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Muscle hypertrophy refers to the increase in total mass of a muscle. The number of muscle fibers in humans is believed to be fixed by the first year of life. While debate exists about the possibility of hyperplasia (increasing muscle fiber number), most muscle growth occurs through increasing muscle fiber size. Muscle growth occurs when muscle protein synthesis exceeds muscle protein breakdown over time. Hypertrophy is stimulated by engaging in strength training exercises that generate metabolic stress. Muscle fibers change in size when adapting to the demands placed upon them, mainly through alterations in muscle protein synthesis and breakdown signals.