FIELD NOTES · DISPATCH No. 17

Physical Training as Preventative Care

Physical training is medicine: a consideration of systematic strength training, aerobic development, and task-specific practice in patient outcomes.

Not Medical Advice

The following discussion is educational and is not medical advice. It does not imply a physician-patient relationship, nor is anything discussed herein intended to advocate for any specific medical treatment or therapy, or to replace standard accepted medical care by a trained healthcare professional. If you are injured or ill, seek immediate and definitive care from a licensed professional.

Preventative care is the first line of defense against injury and illness. In general populations, this typically consists of things like routine physical exams and bloodwork, immunizations, and lifestyle advice. Many of the general guidelines regarding preventative care are, expectedly, general. They’re often derived from averages and, of course, many populations exist in either direction of the median.

It’s difficult to convince the average person to undergo a rigorous, structured program of physical development; so, this potent prophylaxis is often unprescribed.[3,4]

Training implies a developmental process, conducted in accordance with an intended outcome; activity implies movement, but perhaps without a specific structure or destination in mind. For the sake of this article, let’s consider the role of physical training in preventative care, as opposed to general physical activity, and its latent potential for developing strong, vital, and resilient human beings.

When utilizing physical training as a tool for preventative care, it’s critical to understand how the “prescription” works. For this, I point to the model of General Adaptation Syndrome[1], as well as the principle of Specific Adaptation to Imposed Demands[2].

A Grail Strength guest dispatch. Medically reviewed by Matthew J. Bertini, MD.

Adaptation Science

General Adaptation Syndrome: How the Body Adapts to Training Stress

General Adaptation Syndrome, as introduced by endocrinologist Hans Selye, details an organism’s potential responses to stress: alarm, resistance, and exhaustion. While initially intended as a framework for responsiveness to any stress, (including life-or-death situations,) it is immensely useful when applied to the context of physical training; let’s examine it as such.

What is General Adaptation Syndrome? Simply, it’s the body’s conditional response to any stressful stimulus: alarm (the immediate effect), resistance (durability or immunity developed by repeated exposure to stress), and exhaustion (the consequential deterioration, when stress is unable to be resisted or accommodated).

When an unaccustomed, stressful stimulus is applied to an organism (like lifting a heavy weight,) the organism often exhibits a state of alarm — heightened sympathetic nervous system activity, inflammation of tissues, and elevation of stress hormones are expected responses to difficult physical training. If the applied stressful stimulus is tolerated, the organism may develop a resistance to it; greater magnitudes of stress (or heavier weights) will be needed to disrupt equilibrium, in the future. If the stressful stimulus is not able to be accommodated, the organism may display a condition of exhaustion; this includes injury, fatigue, functional overreaching, or overtraining. Sound physical training is a constant Goldilocks problem: seeking that ever-changing “just right,” in terms of application of novel stimulus, to drive adaptation, while avoiding exhaustion or overwhelm. In this regard, it is important to consider what the “minimum effective dose” may be, in any given context.[5] Prescription of physical training, both from a qualitative and quantitative perspective, benefits from precision; the dose must match the indication.

Beyond General Adaptation Syndrome, there is the principle of Specific Adaptation to Imposed Demands. In essence, this principle conveys the following: we adapt to what we repeatedly do. If the cardiovascular system, for example, is not stressed in a specific, intentional manner (i.e. development of aerobic capacity below the first lactate threshold,) it is unreasonable to believe that specific, intentional adaptations will occur.

When utilizing physical training as a preventative care method, consider the following: it should be potent enough to drive an adaptation, specific enough to develop an intended adaptation, and measured enough to not plunge the patient into a state of exhaustion.

So, practically, what does this look like?

For ease of application, I often divide exercise-induced adaptations into three categories: structural, chemical, and neural. Of course, the body contains near-infinite degrees of complex sub-systems, but distilling outcomes of training into a threefold framework allows for streamlined navigation. With this in mind, let’s consider some of the highest “return-on-investment” training objectives, as well as how these adaptations benefit clinical outcomes, quality of life, and physical performance.

A multicolored graph demonstrating General Adaptation Syndrome with and without proper recovery periods.
Structural

Structural: Development of Musculoskeletal Tissues

The musculoskeletal system consists of, predictably: muscles, bones, and everything that connects them. For the purpose of preventative care — building strong, resilient, durable patients — we’ll consider the structural components of this system. (Of course, chemical [or metabolic] and neural adaptations strongly influence musculoskeletal function, as well.) Bottom line up front: the musculoskeletal system benefits from progressive exposure to relatively high forces, safely, over time.[6,7] At a structural level, bones, tendons, and muscles are stress adaptive; ligaments are also stress adaptive, but to a much lesser degree. By utilizing progressive resistance training, muscle cross-sectional area may increase, bone mineral density may increase, tissues may display greater resistance to externally-applied forces (minimized risk for certain acute injuries, like sprained ankles,) and the entire platform upon which the human organism sits may grow stronger.[8,9,10] Progressive resistance training is a tremendously potent, widely underutilized preventative care method for the body’s locomotive components — not to mention its tremendous benefits for metabolic health.[11,12,13]

Brandon Sherwood of Grail Strength

When considering the most efficient tool for musculoskeletal development, barbells are often the most effective choice; this is conditionally dependent on the individual’s ability to precisely and safely execute barbell lifts. Provided that this is the case, barbells provide a consistent platform to progressively, heavily load the human body in such a way that few implements can parallel. The combination of progressive barbell strength work and deliberate metabolic conditioning (often lumped into the ubiquitous “hybrid athlete training” umbrella, although it’s really just concurrent training,) is a potent method for whole-system development.[11,14] For a more granular look at this, I recommend reading “Quantum Strength and Power Training: Gaining the Winning Edge,” by Dr. Pat O’Shea — if you can find a copy of it.[15]

Chemical

Chemical: Development of Aerobic Metabolism

Aerobic exercise is one of the most prevalent prescriptions of preventative care. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity, or 75 minutes of vigorous aerobic activity, per week.[16,17] Everyone knows that aerobic activity is good for you — but, what is aerobic activity? Aerobic metabolism, in the context of exercise, is vastly misunderstood. Much of what we refer to as “aerobic” activity is, in actuality, some combination of aerobic and anaerobic activity; unfortunately, this often applies to the storied “Zone 2” heart rate. Allow me to explain.

Contemporary heart rate models typically exist within a five-zone framework. The first zone is relegated to recovery, the second is relegated to “aerobic base,” the third is relegated to pace or tempo training, the fourth is relegated to “threshold” training, and the fifth is considered “VO2 Max.” While all of this is mostly acceptable for general use, the typical five-zone framework is often wildly inaccurate from a physiological perspective.[18]

For example, all too often does an individual perform “aerobic” work at the heart rate assigned to “Zone 2,” but, in reality, they’ve already surpassed the physiological marker indicative of greater proportional anaerobic metabolism (this is the first lactate threshold, called the anaerobic threshold in older literature.) Zone 2 cardio, as it is often intended, aims to remain below this first threshold, where fat oxidation supplies the bulk of the energy and blood lactate concentrations are generally stable. In reality, many individuals end up overshooting this physiologically, in terms of anaerobic energy contribution and lactate buildup, while their heart rate still reads as within “Zone 2.” For this reason, many clinical settings and elite endurance athletes use a three zone model, based upon the distinct physiological markers of the lactate thresholds, to guide training — but, I digress. This degree of scientific granularity isn’t necessary for most people. What is necessary for most people, however, is some degree of awareness about what makes aerobic (base) training truly aerobic. It must predominantly rely upon the oxidation of fats for energy; this, all else equal, requires low intensities and long durations.

The practical solution to determine if aerobic training is actually aerobic, beyond the niches of exercise physiology or alpinism, is to consider the following: is it actually easy? If patients are describing aerobic workouts as intense, they’re likely not truly aerobic in nature. Even “moderate” is often pushing it, in terms of intensity for true aerobic training. The bulk of aerobic work should be easy and sustained for long durations (at least twenty minutes, up to about two hours.) This looks like walking, rucking with a reasonable load, stationary biking, and perhaps some jogging or swimming (if the patient is very economical at those activities.) When in doubt, slow down. A few higher intensity sessions per week may be appropriate for developing the upper-end of aerobic fitness and maximal oxygen consumption (VO2), but this is a quality independent of the aerobic base, which resides below the first lactate threshold. Sprints are never a replacement for long, sustained, easy, often-boring aerobic work. The benefits of long, easy, truly aerobic exercise are manifold and not just chemical in nature. Yes, the patient will likely display improvements in chemical measures of metabolic health as a result of chronic aerobic training — but, increased mitochondrial density in tissues, lower visceral fat mass, lower average blood pressures, reduced risk of cardiac events, structural cardiac adaptations (increased stroke volume), and numerous other adaptations are likely to occur, as well.[19,20,21,22,23] Genuine aerobic training, with a specific intended outcome, is a reliable and effective tool for preventative care.[24]

A multicolored graph demonstrating lactic acid trhesholds

Figure 17-2. Lactic Acid Thresholds

*Perceived intensity is not always an accurate gauge of exercise metabolism: an aerobically deficient athlete can feel an effort is “easy” while blood lactate sits above 4 mmol/L (beyond LT2), because a highly developed anaerobic system is supplying the energy, running on carbohydrate from the start.

  • : In terms of physiological markers, the majority of aerobic training should occur below the first lactate threshold, typically measured at about ~2 mmol/L, although this varies across patients.[25]
  • : A simple method for the patient to determine appropriate intensity of aerobic exercise is the “talk test.” They should be able to speak in full sentences, without strain, for the duration of low-intensity aerobic training. When in doubt, slow down — it should feel easy.
  • : For patients in need of a truly accurate assessment of lactate thresholds, a field or laboratory lactate threshold test (measuring blood lactate concentrations) is the only clinically-reliable method. Many universities or human performance programs offer this service. This degree of precision is certainly far from mandatory, barring elite populations, but it is certainly a useful measurement for prescription of aerobic training.
Neural

Neural: Development and Practice of Task-Relevant Skills

Neural adaptation is an interesting aspect of physical training, one that still continues to be a point of contention across the world of human performance, exercise physiology, and health science. As such, I’ll keep this section brief and practical: neural adaptations, in the context of physical training, often manifest as increased efficiency, precision, and consistency in performance of task-specific skills. For a competitive weightlifter, this may look like higher firing rates of motor units, generating massive forces in short times, as a consequence of repeatedly and progressively training the same, explosive motor patterns. A tactical athlete may display greater economy of movement when operating under conditions of prolonged or significant fatigue, due to previous practice of task-specific motor patterns — like negotiating obstacles. For an aging patient, neural adaptations may appear as more consistent balance when walking across an unstable surface or greater ease standing up from a chair. The body adapts to what it repeatedly does, or fails to do. In the most practical terms, neural adaptations, as a consequence of physical training, are often a simple consequence of practice. In the context of preventative care, it’s important to consider potential risks and hazards that the patient may likely face. If the patient is at statistical risk of falling, perhaps it’s worth intentionally developing balance and task-specific coordination prior to walking down an icy driveway.[26,27]

The Prescription

Training as Prescription: From Clinic to Deployment

Much like the prescription of a medicine, effective physical training should be appropriate for the condition, precise in delivery, and dosed accordingly to achieve the intended effect. When utilized in this manner, physical training, not just physical activity, can be one of the most potent tools available for preventative care; the entire human body can be progressively developed, fortified, and refined according to individual circumstances.[20,22,24]

Furthermore, integration of effective physical training and human performance programs with existing healthcare frameworks allows for an uncommon degree of robustness and proactivity in preventative care. Consideration of this sort of model is of special importance for military pre-, mid, and post-deployment optimization, as well as any for individuals in austere environments where access to effective care may be inconsistent or delayed.[28,29,30,31,32,33]

Common Questions

Frequently Asked Questions

Is physical training still useful for an untrained patient with existing medical conditions?
To generalize: yes. An analysis of the patient’s current condition can convey the most critical priorities and methods for physical training; find an appropriate starting point, then incrementally increase stimulus over time. For example, if the patient presents with a chronic metabolic condition: low-intensity, steady state aerobic work may be the logical training recommendation. It may be useful to provide prescriptive guidelines such as heart rate zones (“Zone 1 or Zone 2”), exercise modes — (do they require a low-impact option?) — durations, and similar actionable steps. Nearly anyone who would benefit from activity would benefit from structured, prescriptive training. Training, effectively, is just activity with structure, context, precision, and accountability.
I recognize the benefits of structured training, but I don’t have the practical experience to implement it. What is the best approach?
I recommend developing a working knowledge of physical training methods and rationale, and building relationships with trusted professionals who can best implement the appropriate methods for your patient. For example, if you have an aging patient who is a lifelong swimmer, and has been recognized as at-risk for osteoporosis, you may identify them as a candidate for progressive resistance training. From there, you could recommend a trusted, vetted strength training professional to provide advice and instruction to the patient.
How do I identify priorities for physical training, in the context of preventative care?
The most practical course of action is to cultivate an understanding of the patient’s primary risk factors and lifestyle, then work backwards. I often distill this to: what does the individual experience, predictably and repeatedly? A tactical athlete — like an infantryman — might experience long road marches under load, recurring metabolic stress from inconsistent sleep and nutrition, and execution of critical vocational skills under significant fatigue. From this profile, it can be identified that the individual might benefit from incremental exposure to similar stimuli, in order to develop some degree of durability, efficiency, and resistance, prior to performing in a field exercise or operational setting. Loading the axial skeleton with barbell strength training and progressive plyometrics, for example, might be an appropriate preventative training plan prior to hard airborne landings. This same logic applies to nearly any population. What are the risks and hazards that most greatly affect the patient, and how can training be leveraged to mitigate these factors? Furthermore, how can training be leveraged to develop patients that are healthy, capable, and vital — not just to keep them from getting injured or sick?
What wearable devices do you recommend for tracking heart rate or HRV?
In general, I recommend Garmin products. I’m not paid or supported by Garmin in any way, shape, or form. I’ve used their products for a number of years and I’ve had a generally good experience; obviously this may vary depending on the model. For a heart rate monitor to actually be useful, in my experience, it needs to be readable during training. Some of the other wearable options either lack durability or lack readability, i.e., they have tiny screens or no screen at all.
What is the ideal method for strength training and metabolic conditioning?
This depends on your patient’s condition. In terms of sheer efficiency, dealing with a healthy and able-bodied patient, typically barbell strength training and running are the premier choices. Barbell strength training is tremendously effective, because it can be loaded very precisely and incrementally, and because the major barbells lifts tend to load the entire skeleton. A potential limiting factor here is the technical nature of the lifts (your patient will likely need an experienced coach.) Running is highly effective for metabolic conditioning, as it is generally more metabolically strenuous than biking or similar methods, at low to moderate intensities. If your patient is training to develop aerobic capacity, in the form of an aerobic base below the first lactate threshold, they’ll likely need to begin with walking or light hiking, before progressing to running. Of course, for some patients, a low-impact option is the most appropriate method for metabolic development; similarly, machines or other resistance training implements may be more appropriate than barbells for many. The “ideal” method is the one that best serves the patient.
How do I calculate my zone 2 heart rate?
A percentage estimate gets most people close: roughly 60 to 70 percent of maximum heart rate, with maximum commonly estimated as 220 minus age. Physiologically, though, zone 2 ends at the first lactate threshold (about 2 mmol/L of blood lactate), so formulas only approximate it. The talk test is the everyday check: full sentences, without strain, for the entire session. When in doubt, slow down.
What is the difference between the lactate threshold and the anaerobic threshold?
They usually describe the same crossover point. Older literature calls the intensity where anaerobic metabolism begins to dominate the anaerobic threshold; contemporary exercise physiology instead distinguishes a first and a second lactate threshold. Aerobic base training lives below the first; sustained race-pace efforts press against the second.
How long does it take to recover from overtraining?
It depends on how far the exhaustion stage has progressed. Short-term functional overreaching often resolves with days to a few weeks of reduced training, sleep, and adequate fueling, while true overtraining syndrome can take months and warrants clinical evaluation to exclude other causes of persistent fatigue. Prevention through measured dosing is far cheaper than the cure.[34]
How do I test my VO2 max?
The gold standard is a graded exercise test with gas-exchange analysis in an exercise-physiology laboratory. Watch estimates and field protocols (such as timed walk or run tests) are useful for tracking trends, but they can miss the laboratory value considerably. As with lactate testing, many university human performance programs offer this assessment.

Have additional questions regarding the role of physical training in preventative care? Please feel free to email me at brandon@grailstrength.com — I hope to be of service, however I can be. Find Grail Strength at grailstrength.com.

References

  1. Selye H. Stress and the general adaptation syndrome. Br Med J. 1950;1(4667):1383-1392.
  2. Henry FM. Specificity vs. generality in learning motor skill. In: Brown RC, Kenyon GS, eds. Classical Studies on Physical Activity. Prentice-Hall; 1968.
  3. Wattanapisit A, Lapmanee S, Chaovalit S, Lektip C, Chotsiri P. Prevalence of physical activity counseling in primary care: a systematic review and meta-analysis. Health Promot Perspect. 2023;13(4):254-266. doi:10.34172/hpp.2023.31
  4. MacDonald C, Bennekou M, Midtgaard J, Langberg H, Lieberman DE. Clarifying the real challenge: adherence, not efficacy, is the barrier to exercise as medicine. Br J Sports Med. 2025;59(24). doi:10.1136/bjsports-2025-110988
  5. Nuzzo JL, Pinto MD, Kirk BJC, Nosaka K. Resistance exercise minimal dose strategies for increasing muscle strength in the general population: an overview. Sports Med. 2024;54(5):1139-1162. doi:10.1007/s40279-024-02009-0
  6. Paluch AE, Boyer WR, Franklin BA, et al. Resistance exercise training in individuals with and without cardiovascular disease: 2023 update: a scientific statement from the American Heart Association. Circulation. 2024;149(3):e217-e231. doi:10.1161/CIR.0000000000001189
  7. Currier BS, D'Souza AC, Singh MAF, et al. American College of Sports Medicine position stand: resistance training prescription for muscle function, hypertrophy, and physical performance in healthy adults: an overview of reviews. Med Sci Sports Exerc. 2026;58(4):851-872. doi:10.1249/MSS.0000000000003897
  8. D'Onofrio G, Kirschner J, Prather H, Goldman D, Rozanski A. Musculoskeletal exercise: its role in promoting health and longevity. Prog Cardiovasc Dis. 2023;77:25-36. doi:10.1016/j.pcad.2023.02.006
  9. Shen Y, Shi Q, Nong K, et al. Exercise for sarcopenia in older people: a systematic review and network meta-analysis. J Cachexia Sarcopenia Muscle. 2023;14(3):1199-1211. doi:10.1002/jcsm.13225
  10. Tøien T, Berg OK, Modena R, Brobakken MF, Wang E. Heavy strength training in older adults: implications for health, disease and physical performance. J Cachexia Sarcopenia Muscle. 2025;16(2):e13804. doi:10.1002/jcsm.13804
  11. López-Bueno R, Ahmadi M, Stamatakis E, Yang L, Del Pozo Cruz B. Prospective associations of different combinations of aerobic and muscle-strengthening activity with all-cause, cardiovascular, and cancer mortality. JAMA Intern Med. 2023;183(9):982-990. doi:10.1001/jamainternmed.2023.3093
  12. Zhang Y, Lee DH, Rezende LFM, Ma Y, Giovannucci E. Long-term resistance training with all-cause and cause-specific mortality: assessing dose-response and joint associations with aerobic physical activity. Br J Sports Med. 2026;60(12):874-883. doi:10.1136/bjsports-2025-110503
  13. Zhang T, Zhang Y, Lee DH, et al. Long-term resistance training and risk of type 2 diabetes. JAMA Netw Open. 2026;9(6):e2619420. doi:10.1001/jamanetworkopen.2026.19420
  14. Terada T, Pap R, Thomas A, et al. Effects of muscle strength training combined with aerobic training versus aerobic training alone on cardiovascular disease risk indicators in patients with coronary artery disease: a systematic review and meta-analysis of randomised clinical trials. Br J Sports Med. 2024;58(20):1225-1234. doi:10.1136/bjsports-2024-108530
  15. O'Shea P. Quantum Strength & Power Training: Gaining the Winning Edge. 1996.
  16. Swift DL, Ross LM, Laddu DR, et al. Role of physical activity in obesity treatment and cardiometabolic health: a scientific statement from the American Heart Association. Circulation. 2026;154(1):e1-e16. doi:10.1161/CIR.0000000000001441
  17. US Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. US Dept of Health and Human Services; 2018.
  18. Bishop DJ, Beck B, Biddle SJH, et al. Physical activity and exercise intensity terminology: a joint American College of Sports Medicine (ACSM) expert statement and Exercise and Sport Science Australia (ESSA) consensus statement. Med Sci Sports Exerc. 2025;57(11):2599-2613. doi:10.1249/MSS.0000000000003795
  19. Garcia L, Pearce M, Abbas A, et al. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med. 2023;57(15):979-989. doi:10.1136/bjsports-2022-105669
  20. Lang JJ, Prince SA, Merucci K, et al. Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies. Br J Sports Med. 2024;58(10):556-566. doi:10.1136/bjsports-2023-107849
  21. Mi MY, Perry AS, Krishnan V, Nayor M. Epidemiology and cardiovascular benefits of physical activity and exercise. Circ Res. 2025;137(2):120-138. doi:10.1161/CIRCRESAHA.125.325526
  22. Sanchis-Gomar F, Lavie CJ, Rodriguez F, Kokkinos P, Franklin BA. Physical activity, fitness, and longevity. Prog Cardiovasc Dis. Published online July 22, 2026. doi:10.1016/j.pcad.2026.07.004
  23. Edwards JJ, Deenmamode AHP, Griffiths M, et al. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med. 2023;57(20):1317-1326. doi:10.1136/bjsports-2022-106503
  24. Rahmati M, Lee H, Lee H, et al. Associations between exercise training, physical activity, sedentary behaviour and mortality: an umbrella review of meta-analyses. J Cachexia Sarcopenia Muscle. 2025;16(2):e13772. doi:10.1002/jcsm.13772
  25. House S, Johnston S, Jornet K. Training for the Uphill Athlete: A Manual for Mountain Runners and Ski Mountaineers. Patagonia; 2019.
  26. US Preventive Services Task Force, Nicholson WK, Silverstein M, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA. 2024;332(1):51-57. doi:10.1001/jama.2024.8481
  27. Guirguis-Blake JM, Perdue LA, Coppola EL, Bean SI. Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2024;332(1):58-69. doi:10.1001/jama.2024.4166
  28. Bunn PDS, Sodré RDS, Matos MI, et al. Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis. BMJ Mil Health. 2024;170(6):529-536. doi:10.1136/bmjmilitary-2022-002098
  29. Lovalekar M, Keenan KA, Peterson P, et al. Neuromuscular strength and power predict musculoskeletal injury and attrition during Marine Corps recruit training. Mil Med. 2024;189(suppl 2):12-20. doi:10.1093/milmed/usae134
  30. Robitaille E, Reilly T, Heipel S, Buttici H, Chasse E, Tingelstad HC. The value of strength as a predictor of musculoskeletal injury in Canadian Armed Forces basic infantry candidates. Mil Med. 2024;189(7-8):e1675-e1682. doi:10.1093/milmed/usae015
  31. Foulis SA, Proctor SP, Spiering BA, et al. Model for musculoskeletal injury risk factors among US Army basic combat trainees. JAMA Netw Open. 2025;8(6):e2513177. doi:10.1001/jamanetworkopen.2025.13177
  32. Pietiläinen E, Parkkola K, Vasankari T, Santtila M, Luukkaala T, Kyröläinen H. Physical activity, physical fitness and cardiometabolic health among Finnish military workers. BMJ Mil Health. 2025;171(e1):e44-e50. doi:10.1136/military-2024-002800
  33. Acevedo AM, Zeigler Z. Human performance optimization in Special Operations Forces: structure, outcomes, and readiness implications. Mil Med. Published online July 2, 2026. doi:10.1093/milmed/usag303
  34. Meeusen R, Duclos M, Foster C, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186-205. doi:10.1249/MSS.0b013e318279a10a
Source & Attribution

Educational content only. This guest dispatch was written by Brandon Sherwood, CSCS, SSC, USAW-L2 of Grail Strength and medically reviewed by Matthew J. Bertini, MD. Exercise prescription for individuals with medical conditions belongs with their own clinicians; the peer-reviewed literature cited above is provided for context. All clinical services referenced are performed exclusively by licensed physicians through AMC Medicine LTD.

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