Daily answer
Scott Rand
Which of the following is primarily associated with endurance training?
A. Ability to exert increased force
B. Increased protein content of muscle fibers
C. Fast to slow fiber transformation
D. Reduction of muscle capillary bed
E. Increased size of muscle fibers
Correct answer: (C) Fast to slow fiber transformation.
Explanation: There are specific long-term adaptations to exercise training related to endurance training and strength training. The type of training affects the type of of adaptation in skeletal muscle. Endurance training results in adaptations in muscle and cardiopulmonary function that increase both maximal oxygen uptake and lactate threshold. Endurance training results in skeletal muscle mitochondrial biogenesis, fast to slow fiber transformation, expansion of the muscle capillary bed, and changes in metabolism of substrates. Resistance training is associated with increased muscle fiber size. The protein content of muscle fiber also changes in resistance training, leading to the ability to increase force.
(A) This is associated with resistance training.
(B) Increased protein content of muscle fibers is associated with resistance training.
(D) The muscle capillary bed increases in size with endurance training.
(E) Increased size of muscle fibers is the result of resistance training.
https://www.uptodate.com/contents/exercise-physiology? source=search_result&search=exercise&selectedTitle=5~150#H4034285 (http://www.uptodate.com/contents/exercise-physiology?
Scott E Rand, MD FAAFP CAQSM
Director, Primary Care Sports Medicine Fellowship
Co Director of Sports Medicine, Houston Methodist Orthopedics and Sports Medicine Willowbrook
Assistant Professor of Clinical Family Medicine Houston Methodist Academic Institute
Adjunct Assistant Professor of Family and Community Medicine, Texas A&M University
Assistant Professor of Family Medicine in Clinical Medicine Weill Cornell Medical College.
13802 Centerfield Dr Suite 300
Houston, TX 77070
Scott Rand
Which of the following
best describes the primary benefit of early controlled loading in sports injury
rehabilitation?
A. It minimizes tissue oxygenation to prevent fibrosis
B. It promotes collagen alignment and functional recovery
C. It eliminates the need for neuromuscular retraining
D. It replaces the need for sport‑specific progression
Correct Answer: B
Correct Answer: B – It promotes collagen alignment and functional recovery
Explanation:
Early controlled loading enhances mechanotransduction, stimulates proper
collagen alignment, and contributes to functional recovery by restoring
neuromuscular activation. Prolonged immobilization delays healing and increases
reinjury risk, whereas structured loading accelerates return‑to‑play readiness.
[phyedusports.in]
Scott Rand
What is the primary adaptation in skeletal muscle that delays lactate accumulation during prolonged training?
Expected Answer: Increased mitochondrial density and oxidative enzyme activity, enhancing aerobic metabolism. Reference: Draper N, Williams C, Marshall H. Exercise Physiology for Health and Sports Performance, 2nd ed. Routledge; 2024
Scott Rand
All of the following are physiologic adaptations to aerobic conditioning except:
A. Increased ventricular wall thickness and decreased internal diameter
B. Larger stroke volume
C. Lower-end systolic volume
D. Lower resting heart rate
Correct answer is A. Cardiac adaptations include increased ventricular wall thickness and INCREASED internal diameter, leading to increased stroke volume, reduced end diastolic volume and a reduced heart rate at rest.
Scott Rand
In order to avoid overtraining, athletes can initiate training principles that include the use of microcycles, mesocycles and macrocycles. This type of training is called
A. Accommodation training
B. Periodization training
C. Progressive overload training
D. Optimization training
Correct: B
Periodization is a way to implement structural variation into a training program. In this form of training, one or more program variables are altered over time to maintain an optimum stimulus. Cycles of this training technique use differing amounts of rest and activity as well as intensity and duration of training to maximize performance.
1. ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription, 5th Ed. Lippincott, Williams, and Wilkins, 2006
Scott Rand
A 26 year old African American female presents to the medical treatment tent you are staffing at a large cross country ski race in upper Wisconsin. She is complaining of painful edematous purple lesions on her face. She is in excellent health, an avid cross country runner from southern Illinois. She denies pregnancy or any medical problems. She does not seem to be in any acute distress. She and her friends have been taking “nips” out of a pocket flask containing Blackberry brandy. Which of the following is true?
A. She has classic Pernio or chilblain
B. She should immediately stop the race and be transported to the main medical tent 10 kilometers away via ambulance
C. She can go back out after applying protective UV cold barrier ointment on her face
D. She should quickly rewarm her face by sitting next to the propane gas warmer in the tent
E. It is best to warm her face slowly using cool water then to slowly apply heated water to prevent further tissue damage
Correct: A
The patient has classic Pernio, or chilblain, which is characterized by localized inflammatory lesions that result from acute or repetitive exposure to cold. The lesions are edematous, often purple, and are most common in young women. It is one of the milder forms of a cold injury. First degree frostbite is characterized by a central area of pallor and anesthesia of the skin surrounded by edema. A second degree frostbite is recognized by blisters containing a clear milky fluid surrounded by edema and erythema. Third degree frostbite differs from second degree frostbite as the injury is deeper and blisters are hemorrhagic. Alcohol use predisposes cold injury. Risk factors include smoking, previous cold injury and exposure of hands and arms to vibration. African-American women may be at increased risk of cold injury.
This patient does not have any other physical signs that would require immediate transportation to the main medical tent. The best medical advice would be to simply stop the race at this point, and get her to a warm environment. In some areas protective ointments applied to the face have been advocated, this may actually increase the risk of a cold injury. The area should be warmed as soon as possible and it is best to get the patient into a warm environment and remove wet clothing. Stoves or open fires used to rewarm frostbitten tissue is not recommended as the tissue is insensitive and thermal injury can occur. If necessary, it is best to rewarm the area in a water bath 40°C to 42°C which feels warm, but not hot, to the patient.
1. Frostbite. UpToDate. February 11 2008. http://www.uptodate.com. Accessed May 2, 2008.
2. Petrone P, Kuncir EJ, Asensio JA. Surgical management and strategies in the treatment of hypothermia and cold injury. Emerg Med Clin North Am 2003;21:1165.
3. Simon TD, Soep JB, Hollister JR. Pernio in pediatrics. Pediatrics 2005;116:e472.