A concise synthesis of the NSCA Tactical Annual Training session (Season 6)

Reviewed by John Baur, PT, DPT, OCS, CSCS, FAAOMPT

What is “micro‑dosed” training?

The presenters define micro‑dosed programming as distributing the same weekly or micro‑cycle workload across multiple, very short sessions—often ≤ 15 minutes—rather than packing it into a few long workouts. Typical duty days for military, fire, and law‑enforcement personnel are fragmented; sliding in several bite‑sized bouts (e.g., a five‑exercise strength cluster at morning muster, a 10‑minute HIIT block before lunch, and a mobility finisher at shift‑change) keeps cumulative volume high without overwhelming the training calendar.

Tactical advantages at a glance

Key programming principles

1. Volume is sacrosanct – keep weekly tonnage or total sprint distance identical to a traditional plan; only the density changes.
2. Frequency ↑, session length ↓ – most models use 5–10 micro‑sessions per week.
3. Multi‑joint > single‑joint – compound lifts yield the greatest stimulus‑to‑time ratio (e.g., trap‑bar deadlift, push‑ups, kettlebell swings).
4. Brief dynamic warm‑ups – substitute lengthy mobility routines with 1–2 sub‑maximal sets or movement‑specific drills to preserve minutes.
5. Intensity stays on target – load (% 1RM), velocity, or target heart‑rate zone remains aligned with the training goal; only rest intervals and bout duration shrink.
6. Strategic recovery – pepper easy mobility or breathing sessions between high‑output days to modulate fatigue.

Evidence snapshot

(All three studies are referenced in the official NSCA quiz hand‑out)

Implementation template for a 5‑day duty roster

Common pitfalls & solutions

Test your grasp

Bottom line for TSAC facilitators

Micro‑dosed programming lets you “thread the needle” between operational chaos and physiological progression. By keeping the volume constant, intensity appropriate, and sessions surgically brief, you can maintain—and often improve—strength, power, and conditioning without monopolizing precious duty hours. Pair the model with smart monitoring (RPE, wellness checks) and it becomes a sustainable, evidence‑backed strategy for tactical populations year‑round.

A Brief Systematic Review and Meta analysis (Strength & Conditioning Journal, 2025)

Reviewed by John Baur, PT, DPT, OCS CSCS, FAAOMPT

This systematic review and meta‑analysis set out to determine whether low‑load blood‑flow‑restriction (BFR) resistance training can match or outperform conventional traditional resistance training (TRT) for increasing muscle size, strength and endurance in healthy adults. Twenty randomized controlled trials (541 screened records, 20 included) met pre‑defined PICOS criteria; seven contributed hypertrophy data and nine contributed strength data to the quantitative analyses.

• Primary outcome – muscle hypertrophy: 17 of 20 trials reported significant growth with training. A pooled effect size of 0.045 (95 % CI –0.278 to 0.367) indicated no statistical difference between BFR and TRT for increases in whole‑muscle CSA or volume.
• Secondary outcome – strength: Nine studies entered the meta‑analysis (1 RM, isometric or isokinetic tests). The pooled effect size of –0.149 (95 % CI –0.439 to 0.141) likewise showed no significant difference in strength gains between modalities. Qualitative trends suggested TRT may yield faster early‑phase 1 RM gains (< 8 weeks), whereas BFR “catches up” with longer training (> 8 weeks).
• Muscle endurance: Only one study assessed endurance; both methods improved repetitions‑to‑failure equally, preventing firm conclusions.
• Contextual moderators: Rest intervals, training to failure, programme duration and athlete training status moderated results. For example, BFR out‑performed TRT for quadriceps hypertrophy in elite powerlifters—possibly due to the novel metabolic stress imposed by short‑rest, low‑load occlusion work.
• Safety profile: Across all trials no adverse events were reported, supporting BFR as a safe alternative when heavy loading is undesirable or contraindicated.

Practical takeaway: Coaches and clinicians can prescribe low‑load BFR to build muscle and strength when heavy loading is impractical, ensuring programmes run ≥ 8 weeks and use appropriately short rest intervals to maximise metabolic stress.

Reviewed by Madison Hof, SPT

Introduction

Treatment for tendinopathies should be viewed as a multimodal approach, targeting not only the peripheral tissue but the neuromuscular adaptations that occur with persistent pain as well. Addressing the corticospinal control of the muscle by motor activation as a result of excitatory and inhibitory inputs ultimately affects tendon loading and motor production. It is important to consider neuromuscular control of the asymptomatic side as well, comparing side-to-side differences as well as differences in motor control in people with and without tendinopathy.

Motor control in people with and without tendinopathy

Muscle strength is often studied in tendinopathy research as compared to motor control. It has been understood that there is no consistent pattern of strength or performance change (increase or decrease) in tendons being studied such as in Achilles, patellar and RTC tendinopathies as well as in diagnosis such as lateral epicondylalgia. Strength deficits coupled with the presence of tendinopathy has not been consistently demonstrated in past research to reasonably target the peripheral tissue’s power production alone without assessing the neuromuscular component of muscle activation.

Imbalances in recruitment ability of excitatory and inhibitory influences around the painful tendon during muscle loading were found when comparing symptomatic and asymptomatic sides of athletes with patella tendinopathy (PT). It has been hypothesized that a protective adaptation occurs, reducing the mechanical demand that is placed on the tendon. Both peripheral and central contributions are associated with motor control changes and those with PT demonstrated landing mechanic patterns with less variability than to those without PT. Motor patterns that are invariable implies that control coming from the corticospinal tract is altered and may be due to protective strategies. Jumping abilities with less variability has been shown to be a risk factor for developing PT. In fact, these individuals were shown to be better jumpers than those without PT, coining this phenomenon the ‘jumper’s knee paradox’. Therefore, movement variability has been hypothesized as an important attribute in preventing injury.

Pain is commonly accompanied with changes in motor control as an adaptive mechanism that protects us from bodily threat. Motor control while having painful symptoms is altered due to the corticospinal drive to the motor neuron or muscle. Furthermore, there were no differences in muscle strength or activation between groups suggesting that the motor task can cause a potential pain response during jumping even in the absence of nocioception.

Motor control changes may be bilateral

Side-to-side strength deficits were found to be low following unilateral Achilles tendinopathy surgery which may reflect bilateral motor control deficits. These changes following tendinopathy pain may also be system wide which can be due to intrinsic and extrinsic factors, potentially increasing the risk of tendinopathy elsewhere in the body. An increase in global sympathetic drive implies the nervous systems’ involvement in tendinopathies. For example, there is increased inhibition responses on an affected limb following a stroke and an increased corticospinal excitatory response on the unaffected limb. This indicates an increased interhemispheric inhibition from the non-affected hemisphere to the lesioned hemisphere leading to further inhibition on the affected limb during activation of the unaffected limb. Changes in the unaffected side associated with tendinopathies may be the bodies way to attempt motor control homeostasis while trying to protect a region. This may also explain the high injury prevalence of the contralateral tendon following rehabilitation.

Conclusion and clinical implications

In order to address the differences in excitability and inhibition, an alteration to corticospinal control of muscles must be acknowledged as seen in different motor strategies used for protection. Movement variability should be considered following musculoskeletal pain even if nocioceptive input is absent due to the fact that altered motor control could be transmitted to a tendon causing a continuation of previous nocioceptive input. Altered invariable movement patterns that occur with pain are presumed to optimize performance subconsciously. This is demonstrated in those with tendinopathy displaying superior strength and performance despite having inflamed peripheral tissues. Strength training is often the focus for individuals with tendinopathy to stimulate the physiological adaptation of the muscle/tendon, but it is now known that it can modulate pain and corticospinal control of the muscle as well. Rehabilitation should be considered bilaterally to address the unaffected side as well to prevent contralateral motor adaptations from developing.

References

Rio E, Kidgell D, Moseley GL, et al. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. British Journal of Sports Medicine. 2015;50(4):209-215. doi:https://doi.org/10.1136/bjsports-2015-095215