Clinical view of tendon mismatch and injury

Three weeks of stalled squats. The conventional answer is to switch programs because you've crossed into intermediate territory. The data says something else. In Part 3 of the Progressive Loading series, Dr. Jordan Feigenbaum and Dr. Austin Baraki walk through why the standard novice / intermediate / advanced framework runs into trouble in real training, what the four adaptive systems are actually doing across a training career, and why most of what gets called a stall is impatience with the noise floor at your current strength level.

This is Part 3 of the Progressive Loading series. Part 1 covered why loading should react to demonstrated adaptation. Part 2 covered RPE-based autoregulation and the artificial-momentum approach. Today is the mechanism layer.

Pre-order our book, Signal: barbellmedicine.com/signal

Timestamps

• 0:00 - Why your lifts aren't moving
• 1:52 - The novice / intermediate / advanced framework, three claims to test
• 13:23 - What 17 years of powerlifting data show about how long you keep getting stronger
• 32:28 - How getting stronger actually works (four systems on four clocks)
• 38:00 - What early growth is actually made of (the Damas 2016 deuterium study)
• 50:33 - The connective tissue lag and why early-training injuries happen
• 58:32 - Why heavy lifting works for bone density (and why "walk on a treadmill" advice misses)
• 1:05:10 - Why new lifters get hurt 3 to 10 times more than experienced lifters
• 1:12:56 - Fatigue is at least four different things (and most coaches treat it as one)
• 1:26:19 - The CNS fatigue myth (and what the data actually says)
• 1:33:52 - When the bar isn't moving: how to actually diagnose a stall
• 1:45:51 - Takeaways and next week's tease: leptin and low testosterone

What we cover 

- The novice / intermediate / advanced framework: three claims and why each one fails the data test

- The 17-year IPF strength curve and what the no-kink finding does and does not establish (Latella 2024)

- The four adaptive systems and their separate timescales (neural, muscle, connective tissue, bone)

- What early growth actually is, including the deuterium-oxide finding that most week-3 size is fluid (Damas 2016)

- Why connective tissue lags muscle by six to eight weeks, and why that produces patellar tendinopathy four months in

- The 9.5 vs 0.74 to 3.3 injury rate gap between novice and experienced CrossFit participants

- The CNS fatigue myth and the Skarabot 2018 finding that locates the fatigue in the muscle, not the brain

- Why the LIFTMOR trial result (heavy lifting for bone density in women in their 60s and 70s) is being missed by primary care

- A practical decision tree for stalls: environment first, then load, then program

- Tease for next week: leptin, the HPG axis, and the metabolic driver of low testosterone almost nobody connects

Resources 

Training Plateau Action Plan (free): https://www.barbellmedicine.com/training-plateau-action-plan/

Progressive Loading article series: https://www.barbellmedicine.com/blog/progressive-loading/

Beyond Progressive Overload (Part 2 article): https://www.barbellmedicine.com/blog/beyond-progressive-overload/

BBM Programs and Coaching: https://www.barbellmedicine.com/

Support our work on barbellmedicine.supercast.com

Latella C et al. Using powerlifting athletes to determine strength adaptations across ages in males and females. Sports Med. 2024. https://pubmed.ncbi.nlm.nih.gov/

Del Vecchio A et al. The increase in muscle force after 4 weeks of strength training is mediated by adaptations in motor unit recruitment and rate coding. J Physiol. 2019. https://pubmed.ncbi.nlm.nih.gov/30644584/

Lecce E et al. Resistance training-induced adaptations in the neuromuscular system. J Physiol. 2025.

Balshaw TG et al. Neural adaptations after 4 years vs 12 weeks of resistance training. Scand J Med Sci Sports. 2019. https://pubmed.ncbi.nlm.nih.gov/30474171/

Skarabot J et al. Voluntary activation and agonist EMG amplitude in resistance-trained men. J Appl Physiol. 2021.

Roberts MD et al. Mechanisms of mechanical overload-induced skeletal muscle hypertrophy. Physiol Rev. 2023.

Damas F et al. Resistance training-induced changes in integrated myofibrillar protein synthesis are related to hypertrophy only after attenuation of muscle damage. J Physiol. 2016. https://pubmed.ncbi.nlm.nih.gov/27219125/

Damas F et al. Early resistance training-induced increases in muscle cross-sectional area are concomitant with edema-induced muscle swelling. Eur J Appl Physiol. 2016. https://pubmed.ncbi.nlm.nih.gov/26280652/

Lazarczuk SL et al. Mechanical, material and morphological adaptations of healthy lower limb tendons. Sports Med. 2022. https://pubmed.ncbi.nlm.nih.gov/35657492/

Kubo K et al. Time course of changes in the human Achilles tendon properties. Eur J Appl Physiol. 2012. https://pubmed.ncbi.nlm.nih.gov/22105708/

Watson SL et al. High-intensity resistance and impact training improves bone mineral density in postmenopausal women: the LIFTMOR randomized controlled trial. J Bone Miner Res. 2018. https://pubmed.ncbi.nlm.nih.gov/28975661/

Aasa U et al. Injuries among weightlifters and powerlifters: a systematic review. Br J Sports Med. 2017. https://pubmed.ncbi.nlm.nih.gov/27445362/

Prieto-Gonzalez P et al. Injuries in novice participants during an eight-week start-up CrossFit program. Int J Environ Res Public Health. 2020. https://pubmed.ncbi.nlm.nih.gov/32155747/

Kanayama G et al. Tendon rupture in body builders. Sports Med. 2015.

Enoka RM, Duchateau J. Translating fatigue to human performance. Med Sci Sports Exerc. 2016. https://pubmed.ncbi.nlm.nih.gov/27015386/

Behrens M et al. Fatigue and human performance: an updated framework. Sports Med. 2023. https://pubmed.ncbi.nlm.nih.gov/

Halperin I et al. Accuracy in predicting repetitions to task failure: scoping review. Sports Med. 2022. https://pubmed.ncbi.nlm.nih.gov/

Skarabot J et al. Neuromuscular fatigue and recovery after heavy resistance, jump, and sprint training. Eur J Appl Physiol. 2018.

Garcia-Ramos A et al. Greater neuromuscular and perceptual fatigue after low-load to failure than heavy-load to failure. 2024.

Minor, Brian MS, CSCS1; Helms, Eric PhD, CSCS2; Schepis, Jacob3. RE: Mesocycle Progression in Hypertrophy: Volume Versus Intensity. Strength and Conditioning Journal 42(5):p 121-124, October 2020. | DOI: 10.1519/SSC.0000000000000581

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