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Prescription for Mass

Supplement stacks, high-volume training and when to call in the doctor.


Q: What supplement stack do you recommend? I've been getting nowhere with what I'm using now. I'm willing to use anything, as long as it works.

A: I see people trying to use products as soon as they come out'before we know whether they work'or trying to stretch a dollar and using either a cheap brand or half the recommended dose in order to make the stuff last longer. Both are mistakes.

Supplements have certainly become very confusing over the past 10 years. Gone are the days of milk and desiccated liver tablets. It's hard enough to tell the scams from the good products, let alone be familiar with the use, side effects and doses of what's on the market.

Get a solid grip on what you want to do and make a serious commitment toward those goals. It will cost you time, energy and money. You can get by with some simple protein powder and creatine for about $40 a month; however, if you want serious results, you'll need to spend more and be willing to risk more.

Some products have strong muscle-building effects, but risks are associated with their use. If you're willing to accept those risks, realizing that some users have died or experienced permanent side effects, then there are options.

For those willing to take the risks and spend the money, the following supplements have provided positive muscle-building effects. I am not recommending any of these products, merely relating the word-of-mouth reports and the limited research available.

First of all, a quality meal-replacement powder is essential. Several brands that have worked well for many people: Myoplex, Met-Rx, Muscle Meals and N-Large. Many people like Designer Protein. Mixability and flavor are as important as the protein base, since none of them will work if they aren't used. Try to get two MRPs or protein blends each day for an extra 60 to 100 grams of protein above what your regular-food meals provide. An MRP immediately after your workout may help with recovery. [Note: Some supplement manufacturers are designing specific products that take advantage of the anabolic window created by intense workouts. For more information see page 134 of the January '02 IRONMAN.]

Creatine is a must for strength and size. There are more creatine products on the market than there are boy bands in the top-40 countdown. It is effective in its plain creatine-monohydrate-powder form. Research has shown that added sugar makes creatine more effective, which some companies have pushed to the extreme. Popular creatine products with positive reviews include Phosphagen HP, Cell-Tech and effervescent creatine. Creatine can be cheap or expensive. Just look for a quality product. Loading four servings of five grams per day for four days really gives positive results fast. Follow it with a maintenance dose of five grams per day. There's no evidence that higher maintenance doses provide any additional benefit.

Phosphatidylserine prevents cortisol elevations that accompany overtraining. Studies of athletes used 800 milligrams a day, but researchers have also turned up positive results in cognitive processes of the elderly at 300 milligrams a day. Perhaps 800 milligrams a day for two weeks, then 300 a day would provide long-term effects at a lower cost. Muscle-Link's Cort-Bloc is the only brand of P.S. I'm familiar with, but I'm sure there are others. 1-AD is a fairly new pro-hormone by Ergopharm. There have been a few side effects reported but nothing like those reported for the original pro-hormone, 4-androstenedione. Users have had great improvements in strength, and some have reported a cutting-up effect while dieting. Effective doses are around 600 milligrams a day, usually taken as 300 milligrams twice a day.

Essential fatty acids are just that'essential. A blend of omega-6 and omega-3 is necessary for cell function. Muscle-Link's Omega Stak has an optimal blend of omega-6 and omega-3 oils. Fish oil contains specific omega-3 fatty acids that have beneficial effects on both fat loss and muscle recovery. Most people would benefit from using three to six grams of fish oil containing EPA and DHA a day. I use the Twinlab product.

Ephedra-and-caffeine combinations are very effective for fat loss or for a stimulant boost before a workout. Excessive use of ephedra and caffeine has been associated with death and injury. Some people with medical conditions may also be at risk from using such products. No one should exceed the recommended dose. Many organizations, such as the NCAA, the IOC and the NFL, have banned the use of ephedra. I've heard positive comments regarding Xenadrine, Ripped Fuel and Ultimate Diet Fuel.

That supplement stack should provide very noticeable results for an experienced adult bodybuilder. Again, there may be side effects related to the use of some of the products, so each person must weigh the risks and benefits accordingly and discuss them with his physician. The financial cost of such a supplement stack might be around $300 per month, depending on where the products are purchased.

Q: Can you clarify the high-volume training you talked about a few months ago? I didn't get it. Isn't high volume the wrong way to train?

A: You're not the only one who let me know that high-volume training doesn't work. I agree. Performing long workouts every day of the week isn't beneficial for muscle growth, especially in the long term. Muscle growth is as dependent on rest and recovery as it is on the training stimulus. A high-volume approach could be effective for a specific muscle group for a short period'two or three weeks. The strategy is to shock the muscle by changing the training stimulus. Most trainers and strength coaches preach the importance of changing sets-and-reps combinations. The trend for the past several years has been a minimalist approach, most clearly explained by Mike Mentzer in his Heavy Duty principles.

Here's an example of a specific high-volume approach: Use a split routine for the other muscle groups'chest and triceps on Monday, back and traps on Wednesday, quads and hams on Friday'then train biceps Tuesday and Thursday (though Tuesday and Friday would be better, with quads and hams on Thursday rather than Friday). Work biceps using a high number of sets, strip sets, giant sets and supersets. The short-term high-volume approach may provide the stimulus for a lagging muscle group to become balanced with other muscle groups.

Use high-volume training as a change of pace. It should not be used for all muscle groups during the same period. If you did five or six high-volume training sessions in a row, you'd become overtrained quickly and lose muscle.

Q: I have a pinched nerve or something in my neck. I get a sharp pain down the back and side of my neck during almost every workout. Should I see a doctor?

A: Anytime you ask, 'Should I see a doctor?' the answer is clear. You should. Most people ignore an injury, hoping to save the cost of a doctor's visit. In the case of a neck injury, it's important to get it evaluated, as there can be some serious consequences to letting the injury progress. It may be something serious, such as a herniated disk.

One common injury in weightlifters that's not very serious is muscle spasms of the trapezius or the sternocleidomastoid, the two major muscles of the neck. About 90 percent of the time they occur because people turn their heads to look in the mirror while lifting. Those muscles, as well as most of the muscles along the spine'remember that the neck is a part of the spine'need to be tense to maintain a rigid structure while lifting. The most stable position is straight forward, as opposed to turning or twisting your body.

Many people twist their necks to watch their arms while curling or performing triceps pushdowns or even to see themselves squat in a side mirror, supposedly to make sure they hit parallel. That's a recipe for disaster, as the neck can spasm. If you're using heavy weight, the risk of other injuries can be quite serious.

Bottom line: If you have an injury that's bothering you enough to consider seeing a doctor, do it as soon as possible. If you're experiencing neck spasms while lifting and find that you're twisting your neck or trunk to see the mirror, stop doing it immediately. Proper form is essential to long-term lifting success.

Editor's note: Daniel Gwartney, M.D., is a clinical pathologist and a graduate of the University of Nebraska College of Medicine. He's been bodybuilding for more than 18 years. The material presented in this column is for general-information purposes only and is not to be construed as medical advice or an individual recommendation. Consult with your physician or health care provider before embarking on any fitness, training, diet or supplementation program. The author and IRONMAN assume no liability for the information contained in this column. IM

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