Hooper’s Beta Ep. 76

Intro

After a fun weekend of climbing, I came back to see a bunch of requests to review Emil Abrahamsson’s new video about “Hangboard Training 2 Times Per Day For 30 Days,” so, I was immediately curious. I clicked the link, watched the video, and was amazing at the improvements he made. In fact, I myself had to resist the initial urge of “when the heck do I start and send V22!?” BUT, before we just follow the age old Hooper’s Beta motto of “eyes closed, head first, can’t lose,” let’s see if we can figure out what’s really going on here. Yeah that’s right, we’re talkin’ science!

In this video, we will talk about both the research AND what likely happened to Emil in his training from a scientific/anatomical point of view. We will look at the good AND the bad of each. But, to start...

I want to make a note right away that Emil makes a great point (twice) that everyone needs to understand: this is a sample size of 1! (Well, 2 if you count his brother and his claims of improved strength as well). This is a case study at this point. 

But, that aside, let’s get into it and talk about the good, the bad, and the biggest question you all have… should I do this?!

The research - The Good

Before we get into Emil’s actual training, let’s talk about what this was all based around, an article titled “Minimizing Injury and Maximizing Return to Play: Lessons from Engineered Ligaments”. In this article they develop connective tissue, or as they call it ‘Sinew’ from human fibroblast cells that were collected during ACL reconstructive surgery. They used these cells to create hundreds of “Sinew” for their testing. 

One of the main results of the paper were that “sinews, like bone, quickly become refractory to an exercise stimulus, suggesting that short (<10 min) periods of activity with relatively long (6 h) periods of rest are best to train these tissues” (Baar K.). This is the essence of what Emil based his training off of. Let’s jump right into some of those claims. 

Yes, there is truth to the research about the response of tissue every 6 hours. Tenocytes are cells that help create collagen which is essential in our connective tissue and their response has a period of about 6 hours where it will not respond to further stimulus. So, yes, stimulating it every 6 hours will improve collagen synthesis. 

The research also shows that the “data suggest that limited range-of-motion exercises even if performed with a light weight should be effective at increasing collagen synthesis in a developing or regenerating tendon or ligament.” (Baar K). They based this off of having similar results at 2.5% and 10% stretch. Basically saying that there was not a significant difference between those two groups, meaning that adding more force didn’t make a significant change. 

This is why Emil chose light load’s rather than heavy or max weight hangs. This is also what made this safer for him because he wasn’t constantly overloading the tissue creating excess breakdown. 

But… there are some problems with applying this research to a training plan. 

The Research - The Bad

The research paper itself acknowledges one of the main limitations, in my opinion, is that it is an in vitro study, they say "that it is very difficult to understand how the cells within a healthy adult tendon respond to nutrition or exercise". This is important to understand because while this may be as close as we can get to reproducing tests of sinew, it is not perfect. In fact, the paper goes on to state that with the in vitro sinew, “their rate of collagen synthesis is significantly higher” and “they are much weaker than adult sinews” (Baar K). So, right off the bat we have to understand that taking their research may not have a direct correlation to training we do in the real world and there may not be a direct one to one correlation. 

The research article briefly outlines how they determined that frequency and intensity don’t matter, but they don’t go in to many clear details. For example, I mentioned that Emil based the light load off of the fact that in the research they stretched the Sinew at 2.5-10% intensities, but, what does that mean? If they just acknowledged that their tissue was much weaker than adult Sinew, how much force is this? Also, how was it created? Was it pulled from one end like a tendon would be as the muscle initiates the pull and the bone does not? They mention this important aspect earlier, in that tendons have different zones of compliance, but how did they do their actual testing? Did it mimic this? I simply would have liked more details about their methods to truly understand and apply their findings. 

Finally, the recommendations are also very broad and open to interpretation. The basic recommendation is that a session should be less than 10 minutes long, performed with a light weight, and perhaps a smaller range of motion, with 6 hours between sessions. It doesn’t dictate whether that means it needs 10 minutes of active work, rest periods, etc. This actually created some confusion in Emils plan, which we will talk about, but really, was not his fault because the paper doesn’t outline anything specific. 

Finally, the paper classified ligaments and tendons are “Sinew'' and applied their results across the board, despite early on in the tissue recognizing the important differences in tendons and ligaments. In fact, tendons are less prone to injury when they are more compliant where as this is not necessarily the case for ligaments. Climbing depends on ligaments and tendons, which makes this slightly confusing in my opinion. Our finger strength relies on the tendons of the  flexor digitorum superficialis and profundus, tendon of lumbricals, and connective tissue of pulleys, for example. 

OK, so the paper isn’t perfect, BUT it can be a guide map. We can use some of this information to create our own training programs. And then, if you track the results, you can see if it worked for you! Right? Yes! And that’s exactly what Emil did. So, let’s take a look at his training plan!

The Training Plan - The good 

Honestly, I thought the actual training plan was great. If they wanted to stimulate multiple tissues, they did a great job with their planning. The crimp position would bias the pulley’s, the open hand drag would bias the flexor digitorum profundus and superficialis, and the pocket training on the many ligaments of the hand. 

The load he created also made the actual training itself quite safe. He isn’t progressively overloading the tissue, just the opposite. If he was progressively overloading the tissue he wouldn’t have been able to sustain the program, and rather he would have suffered an overuse injury quickly and likely would have noticed a steep drop off in his training. Since the load was so light, he didn’t suffer this fate, and rather, noticed sharp increases in his strength. So… what happened?  Well, before we get into that, let’s talk about what wasn’t great about the training plan. 

The Training Plan - The bad

The only thing I can say here is not an attack on their plan, because they didn’t have anything to go off of. The research paper just states that the activity should be less than 10 minutes long. In the paper it does specify that 1 load per 10 seconds was no different than 1 load per second, but this is not well translated into an actual protocol. So, when Emil and his brother designed the training plan, they chose a 10 second load with a 50 second rest 10 times. Producing a total work of 100 seconds. This is clearly less than 10 minutes, so technically it still follows what the paper is doing. I just think the paper could have outlined a clearer protocol here, because it’s hard to say that Emils results follow directly along with what the paper implies because of this dichotomy. 

BUT, regardless of that, we still see some really crazy changes. Massive increases in hold times and weight across the board. So…. what the heck happened?!?!

What likely happened? - The good 

Well, what likely happened could be two fold. First, I think the frequent low load to the tissue triggered healing to his connective tissue such as his pulleys. This would be more relatable to the research paper as in the paper they use an ACL which is a ligament and our pulley’s are more closely related to that than they are to the tendons of our flexor digitorum profundus and superficialis. This also makes sense as most of his actual testing is in the crimp position not the open hand position, meaning most of the stress of the testing is in the pulley’s and not the aforementioned tendons of the finger flexors. If that’s the case, great! It was a useful tool to help heal up his tissue. 

Let’s explore this concept a little more. If he did use this program truly to help heal his pulley’s, has he been overtraining? If he is now healing, is he pulling harder because he feels stronger / more healed? Is this ability to pull harder now triggering the adaptations that produced the final test results? It is possible, but that kind of significant change in 30 days is so dramatic I don’t know that I can say that’s the only factor. Think about it: if you’re not familiar with regular strength training, you need to know that you need to load tissue to a certain percent of its capacity in order to make great change. If he wasn’t climbing, training, or doing anything else, just doing these submax hangs wouldn’t cause those changes. Let’s make this more clear with a ridiculous example: No one would ever expect that doing a bicep curl with a 2 pound weight for 30 days would allow them to then miraculously lift a 60 pound one. So… what else is going on? 

What likely happened? - The bad

Before we can fully understand what likely happened with his training, we need to talk about a bit of tendon physiology. Tendons, in a general sense, fall along a spectrum of being stiff or compliant (elastic). A stiff tendon will only stretch a small amount and release more energy with more force. A more compliant (or elastic) tendon will stretch more and release energy slowly and with less force. In general, a more compliant tendon is less prone to injury because of its ability to attenuate forces and simply because it cannot create as much force. In fact, the paper itself that is reference in Emil’s video “Minimizing Injury Maximizing Play” states that “the compliant region of a tendon is believed to protect the attached muscle from injury, by acting as a shock absorber” (Baar K)

Research has also shown that tendon stiffness can be increased over just a 4 week period and that these quick changes are more likely related to the physical properties of the tendon (i.e. stimulation of Lysyl oxidase which increases cross-linking of  collagens and elastin), and not actual thickening or hypertrophy of the tendon itself. Tendon thickening or hypertrophy is seen after 8 weeks. 

So, with Emil’s program, what likely happened is the aforementioned. He likely increased his tendon stiffness with this program which improved his ability to apply force through his fingers. This allowed him to generate greater force during all of his tests. While this is amazing, it has its drawbacks: it can increase risk of injury. 

As mentioned, in those 4 weeks while the physical properties of the tendon are changing and becoming stiffer and generating more force, the thickness is not changing. So not only is the compliance of the tendon reducing, but he is also able to handle more force on the tendons without an actual thickening of the tendon. These factors can lead to an increased risk of injury.  

Now, this is not all bad news, it just needs to be employed properly within a training period. 

Turning the bad into good

First, in the rehab world, have you ever done exercises where your therapist made you hold the position for 30 seconds? I know I make my patients do it from time to time, and the purpose is clear. First, it creates a lot of awareness. You know and understand the force, strain, and stress you are placing on your body. Second, and more importantly, a longer, submaximal hold, will improve compliance of the tendons and help heal them.  You can then change your training to work on strength training with short, max holds.  This will stiffen the tendon, WHILE improving muscular strength, WHILE training the proper energy system for your sport, AND improving awareness of the central nervous system to understand the holds it can safely tolerate. 

In short: the program that Emil used, if slightly modified, can be a great tool for improving the health of a tendon, to prepare for a training block that will get you ready for performance.

Essentially, many of you who first watched Emil’s video and are now watching this one introduced a concept in the training world known as periodization or block training. It is a system used to increase performance by cycling different aspects based upon your goals. 

For example: in the offseason when maximum performance is not the goal, using submaximal holds for 30 seconds can help healing and repair of tissue. Then, as the season gets nearer and you want to focus on performance, you can change your program to focus more on strength training to stiffen the tissue, improve muscular strength and make CNS changes that will get you ready to perform. 

Periodized or block training is a key to success for many athletes and if you are looking to take your training to the next level, this is one way to do so. 

Main Takeaways

Training for climbing is a serious endeavor. We all want to improve, and progress can be slow. BUT! That doesn’t stop us from learning more about how to improve your training. That doesn’t stop us from exploring new techniques to crush our next grade. 

Hopefully this video helps to elucidate a few things: 

• Research creates new opportunities for growth, but it has it’s limitations. 

• Case studies are great examples of what can be, but are not law, they are not the rule of thumb, and may not work for everyone. 

• Periodization or block training can really amplify your training, but you need to be strategic with how you do it and understand the cost and benefits each phase has. 

• Educating yourself on advanced topics can be challenging, but there are so many resources out there, you just have to look! That way you can train in a smart, efficient manner that is safe and effective for you. Climb your butt off and always enjoy it. Send your projects… and repeat!

Disclaimer:

As always, exercises are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting new exercises.

Written and Produced by Jason Hooper (PT, DPT, OCS, SCS, CAFS) and Emile Modesitt

IG: @hoopersbetaofficial

RESEARCH

TITLE

Insights into the structure and dynamics of lysyl oxidase propeptide, a flexible protein with numerous partners

CITATION

Vallet, S.D., Miele, A.E., Uciechowska-Kaczmarzyk, U. et al. Insights into the structure and dynamics of lysyl oxidase propeptide, a flexible protein with numerous partners. Sci Rep 8, 11768 (2018). https://doi.org/10.1038/s41598-018-30190-6

KEY TAKEAWAYS

• Lysyl oxidase (LOX) catalyzes the oxidative deamination of lysine and hydroxylysine residues in collagens and elastin, which is the first step of the cross-linking of these extracellular matrix proteins

TITLE

Effects of high loading by eccentric triceps surae training on Achilles tendon properties in humans

CITATION

Geremia, J.M., Baroni, B.M., Bobbert, M.F. et al. Effects of high loading by eccentric triceps surae training on Achilles tendon properties in humans. Eur J Appl Physiol 118, 1725–1736 (2018). https://doi.org/10.1007/s00421-018-3904-1

KEY TAKEAWAYS

• 4 training weeks were sufficient for detecting significant tendon stiffness changes

•  relative increases in tendon stiffness were much bigger than relative increases in CSA, suggesting that changes in tendon stiffness are primarily caused by changes in material properties, and not by tendon hypertrophy

• Achilles tendon material properties already improved after 4 weeks of high-load training: stiffness increased while CSA remained unchanged. Tendon hypertrophy (increased CSA) was observed after 8 training weeks and contributed to a further increase in Achilles tendon stiffness, but tendon stiffness increases were mostly caused by adaptations in tissue properties.
  

TITLE

Minimizing Injury and Maximizing Return to Play: Lessons from Engineered Ligaments

CITATION

Baar K. Minimizing Injury and Maximizing Return to Play: Lessons from Engineered Ligaments. Sports Med. 2017 Mar;47(Suppl 1):5-11. doi: 10.1007/s40279-017-0719-x. PMID: 28332110; PMCID: PMC5371618.

KEY TAKEAWAYS

• Using these tissues, we have learned that sinews, like bone, quickly become refractory to an exercise stimulus, suggesting that short (<10 min) periods of activity with relatively long (6 h) periods of rest are best to train these tissues

• The compliant region of a tendon is believed to protect the attached muscle from injury, by acting as a shock absorber