Therefore, no further adaptations are needed and increases in the desired outcome will eventually stop. Without concomitant changes in overload, the system has no need to adapt to stressors. 1 Increased demands cause the neuromuscular system to adapt by increasing muscular performance but there is also a concurrent increase in the physical, mental, and metabolic cost of recovery. 49 For the neuromuscular system to adapt maximally to the training load or stress, volume and intensity alterations are necessary. 49 This idea has significant implications for programming if preparedness can be optimized by methodical improvements in fitness while minimizing the resulting fatigue. 49 An individual's level of preparedness is thus a result of the interaction between their level of fitness and the amount of fatigue. 47 In contrast to Selye, the fitness‐fatigue model looks at periodization as a balancing act between fitness and fatigue. The final phase occurs if the stressor goes on longer than the organism can adapt, and exhaustion results, whereby the athlete may experience staleness in training or deal with symptoms of overtraining. This is considered to occur at a level greater than that demanded by the stressor and was termed “ supercompensation”. The second phase was termed the resistance phase and is where the body responds to the stressor by adapting to the new stress with less soreness, stiffness, more tolerance to activity, and improved performance. Initial reaction to the stressor is termed the alarm/reaction phase where the athlete may experience stiffness, soreness, or a small drop in performance from fatigue after the training session. 47, 48 According to Selye this is accomplished through a process of three phases. 47 In summary, GAS effectively states that systems will adapt to any stressors they might experience in an attempt to meet the demands of these stressors. The classic understanding of periodization is attributed to Selye's General Adaptation Syndrome (GAS), the template from which the original concept of periodization was derived. 8, 46 Periodization has been shown improve training adaptations but the most effective periodization approach for muscular strength development for a wide variety of populations is yet to be determined. 4, 24, 45 Periodized training is a safe method of training for older adults, as well as those in pain. 1, 39 It appears from the strength training literature that is available that periodization is usually needed for maximal strength gains to occur, 20, 31, 30, 40– 44 although evidence stating otherwise exists. Periodization is defined as the planned manipulation of training variables (load, sets, and repetitions) in order to maximize training adaptations and to prevent the onset of overtraining syndrome. Periodization is one way for the sports physical therapist to approach the design of resistance training programs. 36, 37 Unfortunately, few studies have examined the effect of periodization approaches in adolescent athletic populations. 1 Unfortunately, most strength training research to date on program design has been conducted on healthy, trained and/or untrained adults, 1– 35 while only two studies have been loosely based on rehabilitation. A significant challenge for sports physical therapists is designing optimal training programs that facilitate neural and muscular adaptations while being mindful of biologic healing constraints and safety for the athlete. 1 These programs often follow a logical sequence to not only promote optimal healing, but also to restore peak performance. Sports physical therapists design programs that include several components including endurance, flexibility, proprioception/kinesthesia, balance, joint and soft tissue mobility, speed, and power. Without proper strength development, these qualities cannot be optimized. Strength is the foundation from which all other physical qualities of performance like power, speed, and agility, are developed. Restoration of strength is arguably the most vital aspect of a rehabilitation plan and is a central tenet of strength and conditioning programs.
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