Generally, skeletal muscle adaptations to exercise are perceived through a
dichotomous lens where the metabolic stress imposed by aerobic training leads to
increased mitochondrial adaptations while the mechanical tension from resistance
training leads to myofibrillar adaptations. However, there is emerging evidence
for cross over between modalities where aerobic training stimulates traditional
adaptations to resistance training (e.g., hypertrophy) and resistance training
stimulates traditional adaptations to aerobic training (e.g., mitochondrial
biogenesis). The latter is the focus of the current review in which we propose
high-volume resistance training (i.e., high time under tension) leads to aerobic
adaptations such as angiogenesis, mitochondrial biogenesis, and increased
oxidative capacity. As time under tension increases, skeletal muscle energy
turnover, metabolic stress, and ischemia also increase, which act as signals to
activate the peroxisome proliferator-activated receptor gamma coactivator
1-alpha, which is the master regulator of mitochondrial biogenesis. For
practical application, the acute stress and chronic adaptations to three
specific forms of high-time under tension are also discussed: Slow-tempo,
low-intensity resistance training, and drop-set resistance training. These
modalities of high-time under tension lead to hallmark adaptations to resistance
training such as muscle endurance, hypertrophy, and strength, but little is
known about their effect on traditional aerobic training adaptations.