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2007, Vol. 37, No. 10 (pp. 907-921)


ISSN: 0112-1642

Review Article
Hydration and Muscle Performance

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REVIEW ARTICLE

2007 Adis Data Information BV. All rights reserved.

Hydration and Muscular Performance


Does Fluid Balance Affect Strength, Power and
High-Intensity Endurance?
Daniel A. Judelson,1,2 Carl M. Maresh,1 Jeffrey M. Anderson,1
Lawrence E. Armstrong,1 Douglas J. Casa,1 William J. Kraemer1 and Jeff S. Volek1
1
2

Human Performance Laboratory, Department of Kinesiology, University of Connecticut,


Storrs, Connecticut, USA
Department of Kinesiology, California State University, Fullerton, California, USA

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Contents

Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 907
1. Important Influences in Previous Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 908
1.1 Exacerbating Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 908
1.2 Masking Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909
1.3 Other Potential Influences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910
1.4 Ecological Validity and Best Practices for Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910
2. Effects of Hypohydration on Muscular Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910
2.1 Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 912
2.2 Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 914
2.3 High-Intensity Endurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915
2.4 Comparisons and Relevance of Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 916
2.5 Important Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 917
3. Potential Mechanisms of Hypohydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 917
3.1 Cardiovascular Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 917
3.2 Metabolic Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 918
3.3 Buffering Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 918
3.4 Neuromuscular Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 918
4. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 919

Abstract

Significant scientific evidence documents the deleterious effects of hypohydration (reduced total body water) on endurance exercise performance; however, the
influence of hypohydration on muscular strength, power and high-intensity endurance (maximal activities lasting >30 seconds but <2 minutes) is poorly understood
due to the inconsistent results produced by previous investigations. Several subtle
methodological choices that exacerbate or attenuate the apparent effects of
hypohydration explain much of this variability. After accounting for these factors,
hypohydration appears to consistently attenuate strength (by 2%), power (by
3%) and high-intensity endurance (by ~10%), suggesting alterations in total
body water affect some aspect of force generation. Unfortunately, the relationships between performance decrement and crucial variables such as mode, degree
and rate of water loss remain unclear due to a lack of suitably uninfluenced data.
The physiological demands of strength, power and high-intensity endurance
couple with a lack of scientific support to argue against previous hypotheses that
suggest alterations in cardiovascular, metabolic and/or buffering function
represent the performance-reducing mechanism of hypohydration. On the other

Judelson et al.

908

hand, hypohydration might directly affect some component of the neuromuscular


system, but this possibility awaits thorough evaluation. A critical review of the
available literature suggests hypohydration limits strength, power and highintensity endurance and, therefore, is an important factor to consider when
attempting to maximise muscular performance in athletic, military and industrial
settings.

Some active individuals have difficulty in voluntarily maintaining euhydration during exercise and
often fail to rehydrate properly between exercise
sessions,[1-6] leading to reductions in body water that
affect an array of physiological processes and ultimately limit exercise capacity. Significant research
documents the effects of hypohydration on endurance exercise performance,[7-9] with less attention
given to the influence of hydration status on muscular strength (the maximal force a muscle or muscle
group can generate at a specified velocity),[10] peak
power (the power generated when a muscle engages
in a maximal concentric action at the optimal shortening velocity),[10] or high-intensity endurance
(maximal activities lasting >30 seconds but <2 minutes). In previous original research investigations,
hypohydration inconsistently affects muscle performance; the use of interventions that impair exercise performance independent of water loss (e.g.
exercise-heat stress) explains some of this inconsistency, as does the failure of some studies to control
for factors that obscure the association between hydration state and performance (e.g. caloric restriction or training status).
Although reviews and position statements discussing bodyweight loss[11-23] and general hypohydration[7,24-26] superficially discuss the effects
of hydration state on anaerobic performance, the
literature currently lacks a comprehensive review
describing the effects of hypohydration on strength,
power and high-intensity endurance. Therefore, the
purpose of this article is to objectively analyse the
scientific literature examining the effects of hydration state on muscular performance to determine if,
and how, hypohydration affects muscular strength,
power and high-intensity endurance. A major aim is
to compare and contrast studies to better understand
how different methodological factors contribute to
the relationship between hypohydration and performance. Scientific literature on this topic was ob-

tained through a systematic review of published


articles from Internet databases (e.g. PubMed) and
reference lists from related original research, book
chapters and review articles. Throughout this article,
hypohydration refers to a state of reduced total body
water, while dehydration refers to the process of
reducing total body water (i.e. dehydration leads to
hypohydration).

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1. Important Influences in
Previous Research

Many high-quality investigations that were not


designed to examine isolated hypohydration have
been inappropriately discussed or analysed in the
context of hypohydration. Generally, these studies
employed specific research designs, subject populations and/or testing modalities that preclude a direct
application to only changes in hydration status.
Sometimes these influences magnified the effects of
hypohydration, which if interpreted only in the context of hydration would overemphasise the effects of
hypohydration (exacerbating factors). In other
cases, these influences counteracted or attenuated
the effects of hypohydration, which if interpreted
only in the context of hypohydration would underestimate the effects of hydration on high-intensity
performance (masking factors).
1.1 Exacerbating Factors

Because athletes who participate in weight-control sports (e.g. wrestling and boxing) regularly alter
their body mass, many studies examining the effects
of acute mass loss on performance used these athletes as subjects. In the days or hours preceding a
competition, many weight-control athletes significantly reduce their body mass, typically by decreasing total body water and limiting caloric intake.
Because not every study examining wrestlers or
boxers was designed to evaluate hydration state,

Sports Med 2007; 37 (10)

Hydration and Muscle Performance

weight-loss techniques were frequently uncontrolled


and undocumented. Although dehydration frequently accounted for some mass loss in this research, the
effects of hypohydration are not easily separated
from the potential performance-reducing effects of
caloric restriction.[27-29] Unfortunately, some authors
failed to recognise the physiological divergence separating weight loss from hypohydration and, therefore, inappropriately analysed and discussed acute
weight loss solely in the context of hypohydration.
Independent of hydration, increasing muscle and/
or core temperature above specific thresholds
reduces muscle function, limits work capacity and
promotes fatigue.[30-32] Methodologically, studies
employing dehydration techniques that increased
muscle temperature (via exercise and/or heat exposure), but tested subjects before they adequately
cooled, cannot isolate the effects of hypohydration
from the performance-reducing effects of increased
core temperature. Similarly, many studies employed
dehydration techniques causing muscular fatigue
(primarily exercise); investigations that tested subjects without allowing full recovery cannot separate
the effects of hypohydration from the performancereducing effects of muscle fatigue. Clearly, the specific methodology employed to dehydrate subjects
in hydration studies is vital. If dehydration was
coupled with caloric restriction and/or subjects were
unable to completely recover from the stress of the
dehydration, the isolated effect of hydration cannot
be evaluated.[14,15,30,33-37]

909

tween lean body mass (and hence, reservoir of total


body water) and strength reductions following 1.7%
hypohydration. It appears that any condition (nutritional or physiological) that increases total body
water, including endurance training, helps counteract the effects of hypohydration because the bodys
greater fluid reservoir minimises the percentage of
fluid lost for any given decrease of total body water.
Results of studies examining isolated hypohydration
on endurance-trained athletes[41-43] have rarely
demonstrated physiologically or statistically significant hypohydration-induced reductions of maximal
muscular performance (see sections 2.1 and 2.2),
further supporting the conclusions of Caterisano
et al.[39]
Very little research examines the effect of hydration on strength, power or high-intensity endurance
in women.[33,44-46] None of these studies, however,
controlled for subjects menstrual status. Although
menstrual status appears to exert little influence on
strength or anaerobic exercise performance,[47] the
alterations in concentration and activity of the fluid
regulatory hormones across the reproductive cycle
promote water retention during the luteal
phase.[48,49] This increased fluid reserve, as suggested in the previous paragraph, likely provides a
greater fluid reserve to defend against hypohydration-induced alterations of total body water. Although no scientific investigations confirm this hypothesis, the physiological basis for this argument
and parallel findings in endurance athletes suggest
results obtained from women without controlling for
menstrual status must be cautiously interpreted.
Finally, several studies examining muscular
strength,[50] power[44,51-56] and high-intensity endurance[51,53-59] employed measurements in which only
the subjects body mass resisted the testing movement (e.g. vertical jumping or short-distance sprinting). The decreased body mass characteristic of
hypohydration might offset reduced muscular
strength and/or power, however, complicating the
interpretation of these studies.[37,44] For example, if
hypohydration fails to reduce muscle force or power, vertical jump height will increase as total body
water decreases because the jumper must move less
body mass. Body mass based tests require less force
as hypohydration progresses; this reduction of physiological demand promotes improved performance

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1.2 Masking Factors

Several authors have hypothesised that training


state significantly alters the effects of hydration on
muscular performance,[16,33,38] and at least one study
scientifically confirmed this conjecture. Caterisano
et al.[39] clearly demonstrated that 3% hypohydration
reduced isokinetic quadriceps muscular endurance
(ability to maintain 50% maximal peak torque) in
power athletes and sedentary controls, but failed to
affect performance in endurance athletes. They proposed that the haemodynamic adaptations resulting
from endurance training (primarily increased plasma volume) provided an extra reserve of water to
offset the fluid shifts caused by dehydration. Schoffstall et al.[40] corroborated this hypothesis when they
discovered a significant inverse relationship be 2007 Adis Data Information BV. All rights reserved.

Sports Med 2007; 37 (10)

Judelson et al.

910

and obscures the effects of hypohydration on muscle


function.
1.3 Other Potential Influences

In addition to the primary exacerbating (caloric


restriction, increased muscle temperature and fatigue) and masking (endurance training, menstrual
status and test type) factors, the subjects history of
exercising while hypohydrated has also received
attention as a potential confounding variable. Several authors hypothesised that subjects accustomed to
hypohydration (typically wrestlers) demonstrate insignificant performance alterations due to their familiarity with the characteristic physiological stresses.[16,60] Subjects history of hypohydration is not
considered an important influence in the present
review because (i) no scientific literature documents
a physiological adaptation to hypohydration; (ii) this
effect, if present, would largely result from psychological rather than physiological mechanisms; and
(iii) research examining isolated hypohydration
published after the presentation of this hypothesis
(in the early 1980s) demonstrated significantly reduced muscular performance in individuals with a
history of rapid body mass loss.[40,61]

function, future research must recognise the following three vital components of appropriate research
design: (i) dehydration technique; (ii) subject population; and (iii) performance measures. Scientists
can completely avoid the dehydration methods described in section 1.1 by using diuretics to reduce
total body water (understanding the unique physiological stresses of diuretic-induced hypohydration[64]); however, exercise and heat exposure are
useful methods to dehydrate subjects. In using these
latter techniques, future investigations must consider the time duration between a physiologically
stressful dehydration protocol and the outcome performance measure(s). Sufficient time must separate
dehydration from performance to allow core temperature to stabilise and fatigue to dissipate. Our
laboratory typically dehydrates subjects via lowintensity exercise in the heat the evening prior to a
morning data collection;[65-67] the overnight rest period drastically reduces the effects of the dehydration procedures on subsequent outcome measures.
To account for possible influences of subject
selection, future studies should attempt to maximise
the homogeneity of their subjects endurance training background. Hypohydration can (and should) be
studied in female populations, but authors must acknowledge the potential influence of the menstrual
cycle on fluid balance. While data collection might
properly occur during any phase of the menstrual
cycle, (i) all subjects should be tested during a
common phase; and (ii) all data collection for repeated measures studies (the most appropriate to
eliminate the effects of the dehydration protocol)
must occur during the same menstrual phase. In
terms of outcome measures, subjects must perform
against consistent workloads in all trials. This requirement eliminates tests that rely primarily on the
subject moving his or her body mass (e.g. vertical
jump or short distance sprinting) and mandates that
performance workloads are based upon euhydrated
subject characteristics (e.g. euhydrated one repetition maximum or percentage of euhydrated body
mass).

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1.4 Ecological Validity and Best Practices for
Future Research

Understanding the isolated effects of hypohydration on strength, power and high-intensity endurance is important from a basic science perspective,
but this topic also merits attention due to high ecological validity. While some populations experience
the stress of hypohydration combined with another
factor (e.g. fatigue, caloric restriction or increased
core temperature), multiple groups regularly experience only hypohydration. Training athletes who fail
to adequately rehydrate during or immediately after
an initial exercise bout[1-6] might initiate subsequent
exercise bouts in a hypohydrated state, but the hours
between exercise limit the stress of increased core
temperature or fatigue. Other groups that require
peak muscle function for health and safety, such as
astronauts and the elderly, also frequently experience hypohydration.[62,63]
Given the importance of determining the effect of
isolated hypohydration on high-intensity muscle
2007 Adis Data Information BV. All rights reserved.

2. Effects of Hypohydration on
Muscular Performance
Tables IIII comprehensively summarise the results from studies that cannot be evaluated solely in
Sports Med 2007; 37 (10)

Hydration and Muscle Performance

911

Table I. Effects of hypohydration on muscular strength


Study
Dehydration
Studies with masking factors
2.5% via WD
Bosco et al.[50]

Resultsa

Primary factorb

5.3% strength to mass ratio

BMB

Evetovich et al.[33]

2.9% via WD

3.4% isometric forearm flexion strength

UMS

2.1% isokinetic forearm flexion strength

UMS

Saltin[41]

3.8% via E-H

0.5% R knee extension strength

ETS

3.8% via S

Montain et al.[45]

4.0% via E-H

2.9% L knee extension strength

ETS

2.7% R elbow flexion strength

ETS

0.7% L elbow flexion strength

ETS

0.2% R knee extension strength

ETS

0.4% L knee extension strength

ETS

2.3% R elbow flexion strength

ETS

2.8% L elbow flexion strength

ETS

4.4% knee extension strength

UMS

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Studies with exacerbating factors
1.8% via E

Gutierrez
et al.[44]

Guastella et al.[72]

3.0% via E-H


3.4% via S
4.2% via C

Houston et al.[57]

4.5% via C

Bijlani and Sharma[68]


Viitasalo et al.[52]

4.0% in handgrip strength

Temperature

0.9% in row strength

Temperature

0.0% elbow extensor strength

Temperature

7.8% knee extension strength*

Temperature

2.2% grip strength

11.3% knee extension strength at 30/sec*

11.5% knee extension strength at 180/sec*

Moore et al.[69]
Webster et al.[35]

4.8% via E-S


4.9% via C

Viitasalo et al.[52]
Kraemer et al.[73]

5.8% via C
6% via C

10.5%
8.9%
6.9%
10.2%
7.4%
11.4%
5.5%
2.7%
0.7%
6.9%
3.6%
6.6%
5.2%
4.5%
6.6%
8.1%
8.9%
4.5%
7.7%
7.0%
11.4%
1.1%
2.4%
9.9%
15.2%

knee extension strength at 300/sec*


knee extension strength at 180/sec*
R knee extension strength fast
R knee extension strength slow
R knee flexion strength fast
R knee flexion strength slow
L knee extension strength fast
L knee extension strength slow
L knee flexion strength fast
L knee flexion strength slow
chest press strength fast
chest press strength slow*
chest row strength fast
chest row strength slow
shoulder push strength fast
shoulder push strength slow
shoulder pull strength fast
shoulder pull strength slow*
knee extension strength*
hip/back strength
grip strength*
bear hug strength
knee extension strength at 0/sec
knee extension strength at 60/sec
knee extension strength at 300/sec*

CR

CR

CR

CR
Temperature
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR
CR

Continued next page

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Sports Med 2007; 37 (10)

Judelson et al.

912

Table I. Contd
Study

Dehydration

Resultsa
6.3%
11.1%
2.8%
2.5%
4.9%
8.3%
4.5%

knee flexion strength at 60/sec


knee flexion strength at 300/sec*
elbow flexion strength at 0/sec
elbow flexion strength at 60/sec
elbow flexion strength at 300/sec
elbow extension strength at 60/sec
elbow extension strength at 300/sec

Primary factorb
CR
CR
CR
CR
CR
CR
CR

Studies difficult to interpret


Ahlman and Karvonen[70]
Learning effect
Bell et al.[74]
UWL
Ftaiti et al.[75]
Temperature, fatigue, ETS
Greenleaf et al.[38]
No euhydrated baseline
Greenleaf et al.[46]
Temperature, fatigue, UMS

Gutierrez
et al.[44]
Temperature, UMS
opik

O
et al.[76]
UWL
Serfass et al.[60]
UWL
Singer and Weiss[77]
UWL
Tuttle[78]
UWL, caloric restriction
Vallier et al.[79]
No euhydrated baseline, ETS
Wenos and Amato[59]
UWL
a Data are shown as percentage change from baseline. Results obtained from references[33,35,38,41,44-46,50,52,57,59,60,68-70,72-79] and findings
obtained from references[38,50,57] estimated from figures.
b Primary factor refers to the variable preventing an isolated analysis of the effects of hypohydration on muscular performance.
BMB = body mass based test; C = combination dehydration techniques; CR = caloric restriction; E = exercise; ETS = endurance-trained
subjects; H = heat exposure (3641C); L = left; R = right; S = sauna exposure (7085C); UMS = uncontrolled menstrual status; UWL =
uncontrolled weight loss; WD = water deprivation. indicates improvement; indicates decrement; indicates change; * p < 0.05.

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the context of hypohydration, presenting investigations that examined the effect of hypohydration on
muscular strength (table I), power (table II) and
high-intensity endurance (table III), respectively.
Each table is divided into the following three sections: (i) research with masking factors (i.e. attenuating hypohydration effects); (ii) research with exacerbating factors (i.e. magnifying hypohydration
effects); and (iii) research that cannot be interpreted
based on acknowledged limitations of research design (e.g. learning effect), lack of description or
control of the hypohydration techniques, and/or
combinations of masking and exacerbating factors.
Single publications appear in multiple sections and
on different tables if the methodology included several different dehydration techniques, subject populations or exercise tasks. In those studies examining
the effects of dehydration and subsequent rehydration, only the initial dehydration was evaluated to
eliminate effects of ad libitum food and fluid in 2007 Adis Data Information BV. All rights reserved.

take[55,58,60,68-71] or uncontrolled carbohydrate intake[44] during the rehydration.


Figures 13 display the results of the 11 published, peer-reviewed studies[34,36,37,39,40,50,52,61,81-83]
that accurately assessed only the effects of hypohydration on muscular strength (figure 1), power
(figure 2) and high-intensity endurance (figure 3).
Similar to tables IIII, these figures contain information relating only to initial dehydration and ignore subsequent rehydration.[40,83] To examine possible muscle specificity, figures 13 present findings
from lower, upper and total body musculature separately; whenever possible, results from similar muscle groups/actions are juxtaposed for clarity.
2.1 Strength

Table I and figure 1 present the effects of hypohydration on muscular strength (the maximal
force a muscle or muscle group can generate at a
specified velocity).[10] Protocols used to evaluate
strength typically measured single maximal effort
Sports Med 2007; 37 (10)

Hydration and Muscle Performance

913

Table II. Effects of hypohydration on muscular power


Study
Dehydration
Studies with masking factors
1.1% via E
Hoffman et al.[53]

Resultsa

Primary factorb

4.2% via E-H

3.4%
3.0%
0.0%
3.0%
4.7%
3.8%
0.1%
0.1%
1.0%
1.5%
2.2%
7.1%
7.9%
8.9%
3.9%
1.3%
4.7%

squat jump height


countermovement jump height
squat jump height
countermovement jump height
squat jump height
countermovement jump height
cycling power
50m sprint
200m sprint
jump height
jumping power
jump height*
weighted (+20kg) jump height*
weighted (+40kg) jump height*
weighted (+60kg) jump height
weighted (+80kg) jump height
cycling power

BMB
BMB
BMB
BMB
BMB
BMB
ETS
BMB
BMB
BMB
BMB
BMB
BMB
BMB
BMB
BMB
ETS

Studies with exacerbating factors


2.0% via H
Jacobs[56]
3.0% via E-H
King et al.[80]
3.4% via S
Viitasalo et al.[52]
4.1% via H
Jacobs[56]
4.2% via C
Guastella et al.[72]
4.9% via C
Webster et al.[35]
5.0% via H
Jacobs[56]
5.8% via C
Viitasalo et al.[52]
Kraemer et al.[73]
~6.0% via C

2.2%
2.5%
16.1%
2.1%
0.6%
21.5%
2.3%
19.0%
3.2%

Wingate peak power


cycling peak power
knee extension rate of force development*
Wingate peak power
Wingate peak power
cycling power
Wingate peak power
knee extension rate of force development*
jumping power

Temperature
Temperature, fatigue
Temperature
Temperature
CR
CR
Temperature
CR
CR

1.8% via E

Gutierrez
et al.[44]

1.8% via H

Walsh et al.[42]
Watson et al.[51]

1.8% via E-H


2.2% via D

Viitasalo et al.[52]

2.5% via D
2.5% via D

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Fritzsche et al.[43]

Studies difficult to interpret


Bell et al.[74]
UWL
Doscher[54]
CR, BMB
Fogelholm et al.[55]
CR, BMB

Gutierrez
et al.[44]
Temperature, BMB, UMS
Jacobs[56]
Temperature, BMB
King et al.[80]
Temperature, fatigue, ETS
opik

O
et al.[76]
UWL
Vallier et al.[79]
No euhydrated baseline, ETS
Viitasalo et al.[52]
CR or temperature, BMB
a Data are shown as percentage change from baseline. Results obtained from references[35,42-44,51-56,72-74,76,79,80] and findings obtained
from references[43,53] estimated from figures.
b Primary factor refers to the variable preventing an isolated analysis of the effects of hypohydration on muscular performance.
BMB = body mass based test; C = combination dehydration techniques; CR = caloric restriction; D = diuretic; E = exercise; ETS =
endurance-trained subjects; H = heat exposure (3056C); S = sauna exposure (7085C); UMS = uncontrolled menstrual status; UWL =
uncontrolled weight loss; indicates improvement; indicates decrement; indicates change; * p < 0.05.

isometric, isotonic and/or isokinetic force production of the upper body (e.g. back extension, bear
hug, bench press, row, elbow extension, elbow flexion, forearm flexion, grip strength, shoulder abduction, shoulder adduction and shoulder extension)
2007 Adis Data Information BV. All rights reserved.

and lower body (e.g. hip flexion, knee extension and


knee flexion).
Numerical analysis supports the division of studies by external influence: the average loss of
strength was 2.3%, 0.3% and 3.8% for investigaSports Med 2007; 37 (10)

Judelson et al.

914

Table III. Effects of hypohydration on muscular endurance (activities >30 seconds and <2 minutes)
Study
Dehydration
Studies with masking factors
1.1% via E
Hoffman et al.[53]

1.8% via E

Watson et al.[51]
Caterisano et al.[39]

2.5% via D
3.0% via H

Studies with exacerbating factors


2.0% via H
Jacobs[56]
2.7% via C
Fogelholm et al.[55]

Resultsa

Primary factorb

16.5%
7.2%
4.8%
15.2%
10.5%
0.0%
0.6%
1.2%

jumping power during 30 sec test


jumps in 30 sec
average jump height during 30 sec test
jumping power during 30 sec test
jumps in 30 sec
average jump height during 30 sec test
400m sprint
knee extension endurance

BMB
BMB
BMB
BMB
BMB
BMB
BMB
ETS

0.8%
3.4%
0.3%
31.8%
10.2%
8.5%
3.2%
1.3%
0.7%
9.7%
0.5%

average power during 30 sec Wingate


average power during 1 min Wingate 1 (of 2)
average power during 1 min Wingate 2 (of 2)
elbow extensor endurance*
cycling work in 45 sec*
cycling power at end of 45 sec
cycling fatigue index
average power during 30 sec Wingate
average power during 30 sec Wingate
cycling work in 40 sec*
average power during 30 sec Wingate

Temperature
CR
CR
Temperature
Temperature, fatigue
Temperature, fatigue
Temperature, fatigue
Temperature
CR
CR
Temperature

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Bijlani and Sharma[68]
King et al.[80]

3.0% via E-H


3.0% via E-H

Jacobs[56]
Guastella et al.[72]
Webster et al.[35]
Jacobs[56]

4.1%
4.2%
4.9%
5.0%

via
via
via
via

H
C
C
H

Studies difficult to interpret


Bell et al.[74]
UWL
Doscher[54]
CR, BMB
Houston et al.[57]
CR, BMB
Jacobs[56]
Temperature, BMB
King et al.[80]
Temperature, fatigue, ETS
Klinzing and Karpowicz[58]
CR, BMB
Mnatzakanian and
Undefined weight loss
Vaccaro[71]
Wenos and Amato[59]
UWL, BMB
a Data are shown as percentage change from baseline. Results obtained from references[35,39,51,53-59,68,71,72,74,80] and findings obtained
from references[53,57] estimated from figures.
b Primary factor refers to the variable preventing an isolated analysis of the effects of hypohydration on muscular performance.
BMB = body mass based test; C = combination dehydration techniques; CR = caloric restriction; E = exercise; ETS = endurance-trained
subjects; D = diuretic; H = heat exposure (4058C); UWL = uncontrolled weight loss; indicates improvement; indicates decrement;
indicates change; * p < 0.05.

tions with no factors (i.e. those assessing only isolated hypohydration), masking factors and exacerbating factors, respectively. Only 15 of the 70 total
findings (21%) showed statistically significant performance reductions. Given the relatively small effect of hypohydration, the rarity of statistical significance is not surprising considering the small sample
sizes (mean sample size of uninfluenced studies =
ten) and sometimes insufficiently sensitive testing
modalities.[84] No specific muscle group or action
appears more susceptible to hypohydration, as di 2007 Adis Data Information BV. All rights reserved.

vergent results sometimes occur for the same muscle


(e.g. knee extension and elbow flexion). Although
some variability exists, more than two-thirds of uninfluenced results show negative effects, suggesting
that 34% hypohydration reduces muscular strength
by approximately 2%.
2.2 Power

Table II and figure 2 present the effects of hypohydration on muscular power (the power generated when a muscle engages in a maximal concentric
Sports Med 2007; 37 (10)

Hydration and Muscle Performance

Muscular strength (%)

15

915

Lower body

Total
body

Upper body

Lower body
ag: Knee extension
h:
Leg extension

10
5

Upper body
i:
Bench press
jm: Elbow flexion
no: Handgrip
pq: Shoulder extension
r:
Trunk extension
s:
Composite score

0
5

*
*

10
*
i j k l mn o p q r

ab c d e f gh

15

Fig. 1. Non-confounded effects of hypohydration on muscular strength. Data are presented as mean percentage change from baseline.
Results from: Bosco et al.[50] (a, h, j, n, o, r and s) [estimated from figures]; Greiwe et al.[34] (b and k); Viitasalo et al.[52] (c); Bosco et al.[81] (d,
e, l, m, p and q); Bigard et al.[82] (f and g); and Schoffstall et al.[40] (i). * p < 0.05.

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action at the optimal shortening velocity).[10] Appropriate protocols used to evaluate peak power typically measured performance during maximal intensity
cycling and maximal knee extension (rate of force
development). Numerical analysis again supports
the division of studies based on the type of external
influence: the average change in power was 3.2%,
+1.8% and 7.7% for investigations with no factors,
masking factors and exacerbating factors, respectively. Nine of the 47 total findings (19%) showed
statistically significant performance reductions. Unfortunately, the 21 results shown in figure 2 come
from only four investigations, one of which was
published only in abstract form[61] (complete details
of this research were obtained from the author of the
abstract: Smith SA, 2006, personal communication).
Studies with masking factors that used body mass
based tests further corroborate the power-reducing
effect of hypohydration: in 8 of 15 cases, the per-

centage increase in performance failed to match the


percentage decrease in body mass. Except for two
investigations examining short-distance sprinting,[51,55] all of these studies examined power via
lower body exercise (e.g. jumping or cycling), eliminating an analysis of muscle specificity. Figure 2
displays some variability (more in magnitude than
direction) and uninfluenced findings require replication in future studies, but the current literature suggests that 34% hypohydration reduces muscular
power by approximately 3%.
2.3 High-Intensity Endurance

Table III and figure 3 present the effects of


hypohydration on high-intensity muscular endurance. Appropriate protocols used to evaluate highintensity endurance typically measured total work
(number of repetitions) or average power maintained during 30120 seconds of repeated activities

20

Lower body

Muscular power (%)

15
10
5
0

10
15
20

*
*

Lower body
ah: 1015s Wingate Test
peak power
it: 1015s Wingate Test
average power
u:
Knee extension rate of
force development

*
a b c d e f g h i j k l m n o p q r s t u

Fig. 2. Non-confounded effects of hypohydration on muscular power. Data are presented as mean percentage change from baseline.
Results from: Smith et al.[61] (ae, im); Cheuvront et al.[37] (fh, np); Yoshida et al.[36] (qt) [estimated from figures]; and Viitasalo et al.[52]
(u). * p < 0.05.

2007 Adis Data Information BV. All rights reserved.

Sports Med 2007; 37 (10)

Judelson et al.

916

Muscular endurance (%)

40
30

Lower
body

Total
body

Upper
body

Lower body
ad: Knee extension

20

Upper body
e:
Elbow flexion
f:
Sit-ups

10
0
10
20
30
40

*
a

Total body
g:
Total body isometric
h:
Total body isotonic

*
b

*
g

*
h

Fig. 3. Non-confounded effects of hypohydration on high-intensity muscular endurance (activities lasting >30 seconds but <120 seconds).
Data are presented as mean percentage change from baseline. Results from: Caterisano et al.[39] (a and b); Greiwe et al.[34] (c and e);
Bigard et al.[82] (d); Bosco et al.[81] (f); and Torranin et al.[83] (g and h). * p < 0.05.

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(bench presses, rows, chin-ups, elbow extensions,
elbow flexions, knee extensions, knee flexions,
shoulder abductions, shoulder adductions and/or situps); high-intensity cycling tasks were also evaluated. Division of studies based on external influence
is less numerically convincing for this variable: the
average loss of endurance was 15.0%, 6.7% and
5.6% for studies with no factors, masking factors
and exacerbating factors, respectively. Statistically
significant reductions in performance occurred in 7
of the 27 results (26%). The smaller total pool of
results (only 27 compared with 70 for strength and
47 for power) and/or the physiological differences
separating high-intensity muscular endurance from
strength and power (as endurance relies more heavily on cardiovascular function and muscle metabolism; see sections 3.1 and 3.2) might explain the
altered quantitative relationship among influences.
Regardless, the consistent, statistically significant
reductions noted in the uninfluenced studies suggest
that hypohydration detrimentally affects high-intensity muscular endurance; visual evidence supports a
greater effect in the lower body than the upper body;
however, the small number of results supporting this
hypothesis makes this conclusion tentative. Little
variability exists in figure 3, suggesting that 34%
hypohydration reduces high-intensity muscular endurance by approximately 10%.

2007 Adis Data Information BV. All rights reserved.

2.4 Comparisons and Relevance


of Conclusions

The previous conclusions suggest that hypohydration attenuates the performance of highintensity endurance to a much greater degree than
strength and power exercises. The (i) detrimental
effects of body water loss on traditional endurance
exercises; and (ii) direct relationship between the
magnitude of hypohydration-induced performance
decrement and exercise duration[7,9] support this hypothesis. A 10% reduction in high-intensity endurance performance produces clear decrements in exercise outcome. The relative importance of 23%
reductions in strength and peak power, however, is
less clear. These effects are unlikely to affect the
casual resistance exerciser attempting to maintain
health and reduce risk of disease, but small reductions in exercise performance significantly affect the
outcome of athletic competitions when vanishingly
small differences separate winning from losing.[84]
For example, results from the 1996, 2000 and 2004
Olympic Games indicate the gold medalist in the
100m dash defeated the eighth place finisher by an
average of only 3%. Decrements in peak strength
and power also affect non-elite athletic events, military operations and civil servant activities (e.g. police and fire personnel) when participants strive to
maximise performance for personal satisfaction,
personal or public safety, and overall well-being.

Sports Med 2007; 37 (10)

Hydration and Muscle Performance

917

Table IV. Methodological details of the non-confounded studies examining muscular strength, power and high-intensity endurance
Study
Bigard et al.[82]
Bosco et al.[81]
Bosco et al.[50]
Caterisano et al.[39]
Cheuvront et al.[37]
Greiwe et al.[34]
Schoffstall et al.[40]
Smith et al.[61]
Torranin et al.[83]
Viitasalo et al.[52]
Yoshida et al.[36]

Dehydration method
Sauna
Water deprivation
Water deprivation
Heat
Heat
Sauna
Sauna
Combination
Sauna
Diuretic
Exercise

Degree of hypohydration (%)


3.0
5.7
2.5 and 3.1
3.0
2.7
3.8
1.7
4.5
3.9 and 4.0
2.5
0.7, 1.7, 2.5 and 3.9

2.5 Important Considerations

Variable(s) assessed
Isometric strength, endurance
Isometric strength, endurance
Isometric strength
Endurance
Power
Isometric strength, endurance
Isotonic strength
Power
Endurance
Isometric strength, power
Power

masking or exacerbating factor and four[38,43,53,79]


accurately documented hydration status. Realistically, the limited data available from studies that accurately documented the effects of only hypohydration
(strength,[34,40,50,52,81,82] power,[36,37,52,61] endurance[34,39,81-83]) fail to provide a suitable number of
data points to accurately or reliably evaluate the
relationship between degree of hypohydration and
change of muscle function. Evidence from an endurance model clearly suggests that the technique used
to dehydrate subjects affects subsequent performance outcomes and fluid biocompartmentation.[64]
Presumably, mode of dehydration interacts with degree of hypohydration to determine the overall magnitude of performance decrement.

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The previous analysis omits three obviously relevant variables. Mode of dehydration,[14-16,25,33,52,64]
degree of hypohydration[16,25,38] and rate of water
loss[16,38,85] likely alter the physiological response to
hypohydration. Despite their importance, several
reasons justify the intentional exclusion. Given the
small number of uninfluenced results upon which
the previous conclusions are largely based, comparing the effects of different dehydration methods and
degrees of hypohydration becomes difficult (this
information is provided for the uninfluenced studies
in table IV). A surprising lack of scientific evidence
documenting hydration status further complicates
this assessment. Of the studies evaluated in this
review, approximately half verified hydration status
(pre- or post-dehydration) with any physiological
measurement other than body mass (e.g. urine specific gravity or plasma osmolality). This verification
is vital, especially to ensure hydration indices indicate that subjects baseline body masses represent a
euhydrated state. Without the physiological verification that baseline body mass truly represents
euhydration, the degree of hypohydration post-dehydration cannot be quantified nor can the relationship between the magnitude of hypohydration and
decrement in muscle function be assessed.
Research examining the same subjects completing the same exercise bouts at multiple hypohydrated states most effectively analyses the effect of
degree of hypohydration; unfortunately, very few of
these studies exist. Nine published studies[36,38,43,50,53,56,77,79,80] examined multiple degrees of
hypohydration, but only two[36,50] lack a major
2007 Adis Data Information BV. All rights reserved.

3. Potential Mechanisms
of Hypohydration

How might hypohydration negatively influence


strength, power and high-intensity endurance? Unfortunately, the inconsistent results described in sections 2.12.3 have precluded an extensive analysis
of the hypohydration mechanism. Instead, our current state of knowledge results from a basic understanding of exercise physiology and information
gleaned from studies examining hypohydration and
endurance performance.
3.1 Cardiovascular Mechanisms

During endurance exercise, especially in a hot


environment, many of the deleterious effects of hypohydration result from altered cardiovascular function. Hypohydration reduces total plasma volume,
increasing submaximal heart rates and decreasing
Sports Med 2007; 37 (10)

Judelson et al.

918

maximal cardiac output.[86,87] Further, changes of


muscle blood flow due to water loss can decrease
nutrient delivery, decrease metabolite removal and
alter cellular metabolism.[88,89] The degree to which
these cardiovascular alterations affect strength and
power, however, is unclear. Brief strength and power production occurs essentially independent of the
cardiovascular system because these exercises do
not require peak cardiac output and largely rely
upon stored intramuscular adenosine triphosphate
(ATP) and creatine phosphate (CP) for energy. Although little research examining hypohydration and
muscular performance documents these variables,
the physiology of maximal performance suggests
that decreased cardiovascular function cannot account for reduced strength and power.[13,14,45] The
importance of cardiovascular changes might increase, however, during high-intensity endurance
performance.[14,83] Because repetitive exercises, no
matter how brief, require adequate delivery of oxygen to and removal of metabolic by-products from
the active musculature, reductions of muscle blood
flow might assume greater importance in dictating
performance reductions.[13,36,43,83]

lactate with hypohydration, the vast majority


demonstrate that hypohydration either failed to
change[43,51,56,72,76,82,93] or decreased[41,64,69,80] postexercise lactate. In many cases, the reduced blood
lactate was hypothesised to result from decreased
work rate or work time,[30,96] rather than a physiological effect of hypohydration on lactate production,
efflux, or uptake.[93] On the other hand, decreased
lactate production might occur secondary to dehydration-induced reductions of glycogen stores, not
because hypohydration fundamentally affects carbohydrate metabolism.[13,14,76,97,98] This final possibility explains many findings, as all data demonstrating
reduced post-exercise lactate resulted from subjects
who either restricted caloric intake or increased their
core temperature (each of which promotes glycogen
depletion) during dehydration. Additionally, the dehydration protocols frequently stress subjects, stimulating the sympathetic nervous system. This fight
or flight response promotes glycogenolysis;[99] prolonged dehydration procedures might lead to glycogen depletion and subsequently reduced lactate production during performance testing.[36] Thus, the
collective evidence suggests that isolated hypohydration does not directly alter lactate kinetics or
carbohydrate metabolism. Further research is required to ascertain the effects of hypohydration on
lipid and protein metabolism during exercise, but
these factors appear unlikely to cause decrements in
high-intensity muscular performance.

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3.2 Metabolic Mechanisms

Similar to cardiovascular mechanisms, the physiology of maximal performance suggests only a limited role for muscle metabolism in reducing muscle
function, especially for strength and power.[25]
Closer inspection of basic physiology, however,
shows that hydration-induced changes in cell volume strongly influence cellular metabolism,[90-92]
suggesting that hypohydration might fundamentally
disturb metabolism to affect even the briefest exercises.[80,83] Although altered lipid metabolism has
been suggested as a possible mechanism explaining
the effect of hypohydration on maximal muscle activity,[93-95] the majority of scientific attention and
evidence examines potential changes of carbohydrate metabolism.
Experimental evidence, albeit limited, refutes the
possibility that hypohydration fundamentally
changes intramuscular stores of ATP and CP[13,15,45]
or circulating concentrations of blood glucose.[76,81]
Greater controversy exists over the effect of hypohydration on post-exercise circulating lactate concentrations; although one study[51] showed increased

2007 Adis Data Information BV. All rights reserved.

3.3 Buffering Mechanisms

A third hypothesis proposes that hydration state


affects the acid-base balance of the body. Optimal
cellular functioning requires maintenance of appropriate internal pH, causing several researchers to
suggest that hydration influences performance by
reducing buffer capacity.[13,14,97] Actual evidence examining muscle and blood, however, demonstrated
no hypohydration-induced changes of internal
pH[69,80] and bicarbonate[82] after exercise; therefore,
acid-base balance is unlikely to represent the mechanism for hypohydration.
3.4 Neuromuscular Mechanisms

The three previous mechanisms (cardiovascular,


metabolic and buffering) appear insufficient to exSports Med 2007; 37 (10)

Hydration and Muscle Performance

plain the effects of hydration on strength, power and


high-intensity endurance, leaving a fourth possibility, as stated by Coyle and Hamilton:[24]
It is unlikely that moderate reductions in muscle
water alter force generation capability or energy
production when maximally stimulated. It is more
likely that the infrequently reported reductions in
strength following hypohydration are due to a diminished ability of the central nervous system to
recruit motor units.
Many others similarly claimed that the loss of
total body water affects some component of the
neuromuscular system.[14,36,42,43,45,52,53,75,81,83] Unfortunately, very little scientific evidence evaluates
these hypotheses. Electromyographic data collected
during maximal contractions are limited and inconclusive,[33,75,79,82] and research examining the effect
of hypohydration on muscle membrane excitability
clearly argues against this hypothesis.[100,101] Although altered neuromuscular function is an appealing hypothesis, the literature currently lacks a well
designed study evaluating the effect of hydration
state on a sensitive marker of central drive (e.g.
twitch interpolation or central activation ratio). Until
this gap in the literature is filled, the importance of
neuromuscular alterations in mediating hypohydration-induced decrements of muscle function cannot
be accurately assessed.

919

Acknowledgements
No funding sources were used in the preparation of this
manuscript. Douglas J. Casa serves on the Board of Advisors,
has received grant funding and honoraria from Gatorade and
has received honoraria from Camelbak, Inc. The authors wish
to thank Dr Sinclair A. Smith for his exceptional helpfulness
and Dr Barry A. Spiering for editorial contributions.

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4. Conclusions

When the masking and exacerbating influences


of dehydration procedure, test selection and subject
population have been accounted for, hypohydration
appears to negatively influence muscular strength,
power and high-intensity endurance. After considering the important external factors, future research
should aim to elucidate the magnitude of hypohydration effects, to clarify the mechanism of
these effects, and explore interrelationships with key
modulators such as the degree of hypohydration and
mode of dehydration. Although further work remains to be completed, this critical review of the
available literature suggests hypohydration is an
important factor to consider when attempting to
maximise muscular performance in athletic, military
and industrial settings.
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Correspondence: Dr Daniel A. Judelson, Department of Kinesiology, California State University, 800 North State College Boulevard, Fullerton, CA 92887, USA.
E-mail: djudelson@fullerton.edu

Sports Med 2007; 37 (10)