick RW. Injuries in collegiate wrestling. Am J Sports Med
26: 674–680, 1998.
37. Kanehisa H, Ikegawa S, and Fukunaga T. Comparison of muscle cross-sectional area and strength between untrained women and men. Eur J Appl Physiol Occup Physiol
68: 148–154, 1994.
38. Kendall KL, Smith AE, Graef JL, Fukuda DH, Moon JR, Beck TW, Cramer JT, and Stout JR. Effects of four weeks of high-intensity interval training and creatine supplementation on critical power and anaerobic working capacity in college-aged men. J Strength Cond Res
23: 1663–1669, 2009.
39. Kim J, Cho HC, Jung HS, and Yoon JD. Influence of performance level on anaerobic power and body composition in elite male judoists. J Strength Cond Res
25: 1346–1354, 2011.
40. Kreider RB, Ferreira M, Wilson M, Grindstaff P, Plisk S, Reinardy J, Cantler E, and Almada AL. Effects of creatine supplementation on body composition, strength, and sprint performance. Med Sci Sports Exerc
30: 73–82, 1998.
41. Kubo J, Chishaki T, Nakamura N, Muramatsu T, Yamamoto Y, Ito M, Saitou H, and Kukidome T. Differences in fat-free mass and muscle thicknesses at various sites according to performance level among judo athletes. J Strength Cond Res
20: 654–657, 2006.
42. La Bounty P, Campbell B, Galvan E, Cooke M, and Antonio J. Strength and conditioning
considerations for mixed martial arts. J Strength Cond Res
33: 56–67, 2011.
43. Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, Thomas SD, Griffin LY, Kirkendall DT, and Garrett W Jr. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med
33: 1003–1010, 2005.
44. McGuigan M, Winchester J, and Erickson T. The importance of isometric maximum strength in college wrestlers. J Sports Sci Med:
45. Medicine ACoS. Guidelines for Exercise Testing and Prescription
. Philadelphia, PA: Lippincott, Williams & Wilkins, 2000.
46. Moul JL. Differences in selected predictors of anterior cruciate ligament tears between male and female NCAA division I collegiate basketball players. J Athl Train
33: 118–121, 1998.
47. Murlasits Z. Special considerations for designing wrestling-specific resistance-training programs. J Strength Cond Res
26: 46–50, 2004.
48. Myer GD, Ford KR, Barber Foss KD, Liu C, Nick TG, and Hewett TE. The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clin J Sport Med
19: 3–8, 2009.
49. Myer GD, Ford KR, Brent JL, and Hewett TE. The effects of plyometric vs. dynamic stabilization and balance training on power, balance, and landing force in female athletes. J Strength Cond Res
20: 345–353, 2006.
50. Myer GD, Ford KR, McLean SG, and Hewett TE. The effects of plyometric versus dynamic stabilization and balance training on lower extremity biomechanics. Am J Sports Med
34: 445–455, 2006.
51. Myer GD, Ford KR, Palumbo JP, and Hewett TE. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res
19: 51–60, 2005.
52. Olsen OE, Myklebust G, Engebretsen L, and Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball: A systematic video analysis. Am J Sports Med
32: 1002–1012, 2004.
53. Orishimo KF, Kremenic IJ, Pappas E, Hagins M, and Liederbach M. Comparison of landing biomechanics between male and female professional dancers. Am J Sports Med
37: 2187–2193, 2009.
54. Prestes J, Frollini AB, de Lima C, Donatto FF, Foschini D, de Cassia Marqueti R, Figueira A Jr, and Fleck SJ. Comparison between linear and daily undulating periodized resistance training to increase strength. J Strength Cond Res
23: 2437–2442, 2009.
55. Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W, Georgoulis T, Hewett TE, Johnson R, Krosshaug T, Mandelbaum B, Micheli L, Myklebust G, Roos E, Roos H, Schamasch P, Shultz S, Werner S, Wojtys E, and Engebretsen L. Non-contact ACL injuries in female athletes: An International Olympic Committee current concepts statement. Br J Sports Med
42: 394–412, 2008.
56. Rhea MR, Ball SD, Phillips WT, and Burkett LN. A comparison of linear and daily undulating periodized programs with equated volume and intensity for strength. J Strength Cond Res
16: 250–255, 2002.
57. Schuelke M, Wagner KR, Stolz LE, Hubner C, Riebel T, Komen W, Braun T, Tobin JF, and Lee SJ. Myostatin mutation associated with gross muscle hypertrophy in a child. N Engl J Med
350: 2682–2688, 2004.
58. Sinha-Hikim I, Cornford M, Gaytan H, Lee ML, and Bhasin S. Effects of testosterone supplementation on skeletal muscle fiber hypertrophy and satellite cells in community-dwelling older men. J Clin Endocrinol Metab
91: 3024–3033, 2006.
59. Vingren JL, Kraemer WJ, Ratamess NA, Anderson JM, Volek JS, and Maresh CM. Testosterone physiology in resistance exercise and training: The up-stream regulatory elements. Sports Med
40: 1037–1053, 2010.
60. Weston AR, Myburgh KH, Lindsay FH, Dennis SC, Noakes TD, and Hawley JA. Skeletal muscle buffering capacity and endurance performance after high-intensity interval training by well-trained cyclists. Eur J Appl Physiol Occup Physiol
75: 7–13, 1997.
61. Whiting J. Inside the Cage: The Greatest Fights of Mixed Martial Arts
. Capstone Press, 2009.
62. Willoughby DS, Stout JR, and Wilborn CD. Effects of resistance training and protein plus amino acid supplementation on muscle anabolism, mass, and strength. Amino Acids
32: 467–477, 2007.