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We examined the effects of attentional focus cues on maximal voluntary force output of the elbow flexors and the underlying physiological mechanisms. Eleven males participated in two randomized experimental sessions. In each session, four randomized blocks of three maximal voluntary contractions (MVC) were performed. The blocks consisted of two externally and two internally attentional focus cued blocks. In one of the sessions, corticospinal excitability (CSE) was measured. During the stimulation session transcranial magnetic, transmastoid and Erb’s point stimulations were used to induce motor evoked potentials (MEPs), cervicomedullary MEP (CMEPs) and maximal muscle action potential (Mmax), respectively in the biceps brachii. Across both sessions forces were lower (p = 0.024) under the internal (282.4 ± 60.3 N) compared to the external condition (310.7 ± 11.3 N). Muscle co-activation was greater (p = 0.016) under the internal (26.3 ± 11.5%) compared with the external condition (21.5 ± 9.4%). There was no change in CSE. Across both sessions, force measurements were lower (p = 0.033) during the stimulation (279.0 ± 47.1 N) compared with the no-stimulation session (314.1 ± 57.5 N). In conclusion, external focus increased force, likely due to reduced co-activation. Stimulating the corticospinal pathway may confound attentional focus. The stimulations may distract participants from the cues and/or disrupt areas of the cortex responsible for attention and focus.

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