There’s a lot of science involved in practising correct gym workouts to achieve a specific type of physique while preventing unwanted injuries
BY DR JONAS FERNANDEZ
So, I was carrying my daughter the other day. Her eyes gazed at mine as she sat comfortably in my arms. She then looked down at my belly, paused for a bit and then her eyes caught mine again.
What she said next changed how I chose to live my life a little bit. With much innocence, she asked: “Why do you look like Daddy Pig? Your tummy is so big.”
She caught me completely off guard. I was not expecting this brutal honesty.
For those who do not know, Daddy Pig is a fictional character from a delightful little children’s cartoon called Peppa Pig. Daddy Pig did have a vast and round tummy, and in my mind, no way did mine bear a close resemblance.
Anyway, with my pride beaten, I decided to look down, to point out to her that she was delusional.
As I did, I noticed that this six-year-old girl wasn’t just cuddled in my arms. A significant part of her bottom was resting on my tummy. It was then that I realised that she was right, and something had to change.
I started to visit the gym a little, watch my diet a lot more, and do all kinds of exercises. It wasn’t easy. I wasn’t sure what I needed and how to achieve my goals. It took a lot of googling and experimenting to finally come up with what works best for me.
I am sure many others have faced similar experiences too. Wanting to lose body fat and gain muscle mass is never easy. There’s a lot of science involved in practising correct gym workouts to achieve a specific type of physique while also trying to prevent unwanted injuries.
As I am no expert on the matter, so I decided to track down a couple of experts. Kumareswarren Pillai is a bodybuilder and personal trainer at the Body Factory gym. He was also recently crowned Mr Malaysia 2022 Heavyweight champion.
He gives us his insight into the sport of bodybuilding from an athlete’s perspective. For a more scientific take on the matter, Dr Arvin Raj will provide us with his expert views. He is a Sports Physician and a Certified Sports and Conditioning Specialist who also happens to be a bodybuilding/powerlifting enthusiast.
The three of us discussed what it took to achieve a fitness goal. We will dwell in detail on the topics of training and nutrition. Furthermore, the injuries in this sport and Covid-19-related health issues will be discussed.
TRAINING
KUMARES
How much must I train to become a bodybuilder?
It differs from individual to individual. Some athletes have stepped up on stage in less than a year of weight training, and some also took a few years to compete. It all depends on their genetics and their foundation. One key factor is how athletic they were at a younger age.
Is resting as crucial as training?
Definitely, growth takes place when we are resting. We need to recover well before our next session.
How much should I carry? Is weight or reps more important?
This is also very subjective. Weights and reps are equally important but more important is the form of the exercise being performed. The eccentric movement has to be in control, and the mind over muscle connection is critical. Bodybuilders aren’t weightlifters or powerlifters. It’s not about how much you can lift or break your personal record. It’s about developing the muscles with balance and symmetry.
How do I know if I am pushing enough?
For beginners, it’s most important to stick to their plan and not do more than advised. Just focus on perfecting the form.
Can I lose fat and gain muscle mass at the same time?
Yes, it is possible. Although it’s two separate things, they can happen simultaneously.
Is cardio training as necessary as weight training?
Yes, it is.
DR ARVIN
How are bodybuilders able to gain such muscle mass?
It is because their training, nutrition and lifestyle are muscle hypertrophy-centric. You have to train a certain way, eat a certain way, and lead a particular lifestyle to maximise that potential.
Does genetics play a role in gaining muscle mass?
Of course. The top one per cent of bodybuilders are gifted, but that doesn’t mean they train any less or do not bother about their nutrition. If anything, they owe it to themselves to harness that genetic potential. On the other hand, numerous successful bodybuilders may not be as gifted, especially with some body parts, but they work hard to make up for it, which carves a different kind of success story.
What is muscle hypertrophy?
Muscle hypertrophy is the increment of muscle mass (weight) and cross-sectional area (size).
Will I lose muscle mass if I stop training?
Detraining affects individuals differently. The extent of muscle loss can be just a matter of reduced stored muscle glycogen which happens within the first 2-3 weeks of cessation of training. As the period of detraining prolongs to months, this affects dry muscle mass as well. The effect of detraining is more apparent in those who are bedridden or hospitalised for prolonged periods. This is known as muscle atrophy.
What are concentric and eccentric exercises? Which is better for mass gain?
Concentric and eccentric movements are phases of muscle contraction, with concentric being the shortening and eccentric being the lengthening of muscle fibres. Most forms of movement tempo for hypertrophy give equal attention to both. For example, two counts up and two counts down. It is when the rhythm is focused on either phase of the contraction. We name it concentric or eccentric focused movement.
Does the number of reps or weight matter more?
Both. Weight of 30-90 per cent one repetition has shown to induce hypertrophy. That roughly translates to 4–30 repetitions (Schoenfeld et al., 2021). However, the lighter the loads are, the closer you need to train to failure. This has been shown in multiple research papers (Grgic et al., 2021). However, another essential factor for hypertrophy is training volume, which means the number of practical sets (sets done close to failure) done per week for each muscle group.
Do I get bigger as I lift weights or when I rest?
Both. The training stimulus is equally as important as the emphasis on adequate recovery. This varies from person to person. So, poor planning leads to poor results.
NUTRITION
KUMARES
Must I calculate my food intake calories?
Yes, if you are a competitive bodybuilder. It’s advisable to know how much macros you are consuming. Only then can we make the necessary changes to improve and achieve the desired physique.
What is optimal nutrition?
This differs from individual to individual. It depends on the starting point of the athlete. They have to design their nutritional plan accordingly. For example, if someone is underweight with a lower body fat level and lesser muscle mass, their goal would be to make gains. They would have to consume more kcal, and the carb intake will also be higher. Someone with a higher body fat level would probably have to go on a kcal deficit to drop their body fat level.
Will a cheat day affect me?
It will affect you but is the effect good or bad? Well, that depends. If the person has been on a kcal deficit for a certain period and has reached a low body fat level, having a cheat meal occasionally would be good. It’s more like a re-feed and increases their metabolic rate.
Can I become a bodybuilder without watching my diet?
It’s almost impossible to become a bodybuilder without watching your diet.
Do I need to take steroids to get bigger?
No.
DR ARVIN
Should all bodybuilders be on a special diet?
If by special you mean a highly nutritional diet with a protein focus, then yes. Hypertrophy only happens if the environment is suitable for the muscles to grow. You can have the best blueprint of a house and all the workers, but it is useless when there is inadequate raw material.
What is the optimal diet?
For hypertrophy, the athlete’s diet not only has to fuel the muscle growth, but it also must fuel the training and the entire physiological milieu that makes this growth possible. That means all macro and micronutrients have to be adequate. Of course, adequate protein intake is a given, with research showing 1.4 – 2.2g/kg body weight being ideal. However, carbohydrates and fats are other macronutrients which have their roles in growth and fuelling training performance. On the other hand, the micronutrients support the body’s other physiological functions, including hormonal function.
Is protein intake the most critical factor in mass muscle gain?
Yes.
What is a calorie deficit?
Calorie deficit means eating lesser than what the body expends in a day.
What are the possible side effects of steroid use?
The extent of steroid side effects depends on dosage and duration of usage, polypharmacy amongst anabolic steroid users and, of course, the quality of products that are abused.
The androgenic side effects can be things like hair loss, acne, oily skin, high blood pressure, raised low-density cholesterol levels, increased body hair (hirsutism), deepening of the voice (female users), altered mood (aggressive behaviour, depression and manic like symptoms) and addiction to anabolic usage. It also affects the liver (tumours and cysts), kidney (acute, chronic and end-stage renal failures) and heart function (increased risk of heart attacks and clots). It causes fertility issues like azoospermia or oligospermia in males and menstrual irregularities in females. Besides that, it can cause shrinkage of testicles and gynaecomastia.
INJURY
KUMARES
What is the most common injury seen in bodybuilders?
Shoulder injury, most commonly the rotator cuffs. This is probably because the shoulder is the most used part.
What is the worst injury you have sustained?
The worst injury I have sustained in bodybuilding was when I tore my left biceps tendon.
Do you continue to train with an injury?
Yes.
What do you do to try to prevent injuries?
Since then (injuring my biceps tendon), I’ve given a lot of importance to dynamic stretching before I start training. I also ensure that the eccentric movement is always in control. I avoid carrying too much weight until I start compromising on my form.
Is physiotherapy an essential part of your training regime?
It’s imperative to me. I do it every week.
DR ARVIN
Are bodybuilders more prone to injuries?
Not necessarily. A study by Keogh et al in 2017 showed that bodybuilders have 0.24 – 1 injury per 1000 hours lifted, whereas strongmen have 4.5 – 6.1 injuries per 1000 hours, and sports like rugby and football can have 15 – 81 injuries per 1000 hours. So, it is safe to say it is a relatively safe sport, and most injuries are self-inflicted, unlike contact sports.
What is the most common type of injury seen in them?
Muscle strains are the commonest, from minor strains to tears usually surrounding the lower back, shoulder, and knee complex. Ligaments can also get injured, with sprains usually affecting the elbow, wrist, hip, and knee.
How to prevent injuries in bodybuilders?
Proper training technique, load and volume management and adequate recovery.
What is tendinopathy, and is it common among bodybuilders?
Tendinopathy describes a clinical condition characterised by pain, swelling, and functional limitation of the tendon and contiguous anatomical structures (Loiacono et al., 2019). It commonly affects the rotator cuffs, biceps tendons and hamstring muscles in bodybuilders, likely due to the shear loads lifted and the training intensity.
What are stress/fatigue fractures? Are bodybuilders prone to such injuries?
Stress fractures can be either due to fatigue reaction or insufficiency reaction. In athletes/military, fatigue reaction is more common as normal bones are subjected to abnormal loading volume that leads to these microfractures. Insufficiency reactions are everyday stress on abnormal bones. Fatigue fractures are not common in bodybuilders.
COVID-19
KUMARES
How did Covid-19 affect your training?
It did but only for a week. I was able to get back to training immediately after.
Has it been challenging to get back to training?
Initially, yes, it wasn’t easy. But now I’ve almost forgotten that I once had Covid.
Have there been any long-term effects?
No, I’ve not experienced any effects.
DR ARVIN
How does Covid-19 affect bodybuilders/athletes?
Like any person, Covid-19 infection affects athletes due to their inability to train, reduced training capacity post-infection and the possible long Covid side effects.
Are there possibilities of long-term effects?
Yes. Long Covid is defined as Covid-related symptoms three months after the initial infection. Like many others, athletes can be victims of this as well. As Covid affects the cardiopulmonary systems, some athletes have reported persistent asthma symptoms and reduced exercise tolerance, eventually affecting their performance. Some even have to quit as they could not return to previous levels over six months to a year. Even more concerning was the cardiac inflammation the infection caused; there are case studies that showed individuals with no symptoms at rest but had ongoing cardiac inflammation on MRI. Exercising at high intensity with an ongoing Covid -19 related myocarditis can be life-threatening. Once diagnosed, athletes will be side-lined for 3-6 months, which can be career-ending for some.
Should one be wary about returning to sports too soon after a Covid infection?
What about after the Covid vaccination?
Yes, once infected, it is best to err on the side of caution and follow the return to sports protocol that has been outlined. Most individuals will gradually be able to return to previous levels of activity with no issues.
Covid-related myocarditis can be life-threatening. Those with premorbid like diabetes, hypertension or previous cardiac issues have more reasons to consult a physician to guide them back to previous activity levels.
High-level athletes may follow guidelines outlined by establishments like the British Journal of Sports Medicine (Graduated Return to Play after SARS-CoV 2 infection).
As for the vaccine, especially the mRNA vaccines, it is best to reduce the intensity of training 1 – 2 weeks post-vaccination. If there are no worrying symptoms like chest pain, breathing difficulties or fever, they may return safely to the previous training intensity. – The Health
Dr Jonas Fernandez is an Orthopaedic Surgeon at Putrajaya Hospital. He is also a member of the Malaysian Arthroscopy Society (MAS).
