Bodybuilding

The Farnese Hercules, 216 AD

Stone-lifting traditions were practiced in ancient Egypt, Greece, and Tamilakam.[5] Western weightlifting developed in Europe from 1880 to 1953, with strongmen displaying feats of strength for the public and challenging each other. The focus was not on their physique, and they often had large bellies and fatty limbs.[6]

Eugen Sandow, often referred to as the "Father of Modern Bodybuilding"

Bodybuilding developed in the late 19th century, promoted in England by German Eugen Sandow, now considered as the "Father of Modern Bodybuilding". He allowed audiences to enjoy viewing his physique in "muscle display performances". Although audiences were thrilled to see a well-developed physique, the men simply displayed their bodies as part of strength demonstrations or wrestling matches. Sandow had a stage show built around these displays through his manager, Florenz Ziegfeld. The Oscar-winning 1936 musical film The Great Ziegfeld depicts the beginning of modern bodybuilding, when Sandow began to display his body for carnivals.

Sandow was so successful at flexing and posing his physique that he later created several businesses around his fame, and was among the first to market products branded with his name. He was credited with inventing and selling the first exercise equipment for the masses: machined dumbbells, spring pulleys, and tension bands. Even his image was sold by the thousands in "cabinet cards" and other prints. Sandow was a perfect "Gracilian", a standard of ideal body proportions close to those of ancient Greek and Roman statues. Men's physiques were then judged by how closely they matched these proportions.

Sandow organized the first bodybuilding contest on September 14, 1901, called the "Great Competition". It was held at the Royal Albert Hall in London.[7] Judged by Sandow, Sir Charles Lawes, and Sir Arthur Conan Doyle, the contest was a great success and many bodybuilding enthusiasts were turned away due to the overwhelming amount of audience members. The trophy presented to the winner was a gold statue of Sandow sculpted by Frederick Pomeroy. The winner was William L. Murray of Nottingham. The silver Sandow trophy was presented to second-place winner D. Cooper. The bronze Sandow trophy — now the most famous of all — was presented to third-place winner A.C. Smythe. In 1950, this same bronze trophy was presented to Steve Reeves for winning the inaugural NABBA Mr. Universe contest. It would not resurface again until 1977 when the winner of the IFBB Mr. Olympia contest, Frank Zane, was presented with a replica of the bronze trophy. Since then, Mr. Olympia winners have been consistently awarded a replica of the bronze Sandow.

From December 28, 1903 to January 2, 1904,[8] the first large-scale bodybuilding competition in America took place at Madison Square Garden in New York City. The competition was promoted by Bernarr Macfadden, the father of physical culture and publisher of original bodybuilding magazines such as Health & Strength. The winner was Al Treloar, who was declared "The Most Perfectly Developed Man in the World".[9] Treloar won a $1,000 cash prize, a substantial sum at that time. Two weeks later, Thomas Edison made a film of Treloar's posing routine. Edison had also made two films of Sandow a few years before. Those were the first three motion pictures featuring a bodybuilder. In the early 20th century, Macfadden and Charles Atlas continued to promote bodybuilding across the world.

Many other important bodybuilders in the early history of bodybuilding prior to 1930 include: Earle Liederman (writer of some of bodybuilding's earliest books), Zishe Breitbart, Georg Hackenschmidt, Emy Nkemena, George F. Jowett, Finn Hateral (a pioneer in the art of posing), Frank Saldo, Monte Saldo, William Bankier, Launceston Elliot, Sig Klein, Sgt. Alfred Moss, Joe Nordquist, Lionel Strongfort ("Strongfortism"),[10] Gustav Frištenský, Ralph Parcaut (a champion wrestler who also authored an early book on "physical culture"), and Alan P. Mead (who became an impressive muscle champion despite the fact that he lost a leg in World War I). Actor Francis X. Bushman, who was a disciple of Sandow, started his career as a bodybuilder and sculptor's model before beginning his famous silent movie career.

Bodybuilding became more popular in the 1950s and 1960s with the emergence of strength and gymnastics champions, and the simultaneous popularization of bodybuilding magazines, training principles, nutrition for bulking up and cutting down, the use of protein and other food supplements, and the opportunity to enter physique contests. The number of bodybuilding organizations grew, and most notably the International Federation of Bodybuilders (IFBB) was founded in 1946 by Canadian brothers Joe and Ben Weider. Other bodybuilding organizations included the Amateur Athletic Union (AAU), National Amateur Bodybuilding Association (NABBA), and the World Bodybuilding Guild (WBBG). Consequently, the contests grew both in number and in size. Besides the many "Mr. XXX" (insert town, city, state, or region) championships, the most prestigious titles were Mr. America, Mr. World, Mr. Universe, Mr. Galaxy, and ultimately Mr. Olympia, which was started in 1965 by the IFBB and is now considered the most important bodybuilding competition in the world.[1]

During the 1950s, the most successful and most famous competing bodybuilders were Bill Pearl, Reg Park, Leroy Colbert, and Clarence Ross. Certain bodybuilders rose to fame thanks to the relatively new medium of television, as well as cinema. The most notable were Jack LaLanne, Steve Reeves, Reg Park, and Mickey Hargitay. While there were well-known gyms throughout the country during the 1950s (such as Vince's Gym in North Hollywood, California and Vic Tanny's chain gyms), there were still segments of the United States that had no "hardcore" bodybuilding gyms until the advent of Gold's Gym in the mid-1960s. Finally, the famed Muscle Beach in Santa Monica continued its popularity as the place to be for witnessing acrobatic acts, feats of strength, and the like. The movement grew more in the 1960s with increased TV and movie exposure, as bodybuilders were typecast in popular shows and movies.[5]

Ed Fury posing with model Jackie Coey in 1953

In the 1970s, bodybuilding had major publicity thanks to the appearance of Arnold Schwarzenegger, Franco Columbu, Lou Ferrigno, and others in the 1977 docudrama Pumping Iron. By this time, the IFBB dominated the competitive bodybuilding landscape and the Amateur Athletic Union (AAU) took a back seat. The National Physique Committee (NPC) was formed in 1981 by Jim Manion,[11] who had just stepped down as chairman of the AAU Physique Committee. The NPC has gone on to become the most successful bodybuilding organization in America and is the amateur division of the IFBB. The late 1980s and early 1990s saw the decline of AAU-sponsored bodybuilding contests. In 1999, the AAU voted to discontinue its bodybuilding events.

This period also saw the rise of anabolic steroids in bodybuilding and many other sports. In bodybuilding lore, this is partly attributed to the rise of "mass monsters", beginning with Arnold Schwarzenegger, Sergio Oliva, and Lou Ferrigno in the late 1960s and early 1970s, and continuing through the 1980s with Lee Haney, the 1990s with Dorian Yates, Ronnie Coleman, and Markus Rühl, and up to the present day. Bodybuilders such as Greg Kovacs attained mass and size never seen previously but were not successful at the pro level. Others were renowned for their spectacular development of a particular body part, like Tom Platz or Paul Demayo for their leg muscles. At the time of shooting Pumping Iron, Schwarzenegger (while never admitting to steroid use until long after his retirement) said that "you have to do anything you can to get the advantage in competition". He would later say that he does not regret using anything.[12]

To combat anabolic steroid use and in the hopes of becoming a member of the IOC, the IFBB introduced doping tests for both steroids and other banned substances. Although doping tests occurred, the majority of professional bodybuilders still used anabolic steroids for competition. During the 1970s, the use of anabolic steroids was openly discussed, partly due to the fact they were legal.[13] In the Anabolic Steroid Control Act of 1990, U.S. Congress placed anabolic steroids into Schedule III of the Controlled Substances Act (CSA). In Canada, steroids are listed under Schedule IV of the Controlled Drugs and Substances Act, enacted by the federal Parliament in 1996.[14]

In 1990, professional wrestling promoter Vince McMahon announced that he was forming a new bodybuilding organization named the World Bodybuilding Federation (WBF). McMahon wanted to bring WWF-style showmanship and bigger prize money to the sport of bodybuilding. A number of IFBB stars were recruited but the roster was never very large and featured the same athletes competing; the most notable winner and first WBF champion was Gary Strydom. McMahon formally dissolved the WBF in July 1992. Reasons for this reportedly included lack of income from the pay-per-view broadcasts of the contests, slow sales of the WBF's magazine Bodybuilding Lifestyles (later WBF Magazine), and the expense of paying multiple six-figure contracts while producing two TV shows and a monthly magazine.

Eight-time Mr. Olympia Ronnie Coleman in October 2009

In 2003, Joe Weider sold Weider Publications to AMI, which owns the National Enquirer. The position of president of the IFBB was filled by Rafael Santonja following the death of Ben Weider in October 2008. In 2004, contest promoter Wayne DeMilia broke ranks with the IFBB and AMI took over the promotion of the Mr. Olympia contest: in 2017 AMI took the contest outright.[15]

In the early 21st century, patterns of consumption and recreation similar to those of the United States became more widespread in Europe and especially in Eastern Europe following the collapse of the Soviet Union. This resulted in the emergence of whole new populations of bodybuilders from former Eastern Bloc states.

In the early 2000s, the IFBB was attempting to make bodybuilding an Olympic sport. It obtained full IOC membership in 2000 and was attempting to get approved as a demonstration event at the Olympics, which would hopefully lead to it being added as a full contest. This did not happen and Olympic recognition for bodybuilding remains controversial since many argue that bodybuilding is not a sport.[16]

Three-time Mr. Olympia Frank Zane, said to have the greatest physique in the history of bodybuilding due to his meticulous focus on symmetry and proportion[17][18]

In the modern bodybuilding industry, the term "professional" generally means a bodybuilder who has won qualifying competitions as an amateur and has earned a "pro card" from their respective organization. Professionals earn the right to compete in competitions that include monetary prizes. A pro card also prohibits the athlete from competing in federations other than the one from which they have received the pro card.[19] Depending on the level of success, these bodybuilders may receive monetary compensation from sponsors, much like athletes in other sports.

Due to the growing concerns of the high cost, health consequences, and illegal nature of some steroids, many organizations have formed in response and have deemed themselves "natural" bodybuilding competitions. In addition to the concerns noted, many promoters of bodybuilding have sought to shed the "freakish" perception that the general public has of bodybuilding and have successfully introduced a more mainstream audience to the sport of bodybuilding by including competitors whose physiques appear much more attainable and realistic.[20]

In natural contests, the testing protocol ranges among organizations from lie detectors to urinalysis. Penalties also range from organization to organization from suspensions to strict bans from competition. It is also important to note that natural organizations also have their own list of banned substances and it is important to refer to each organization's website for more information about which substances are banned from competition. There are many natural bodybuilding organizations; some of the larger ones include: MuscleMania, Ultimate Fitness Events (UFE), INBF/WNBF, and INBA/PNBA. These organizations either have an American or worldwide presence and are not limited to the country in which they are headquartered.[20]

Due to the number of people who found bodybuilding to be "too big" or "ugly" and unhealthy, a new category was started in 2013. The first MR. Olympia was Mark Wingson, which was followed by Jeremy Buendia for consecutive years. Like bodybuilding, the federations in which you can compete in are all the same, there is natural and regular as well but the main difference between the two is that men's physique pose in board shorts rather than a traditional posing suit. Bodybuilders are much larger than the men physique competitors as well as have an extensive routine when posing while the Physique category only gets judged by the front and back poses. Many of the competitors are not too large and have a bit of a more attainable and aesthetic physique in comparison to bodybuilding. Although this category started off slow, it grew tremendously in the past 5 years, now Men's Physique seems to be the most popular class to be in.

This is the middle ground of both Men's Physique and Bodybuilding. The competitors in this category are not nearly as big as bodybuilders but not as small as mens physique competitors. They pose and perform in mens boxer briefs to show off the legs, unlike Mens Physique which hide the legs in board shorts. Classic physique has only been around for 3 years now as it started in 2016. Danny Hester was the first Classic Physique Mr. Olympia and now Chris Bumstead is the 2019 Mr. Olympia.

Nikki Fuller posing

The first U.S. Women's National Physique Championship, promoted by Henry McGhee and held in Canton, Ohio in 1978, is generally regarded as the first true female bodybuilding contest—that is, the first contest where the entrants were judged solely on muscularity.[21] In 1980, the first Ms. Olympia (initially known as the "Miss" Olympia), the most prestigious contest for professionals, was held. The first winner was Rachel McLish, who had also won the NPC's USA Championship earlier in the year. The contest was a major turning point for female bodybuilding. McLish inspired many future competitors to start training and competing.

In 1985, the documentary Pumping Iron II: The Women was released. It documented the preparation of several women for the 1983 Caesars Palace World Cup Championship. Competitors prominently featured in the film were Kris Alexander, Lori Bowen, Lydia Cheng, Carla Dunlap, Bev Francis, and McLish. At the time, Francis was actually a powerlifter, though she soon made a successful transition to bodybuilding, becoming one of the leading competitors of the late 1980s and early 1990s.

In recent years, the related areas of fitness and figure competition have increased in popularity, surpassing that of female bodybuilding, and have provided an alternative for women who choose not to develop the level of muscularity necessary for bodybuilding. McLish would closely resemble what is thought of today as a fitness and figure competitor, instead of what is now considered a female bodybuilder. Fitness competitions also have a gymnastic element to them. A study by the Clinical Journal of Sport Medicine found that female bodybuilders who are taking anabolic steroids are more likely to have qualified for substance dependence disorder, to have been diagnosed with a psychiatric illness, or to have a history of sexual abuse.[22]

E. Wilma Conner competed in the 2011 NPC Armbrust Pro Gym Warrior Classic Championships in Loveland, Colorado, at the age of 75 years and 349 days.[23]

Lukas Osladil posing onstage with a variation of the Most Muscular pose

The general strategy adopted by most present-day competitive bodybuilders is to make muscle gains for most of the year (known as the "off-season") and, approximately 12–14 weeks from competition, lose a maximum of body fat (referred to as "cutting") while preserving as much muscular mass as possible. The bulking phase entails remaining in a net positive energy balance (calorie surplus). The amount of a surplus in which a person remains is based on the person's goals, as a bigger surplus and longer bulking phase will create more fat tissue. The surplus of calories relative to one's energy balance will ensure that muscles remain in a state of anabolism.[26]

The cutting phase entails remaining in a net negative energy balance (calorie deficit). The main goal of cutting is to oxidize fat while preserving as much muscle as possible. The larger the calorie deficit, the faster one will lose weight. However, a large calorie deficit will also create the risk of losing muscle tissue.[27]

The bulking and cutting strategy is effective because there is a well-established link between muscle hypertrophy and being in a state of positive energy balance.[28] A sustained period of caloric surplus will allow the athlete to gain more fat-free mass than they could otherwise gain under eucaloric conditions. Some gain in fat mass is expected, which athletes seek to oxidize in a cutting period while maintaining as much lean mass as possible.

The attempt to increase muscle mass in one's body without any gain in fat is called clean bulking. Competitive bodybuilders focus their efforts to achieve a peak appearance during a brief "competition season".[29] Clean bulking takes longer and is a more refined approach to achieving the body fat and muscle mass percentage a person is looking for. A common tactic for keeping fat low and muscle mass high is to have higher calorie and lower calorie days to maintain a balance between gain and loss. Many clean bulk diets start off with a moderate amount of carbs, moderate amount of protein, and a low amount of fats.[30] To maintain a clean bulk, it is important to reach calorie goals every day. Macronutrient goals (carbs, fats, and proteins) will be different for each person, but it is ideal to get as close as possible.

"Dirty bulking" is the process of eating at a massive caloric surplus without trying to figure out the exact amount of ingested macronutrients. Weightlifters who are attempting to gain mass quickly with no aesthetic concerns often choose to use the "dirty bulk" method.[31] Many non-competitive bodybuilders choose not to adopt this conventional strategy, as it often results in significant unwanted fat gain during the "bulking" phase.

In the last week leading up to a contest, bodybuilders usually decrease their consumption of water, sodium, and carbohydrates, the former two to alter how water is retained by the body and the latter to reduce glycogen in the muscle. The day before the show, water is removed from the diet, and diuretics may be introduced, while carbohydrate loading is undertaken to increase the size of the muscles through replenishment of their glycogen. The goal is to maximize leanness and increase the visibility of veins, or "vascularity". The muscular definition and vascularity are further enhanced immediately before appearing on stage by darkening the skin through tanning products and applying oils to the skin to increase shine. Some competitors will eat sugar-rich foods to increase the visibility of their veins. A final step, called "pumping", consists in performing exercises with light weights or other kinds of low resistance (for instance two athletes can "pump" each other by holding a towel and pulling in turn), just before the contest, to fill the muscles with blood and further increase their size and density.

Intensive weight training causes micro-tears to the muscles being trained; this is generally known as microtrauma. These micro-tears in the muscle contribute to the soreness felt after exercise, called delayed onset muscle soreness (DOMS). It is the repair of these micro-traumas that results in muscle growth. Normally, this soreness becomes most apparent a day or two after a workout. However, as muscles become adapted to the exercises, soreness tends to decrease.[32]

Weight training aims to build muscle by prompting two different types of hypertrophy: sarcoplasmic and myofibrillar. Sarcoplasmic hypertrophy leads to larger muscles and so is favored by bodybuilders more than myofibrillar hypertrophy, which builds athletic strength. Sarcoplasmic hypertrophy is triggered by increasing repetitions, whereas myofibrillar hypertrophy is triggered by lifting heavier weight.[33] In either case, there is an increase in both size and strength of the muscles (compared to what happens if that same individual does not lift weights at all), however, the emphasis is different.

Many trainees like to cycle between the two methods in order to prevent the body from adapting (maintaining a progressive overload), possibly emphasizing whichever method more suits their goals; typically, a bodybuilder will aim at sarcoplasmic hypertrophy most of the time but may change to a myofibrillar hypertrophy kind of training temporarily in order to move past a plateau. However, no real evidence has been provided to show that trainees ever reach this plateau, and rather was more of a hype created from "muscular confusion".

The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[34] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[35]

Carbohydrates play an important role for bodybuilders. They give the body energy to deal with the rigors of training and recovery. Carbohydrates also promote secretion of insulin, a hormone enabling cells to get the glucose they need. Insulin also carries amino acids into cells and promotes protein synthesis.[36] Insulin has steroid-like effects in terms of muscle gains.[37] It is impossible to promote protein synthesis without the existence of insulin, which means that without ingesting carbohydrates or protein—which also induces the release of insulin—it is impossible to add muscle mass.[38] Bodybuilders seek out low-glycemic polysaccharides and other slowly digesting carbohydrates, which release energy in a more stable fashion than high-glycemic sugars and starches. This is important as high-glycemic carbohydrates cause a sharp insulin response, which places the body in a state where it is likely to store additional food energy as fat. However, bodybuilders frequently do ingest some quickly digesting sugars (often in form of pure dextrose or maltodextrin) just before, during, and/or just after a workout. This may help to replenish glycogen stored within the muscle, and to stimulate muscle protein synthesis.[39]

Protein milkshakes, made from protein powder (center) and milk (left), are a common supplement

The motor proteins actin and myosin generate the forces exerted by contracting muscles. Cortisol decreases amino acid uptake by muscle and inhibits protein synthesis.[40] Current recommendations suggest that bodybuilders should consume 25–30% of protein per total calorie intake to further their goal of maintaining and improving their body composition.[41] This is a widely debated topic, with many arguing that 1 gram of protein per pound of body weight per day is ideal, some suggesting that less is sufficient, while others recommending 1.5, 2, or more.[42] It is believed that protein needs to be consumed frequently throughout the day, especially during/after a workout, and before sleep.[43] There is also some debate concerning the best type of protein to take. Chicken, turkey, beef, pork, fish, eggs and dairy foods are high in protein, as are some nuts, seeds, beans, and lentils. Casein or whey are often used to supplement the diet with additional protein. Whey is the type of protein contained in many popular brands of protein supplements and is preferred by many bodybuilders because of its high biological value (BV) and quick absorption rates. Whey protein also has a bigger effect than casein on insulin levels, triggering about double the amount of insulin release.[44] That effect is somewhat overcome by combining casein and whey.

Bodybuilders were previously thought to require protein with a higher BV than that of soy, which was additionally avoided due to its alleged estrogenic (female hormone) properties, though more recent studies have shown that soy actually contains phytoestrogens which compete with estrogens in the male body and can block estrogenic actions.[45] Soy, flax, and other plant-based foods that contain phytoestrogens are also beneficial because they can inhibit some pituitary functions while stimulating the liver's P450 system (which eliminates hormones, drugs, and waste from the body) to more actively process and excrete excess estrogen.[46] Contrary to the common belief that animal-based protein is more suitable to trigger muscle growth than plant-based protein, a 2017 study published in The American Journal of Clinical Nutrition found that the proper combination of plant protein can actually have a higher biological value than animal protein.[47] A combination of wheat protein (e.g. seitan) and soy protein (e.g. tofu) has thus been favored by bodybuilders who follow a strict vegan diet, such as Patrik Baboumian[48] and Robert Cheeke.[49] An increasing number of non-bodybuilding athletes have also turned to veganism; while nine-time Olympic gold medalist Carl Lewis has been a vegan since 1990,[50] other sportspeople have adopted the diet more recently, including boxer David Haye,[51] mixed martial artists Nick[52] and Nate Diaz,[53] and numerous players in the National Football League (NFL)[54] and English Premier League (EPL).[55]

Some bodybuilders often split their food intake into 5 to 7 meals of equal nutritional content and eat at regular intervals (e.g., every 2 to 3 hours). This approach serves two purposes: to limit overindulging in the cutting phase, and to allow for the consumption of large volumes of food during the bulking phase. Eating more frequently does not increase basal metabolic rate when compared to 3 meals a day.[56] While food does have a metabolic cost to digest, absorb, and store, called the thermic effect of food, it depends on the quantity and type of food, not how the food is spread across the meals of the day. Well-controlled studies using whole-body calorimetry and doubly labeled water have demonstrated that there is no metabolic advantage to eating more frequently.[57][58][59]

The important role of nutrition in building muscle and losing fat means bodybuilders may consume a wide variety of dietary supplements.[60] Various products are used in an attempt to augment muscle size, increase the rate of fat loss, improve joint health, increase natural testosterone production, enhance training performance and prevent potential nutrient deficiencies.

Most bodybuilders use drugs such as anabolic steroids and precursor substances such as prohormones to increase muscle hypertrophy. Anabolic steroids cause hypertrophy of both types (I and II) of muscle fibers, likely caused by an increased synthesis of muscle proteins. They also provoke undesired side effects including hepatotoxicity, gynecomastia, acne, the early onset of male pattern baldness and a decline in the body's own testosterone production, which can cause testicular atrophy.[61][62][63] Other performance-enhancing substances used by competitive bodybuilders include human growth hormone (HGH). HGH is also used by female bodybuilders to obtain bigger muscles "while maintaining a 'female appearance'".[64]

Muscle growth is more difficult to achieve in older adults than younger adults because of biological aging, which leads to many metabolic changes detrimental to muscle growth; for instance, by diminishing growth hormone and testosterone levels. Some recent clinical studies have shown that low-dose HGH treatment for adults with HGH deficiency changes the body composition by increasing muscle mass, decreasing fat mass, increasing bone density and muscle strength, improves cardiovascular parameters, and affects the quality of life without significant side effects.[65][66][67]

In rodents, knockdown of metallothionein gene expression results in activation of the Akt pathway and increases in myotube size, in type IIb fiber hypertrophy, and ultimately in muscle strength.[68]

A recent trend in bodybuilding is to inject synthol[69] into muscles to create larger bulges, or injecting PMMA into muscles to shape them. Use of PMMA to shape muscles is prohibited in the United States.[70]

Site enhancement oil, often called santol or synthol (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lacking.[71] This is known as "fluffing".[72][73] Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol.[72] It is not restricted, and many brands are available on the Internet.[74] The use of injected oil to enhance muscle appearance is common among bodybuilders,[75][76] despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[77] stroke,[72] and the formation of oil-filled granulomas, cysts or ulcers in the muscle.[76][78][79] Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.[80]

Sesame oil is often used in such mixtures, which can cause allergic reactions such as vasculitis.[81]

As the injected muscle is not actually well-developed, it might droop under gravity.[74]

Although muscle stimulation occurs in the gym (or home gym) when lifting weights, muscle growth occurs afterward during rest periods. Without adequate rest and sleep (6 to 8 hours), muscles do not have an opportunity to recover and grow. Additionally, many athletes find that a daytime nap further increases their body's ability to recover from training and build muscles. Some bodybuilders add a massage at the end of each workout to their routine as a method of recovering.[82]

Overtraining occurs when a bodybuilder has trained to the point where their workload exceeds their recovery capacity. There are many reasons why overtraining occurs, including lack of adequate nutrition, lack of recovery time between workouts, insufficient sleep, and training at a high intensity for too long (a lack of splitting apart workouts). Training at a high intensity too frequently also stimulates the central nervous system (CNS) and can result in a hyperadrenergic state that interferes with sleep patterns.[83] To avoid overtraining, intense frequent training must be met with at least an equal amount of purposeful recovery. Timely provision of carbohydrates, proteins, and various micronutrients such as vitamins, minerals, phytochemicals, even nutritional supplements are acutely critical. A mental disorder, informally called “bigorexia” (by analogy with anorexia), may account for overtraining in some individuals. Sufferers feel as if they are never big enough or muscular enough, which forces them to overtrain in order to try to reach their goal physique.[84]

An article by Muscle & Fitness magazine, "Overtrain for Big Gains", claimed that overtraining for a brief period can be beneficial. Overtraining can be used advantageously, as when a bodybuilder is purposely overtrained for a brief period of time to super compensate during a regeneration phase. These are known as "shock micro-cycles" and were a key training technique used by Soviet athletes.[85]