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0112-1642/12/00(O76'5/S49.96/0 Adis 2012 Springer International Publishing AG. All rights reserved.

Unique Aspects of Competitive Weightlifting

Contents
Abstract 1. Introduction 2. Literature Reviewed 3. Weightlifting Performance 3.1 The Snatch 3.2 The Clean and Jerk 4. Training 4.1 Exercises 4.2 Annual Training Structure 4.3 Application and Variation in Training Load 4.4 Metaboiic Cost of Weightiifting and Nutritional Practices 4.5 Influence of Body Weight Changes on Performance 5. Anthropomtrie Characteristics of Weightiifters 6. Physiological Responses and Adaptations to Weightlifting 6.1 Skeietai Muscle Structure and Function 6.1.1 Fibre Type Composition 6.1.2 Neuromuscuiar Function 6.1.3 Sex- and Age-Reiated Differences in Neuromuscular Function 6.2 Bone Mineral Density 6.3 Cardiovascular Structure and Function 6.4 Endocrine 6.4.1 Testosterone 6.4.2 Testosterone ; Cortisol Ratio 6.4.3 Grovi^h Hormone 7. Recommendations and Conclusions 769 770 771 771 771 771 774 774 774 775 776 777 777 777 778 778 778 779 780 780 781 781 781 782 782

Abstract

weightlifting is a dynamic strength and power sport in which two, multijoint, whole-body lifts are performed in competition; the snatch and clean and jerk. During the performance of these lifts, weightiifters have achieved some of the highest absolute and relative peak power outputs reported in the literature. The training structure of competitive weightiifters is characterized by the frequent use of high-intensity resistance exercise movements. Varied coaching and training philosophies currently exist around the world and further research is required to substantiate the best type of training programme for male and female weightiifters of various age groups. As competitive

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weightlifting is contested over eight male and seven female body weight categories, the anthropomtrie characteristics of the athletes widely ranges. The body compositions of weightlifters are similar to that of athletes of comparable body mass in other strength and power sports. However, the shorter height and limb lengths of weightlifters provide mechanical advantages when lifting heavy loads by reducing the mechanical torque and the vertical distance that the barbell must be displaced. Furthermore, the shorter body dimensions coincide with a greater mean skeletal muscle cross-sectional area that is advantageous to weightlifting performance. Weightlifting training induces a high metabohc cost. Although dietary records demonstrate that weightlifters typically meet their required daily energy intake, weightlifters have been shown to over consume protein and fat at the expense of adequate carbohydrate. The resulting macronutrient imbalance may not yield optimal performance gains. Cross-sectional data suggest that weightlifting training induces type IIX to IIA fibre-type transformation. Furthermore, weightlifters exhibit hypertrophy of type II fibres that is advantageous to weightlifting performance and maximal force production. As such, the isometric peak force and contractile rate of force development of weightlifters is -15-20% and -13-16% greater, respectively, than in other strength and power athletes. In addition, weightlifting training has been shown to reduce the typical sexrelated difference in the expression of neuromuscular strength and power. However, this apparent sex-related difference appears to be augmented with increasing adult age demonstrating that women undergo a greater age-related decline in muscle shortening velocity and peak power when compared with men, Weightlifting training and competition has been shown to induce significant structural and functional adaptations of the cardiovascular system. The collective evidence shows that these adaptations are physiological as opposed to pathological. Finally, the acute exercise-induced testosterone, Cortisol and growth hormone responses of weightlifters have similarities to that of following conventional strength and hypertrophy protocols involving large muscle mass exercises. The routine assessment of the basal testosterone : Cortisol ratio may be beneficial when attempting to quantify the adaptive responses to weightlifting training. As competitive weightlifting is becoming increasingly popular around the world, further research addressing the physiological responses and adaptations of female weightlifters and younger (i.e, <17 years of age) and older (i.e. >35 years of age) weightlifters of both sexes is required.

1. Introduction Weightlifting has been a longstanding part of the modern Olympic Games and has wide and growing intemational participation. During the performance of the two competitive lifts, the snatch and the clean and jerk (C&J), weightlifters are required to generate extremely high peak forces and contractile rates of force development and, consequently, high peak power outputs and contractile impulses,!'"'']
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This review details the unique performance and training requirements of competitive weightlifters with particular emphasis on the movement demands, training intensities and commonly adopted nutritional practices of these athletes. Further attention is directed towards descriptions of the physiological responses and adaptations of the musculoskeletal, cardiovascular and endocrine systems to weightlifting training and competition, Finally, as weightHfting is becoming increasingly
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popular with females, and younger and older individuals, we highlight potential areas for future research that will enable the development of safe and effective training guidelines for these populations. 2. Literature Reviewed The search for scientific literature relevant to this review was conducted using the US National Library of Medicine (PubMed), SPORTDiscus and Google Scholar databases. Key search terms of'Olympic weighthfting', 'weightlifter/s', 'snatch', 'clean and jerk', 'muscular strength' and 'muscular power' were used. Further literature was obtained from electronic 'related articles' searches and by manually screening the reference lists of included studies. The inclusion criteria for all articles were; (i) refereed articles published in Enghsh language journals and books from the 1970s until February, 2012; and (ii) the terms 'weightlifter' and 'weightlifting' had to be in context with the sport of competitive weightlifting as opposed to general weight/resistance training. 3. Weigtitlifting Performance The snatch and C&J are complex whole-body movements encompassing a series of high-intensity muscular contractions. During these lifts, weightlifters achieve power outputs unmatched by any other athletes.t'l Since 1998, the recognized body weight classes are: men <56kg, <62kg, <69kg, <77kg, <85kg, <94kg, <105kg and>105kg; and women <48kg, <53kg, <58kg, <63kg, <69kg, <75 kg and >75 kg. Athletes must weigh-in during a 1-hour window that begins 2 hours before the start of their competition session. The athlete's placing within their respective body weight class is determined by their competition total, which is the sum of their highest recorded snatch and C&J. 3.1 The Snatch The snatch requires the weighted barbell to be lifted from the floor (using a wide grip) to an overhead position in one continuous movement.t^' The snatch includes six phases (figure 1). The first pull is initiated when the lifter extends their knees
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to raise the barbell off the platform to a position just below knee level. A transition period (also referred to as the 'double-knee bend') follows whereby the knees are re-bent and are moved under the barbell whilst the lifter's trunk is moved to a near vertical position.[^"'"^ The 'double-knee bend' allows the lifter to take advantage of a stretchshortening cycle during the subsequent second pul^^^ The second pull requires the lifter to maximally accelerate the barbell by simultaneously shrugging the shoulders and extending the hips, knees and ankles. During the performance of near maximal to maximal full snatch attempts, the vertical velocity of the barbell during the second pull can range between 1.65m/sec and 2.28m/sec.['*'''"'*l During submaximal attempts and snatch-related movements (i.e. power snatch), barbell velocities may exceed 3.00m/sec.'''''^l As the barbell rises in the vertical plane to -62-78% of the lifter's height,!"''^"'^1 the lifter begins to 'pull' their body underneath the barbell; this phase is referred to as the turnover. The lifter then 'catches' the barbell in a straight-arm overhead position whilst fiexing at the knee and hip into a full squat position. The lifter then 'recovers' out of the full squat to a standing position whilst maintaining the barbell overhead. The duration of effort from the start of the first pull until the competition referees signal a successful lift is -3-5 seconds. Each athlete is entitled to three snatch attempts in competition. 3.2 The Clean and Jerk The C&J is a two-part lift that enables heavier loads (-18-20% greater) to be lifted than during the snatch. The clean requires the barbell to be raised from the floor (using a shoulder width grip) to the front of the shoulders in one continuous movement. There are six phases of the clean (figure 2). The mechanical principles behind the first three phases (first pull, transition/doubleknee bend and second pull) are the same as those of the snatch. During the second pull of near maximal to maximal attempt cleans, the vertical velocity of the barbell can range from 0.88 m/sec to 1.73m/sec.f^''*l However, during submaximal attempts and clean-related movements (i.e. power clean), barbell velocities may exceed 2.5

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Fig. 1 . The six phases of the snatch: (a) first pull; (b) transition to the start of the second puii; (c) compietion of the second puil; (d) turnover; (e) catch; (f) recovery.

As the barbell rises in the vertical plane to -55-65% of the lifter's height,P'l the lifter initiates the 'turnover' phase. The lifter then 'catches' the barbell on their shoulders and descends into a full squat position. The lifter then 'recovers' from the full squat position to prepare for the jerk. The jerk also has six phases (figure 2): (i) start; (ii) dip; (iii) jerk drive; (iv) unsupported spht under the bar; (v) supported split under the bar; and (vi) recovery. During the start phase, the lifter and the barbell must become motionless. The lifter then begins to dip down by flexing at the knee and hip, with the barbell held across the shoulders. At the lowest point of the dip, the lifter makes the transition to the jerk drive where they are required to accelerate the barbell in the vertical plane. During this transition period, the athlete may be exposed to a downward force equivalent

to 17 times their body mass.^^^ Reported power outputs during maximal attempt jerk drives range from 2140 watts (W) for a lifter in men's under 56 kg class to 4786 W for a lifter in the men's 105 kg+ class.^'^ At the completion of the jerk drive, the barbell is vertically driven off the shoulders and the lifter's feet leave the ground. This phase represents the 'unsupported split under the bar'. Once the lifter's feet are in contact with the ground and the barbell is held overhead with fully extended arms, the lifter is in the 'supported split under the bar' phase. The hfter must then recover and is required to stand motionless with their feet parallel to one another. The duration of effort from the start of the first pull to the signal of a successful lift is -812 seconds. Each athlete is entitled to three C&J attempts in competition.

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Fig. 2. The twelve phases of the clean and jerk: (a) first puil; (b) transition to the start of the second pull; (c) completion of the second pull; (d) turnover; (e) catch; (f) recovery from the clean; (g) start position for the jerk; (h) jerk dip; (i) jerk drive; (j) unsupported spiif under fhe bar; (k) supported split under fhe bar; (I) recovery from fhe jerk.

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4. Training There is limited evidence comparing the performance and physiological responses arising from different weightlifting training programmes.'^^"^''! However, the English language coaching literature and empirical evidence suggests that numerous and varied practices exist amongst internationally competi ti ve weightiifters ,'^ ' '^^"^^^
4.1 Exercises

The two competitive lifts form the basis of the training programmes for junior and senior weightiifters. Complementary exercises that have movement patterns similar to the competitive lifts (e,g, hang/power snatch, hang/power clean, snatch and clean pulls, front and back squats) and supplementary exercises (e.g. overhead presses, back extensions and abdominal work) that target synergistic muscle groups are also used. The complementary exercises are also incorporated into the training programmes of other power athletes'^*'^^'-"' as follows: (i) kinematic similarities exist between the propulsive phases in both weightlifting and jumping movements;'^^"^^' and (ii) significant relationships exist between weightlifting ability and power output during jumping (r = 0,59 to 0.93) and sprinting (r=-0,52 to -0.76)t".3v-40] and tests of agility (-0.41).'"! However, despite commonalities in the mode of exercise and other acute variables, the training programmes of weightiifters differ, particularly in the frequency and volume of high-intensity loads, from that of other power athletes (refer section 4.3). The collective differences in the competitive demands and the required physiological adaptations of other various athletes may account for these discrepancies. Furthermore, due to the technically and physically demanding nature of the snatch and C&J, modified versions are often employed by other athletes for the enhancement of muscular power, 4.2 Annual Training Structure Broad descriptions of variations in weightlifting training variables have been offered in the literature.P''^^"^*'^^-'*'^ More specific details are rarely outlined. Due to the success of many
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Eastern European teams, in particular the former Soviet Union and Bulgaria, a number of the world's training programmes are variations of the generalized training models established by these nations.P^ However, Western coaches were required to make modifications to these training methods presumably due to the higher prevalence of anabolic steroid use amongst Eastern Bloc teams;'"''*^''*^' since the 1970s, competitive weightiifters have been subjected to random drug testing''*^' that can include both urine and blood assays. The training programmes from the former Soviet Union were based upon the classic 'periodization' model'^^ consisting of a preparatory phase (generalized and specific conditioning), competition phase (specific training mimicking the demands of competition), and a transition phase (generalized conditioning at the end of a training cycle). A wide variety of exercises at varying intensities and volumes were incorporated into these programmes with the belief that this would prevent athletes reaching a state of overtraining due to 'movement pattern monotony','^^ Although international-level weightiifters would typically perform 20 000-25 000 multijoint exercise repetitions per year, only 15-35% of those repetitions were competition lifts performed at 80-90% of their one-repetition maximum (lRM) with an additional 4-7% being performed at >90% of lRM,'2'-25.44] In contrast, the Bulgarian training approach is characterized by frequent, near-maximal to maximal-intensity loading'^'^^'^"'**1 and is more closely aligned with the demands of competition. It has been reported that Bulgarian lifters performed between 1400 and 4000 maximal attempts, and 450 and 460 failed supramaximal attempts each year in training.'^'''*^' Approximately 10% of the total training time is devoted to warm-up exercises, 45% to competition lifts, 40% to complementary strength exercises, 3% to supplementary exercises and 2% to other sports and cross-training activities,'^'' There is very little variation in training intensity, by comparison with the training programmes of the former Soviet Union, However, fluctuations in training volume are applied. The training follows a repeated pattern of 2-3 weeks of increased loading followed by 1 week of reduced loading. This cyclic pattern of 'overload' and

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'recovery' is believed to contribute to subsequent long-term improvements in performance.'^'*''*''^ Although the competitive performances of weightlifters continue to improve, as evident by increases in national and world records, further research needs to be directed towards several aspects of weightlifting programme design. These aspects include (i) effective coaching strategies for novice weightlifters; (ii) the infiuence of exercise volume and intensity on physiological and performance variables in female and youth weightlifters; and (iii) the efficacy of variations in training techniques (e.g. the incorporation of eccentric-only exercises). 4,3 Application and Variation in Training Load International-level weightlifters perform two or more high-intensity resistance exercise (HIRE) [>80% lRM] sessions per day, of the same major muscle groups, 6 or 7 days per week.P'-^^'^*] An extreme example of this high-frequency of training was demonstrated by the Greek weightlifting team during preparations for the 1996 Olympic Games, Across a 6-day training week, the Greek team performed 13 snatch, 11 C&J, 11 back squat and 9 front squat sessions,'^'' In senior weightlifters, dividing a given training volume across two sessions that are performed on the same day produces significantly greater increases in muscular strength, hypertrophy and maximal neural activation of the trained musculature.^'**'''^] However, as the majority of the exercises that are performed by weightlifters are the competitive lifts and similar muitijoint movements, a large number of muscle contractions are performed by the same major muscle groups within each training session. Thus, the frequency of HIRE performed by weightlifters exceeds evidence-based recommendations for improving muscular strength and power in advanced trained adults. For example, the American College of Sports Medicine (ACSM) propose (i) a training frequency of 46 sessions per week; and (ii) training different muscle groups during subsequent strength and power sessions to allow for adequate recovery.'^^'^'i Previous evidence has also shown that repeated HIRE bouts of the same muscle group/s result in the persistent

suppression of key anabolic mediators, prolonged infiammatory signalling and decrements in muscular performance.f^^"^^ In contrast to these findings, weightlifters demonstrate both acute and long-term improvements in competitive lifting performance in response to their frequent HIRE training Although little evidence exists to suggest that weighthfting training, under proper supervision, is more injurious to children or adolescents when compared with other sports,'^'"*^1 considerable controversy still surrounds the use of weightlifting exercises in younger populations (i.e. <17 years of age). As such, definitive biological and/or training age appropriate weightlifting training guidelines have yet to be established. The training age of a weightlifter greatly inuences their ability to positively adapt to the frequent use of HIRE. Over a 10-week training period in competitive junior (17-20 years of age) weightlifters, moderate volumes of high-intensity (>90-100% lRM) loading produced significantly greater strength gains (10.5% improvement in C&J and 9.5% improvement in back squat) when compared with low (3,0% improvement in C&J and 5,3% improvement in back squat) and high (6,9% improvement in back squat performance only) volumes of similarly high-intensity loading.t-^^' Furthermore, it has recently been demonstrated that performing additional high-intensity training sessions within the same day does not lead to significantly greater performance improvements in young weightlifters.t^*! In comparison, international-level senior weightlifters (20-35 years of age) demonstrate a greater ability to tolerate and adapt to higher volumes of high-intensity loading.f^-'--*-^^' However, masters' weightlifters (>35 years of age) exhibit significant declines in training ability and weightlifting performance,'^^"*^' which is in accordance with the well documented impaired adaptive responses to resistance exercise with increasing adult age.[^'"^'l On the basis of these findings, we propose that an inverted U-shaped relationship exists between competitive age and the volume of high-intensity loading that leads to enhanced weightlifting performance (figure 3). During ballistic activities such as bench throws or jump squats, absolute peak power output (PP)
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High Volume of high-intensity loading Moderate Lovi/

Fig. 3. Proposed relationship between the volume of high-intensity (90-100% of one-repetition maximum) loading that ieads to enhanced weightlifting performance and competitive age. Junior: 17 to <20 years of age; senior: >20 to <35 years of age; masters: >35 years of age.

has been shown to occur between training loads of 30-50% of lRM.I^^-"] However, more recent research suggests that the load required to elicit PP during jump squats may even be as low as body mass only.t''''^'''J Therefore, the prescription of relatively low-intensity (i.e. 0-60% lRM) resistance exercise (inclusive of complementary weightlifting exercises) is often recommended to improve muscular power and dynamic athletic performance.t^'''''*'^"-^^' For example, the lighter relative training loads used for the power snatch, power clean and various pulling movements result in a greater maximum barbell vertical velocity, contractile impulse and thus a greater PP when compared with maximal competition iifts.[i8-20.36,86,87] During the snatch and/or C&J, PP has been shown to occur with loads of 70-80% of I R M " 9-30,86,88] demonstrating that the high-intensity training of weightlifters results in improved PP under highload conditions. Therefore, weightHfters will frequently train for the competitive lifts at intensities >70% of lRM.Pi.25-28] Athletes who are required to generate high PP against heavy external loads (e.g. wrestlers, bobsledders and rugby union/league players) are likely to benefit from high-load weightlifdng training.['^^''^^^^^^^' However, at present there is a paucity of research examining the efficacy of power training with high- versus low-load weighthfting exercises in trained strength and power athletes. 4.4 Metabolic Cost of Weightlifting and Nutritionai Practices The metabolic demands of weightlifting training are refiected in the relatively high energy exAdis 2012 Springer International Publishing AG. Att rtgtits reserved.

penditures incurred by the athletes. For example, a mean caloric expenditure of 39.5kJ/min was recorded in male weightlifters during a 1 week preparatory phase of training characterized by a moderate- to high-volume of moderate- to highintensity lifts.'^'l This value is comparable with the metabolic cost incurred by high-volume circuit-style resistance exercise.''^^ Furthermore, the training stimulus alone produced a weekly energy expenditure of 16456kJ.'^'l The reported mean daily energy intakes of male weighthfters range between 13 212 kJ and 19 307kJ,['3-97] ^^i^.^ ^^^ consistent with the values recommended for 'hard training' male athletes (14 700-23 100kJ/day).['*l As expected, the corresponding relative daily energy intakes values of 134-244 kJ/kg/dayP3,95-97] are comparable with those of other strength and power athletes.P^''^-'^'''l In regards to macronutrient consumption, it is reported that weightlifters consume a greater number of daily servings of protein-rich sources when compared with other athletes.P^'9'*''l As a result, the protein intake of male weightlifters has been reported to range between 1.6g/kg/day and 3.2g/kg/day,''^'^^ which is high when compared with the recommended 1.2-1.7 g/kg/day for resistance training athletes.'^'^^'^^'''l Furthermore, weightlifters derive approximately 40-44% of their daily energy intake from dietary fat,P3.95,96,i02] ^^ich is also well above the acceptable range for health and athletic performance of 20-35%.['3-'O'*' This is a possible consequence of their greater intake of protein-rich animal products. Conversely, the reported carbohydrate intakes in weighthfters of 2.9-6.1 g/kg/dayP^-'^''^l are insufficient according to the current recommended levels of 7-8 g/kg/day for athletic individuals.'""'^ Combined, these reports suggest that the dietary habits of male weightlifters may not yield the desired training gains and/or health benefits due to the emphasis placed on protein consumption (with high fat) at the expense of adequate carbohydrate ingestion. As the training and competition demands of weighthfters differ to those of other strength and power athletes, further research is required to (i) document the current dietary habits of competitive weightlifters; and (ii) identify the optimal macronutrient balance for weighthfting performance.

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4.5 Influence of Body Weight Changes on Performance Athletes participating in weight-restricted events will often train at a body mass that is 5-10% above their required competition weight class.^^' In the week leading up to competition, a minor reduction in body mass (e.g. a loss of 1-2 kg) might be achieved by restricting fluid intake and consuming a low residue diet.'""' To 'make weight' and to avoid the loss of lean muscle mass, it is common for weightiifters to rapidly reduce total body water content prior to competition weigh in. This is achieved via passive methods including self-limited fiuid intake, acute heat exposure and/or the use of (banned) diuretic agents.['^' Whilst the detrimental effects of hypohydration on endurance performance are well documented,''^""' less evidence exists regarding the effects of hypohydration on muscular strength and power. Evaluations of the effects of short-term hypohydration on maximal force production, muscular endurance and PP have demonstrated a decrease'"'""^' or no change'"^""'^ in these variables. Where mild hypohydration (i.e. <2% reduction in body mass) techniques have attenuated neuromuscular performance, rapid rehydration interventions over a short period of time (i.e. over a 2 hour period as done in competition) have effectively restored performance variables.''"1 However, an athlete's ability to overcome the detrimental effects of dehydration is severely affected when hypohydrationinduced reductions in body mass reach 3-4%.''^-' '*' It is thus tenable that severe hypohydration would impair weightlifting performance. For weightlifters opting to train at a body mass >3% above their competition weight, minor dietary modifications should be introduced in the weeks leading up to competition to achieve a body mass of <2% above that desired/required for competition. Mild hypohydration techniques may then be implemented 24 hours prior to competition weigh-in, followed by effective rehydration strategies afterwards. 5. Anthropomtrie Charaoteristios of Weightiifters The anthropomtrie characteristics of male weightiifters have been documented extensivejy [10,120-125] Light;, to middle-weight male weightAdis 2012 Springer internationai Pubiishing AG. Aii rights reserved.

lifters (i.e. <56 kg to <85 kg) are somatotyped as predominately ectomorphic or mesomorphic''2^*' with body fat percentages of 5-10%."0-'22-i23,i25] These compositional characteristics are comparable to weight restricted wrestlers and athletes competing in the sprinting and jumping events of athletics.''"'^^'''^^l Conversely, weightiifters in the heavy to unlimited weight classes (i.e. <94 kg to >105kg) tend to be more endomorphic mesos''^^' with corresponding body fat percentages ''^'-'^^ These individuals possess similar body compositions to heavyweight wrestlers, powerlifters, discus, shot put and hammer throwing athletes."''2''"'3'l Although the anthropomtrie data on female weightiifters is less comprehensive, the limited data suggest that the body fat percentages of female weightiifters may be double that of male weightiifters of a similar body mass.''''^^''^^l However, elite male and female weightiifters exhibit a lower body fat percentage when compared with lower level competitors of a similar total body mass.''^^''^^' Thus, the resulting differences in lean body mass becomes a major contributing factor to the divergent neuromuscular responses seen between male and female and elite versus nonelite weightiifters (refer section 6.1.3).''22.i33-i40] In comparison to other strength and power athletes of a similar body mass and composition, weightiifters have proportionally shorter arm span and tibial lengths, larger biacromial breadths and are shorter in height.''2O''22.125,136] ^uch anthropomtrie characteristics provide two mechanical advantages when lifting maximal loads: (i) the mechanical torque that is required to lift a given load is less due to shorter lengths of the resistance lever arms; and (ii) the amount of muscular work required to lift a given load is decreased via a reduction in the vertical distance that the barbell must be displaced.''^'l Furthermore, the shorter body dimensions coincide with a greater mean skeletal muscle cross-sectional area, which is advantageous to weightlifting performance.''''*] 6. Physioiogicai Responses and Adaptations to Weightiifting The complexity, intensity and brevity of weightlifting impose great challenges when attempting
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to obtain valid and meaningful physiological data from competitive weightlifters. Furthermore, it is onerous and/or inappropriate to apply similar exercise protocols in non-weightlifters due to the technically demanding nature of the specific movements. As such there is limited data on the acute neuromuscular, cardiovascular and endocrine responses that occur (especially in female weightlifters) during weightlifting training and competition. Furthermore, few studies have examined the adaptations of the neuromuscular and endocrine systems that arise from moderate (weeks-months) to long-term (months-years) periods of weightlifting-specific training. However, investigations into the physiological responses and adaptations of masters' weightlifters do provide some insight into the long-term benefits of weightlifting training.

HIRE studies in non-weightlifters indicates that there may also be a concomitant IIX to IIA fibretype transformation.''^'^*! Conversely, a restoration of type IIX content has been shown to occur in other athletes (i.e. swimmers, runners and cyclists) during pre-competition tapers, which involve a planned reduction in training volume.''^^"'*^' However, the existence of a tapering-induced reshift in the fibre-type composition of competitive weightlifters has yet to be quantified.
6.1.2 Neuromuscular Function

Maximal voluntary isometric peak force (PF) and PP are strongly related to weightlifting performance.''*'*''**! During isometric conditions, PF is reached in the vicinity of 300-400msec.I'*"-'*''-'^'! However, during dynamic weightlifting movements, weightlifters achieve PF, PP and maximum barbell velocities in <260msec.''*''^-''*-'^^! Thus, the maximal contractile rate of force development (RFD) in 6.1 Skeletal Muscle Structure and Function the early phase of muscle contraction is of great 6.1.1 Fibre Type Composition importance to these athletes.''*''''^^-'^'*! The force-velocity properties of a muscle are in Improvements in both PF and contractile RFD part determined by the relative proportions of have been reported in male and female weightfast-twitch (type IIA and IIX; formerly identified lifters following moderate- to long-term periods as IIB) and slow-twitch (type I) muscle fibres.'^"*-"*'! of training.P^-**'''-^^-''*^! These findings demonstrate Strength and power athletes, including weight- that the frequent high-intensity training used by lifters, exhibit mean percentages of fast-twitch weightlifters (refer to sections 4.2 and 4.3) effecfibres in the vastus lateralis ranging from 53% to tively increases muscular strength and power con65%.l^''-''*^"''**! Although similar percentages have currently.''*^-'^^ As a result, the isometric PF and been reported in untrained adults,'''*'*-"*'-'^^! the peak RFD of male weightlifters is -15-20% and cross-sectional areas of type II fibres are con- -13-16% greater, respectively, when compared siderably larger in weightlifters.i"*^-""*-"*'-"**! Such with other strength and power athletes (i.e. football a structural difference is advantageous to force players, sprinters, throwers and jumpers).''^*''^^! production as type II fibres possess a greater ca- This improved muscular function may arise due pacity to generate power per unit cross-sectional to an enhanced voluntary and/or refiex-induced area when compared with type I fibres.'''*'-'^'"'^^! neural activation of motor units''**''*''*"-'*'! and/ Both the proportion of type IIA fibres and the or a selective recruitment of fast-twitch motor [180,181] relative myosin heavy chain IIA isoform content have been shown to be greater in weightlifters when During the performance of the snatch and compared with recreationally active adults.'''*^! In C&J, weightlifters have demonstrated some of addition, weightlifting performance is strongly cor- the highest absolute and relative PP reported in related to type IIA percent content (r=0.94) and the literature.''-^-'*-^! For example, during the type IIA percent fibre area (r = 0.83).["*3! Thus, second pull of maximal snatch and C&J attempts, evidence from cross-sectional studies suggests that values as high as 5442 W and 6981 W, respectthe frequent high-intensity training of weight- ively, have been reported in male weightlifters.'^-^! lifters results in hypertrophy of type IIA fi- Furthermore, the corresponding relative PP for bres.'''*^-''*'*-'''^-''**! Evidence from longitudinal male and female weightlifters range from 53 W/kg
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to 56 W/kg and 38 W/kg to 40 W/kg, respectively,[4,5] ^g ^ comparison, during maximal bench press and deadlift exercises performed by male strength athletes, absolute PP of 415 W and 1274 W, respectively, have been reported''*-^' with relative PP ranging from -4-12 W/kg.''^' In addition, during exercise tests that incorporate the lower body (i.e. clean pulls and various jumps) the reported PP of male weightiifters is -13-36% greater when compared with other power athletes.''^''''^^-'^'-'^^' However, during upper body only exercise, no differences in absolute or relative PP were shown to exist between weightiifters and handball players.'^^^ These findings highlight the important contribution that the lower body makes to power development in weightiifters. Furthermore, they may be explained by the specificity of training, as handball players are required to perform repeated highintensity upper body movements (i.e. throwing) in competition,'^^'^^' Conversely, the upper body musculature of a weightlifter plays a relatively lesser role, in comparison to the legs, during the snatch and
6.].3 Sex- and Age-Related Differences in Neuromuscuiar Function

To compare performances across the different body weight classes, Sinclair scores, based upon current world record totals and adjusted each Olympic year, are used,''^^' The lifter's actual competition total is multiplied by the appropriate Sinclair coefficient. The resulting score is a projec-

tion of the total the lifter would theoretically achieve if they were in the super heavy-weight class with the same lifting ability. Various other allometric scaling formulae have been derived.''-''*-'^^''^^' However, many tend to yield either an overestimation or underestimation for certain body weights. In untrained and/or recreationally trained males and females, reported sex-related differences in absolute neuromuscular strength and power range from 31% to 48% and 17% to 46%, respectively [139,189-192] However, when comparing the current under 69 kg (the only common body weight class between sexes) world record lifts for youth, junior and senior male and female weightiifters, there is a consistent sex-related difference of 15-20% (table I), Thus, it is evident that although long-term weightlifting training minimizes the sexrelated difference in neuromuscular function, factors such as the distribution and total amount of lean body mass in male and female weightiifters will ultimately influence the expression of strength and power across all age and weight categories.'*^'^'^J As competitive weightlifting is becoming increasingly popular in masters' athletes, a number of studies have investigated the influence of increasing age on competitive weightlifting performance and neuromuscular function,'*^"**-"^-"'^' Pearson et al.'*^' demonstrated that, on average, masters' weightiifters (aged 40-87 years) were able to generate 32% more isometric knee extensor force and lower body explosive power when compared with age-matched, healthy, untrained

Table I, Sex- and age-related differences in the under 69 kg world records' Category Youth Lift Snatch C&J Total Junior Snatch C&J Total Senior Snatch C&J Total a C&J = clean and jerl<. Male 142
172 310 158 190 346 165 197

Female 117 145 262 123 157

Percentage of the male record obtaihed by a female 82.4 84.3 84.5 77.8 82.6 79.5 77.6 80.2 79.9

MeanSD(%)

83.711.2

80.0 + 2.4

128 158
286

79.2 1.4

357

Current world records as of November, 2011.

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adults. It is likely that neural factors contributed to this enhanced functionality in older weightlifters as no significant differences in lean lower-limb volume existed between groups,'^^' Furthermore, the maximal motor unit discharge rates in the rectus femoris of masters' weightlifters have been shown to be -20% greater than in untrained, agematched adults.'"^' Therefore, it appears that longterm weightlifting training and competition has the potential to attenuate the age-related decline in motor unit size, number and/or function that becomes apparent after the age of 60 years.'"^"^' A significant reduction in type II fibre size and content is associated with increasing agel"**"^""' and is likely to contribute to the annual decline of -1-1.5% in PP and competitive performance that has been reported in masters' weightlifters.I*^-''^! According to Anton et al. ,1*^1 the rate of decline in competitive performance is markedly greater in women across all weight classes.t^^' These previous findings are confirmed when comparing the current under 69 kg male and female world records across all age categories (figure 4). Interestingly, no such sex-related difference with increasing age has been reported during the expression of maximal strength in competitive powerlifting,'^^' Therefore, it was concluded that only the ability to perform complex and explosive power-type exercises declines at a greater rate in women.'^^1 These findings are in accordance with previous investigations, which have demonstrated that women undergo
60-|

greater age-related declines in muscle shortening velocity and PP than men, which is likely due to a decreased neural drive and a combination of muscle fibre loss and atrophy.^^o'-^o^]
6.2 Bone iVIineral Density

The skeletal structures of weightlifters undergo significant adaptations in response to the large compressive and shear forces that are encountered during training and competition,'^22,36,203] gj^, chemical indicators of bone formation are elevated by up to 35% in actively competitive weightlifters when compared with age-matched, healthy adults.'^''^ Furthermore, greater site-specific increases in trabecular and cortical bone densities have been reported in the vertebrae (13-42%), femoral neck/trochanter (12-24%), tibia (9-12%) and radius (10%) of competitive weightlifters when compared with untrained and recreationally trained adults.'^^"-^'l Following -30 years of retirement from weighthfting, former weightlifters aged between 50 and 64 years have been shown to exhibit a significantly greater bone mass when compared with age-matched controls.pos) However, between the ages of 65-79 years, no differences in bone mass existed between groups.^^'l Thus, it is evident that weightlifters must maintain an adequate level of physical activity past the age of 65 in order to attenuate age-related dechnes in bone mass. 6.3 Cardiovascuiar Structure and Function High-intensity resistance exercise increases peripheral vascular resistance, thereby stimulating concentric left ventricular (LV) hypertrophy,^"^'^''1 The increase in myocardial wall thickness arises due to the parallel addition of new myofibrils and is a compensatory attempt to reduce LV wall stress and systolic pressure.P"'^'^' A number of studies have examined the ventricular morphology and function in competitive weightlifters.['2'-2'3-227] go^ig investigations have reported that the absolute LV mass (g) of weightlifters may be -13-30% larger than that of age-matched healthy and/or sedentary control subjects.P"''2'^'222-22^-229] However, in most instances, the increased LV mass exhibited by weightlifters is proportional to their total body mass, body surface area and/or lean body mass, thereby indicating a

= 0.90 10-

Age category (years) Fig, 4. The sex-related differences as a funcfion of age (years) between male and female world record tofals in the under 69 kg category. World record totals as of November, 2011, M = masters; R^ = coefficient of determination.

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physiological as opposed to a pathological adaptation.P'9,222,228,229] -j-j^g^^^f importance as LV hypertrophy is categorized as an independent risk factor for cardiovascular morbid events.'^"' Conversely, other studies have shown no significant differences in absolute or relative measures of cardiac morphology between weighthfters and healthy adults.'^'5.2'8.221,224,226] j ^ e lack of difference in these results may be explained by (i) the experimental groups being more evenly matched for body dimensions;'2'5'2'^l (ii) differences in the training history of the control subjects (e.g. sedentary/untrained vs recreationally trained);'^^^' and (iii) possible sex-related differences in cardiac hypertrophy as only one study has examined cardiac morphology in female weighthfters.'^'^' In hght of these findings, the consensus of opinion is that weighthfting does not induce a true concentric enlargement of the left ventricle as seen in pathological conditions. The cardiorespiratory function of competitive male weightlifters, as determined by maximal oxygen consumption (VOjmsjd^ has been reported to range between 42.0 and 50.7mL/kg/min."2i-226-228,230,23i] As expected, these mean values are similar to those of other athletes involved in short-duration highintensity/power activities.'''^'! Short-term (8 weeks) weighthfting-style training in active adults has been shown to increase both absolute and relative VO2max by ~6-7%.'22''l However, annual evaluations over the course of 3 years of specific weightlifting training in competitive weightlifters revealed significant reductions in both absolute and relative VOsmax of -4% and 11%, respectively.'232] With regards to resting haemodynamics, reported values for mean heart rates range between 60 beats per minute (bpm) and 81bpm, systolic blood pressure between 115 mmHg and 153 mmHg, and diastolic blood pressure between 71 mmHg and 93 mmHg.'2i4.22i,222,226-228,23t,233] -pj^ese data classify weightlifters as being 'normal' or stage 1 hypertensive as per the ACSM guidehnes.^^"*! 6.4 Endocrine Evidence of endocrine responses and adaptations in weightlifters and/or related to weightlifting performance are predominately limited to anabolic
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and catabolic hormones for the large part in young male weightlifters. Here we include where substantial data have been obtained, the responses of testosterone, cortisol and growth hormone.
6.4.1 Testosterone

Testosterone is a potent androgenic-anabolic hormone that is considered to be a major promoter of muscular hypertrophy, strength and power.'235'2361 The reported basal serum total testosterone concentrations in male weightlifters range from ~14.4nmol/L to 27.7nmol/L,"^0-'^-237-24i] which is within the normal range for young, healthy untrained men (12.1-34.7 mol/L).'2''242.243] shortterm exercise-induced increases in total serum testosterone of-17-30% have been reported in male weightlifters in response to acute weightlifting training sessions of moderate to high intensity and volume.'''''^^'2'*'l In addition to the influence of exercise type, volume and intensity, the training age of an individual also affects the exercise-induced testosterone response. Elite junior weighthfters with >2 years training experience exhibit significantly greater exercise-induced increases in serum testosterone when compared with those with <2 years training experience.'^"*'! Combined, these results demonstrate that weighthfting training ehcits a response similar to that reported for conventional strength and hypertrophy protocols involving large muscle mass exercises.'^**"^"*^ The available data pertaining to the testosterone response to competition and competition-hke settings is limited to salivary measures.'^^--^'*^' During official and simulated weightlifting competitions, Passelergue et al.'^'*^' reported no significant changes in sahvary total testosterone. From this limited data, it appears that competition settings fail to meet the exercise volume threshold that is required to induce a significant testosterone response in weightlifters.'^^*! Xhis is in accordance with previous investigations that have demonstrated no significant changes in total testosterone following highintensity, low-volume, moderately long rest period duration, resistance exercise protocols.'^'^^'^'^^'^''''^^"!
6.4.2 Testosterone : Cortisol Ratio

The basal testosterone : cortisol (T : C) ratio is often used to represent the physiological strain
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imposed by a training programme,'2^'"253] as it generally exhibits an inverse relationship with exercise volume.''^2.238.254-256] p^j. example, across a 5-week training period in elite female weightlifters, a 37.0% reduction in training volume elicited a mean increase of 72.5% in basal T ; C ratios.''^^' Conversely, Wu et al.'^^^^ demonstrated that a 54% increase in weightlifting training volume over 2 weeks resulted in a 60% reduction in the basal T : C ratio. However, weightlifting training for >1 year and prior exposure to increased training volumes appears to attenuate this relationship.'^^' Furthermore, during extended training periods (i.e. \2lA weeks) of varying intensity and volume, experienced weightiifters have demonstrated a positive association between an increased basal T : C ratio and maximal voluntary isometric PF and pp.[i32,255,257] ji^yg^ ^j^g routine assessment of the basal T : C ratio may provide an effective way in which to measure acute and chronic adaptive responses to weightlifting training. In competition settings, the T : C ratio is greatly inffuenced by pre-competition anxiety and may decrease prior to any form of strenuous physical activity.P"*^! Furthermore, an official weightlifting competition has been shown to produce a higher salivary cortisol response and, thus, a greater decrease in the salivary T : C ratio, when compared with a simulated competition.'^^] However, competitors with higher pre-competition salivary cortisol levels also exhibited superior lifting performances.'^^' In stressful situations, salivary cortisol levels have been shown to increase by 230% from basal values.l^^^] A pre-competition anticipatory rise in circulating catecholamines'^^-^^'] may stimulate the release of adrenocorticotropic hormone, which in turn increases cortisol secretion.P^' As a positive association exists between increased catecholamine levels and force production,'-^^'' it is possible that this mechanism may account for the higher cortisol levels and the superior lifting performances that were reported during an official competition.'^^'
6.4.3 Growth Hormone

in male and female weightlifters''33,i76,24i,245,254] and other strength athletes (i.e. bodybuilders and powerlifters) when compared with recreationally trained and untrained adults.'242.244,26i,262] g^g. nificant exercise-induced increases in GH occur similarly in men and women in response to moderate-intensity, high-volume and short rest period resistance exercise protocols (i.e. hypertrophy training).'^'*^'^^''^^^] Conversely, only minor increases in GH have been reported following conventional strength and power protocols that use high loads, low repetitions and long rest periods.'^''^'^^"^*^] In contrast to these latter findings, 4.5-13-fold increases in GH have been reported in male weightiifters in response to their high-intensity, high-power training.''^^'^'*''^^' However, these confficting results may be explained by (i) the differences in the training experience of participants that has been shown to affect the magnitude of GH release;'^''^'^^^'^*^ and (ii) differences in the absolute and relative intensity, volume and type of exercise performed (i.e. isolation vs multijoint exercise) in each i 7. Recommendations and Conciusions The high-intensity, explosive nature of weightlifting training and competition results in a number of structural and functional adaptations of the musculoskeletal and cardiovascular systems. Of particular interest is that the rapid force and power generating ability of weightiifters exceeds that of other strength and power athletes. Although the use of weightlifting exercises are becoming increasingly popular across a number of sports, the frequency of HIRE performed by weightiifters is unmatched by other athletes and exceeds the current ACSM recommendations for strength and power training. As younger and older individuals of both sexes are being drawn to the sport of weightlifting, it is imperative that further research is conducted in these populations to ensure the development of safe and effective training programmes. Particular focus needs to be directed towards understanding the acute responses and long-term adaptations of female weightiifters, as the majority of existing research has solely been conducted in male athletes.

Conventional resistance exercise does not appear to affect basal concentrations of growth hormone (GH).P^'] In accordance with this contention, similar basal GH concentrations have been reported
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Acknowledgements
The authors have no potential conflicts of interest. No ftinding was received for this review. The authors would like to thank Jonathan Milne and our athlete model for their assistance with supplying the photographs for this publication.

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Correspondence: Adam Storey, Department of Sport and Exercise Science, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand. E-ma: adam.storey@auck]and,ac.nz

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