Making muscles "stronger": exercise, nutrition, drugs

As described in this review, maximal muscle strength is strongly influenced by resistive-types of exercise, which induce adaptive changes in both neuromuscular function and muscle morphology. Further, timed intake of protein in conjunction with resistance training elicit greater strength and muscle size gains than resistance training alone. Creatine supplementation amplifies the hypertrophic response to resistance training, although some individuals may not respond positively. Locally produced muscle growth factors are upregulated during creatine supplementation, which contributes to increase the responsiveness of muscle cells to intensive training stimuli. Usage of anabolic steroids boosts muscle hypertrophy beyond inherent genetical limits, not only by increasing the DNA transcription rate for myofibrillar proteins but also by increasing the nucleus-to-cytoplasm ratio due to accelerated activation of myogenic satellite cells. However, severe tissue damaging effects exist with anabolic steroids, some of which are irreversible.