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While creatine's influence on physical performance has been well documented since the early twentieth century, it came into public view following the 1992 Olympics in Barcelona . An August 7, 1992 article in The Times reported that Linford Christie , the gold medal winner at 100 meters, had used creatine before the Olympics. An article in Bodybuilding Monthly named Sally Gunnell , who was the gold medalist in the 400-meter hurdles, as another creatine user. In addition, The Times also noted that 100 meter hurdler Colin Jackson began taking creatine before the Olympics. [21] [22]

Finally, and this is likely the biggest and most important question, but what exactly stimulates hypertrophy? There are hypotheses out there, some of which are supported by evidence, but in my opinion, it is still inconclusive. (20) Tension on muscles themselves might be enough to stimulate hypertrophy, but when you get tension, you also get ischemia and increased metabolite build-up. The pump you get from lifting weights might contribute, but heavy weight/low rep sets tend not to elicit much of a pump, and hypertrophy has been shown to be the same as for higher rep sets. Metabolic byproduct concentration might be the main stimulator, but there isn’t much evidence examining the idea yet. At this point, we can only conclusively look at muscle growth on a large scale and say that picking things up and putting them down a lot makes muscles get bigger.

Alan: In the research I’ve collaborated on thus far, I unfortunately can’t report anything spectacular. In fact, it’s some of the most anticlimactic/unsexy results in the literature (LOL). However, in the most recent RCT of ours that’s in publication (PMID: 28070459), we did report individual data, and one of the subjects showed approximately an 18 mm gain in biceps thickness ( inches), measured via ultrasound, over an 10-week period.  The rest of the subjects – all of whom were resistance-trained – stayed pretty much the same, which was not surprising since they were in hypocaloric conditions. It’s interesting to imagine what type of response this high responder would have if conditions were optimized for muscle growth, and/or supplementation was implemented. On the poor responder side, one of the subjects experienced a huge drop in quadriceps thickness (25 mm; about 1 inch) during this study. Interindividual response variability is just the nature of the beast, and a very poignant example of this is work by Ahtiainen et al (PMID: 26767377), who demonstrated vast heterogeneity in subjects’ responses to resistance training. Their study is openly accessible, have a look at this figure showing the full range of differences in strength & size gains (and losses): https:///pmc/articles/PMC5005877/figure/Fig4/.  
High responders gained 4-5 times the muscle mass of average responders. Of course there are the unfortunate subjects (2% of the subjects were classified as low responders) who included those who experienced losses in size and strength as a result of resistance training (and in my speculation, other factors as well).

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