Alterations in strength, mass, and neural adaptations with resistance exercise over time. Resistance exercise studies (8 to 12 wk of training) display an early increase in strength as a result of neural adaptations. With prolonged strength training, muscle mass slowly increases and drives the later changes in strength after neural adaptations begin to plateau. Finally, at the elite level, individuals show small changes in all three core adaptations that accompany strength training. At this point, new stimuli (possibly targeting the extracellular matrix [ECM]) are needed to increase strength.