Runner with anatomical muscle and nervous-system detail
EXERCISE × SYSTEMIC HEALTH

Context, Modality
and Dose

What Shapes the Individual Exercise Response?

Exercise does not produce an identical response in every individual. Biological condition, behavioral state, exercise modality and exercise dose interact to determine how the body perceives and responds to physical activity.

Circadian state, sleep status, stress load, motivation, affect and environmental context can influence neuroendocrine activation, autonomic tone, perceived exertion and overall exercise responsiveness.

Behavioral & Contextual
Modifiers

  • Circadian State
  • Sleep Status
  • Stress Load
  • Motivation / Affect
  • Environmental
    Context

Individual
Physiological State

  • Neuroendocrine
    Activation
  • Autonomic Tone
  • Perceived
    Exertion
  • Exercise
    Responsiveness

Exercise Modalities

  • Aerobic
    (Endurance)
  • Resistance
    (Strength)
  • HIIT
    (Interval)
  • Mobility /
    Balance

Exercise Dose

  • Intensity
  • Duration
  • Frequency
  • Progression
  • Recovery
Runner surrounded by behavioral, physiological and exercise inputs; arrows point toward the runner.

Behavioral & Contextual
Modifiers

Circadian State

Sleep Status

Stress Load

Motivation / Affect

Environmental
Context

Individual
Physiological State

Neuroendocrine
Activation

Autonomic Tone

Perceived
Exertion

Exercise
Responsiveness

Exercise Modalities

Aerobic
(Endurance)

Resistance
(Strength)

HIIT
(Interval)

Mobility /
Balance

Exercise Dose

  • Intensity
  • Duration
  • Frequency
  • Progression
  • Recovery
Read diagram text

Behavioral & Contextual Modifiers

Circadian State

Sleep Status

Stress Load

Motivation / Affect

Environmental Context

Individual Physiological State

Neuroendocrine Activation

Autonomic Tone

Perceived Exertion

Exercise Responsiveness

Exercise Modalities

Aerobic (Endurance)

Resistance (Strength)

HIIT (Interval)

Mobility / Balance

Exercise Dose

  • Intensity
  • Duration
  • Frequency
  • Progression
  • Recovery
Muscle and tendon, mitochondrion, blood vessel, and brain–adrenal signaling converge on the acute physiological response

Physiological Sensors During Exercise

How the Body Detects Physical Activity

During exercise, the body simultaneously detects mechanical, metabolic, vascular and neuroendocrine changes.

Mechanical loading reflects muscle contraction and stress on tendons and bones. Metabolic stress reflects increased energy demand,
calcium signaling, lactate production and glycogen use.

Changes in blood flow and oxygen availability generate hemodynamic and hypoxic signals, while sympathetic and hormonal activation
coordinates whole-body readiness.

Together, these signals initiate the body’s acute physiological response.

Mechanical Loading

  • Muscle Contraction
  • Tendon & Bone Stress
  • Mechanotransduction
  • Integrin / FAK / YAP–TAZ

Metabolic Stress

  • AMP/ATP Ratio ↑
  • AMPK Activation
  • Ca²⁺ Signaling
  • Lactate ↑
  • Glycogen Depletion

Hemodynamic & Hypoxic Signals

  • Blood Flow & Shear Stress ↑
  • Nitric Oxide (NO) ↑
  • Transient Hypoxia
  • HIF-1α Activation

Neuroendocrine Activation

  • Sympathetic Activation
  • Catecholamines ↑
  • Growth Hormone ↑
  • Cortisol (Acute) ↑
  • Insulin / Glucagon Modulation

ACUTE PHYSIOLOGICAL RESPONSE

Heart, lungs, circulation, temperature, hormonal and metabolite responses converge through colored arrows on four acute outcomes

Acute
Physiological
Responses

From Physiological Detection to Immediate Action

Mechanical, metabolic, vascular and neuroendocrine signals converge to produce rapid physiological changes within minutes to hours.

Heart rate, ventilation, circulation and body temperature increase, while hormones and metabolites enter circulation. These coordinated responses improve substrate availability, deliver oxygen and nutrients to active tissues and prepare cells and neuroendocrine systems for adaptation.

Acute Physiological Responses — Minutes to Hours

  • Heart Rate &
    Cardiac Output ↑
  • Ventilation &
    Oxygen Uptake ↑
  • Blood Flow to Active &
    Key Organs ↑
  • Body
    Temperature ↑
  • Hormonal
    Surge
  • Metabolite
    Release
Six physiological responses converge on enhanced oxygen delivery, energy mobilization, lactate and ROS signaling, and neuroendocrine priming

Key Acute Outcomes

Enhanced Nutrient &
Oxygen Delivery

Improved Perfusion and
Substrate Availability.

Energy Mobilization

Glucose and Fatty Acids;
Increased Substrate
Availability.

Metabolic By-Product
Signaling

Lactate and ROS;
Signals to Inform Cells.

Neuroendocrine Priming

Elevated Readiness
for Adaptation.

Six acute physiological responses converge through colored arrows on four immediate outcomes.

Acute Physiological Responses — Minutes to Hours

Heart Rate &
Cardiac Output ↑

Ventilation &
Oxygen Uptake ↑

Blood Flow to Active &
Key Organs ↑

Body
Temperature ↑

Hormonal
Surge

Metabolite
Release

Key Acute Outcomes

Enhanced Nutrient &
Oxygen Delivery

Improved Perfusion and
Substrate Availability.

Energy Mobilization

Glucose and Fatty Acids;
Increased Substrate
Availability.

Metabolic By-Product
Signaling

Lactate and ROS;
Signals to Inform Cells.

Neuroendocrine Priming

Elevated Readiness
for Adaptation.

Lactate

ROS

Read diagram text

Acute Physiological Responses — Minutes to Hours

Heart Rate & Cardiac Output ↑

Ventilation & Oxygen Uptake ↑

Blood Flow to Active & Key Organs ↑

Body Temperature ↑

Hormonal Surge

Metabolite Release

Key Acute Outcomes

Enhanced Nutrient & Oxygen Delivery

Improved Perfusion and Substrate Availability.

Energy Mobilization

Glucose and Fatty Acids; Increased Substrate Availability.

Metabolic By-Product Signaling

Lactate and ROS; Signals to Inform Cells.

Neuroendocrine Priming

Elevated Readiness for Adaptation.

Lactate

ROS

Peripheral Signals
from Contracting
Muscle

Skeletal Muscle as an Endocrine Organ

Contracting skeletal muscle does more than produce movement. During exercise, it releases biochemical signals that communicate its activity and energetic state to the brain and other organs.

These signals include myokines, exerkines,
metabolites and growth or vascular factors.
Through circulation and neural communication,
they contribute to coordinated systemic
responses.

Contracting skeletal muscle releases purple myokines, red metabolites and teal growth factors into the circulation

Contracting
Skeletal Muscle as
an Endocrine Organ

Myokines / Exerkines

  • IL-6
  • Irisin (FNDC5)
  • IL-15
  • FGF21
  • Apelin
  • Myonectin

Metabolites

  • Lactate
  • ATP / ADP / AMP
  • Amino Acids
  • Ketone Bodies

Growth / Vascular Factors

  • IGF-1
  • VEGF
  • HGF
Contracting muscle releases three groups of molecular signals into a curved blood vessel.

Myokines / Exerkines

  • IL-6
  • Irisin (FNDC5)
  • IL-15
  • FGF21
  • Apelin
  • Myonectin

Metabolites

  • Lactate
  • ATP / ADP / AMP
  • Amino Acids
  • Ketone Bodies

Growth / Vascular Factors

  • IGF-1
  • VEGF
  • HGF

Contracting
Skeletal Muscle as
an Endocrine Organ

Read diagram text

Myokines / Exerkines

  • IL-6
  • Irisin (FNDC5)
  • IL-15
  • FGF21
  • Apelin
  • Myonectin

Metabolites

  • Lactate
  • ATP / ADP / AMP
  • Amino Acids
  • Ketone Bodies

Growth / Vascular Factors

  • IGF-1
  • VEGF
  • HGF

Contracting Skeletal Muscle as an Endocrine Organ

Muscle, joint and metabolic sensors communicate with the brain, which coordinates autonomic, hormonal and motor output; sensory and emotional inputs also influence these pathways

Neural Pathways
and CNS Integration

How Peripheral Exercise Signals Reach the Brain

Sensory information from muscles, joints and metabolic receptors travels through afferent pathways to the central nervous system.

The brainstem, hypothalamus, limbic system and cortex integrate these signals. Efferent output then coordinates the autonomic nervous system, HPA axis and motor system, allowing the brain and peripheral tissues to communicate in both directions.

Sensory and emotional context can further modify this response through limbic–hypothalamic, autonomic and neurochemical pathways.

Afferent Signals

  • Muscle
    Sensors
  • Joint
    Sensors
  • Metabolic
    Sensors

CNS Integration

Brainstem; Hypothalamus; Limbic System; Cortex

Brain structures integrate afferent signals and coordinate efferent responses

Efferent Output

  • ANS
  • HPA Axis
  • Motor
    System

Sensory–Affective Neuroregulatory Inputs

Sensory and emotional context influences neural signaling
  • Sensory Context
  • Affective Valence
  • Autonomic Modulation
  • Stress-Buffering Inputs
  • Limbic–Hypothalamic
    Circuitry
  • HPA Axis / ANS
  • Neurochemical
    Signaling
Afferent sensors connect to the central brain, efferent outputs sit at right, and a sensory–affective panel connects from below.

Afferent Signals

Muscle
Sensors

Joint
Sensors

Metabolic
Sensors

CNS Integration

Brainstem; Hypothalamus; Limbic System; Cortex

Efferent Output

ANS

HPA Axis

Motor
System

Sensory–Affective Neuroregulatory Inputs

  • Sensory Context
  • Affective Valence
  • Autonomic Modulation
  • Stress-Buffering Inputs

Limbic–Hypothalamic
Circuitry

HPA Axis / ANS

Neurochemical
Signaling

Read diagram text

Afferent Signals

Muscle Sensors

Joint Sensors

Metabolic Sensors

CNS Integration

Brainstem; Hypothalamus; Limbic System; Cortex

Efferent Output

ANS

HPA Axis

Motor System

Sensory–Affective Neuroregulatory Inputs

  • Sensory Context
  • Affective Valence
  • Autonomic Modulation
  • Stress-Buffering Inputs

Limbic–Hypothalamic Circuitry

HPA Axis / ANS

Neurochemical Signaling

Brain networks connect monoaminergic, cholinergic, excitatory–inhibitory, reward and neurotrophic signaling through five illustrated pathways

NeuroChemical and
NeuroRegulatory
Responses

How Exercise Modulates Brain Signaling

Exercise influences multiple neurochemical systems involved in motivation, emotional regulation, cognition, pain perception and neural adaptation.

Monoaminergic, cholinergic, excitatory–inhibitory and endogenous reward pathways respond alongside neurotrophic factors. These systems do not operate independently; their coordinated regulation shapes the brain’s response to physical activity.

Five signaling pathways surrounding the brain

Monoaminergic System

  • Dopamine (DA)
  • Serotonin (5-HT)
  • Norepinephrine (NE)

Excitatory–Inhibitory
Balance

  • Improved
    Glutamate–GABA
    Balance

Cholinergic
Signaling

  • Acetylcholine (ACh)

Endogenous Reward
& Analgesia

  • Endocannabinoids
    (AEA, 2-AG)
  • β-Endorphin

Neurotrophic Factors

  • BDNF
  • IGF-1
  • VEGF
Five colored neural pathways surround a central brain with circular synapse and neurotrophic illustrations.

Monoaminergic System

  • Dopamine (DA)
  • Serotonin (5-HT)
  • Norepinephrine (NE)

Excitatory–Inhibitory
Balance

  • Improved
    Glutamate–GABA
    Balance

Cholinergic
Signaling

  • Acetylcholine (ACh)

Endogenous Reward
& Analgesia

  • Endocannabinoids
    (AEA, 2-AG)
  • β-Endorphin

Neurotrophic Factors

  • BDNF
  • IGF-1
  • VEGF
Read diagram text

Monoaminergic System

  • Dopamine (DA)
  • Serotonin (5-HT)
  • Norepinephrine (NE)

Excitatory–Inhibitory Balance

  • Improved Glutamate–GABA Balance

Cholinergic Signaling

  • Acetylcholine (ACh)

Endogenous Reward & Analgesia

  • Endocannabinoids (AEA, 2-AG)
  • β-Endorphin

Neurotrophic Factors

  • BDNF
  • IGF-1
  • VEGF
Contracting skeletal muscle communicates in both directions with the brain, heart, bone, gut, pancreas, adipose tissue and liver

Inter-Organ
Crosstalk

Exercise Connects Muscle
with Systemic Organs

Signals generated during exercise create multidirectional communication between skeletal muscle, the brain and peripheral organs.

This inter-organ crosstalk coordinates
neural, metabolic, vascular, skeletal
and immune responses. Rather than
acting on one tissue alone, exercise
produces an integrated systemic
response across multiple biological
axes.

Muscle and seven organs linked by bidirectional signaling pathways

CONTRACTING
SKELETAL MUSCLE

Muscle–Brain Axis

  • Neuroplasticity
  • Mood
  • Cognition
  • Stress Resilience

Muscle–Heart &
Vascular Axis

  • NO Production
  • Angiogenesis
  • Blood Pressure
    Regulation

Muscle–Bone Axis

  • Osteoblast Activity
  • Bone Remodeling

Muscle–Liver Axis

  • Glucose Uptake
  • Glycogen Regulation
  • Insulin Sensitivity

Muscle–Adipose Axis

  • Lipolysis
  • Reduced Visceral Fat
  • Adipokine Modulation

Muscle–Pancreas Axis

  • Insulin Secretion
  • Glucose Homeostasis

Muscle–Immune / Gut Axis

  • Immune Regulation
  • Cytokine Balance
  • Gut Microbiota Modulation
Central skeletal muscle communicates through bidirectional arrows with seven surrounding organs.

Muscle–Brain Axis

  • Neuroplasticity
  • Mood
  • Cognition
  • Stress Resilience

Muscle–Heart &
Vascular Axis

  • NO Production
  • Angiogenesis
  • Blood Pressure
    Regulation

Muscle–Bone Axis

  • Osteoblast Activity
  • Bone Remodeling

Muscle–Liver Axis

  • Glucose Uptake
  • Glycogen Regulation
  • Insulin Sensitivity

Muscle–Adipose Axis

  • Lipolysis
  • Reduced Visceral Fat
  • Adipokine Modulation

Muscle–Immune / Gut Axis

  • Immune Regulation
  • Cytokine Balance
  • Gut Microbiota Modulation

Muscle–Pancreas Axis

  • Insulin Secretion
  • Glucose Homeostasis

CONTRACTING
SKELETAL MUSCLE

Read diagram text

Muscle–Brain Axis

  • Neuroplasticity
  • Mood
  • Cognition
  • Stress Resilience

Muscle–Heart & Vascular Axis

  • NO Production
  • Angiogenesis
  • Blood Pressure Regulation

Muscle–Bone Axis

  • Osteoblast Activity
  • Bone Remodeling

Muscle–Liver Axis

  • Glucose Uptake
  • Glycogen Regulation
  • Insulin Sensitivity

Muscle–Adipose Axis

  • Lipolysis
  • Reduced Visceral Fat
  • Adipokine Modulation

Muscle–Immune / Gut Axis

  • Immune Regulation
  • Cytokine Balance
  • Gut Microbiota Modulation

Muscle–Pancreas Axis

  • Insulin Secretion
  • Glucose Homeostasis

CONTRACTING SKELETAL MUSCLE

Muscle, brain and systemic organ signals converge at the cell membrane and activate six intracellular pathways

Downstream
Intracellular
Signaling

How Exercise Signals Produce Cellular Adaptation

Peripheral, neural and inter-organ signals ultimately converge on intracellular pathways that regulate energy use, mitochondrial function, protein synthesis, antioxidant defense, cellular renewal and inflammatory adaptation.

With repeated exercise, activation of these pathways allows short-term physiological responses to develop into more persistent cellular and systemic adaptations.

Signals cross the cell membrane and activate AMPK, PGC-1α, Akt / mTOR, Nrf2, Sirtuins and NF-κB pathways

Peripheral Signals

(From Contracting Muscle and Other Tissues)

  • Myokines /
    Exerkines
  • Metabolites
  • Growth /
    Vascular Factors

Neurochemical and
Neuroregulatory Responses

(Central Nervous System)

Inter-Organ Crosstalk

Extracellular space

Cell membrane

Cytoplasm

AMPK
Energy
Metabolism
PGC-1α
Mitochondrial
Biogenesis
Akt / mTOR
Protein
Synthesis
Nrf2
Antioxidant
Defense
Sirtuins
(SIRT1)
Autophagy /
Mitophagy
NF-κB
(Chronic)
Cellular Repair &
Anti-Inflammatory
Adaptation
Muscle, brain and organ signals cross a cell membrane into six illustrated intracellular pathways and their outcomes.

Peripheral Signals

(From Contracting Muscle and Other Tissues)

Myokines /
Exerkines

Metabolites

Growth /
Vascular Factors

Neurochemical and
Neuroregulatory Responses

(Central Nervous System)

Inter-Organ Crosstalk

Extracellular space

Cell membrane

Cytoplasm

AMPK

PGC-1α

Akt / mTOR

Nrf2

Sirtuins
(SIRT1)

NF-κB
(Chronic)

Energy
Metabolism

Mitochondrial
Biogenesis

Protein
Synthesis

Antioxidant
Defense

Autophagy /
Mitophagy

Cellular Repair &
Anti-Inflammatory
Adaptation

ATP

Read diagram text

Peripheral Signals

(From Contracting Muscle and Other Tissues)

Myokines / Exerkines

Metabolites

Growth / Vascular Factors

Neurochemical and Neuroregulatory Responses

(Central Nervous System)

Inter-Organ Crosstalk

Extracellular space

Cell membrane

Cytoplasm

AMPK

Energy Metabolism

PGC-1α

Mitochondrial Biogenesis

Akt / mTOR

Protein Synthesis

Nrf2

Antioxidant Defense

Sirtuins (SIRT1)

Autophagy / Mitophagy

NF-κB (Chronic)

Cellular Repair & Anti-Inflammatory Adaptation

ATP