a lot of the time
i used to be involved in amateur olympic lifting
a lot of these guys were true natural, obvious by their builds and lifts
most of them trained for years and years on very low rep like 3 rep max, once in a blue moon 5 reps was high
but since they are natural the weights were not much more than 2.25xbw on squats for example (well some maybe more, the very best)
now i also did this stuff for years
but got a few minor injuries in the end so quit while i was ahead
i know one guy tho who has literally been lifting low rep "heavy" weights for 3 years
i dont think he suffered any significant injuries