Introduction: The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study: To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods: Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated, and then analyzed by experienced raters. The raters then were asked to analyze the images using open-source software for scaling measurements, subcutaneous fat thickness, cross-sectional area, and echo intensity. Matched image values for each measurement where compared for intra- and inter-rater reliability. Results: Intra-rater reliability ranged from fair (ICC3,1 = 0.32) to high (0.98), with echo intensity values being the least reliable (>0.55), and scaling and depth measurements being the most reliable (<0.85). Inter-rater reliability ranged from good (0.77) to high (0.97). Conclusion: Ultrasound- derived measures of cross-sectional area and echo intensity can be measured reliably, with echo intensity being the most difficult to replicate. However, reliability measures are unique to the rater and study and, therefore, should be clearly reported in every paper.

This narrative review explores the intricate relationship between circadian regulation and exercise performance, emphasizing the importance of aligning training strategies with the body’s natural physiological fluctuations. The three key mechanisms investigated are temperature, hormonal fluctuations, and diurnal chronotype—an individuals’ exhibition of enhanced physical or cognitive performance at specific times of day. Core body temperature variations impact exercise performance, suggesting strategic workout timing and intensity adjustments. Hormonal patterns (i.e., insulin, cortisol, testosterone) influence energy metabolism and muscle growth, informing tailored training plans. Diurnal chronotypes significantly affect performance, advocating for personalized training sessions based on individual preferences and entrained awakening. Integrating circadian mechanisms into training offers strategic advantages, guiding practitioners to design effective, personalized regimens, though we acknowledge relevant challenges and the need for further research.

The aim of this study is to explore the relationships between internal and external load measures in American football. Thirty football players wore a portable integrated monitor unit for 10 weeks during the fall football season. Relationships between internal and external load measurements were determined. Internal load consisted of heart rate zones and heart rate-derived measures and session Ratings of Perceived Exertion (sRPE). External load consisted of distance in different speed zones, total distance traveled, and accelerations. There were many significant positive relationships, but the meaningful relationships (r > 0.5) were between heart rate-derived measures of load (Training Impulse and heart rate reserve) and low-intensity movement and total distance. Only accelerations between 1 and 1.99 m·s⁻² were moderately correlated to heart rate-derived internal load. RPE values alone did not correlate strong enough with any of the measure but sRPE training load (sRPE-TL) correlated to most external values. Overall, moderate correlations were present between heart rate-derived internal load to total distance and lower intensity movement. sRPE-TL values had high correlations but were highly dependent on duration, not perceived exertion. When addressing load in American football, duration of the session is a key component in determining internal load as HR data and sRPE alone do not correlate highly with external loads.

Prior to training, many athletes perform different soft-tissue preparation protocols. Many of these protocols involve stretching, foam rolling, and/or percussion massage. Many of these modalities have been studied, but not as a group to observe muscle alterations and differences in males and females. In total, 40 (20 males, 20 females) participants performed five minutes of static stretching, foam rolling, and percussion massage. Pre- and post-isometric leg strength, muscle activation and ultrasound assessments (cross-sectional area, echo intensity, pennation angle, fascicle length, and muscle thickness) were taken. The results indicate that there is no significant difference among modalities, and that they do not significantly alter any muscle characteristic or improve performance. There is a significant difference in size between males and female, with males having larger muscle and greater pennation angles than females. This allows males to generate significantly more muscle force. However, they both respond similarly to each modality. In conclusion, the muscle response to static stretching, foam rolling, and percussion massage do not differ among modalities and do not contribute to an increase or decrease in maximal isometric knee extension with similar effects between males and females.