Category Archives: Sports Performance

Knee Osteoarthritis and ACL Injury

ACLSix months (+/- a few) is the standard time needed for an athlete to return to competition following anterior cruciate ligament (ACL) surgery. To reach this date, therapy must be thorough and exact. Range of motion, neuromuscular control, or strength deficits that go unaddressed, negatively influence return to play and can also lead to other long-term consequences.

Those who suffer from ACL injuries are at greater risk of developing knee osteoarthritis (OA). Knee OA is a condition whereby the cartilage slowly wears away. This is a painful, life-long health issue that can lead to disability. With proper rehabilitation and adequate strengthening of the quadriceps, OA can be prevented. Sounds simple, but clinicians must also deal with arthrogenic muscle inhibition (AMI).

ASpinal tractMI is a neuromuscular dysfunction that limits the ability to strengthen muscle and is common following ACL surgery. With AMI, neurological signals from the quadriceps muscle to the brain and spinal cord are interrupted or slowed. You can read more about Brain and CNS deficits here.  So the question is, how do you combat AMI to properly strengthen the quad and subsequently prevent knee OA? The answer might be vibration training.

Vibration training employs a low-amplitude, low-frequency mechanical stimulation that exercises musculoskeletal structures. Vibration training provides strength gains without joint loading and stimulates osteoblastic and chondrocyte activity through the mechanisms of  Power Platemechanobiology. Subsequently, bone and joint health are improved.

A recent article by UNC’s EXSS Impact site found that vibration training (local or whole-body) improves quadriceps function by improving central nervous system function. Following vibration training, brain activity was altered in such a way that it became easier for these subjects to activate and use their quadriceps muscles. As such, muscle vibration can be an effective method to improve quadriceps strength and reduce the risk of developing knee OA.

Below is the full article from UNC.

Why did you do this study?

Individuals with anterior cruciate ligament (ACL) injuries are at greater risk of developing osteoarthritis (OA). OA is a considerable burden on the US healthcare system and contributes to physical disability and comorbidities such as obesity and diabetes. The lifetime cost of ACL injury amounts to $7.6 billion annually for patients that undergo reconstruction, $17.7 billion for patients that undergo non-surgical rehabilitation. Quadriceps dysfunction is ubiquitous following ACL injury and reconstruction, and is a major contributor to the development of OA. The quadriceps are responsible for absorbing impact forces during everyday tasks like walking and stair climbing, and also athletic tasks like running and jumping. When the quadriceps fail to act appropriately, their ability to attenuate these forces is reduced, and cartilage within the knee joint experiences greater loading. Subtle increases in joint loading are amplified through repetitive activities like walking, and over time, greater loading contributes to a gradual breakdown of articular cartilage.

Given the implication for future OA development, the restoration of proper quadriceps function is extremely important in rehabilitation. However, quadriceps dysfunction is caused by a neuromuscular phenomenon called arthrogenic muscle inhibition (AM), which presents a substantial limitation to muscle strengthening. Essentially, sensory signals from the knee joint inform the central nervous system – the brain and spinal cord – that the ACL as been injured. In response, our central nervous system responds by inhibiting the quadriceps to prevent further damage of the injured joint. While this mechanism may protect the joint in short term, AMI persists for many years following the initial injury and is thought to contribute to excessive cartilage loading and the development of OA. Therefore, strengthening the quadriceps is important in rehabilitation, but traditional exercises do not address AMI. Novel rehabilitation modalities are needed to combat AMI prior to the implementation of strengthening exercises.

Previous work in our laboratory indicates that muscle vibration provided directly (local muscle vibration – LMV) and indirectly (whole body vibration – WBV) may improve quadriceps function. However, what remains unclear is the mechanism by which these vibratory stimuli actually work to enhance muscle function. Given that AMI involves alterations in central nervous system function, it is imperative to understand how muscle vibration influences characteristics of spinal cord and brain function. Therefore, the purpose of this study was to understand how both WBV and LMV influence characteristics of central nervous system function.

What did you do and what did you find in this study?

Left - Transcranial magnetic stimulation to assess cortical neuron excitability; Right - Whole body vibration platform

We recruited subjects with ACL reconstruction for this study. First, we measured various characteristics of quadriceps function (i.e. strength and activation), and also how the brain and spinal cord contribute to muscle contraction. Following baseline measurements, subjects received an intervention of WBV, LMV, or control (no vibration) treatment. We repeated the same measurements of quadriceps function and central nervous system function following the treatment.

Active motor threshold was used to assess corticomotor excitability. In this case, both WBV and LMV lowered AMT relative to the control condition. This indicates that it becomes easier for the brain to activate the quadriceps following treatment. (* indicates P<0.0083)

We found that both WBV and LMV acutely improved quadriceps function (strength and activation) relative to the control treatment, and that this improvement was likely due to greater cortical neuron excitability. In other words, muscle contraction can either be voluntary (the brain tells the muscle to contract) or involuntary (spinal reflex loops). What we found was that following WBV and LMV, brain activity was altered in such a way that it became easier for these subjects to activate and use their quadriceps muscles.

How do these findings impact the public?

These findings indicate that vibratory stimuli acutely improve quadriceps function, and could be useful in addressing deficits in central nervous system function such as AMI. As such, muscle vibration could be an effective method to improve quadriceps strengthening protocols following ACL injury, and in turn reduce the risk of developing knee OA. Overall, knee OA is a major economic burden on the US healthcare system, and these findings could have important relevance for alleviating healthcare costs and physical disability.

A comprehensive rehabilitation program is vital for an athlete’s return to competitive sport. Failure to normalize range or motion, strength, and neuromuscular control can result in performance loss, reinjury, or long-term disabilities, such as knee OA. Make sure your rehabilitation program is inclusive of all components. Of course, the best cure for ACL surgery is preventing ACL tears all-together. If you want to prevent ACL injury, read about the RIDS Program designed to prevent injury. 

Pregnancy Fitness Program Using TRX RIP Trainer

Watch the video below as I take my client who is 8 months pregnant through a 30 minute total-body circuit program using only the RIP Trainer by TRX.

A little over a year ago I wrote “A Runner’s Story: From Pain to Performance” which is about a client I began working with about 2 years ago. When we met, the simple task of walking caused sharp pain in her hips and had essentially given up on her long-time passion of running.

After a few months of working together she was racing 5ks and 10ks. In one year’s time (April, 2014) she ran the Illinois half-marathon. I still train her today, but now we have a new challenge; she’s expecting a baby at the end of March. Continue reading

Planks: You’re Doing Them Wrong

Here’s a challenge: I bet you cannot do a forward or side plank for 1 minute straight. Many people will say that is easy. So, let me rephrase: I bet you cannot do a forward or side plank properly for 1 minute straight.

Many fitness enthusiasts choose planks to work the core, but are they really working the core? When I observe clients perform the plank exercise, 9 out of 10 fail to perform the exercise properly. Take a look at the common compensation patterns that occur during the plank exercise and then challenge yourself. Can you do the exercise for 1 minute, with perfect technique, and without compensation? Continue reading

15 Myths and Facts for Runners

runningRunners are a very particular type of athlete and will try almost anything to run longer, faster, and remain injury free. Unfortunately, there is a lot anecdotal and pseudoscience being pulled from the internet that leads runners astray. In this article I talk about the biggest myths and facts in running.

  1. Static stretching decreases performance.

MYTH: A study done a few years ago demonstrated static stretching reduced power output and performance. Suddenly, performance experts started saying “Static stretching is the worst thing you can do.” This is not true! These people just misinterpreted the facts.  The data stated that performance decreased when the muscle was stretched for 45 seconds or longer… When a stretch was held for 30 seconds or less – as recommended – there was no performance loss.  A recent study published in the Journal of Strength and Conditioning confirmed this (1). This study found that the threshold of continuous static stretching in which muscular power output decreased was 60 seconds. Static stretching for a short-duration (30 seconds) had a negligible influence on performance.

  1. Static stretching can increase tightness.

stretchFACT:  Muscle is made up of two types of fibers, intrafusal and extrafusal.  Inside the intrafusal fibers is a receptor called the muscle spindle. It’s like a spring-loaded sensory detector. It is a protective mechanism that when over stretched sends a signal to the brain and spinal cord telling the muscle to contract and protect itself, thus making the muscle tighter. Some muscle spindles are overly active causing chronic tightness. So, when you stretch a muscle that already has over active muscle spindle, the tightness can increase. I wrote an article about this phenomena, if you want to read more about that.  I understand this can be confusing, but when you read #3 you will see how all of this comes together.

  1. You should foam roll after running.

Foam Roll TFL

MYTH: Foam rolling or self myofascial release is one of the most effective tools to improve motion and prevent muscle injury. Unfortunately, many runners foam roll after a run. It is just as important, or even more important, to foam roll before a run. As I mentioned in #2, muscle spindles create tightness when stretched. Due to the repetitive nature of running, runners are very susceptible to developing hyper-active muscle spindles. Foam rolling or self myofascial release targets the muscle spindle and inhibits it (hence the term release in myofascial release). Foam rolling overloads the muscle spindle and the nervous system and gets it to relax and turn off. This allows the muscle to be stretched without the muscle spindle becoming overprotective. Every client I see is directed to foam roll first, stretch, then exercise.

  1. Icing or an ice bath after a run helps injury and speeds recovery

MYTH: Inflammation is REQUIRED for the body to bring supplies to worked areas, clean up any debris and help rebuild tissue. When we ice that sore knee, aching Achilles, or painful plantar fascia after a run or workout we are delaying our body’s innate ability to repair that tissue. Yes, icing is not all it is cracked up to be. Even the physician who coined the term RICE (Rest, Ice, Compression and Elevation) has said that icing is wrong. I’ve written many articles about this, but the most recent, explains why RICE is no longer accepted as the cure-all.  If you want to recover, cool down with foam rolling and stretching, and have a few days of light exercise or rest.

  1. Drinking extra liquid will prevent heat illness.

MYTH: In general we overhydrate. Tim Noakes, MD, a long-time researcher of water balance and author of “Waterlogged:  The Serious Problem of Overhydration in Endurance Sports,” says we have been misled to believe that we need to drink to stay ’ahead of thirst’.  Hydration prevents dehydration, but it does NOT prevent heat illness. Dehydration and heat illness have very similar symptoms and often we use the two interchangeably, but they are not the same. If someone is suffering from heat illness, giving them water is not the answer, cooling their body temperature is. Giving excessive water to a person suffering from heat illness can cause a serious or fatal event called exercise-associated hyponatremia encephalopathy (EAHE).   Marathoners and distance runners who drink at every aid station or drink excessively before a run put themselves at risk for this condition. Dr. Noakes states we should aim for ingestion rates that never exceed 27 ounces/hr (2). 20140501More about our hyper-hydration nation can be found in this article.

 

  1. Dehydration kills performance.

MYTH: It’s long been held as fact that losing more than 2 percent of bodyweight to dehydration will hurt performance. But several recent studies, as well as anecdotal evidence from the world’s top runners, suggest it’s possible to lose more than 2 percent with little to no detriment to performance. A study in the British Journal of Sports Medicine found that current hydration guidelines are erroneous and that dehydration does not impair performance (3). In this article the authors found weight loss of up to 3 percent did not slow down athletes (cyclists, in this case) or lower their power output.  Finally, in 2012 a study found that Haile Gebreselassie lost a whopping 9.8 percent of his bodyweight during the 2009 Dubai Marathon—and still won, in 2:05:29 (4).

  1. Energy chews prevent bonk or fatigue.

FACT: But don’t be fooled: Energy chews do work to prevent fatigue during long distance running events, but so do raisins!  A study published a few years ago compared raisins vs. energy gummies. There was no difference in performance between the raisin group and the gummy group. In addition, the raisin group showed a lower insulin spike when compared to the gummy group, a win for the raisin. Plus, the raisin group demonstrated higher free fatty acid content in the blood post activity, demonstrating more fat metabolism. So, for the same performance gains, you can gain additional benefits from raisins over energy gummies.

  1. Bananas prevent cramps

MYTH: While bananas are a great source of nutrition and do contain many electrolyte replacing nutrients, they alone do not prevent cramping. Cramping can be caused by a large number of reasons, including over hydration (see above) or poor conditioning. Tim Noakes, MD, in Lore of Running, 4th Edition, suggests muscle cramps are caused by muscle fatigue and that cramping has more to do with not training properly than nutritional or hydration deficits.

  1. Runners need to strength train.

FACT: Running strengthens your muscles, but it only strengthens certain muscle fibers to a certain degree. A total body strength training is imperative for running performance. Strength and stability of the core and shoulder help translate to lower body power and efficiency. If you need a kick to climb a hill faster or sprint to beat an opponent to the line, strength training is imperative. Proper strength training and targeting specific muscles will also prevent injury. John Martinez, the assistant head doctor for the Ironman World Championships says “You can run five days a week and you’ll finish a marathon, but if you want to PR or qualify for Boston you need to have some kind of strength training in there. It’s about improving our performance.” Always add a strength training component to your training program. Running alone is not enough.

  1. Running is the best way to lose weight.

Graphics like this misguide those seeking weight loss.

MYTH: You’re being duped folks! Long duration cardio training does not make you lose more fat or weight. Running in the “fat burning zone” as depicted on a cardio machine does NOT burn more fat. If you want to lose weight, you need to burn calories. What burns calories? Intensity! Higher intensity requires more oxygen demand and thus a greater oxygen debt.  High intensity training has a caloric after burn that lasts for 12-24 hours. Standard steady state running only has a caloric after burn of 1-4 hours. You can burn more calories in a 20 minute high intensity interval training program than you can running for 60 minutes at a steady pace. If you want to lose weight, get off the treadmill!

  1. Minimalist shoes improve running mechanics and prevent injury.

vibram-shoes1MYTH: Will the minimalist running trend ever end? Minimalist shoes do not prevent injury. In fact, those who jump from a normal shoe to a minimalist shoe without proper training or adaptation are at an increased risk for injury. Five separate studies presented at the annual meeting of the American College of Sports Medicine “found no significant benefits, in terms of economy, from switching to minimalist, barefoot-style footwear.” Minimalist shoes also do not magically improve your running mechanics. There are no quality studies that show running in a minimalist shoe improves mechanics. In order to improve mechanics, you need a quality strengthening and flexibility program that encourages appropriate muscles firing. If you want to go the minimalist route, walk first. Adapt to the new style and supplement with a structured training program.

  1. Getting a shoe that matches your arch height will prevent shin splints.

MYTH: Shin splints are not caused by a high or low arch. Many runners with a high or low arch can avoid shin splints. Similarly, runners with a “perfect” arch can develop shin splints. The cause of shin splints is multifactorial and correcting musculoskeletal dysfunction through a structured program prevents shin splints. The article Shin splints 101 demonstrates how to prevent shin splints. A systematic literature, published in the Journal of Sports Physical Therapy found that selecting running shoes based on arch height had little influence on injury risk. (5)

  1. A midfoot strike is best for performance.

MYTH: If you run slower than a 5-minute mile, it may be most efficient to heel strike. A study published in Medicine and Science in Sports and Exercise found that rear-foot strikers are up to 9.3 percent more economical than midfoot strikers (6). Lead author Ana Ogueta-Alday believes the reason for the improved efficiency stems from the increased ground contact time the study observed in rearfoot strikers. More contact time with the ground allows for more force to be applied, while also decreasing the metabolic cost of running. If you’re a heel striker and haven’t been chronically injured, there’s no need to change your ways.

  1. The more mileage you run per week the better your performance.

MYTH: If you want to improve, you need rest, recovery, and varied training. I challenge you to find an elite marathoner who trains only by running. The elite runners have rest and cross-training built into their weekly programs. See the importance of strength training in item #9 above.  Two of the best known experts on running, Jack Daniels and Hal Higdon, provide run training programs. There programs stress the importance of recovery days and strength training days. In fact, Jack Daniels says that when training for long running events, train for time, not mileage. Getting 20+ miles is not the best for all runners and could cause injury.

  1. Preventing injury is a matter of not doing too much too fast.

FACT: There are many things that can cause injury, but one of the biggest determinants of injury is doing too much too fast. A study in the Journal of Sports Physical Therapy evaluated progression of running distance and its relation to injury. The authors found novice runners who progressed their running distance by more than 30% over a 2-week period seem to be more vulnerable to distance-related injuries than runners who increase their running distance by less than 10% (7). Owing to the exploratory nature of the present study, randomized controlled trials are needed to verify these results, and more experimental studies are needed to validate the assumptions. Still, novice runners may be well advised to progress their weekly distances by less than 30% per week over a 2-week period. So stick with the 10% rule.

If you are a runner and look to increase performance or prevent injury, please feel free to contact me for a free consultation.

References:

  1. Pinto, MD, et al. Differential Effects of 30- Vs. 60-Second Static Muscle Stretching on Vertical Jump Performance. December 2014. 28:12. p 3440–3446.
  2. Noakes, T. Waterlogged: The Serious Problem of Overhydration in Endurance Athletes. Human Kinetics. Champaign, IL. 2012.
  3. Wall, BA, et. al. Current hydration guidelines are erroneous: dehydration does not impair exercise performance in the heat. Br J Sports Med. 2013 Sep 20.
  4. Beis, LY, et. al. Drinking behaviors of elite male runners during marathon competition. Clin J Sport Med. 2012 May;22(3):254-61
  5. Knapik JJ, et, al. Injury-reduction effectiveness of prescribing running shoes on the basis of foot arch height: summary of military investigations. J Orthop Sports Phys Ther. 2014 Oct;44(10):805-12.
  6. Ogueta-Alday, A, et. al. Rearfoot striking runners are more economical that midfoot strikers. Med Sci Sports Exerc. 2014; 46(3):580-5.
  7. Nielsen RØ, et. al. Excessive progression in weekly running distance and risk of running-related injuries: an association which varies according to type of injury. J Orthop Sports Phys Ther.2014 Oct;44(10):739-47.

 

 

The Sit-up: So Simple, Yet So bad!

I have nSit upo idea how long the sit-up has been around – a thousand years maybe? Whatever it is we’ve been doing it for a long time. I don’t know how many times I’ve heard “I do crunches every day.”, “I’m working my core.”, or “Look at my 6-pack.”. My responses to those statements: “No you don’t.”, No you’re not.”, and “great, do you want a cookie for your efforts?”  The fact is I see so many people “working their core” and the only thing they are doing is making a bad problem worse. Something so simple and you are doing it wrong!

I do not have a 6-pack. I do not have a 12-pack. I have what some may refer to as a party-ball of Guinness Extra Stout. Ask my wife, she will vouch for this sexy, fuzzy pillow that serves as my beer containment center. Despite my rather portly and ovoid mid-section, I know my core is a lot stronger, more stable, and less susceptible to injury than the 24 yr. old fitness geek down the street referred to as Jacked Jimmy. Yeah, that guy with glistening abs, who at every chance will raise his extra tight wife-beater tank top up, ever so slightly, just so he can hear the throngs of women fall unconsciously to the ground. Yeah that guy. How do I know that I can beat him in a core-off? Because more likely than not, he’s doing it wrong. I’ve seen too many “fit” clients fail miserably when I put them through a core routine. Continue reading

The Hydration Nation: Hyper-Hydration vs. Dehydration

20140501“Are you drinking water?” “Drink water!” “Hydrate!” “If you’re thirsty it is too late, you are already dehydrated.”  This craze of hydrate, hydrate, hydrate has gone overboard and could be causing more harm than good. Who is more at risk for serious medical complications, the hyper-hydrated or dehydrated. For performance, is it best to be overly hydrated, dehydrated or euhydrated? What follows might surprise you. Continue reading

3C’s + P Approach to Successful Outcomes

How many times have you racked your head wondering; why is this not getting better? How come they’re still in pain? How do we have all of this evidence and knowledge at our disposal, yet individuals do not respond as anticipated? The science says, for injury ‘Z’ treat with ‘X’ and rehabilitate with ‘Y’, yet when we apply those tools they don’t work? Why are they not getting better? What are you doing wrong? What are they doing wrong? Continue reading

Multivitamins: A Multibillion Dollar Waste of Money

Pills Pouring out of BottleIt’s a shame that a multibillion dollar industry is fueled by misleading people. The business of supplementation is championed by big businesses who utilize fear-mongering tactics to influence the public. These companies disseminate biased data and purport ridiculous claims. ‘We are a nation of rising chronic disease, take this multivitamin.’ ‘We are a nation of malnourished kids, take this multivitamin.’ ‘Autism linked to vitamin deficiency, take this multivitamin.’ ‘Agriculture has ruined our soil; it is depleted of nutrients, take this multivitamin.’ It is an infestation of pseudoscience propaganda that gets delivered daily to our email inbox and shared via social media.

Last night, I was in my normal geek mode and came across a news story on my Flipboard feed; Are multivitamins a waste of money?  I was glad to see an article disputing the inaccurate claims made by the industry. The article quotes an editorial published in this week’s Annals of Internal Medicine to support the claim that using supplements and multivitamins to prevent chronic conditions is a waste of money.

Hallelujah! Continue reading

A Runner’s Story: From Pain to Performance

Photo_shoot_runningIn 2010, I left clinical rehabilitation and performance training. While I love my current job, I do miss the clinical aspect, which is why I seize opportunities to take on random clients with complex issues.  I’ve never written about my clients, but this case is so common, yet complex, that I thought my readers might be challenged with similar clients/athletes, or might be experiencing similar issues themselves. Here is a runner’s story that went from marathon training, to painful walking and an inability to run. Her experiences with continued failed treatment and the road we have taken to get her back to training and setting personal records. Continue reading

Kids and Distance Running

By now, some, if not most, have read the article of the 6-year-old girl who became the youngest ever to complete a half-Half marathonmarathon. Not only did she become the youngest ever, she finished 5th out of 10 in a group of competitors aged 14 and under – she was the only competitor under 12 years old. Race announcer said “she seemed to be barely even breathing hard at the finish line.” So the question being asked – is this safe and appropriate? The question I ask: is this a real concern or more of an excuse? Continue reading

Physiology of Reversibility: If You Don’t Use It, You Lose It!

Have you heard the old adage “if you don’t use it, you lose it”? james-stewart26Does this really happen? If so, to what degree does one “lose it”? I was riding dirt bikes since the age of three, began racing motocross at age six and ‘retired’ –moved from home and went to graduate school – around the age of 21. After 18 years of riding and racing, I know I can still swing my leg over a seat and take off and ride much better than most. But, I could not go as fast as I once could. I would not have the technique nor would I have the strength power or endurance to ride for long. What about my neural impulse and reaction – that would be nonexistent, wouldn’t it?  Countless studies have demonstrated the positive correlation between practice and reaction. I haven’t practiced and with my luck, I’d hit a rock and run in to a tree. Continue reading

Post-exercise Nutritional Tips for Improving Performance and Recovery

My former co-worker giving me a stretch during the Spartan race after cramps set in.

My former co-worker giving me a stretch during the Spartan race after cramps set in.

A couple of weeks ago, I participated in a 5k and a 10k challenge that was scheduled 12 hours apart. Fitness enthusiasts would consider a back to back 5k / 10k as just another training session. I, on the other hand, am quite the opposite. I have developed a hate-hate relationship with aerobic exercise –specifically, running. I like speed, agility, quickness, strength, and power – arrg arrg arrg! I am five foot nothin’ and a hundred somethin’ (emphasis on the nothin’ and somethin’).  I would rather pluck my eyelashes than run. But, I do love the exercise science.

You’d think I’d use my knowledge for exercise science as a useful tool. Unfortunately, my continued pursuit of knowledge does not translate to practical utility. What follows is what I should have done to enhance recovery and optimize performance during this short 12 hour recovery period between races. Since, I won’t listen to myself, maybe you will!

First, we must understand the physiology of producing energy, fatigue and recovery. I do not want to turn this in to an advanced exercise physiology session on metabolic pathways but this general background is helpful. When we exercise energy (ATP) is needed.  This energy is created by our body using three systems:  ATP-PCr system, the glycolytic system and the oxidative system. Each energy system has its own method of generating energy. Likewise, each energy system becomes fatigued after an imbalance occurs in its system.

In the ATP-PCr system our body uses stored Phosophocreatine and through a series of reactions quickly generates ATP. Unfortunately, this system gets depleted of stores rather quickly. This is why you can only perform and all out sprint for 10 – 20 seconds. After a 2 minute rest period the ATP resynthesizes giving you the ability to perform an all-out sprint again. If we going longer than 20 seconds our body must enter the glycolytic system. Here we begin to use glycogen to make energy. When glycogen is broken down without oxygen present, our cells becomes acidic (commonly known as lactic acid buildup or lactate threshold). This acidity inhibits enzyme activity. Since enzymes are the catalysts for almost all body functions, we fatigue when they stop working.

If intensity is low enough in the glycolytic system, our body has time to use oxygen to breakdown glycogen and prevent lactic acid build-up. This is the oxidative system. Using oxygen to breakdown glycogen is our long-term energy system, which we use to perform tasks like distance running. Carbohydrate is stored in our body as glycogen in muscle and liver. This is our preferred and primary energy source. However, when we exercise we deplete glycogen stores and sometimes have to call on fat to make energy. When we reach this phase our body will fatigue. So, in review, during high-intensity exercise we fatigue because we deplete ATP and Phosphocreatine stores. During moderate activity we fatigue due to lactate build-up. During long and steady state exercise we fatigue when glycogen stores become depleted.

To combat this fatigue we must train our body to adapt to these physiological changes, or provide opportunity for our body to recover through rest. You can also practice good post-exercise refueling habits. By eating and drinking macronutrients (carbohydrate, fat and protein) we replace what we just used. So, what do we eat and when do we eat to replenish?

A Study published by Howarth, et al., in 2009 found that ingesting a carbohydrate and protein mixture at a 4:1 ration provided the best benefits when compared to carbohydrates alone. Similarly, Koopman, et al., in 2005 found a 3:2 ration of carbohydrate to protein ingested post exercise was better than carbohydrate alone. The Koopman study also investigated the benefit of leucine – an essential amino acid found in soy, beef and salmon, known to facilitate muscle regeneration – and demonstrated an added benefit of this supplement. Even though some current data is contradictory most studies show that the amount of glycogen formed is significantly greater in athletes consuming the mixture of Carbohydrate and Protein.

Timing also plays an important role. You may have heard of nutrient timing – it’s getting a lot of attention lately. In order to compensate for protein loss during exercise, the timing of post-exercise protein supplementation is important. The efficiency of protein synthesis is improved by ingesting rapidly after exercise.  Another challenge is the refueling with carbohydrates. Bottom line, the sooner carbohydrate is consumed post-exercise; the greater the amount of muscle glycogen is resynthesized. When time is short between fuel-demanding events, it makes sense to start refueling as soon as possible.

Keep it simple, post-exercise meals should be built on a foundation of carbohydrate-rich foods plus a smaller amount of protein. Greek yogurt or cottage cheese with fruit or bananas with peanut butter are both good options. If you are a stickler for protein powder, switch it up – make yourself a fruit smoothie and add a scoop of protein.

My times for the 5k and 10k were 29:37 and 63:26 respectively; certainly not awesome.  Maybe if I’d apply what I know, I would have done better. Maybe if I replenished with a healthy carbohydrate protein drink instead of beer and pizza, I would have done better on day 2. If I’d just listen to my brain and not my fat cells I might have finished under 60 minutes. If I’d listen to my brain, not watch the ESPN, I could improve. If I chose to get up rather than drool on my pillow, I might approach 45 minutes. Someday I will get the hint and practice what I preach. Maybe I need the late Chris Farley’s famous character, Matt Foley, as my personal motivational speaker.

Core Before or Core After?

I was recently asked by a colleague: Why does NASM recommend performing core exercises prior to SAQ and resistance exercises when most other organizations state to perform core at the end? It is a long-winded, highly-debatable question, so I decided to write a short blog on the topic providing my thoughts.

The theory of performing core exercise at the end of training is very valid and certainly has utility.The primary theory to performing core exercise after resistance training is fatigue. Resistance, reactive and SAQ training targets our prime movers which are predominately made of Fast Gylcolytic (FG) and Fast Oxidative Glycolytic (FOG) muscle fibers. These fibers are easily fatigued due to their avascular properties. Core musculature is rich in Slow Oxidative (SO) muscle fibers. High vascularity makes SO fibers resistant to fatigue secondary to the accessibility to oxygen.

A common fault with core training technique is allowing the prime movers – saturated with FG / FOG fibers – to dominate the SO dominant muscle fibers of the core. Subsequently, we are not properly working the core muscles, we are just training our prime movers to act as core stabilizers. During higher intensity exercise like SAQ, reactive, and resistance training the FG and FOG muscle fibers become fatigued. Thus, when we transition to core exercises, the fatigued prime movers are less likely to become dominant and will allow for the core musculature and SO dominant muscles to do there job. So the organizations that support this method are certainly not wrong.

Conversely, NASM has a completely different outlook on when to perform core exercises. By performing core exercise after flexibility and prior to SAQ, plyometric, or resistance exercise serves as a functional warm-up to stimulate the neuromuscular system and enhance neuromuscular efficiency during more intense exercise. By doing so, our neuromuscular system is prepared and ready for higher intensity exercise and can prevent unwanted motion of joints and prevent injury.

The thought process behind this is the increased neurological stimulation that occurs when performing core exercise. This increased neural stimulation is much like the neural response that occurs with post-activation potentiation (PAP). PAP operates on the principle that heavy muscle loading creates increased stimulation of the central nervous system, resulting in greater motor unit recruitment and subsequently force production (1, 2).

There are two theories behind PAP. The first states that maximal muscle contraction yields an increased phosphorylation of myosin. The increased phosphorylation causes actin and myosin binding to be more responsive to calcium ions released from the sarcoplasmic reticulum (3).  This enhances force muscle production at the structural level of muscle (4).  As a result, faster contraction rates develop (1).

The second theory behind PAP involves the Hoffmann Reflex (4). The Hoffman reflex is excitation of muscle spindle nerve fibers. Physiologically, PAP increases speed of H-reflex, thus increasing the firing rate to muscle (5). It is this rate coding, and the aforementioned  phosphorylation of myosin that the NASM model suggests occurs during and following core exercise.

By stimulating the core musculature, the core will be active during the core exercise and also be activated during higher intensity exercise. Subsequently, the core is working longer and it is helping prevent injury by enhancing neuromuscular efficiency during higher intensity exercise.

What do you think? Which method do you prefer? Personally, through research and exercise experience, I favor the NASM version, but that could easily be attributed to my work experience at NASM. Nonetheless, the question remains and I think it would be a great research study comparing the two variables. Any doctoral students looking for a project?

References:

  1. Chiu, L.Z., Fry, A.C., Weiss, L.W., Schilling, B.K., Brown, L.E., & Smith, S.L. (2003). Postactivation potentiation response in athletic and recreationally trained individuals. Journal of Strength and Conditioning Research. 17(4), 671-677.
  2. Rixon, K.P., Lamont, H.S., & Bemden, M.G. (2007). Influence of type of muscle contraction, gender, and lifting experience on postactivation potentiation performance. Journal of Strength and Conditioning Research, 21(2), 500-505.
  3. Kravitz
  4. Hamada, T., Sale, D.G., MacDougall, J.D., & Tarnopolsky, M.A. (2000a). Postactivation potentiation, muscle fiber type, and twitch contraction time in human knee extensor muscles. Journal of Applied Physiology, 88, 2131-2137.
  5. Hodgson, M., Docherty, D., & Robbins, D. (2005). Post-activation potentiation underlying physiology and implications for motor performance. Sports Medicine, 25 (7), 385-395.

Eat This! Don’t Take That!

Multivitamins, fish oil, antioxidants, vitamin D, B-complex vitamins, conjugated linoleic acid, amino acids, protein powders, chromium, pyruvate, GuChomps/Gel Packs, creatine, fat burners, how many supplements do we need? You might be sick of hearing me say this, but let your body do its job. Why all of a sudden do we feel it is necessary to incorporate supplements in our diet? Our body has always been able to do its job.

Supplements are just that, designed to supplement, not overrun the diet. We only need enough to make up for shortfall of our recommended dietary allowance. RDA is the dietary intake level of a nutrient considered sufficient by the Food and Nutrition Board. These nutrient levels are set to meet the needs for over 95% of the population. The kicker is that most balanced diets of 2,000 calories will meet these needed levels. Eating more is not better.

Without a doubt, nutrients play an integral in human physiology, but over abundance of a particular nutrient may inhibit other physiological functions, creating a nutrient tug-o-war. There are Tolerable Upper Intake Levels (UL) that are set to caution against excessive nutrient consumption, because it can be harmful. Yet, despite eating a balanced meal, many still take additional supplements that can have significant adverse reactions.

There are a scant few in the population that actually need supplements. For example, nursing or pregnant women, those with strict calorie restrictions or nutritional deficits secondary food intolerance, seniors or those with medical illness and some athletes. But, these individuals need a select few supplements, not excessive amounts of unnecessary supplements.

For this blog, I wanted to talk about the most common nutritional supplements, share their toxicity effects and then provide a reasonable food source that is a better choice that the supplement of choice.

Don’t Take That: Multivitamin

Really, is your body deficient in 30 plus vitamins and minerals? You might be deficient in 1 or 2, but not all. Many times the vitamin / mineral intake level of a the standard multivitamin far exceeds RDA levels and sometimes certain vitamins or minerals are near the UL. Now, add this with normal eating and you are certain to go beyond the UL in many of your vitamins and minerals. This creates toxic effects, which can alter normal body physiology, cause illness, and inhibit other minerals from doing their job.

Eat This! A Well-balance meal

This is easy, to get all of your vitamins and minerals in adequate levels eat a well-balanced meal that meets your caloric needs. This will prevent toxicity and get all vitamins and nutrients for optimal human functioning.

Don’t Take That: Vitamin D

Vitamin D certainly has a positive impact on the body, including increased bone mineral density. Unfortunately, chronic overdose of Vitamin D can lead to hyperparathyroidism and hypercalcemia, which can lead to nausea, weakness, insomnia, and even renal failure.

Eat This! Mushrooms, fish, and sunlight.

Most of the Vitamin D needed for you body can be achieved through our own internal synthesis. In just 10-15 minutes of sunlight your skin will begin to synthesize vitamin D. However, if you live in a cave, or are nocturnal, eat fish – catfish, salmon, mackerel with a side of mushrooms to get your vitamin D needs.

Don’t Take That: Omega-3

Omega-3 fatty acids or fish oils are the absolute best fat one can have. They are best known for the significant cardiovascular benefits. Unfortunately, excessive amounts cause excessive bleeding, stroke, headaches,  increased blood glucose levels, and Gastrointestinal disorders.

Eat This! Fish, avacados, nuts, flax seeds, oils

There are many foods that are rich in Omega-3 fatty acids. It is easy to get the recommended amount in the typical diet. In addition, to the richness of Omega-3 content you also get all the other nutrients that accompany these foods, making food a much better option than the supplement.

Don’t Take That: B-Complex Vitamins

A water soluble vitamin that has many positive effects such as reduced stress, increased energy, and higher metabolic rates. Since B vitamins are water soluble toxic effects are rare as the excess is typically excreted in urine. However, Vitamin B6 (pyridoxine) is linked to peripheral neuroathy, and B12 is linked to pernicious anemia disease, but these are rare. Others have been linked to skin and neurological disorders. The biggest factor here is that we rarely need them

Eat This! Most foods

Found in most unprocessed foods, plants, dairy products, meats and fortified cereals, it is rare that we have a deficiency in B-vitamins. If you are stressed, or lacking energy, go exercise – don’t take a pill, you will just excrete it all in a few hours anyway.

Don’t Take That: Vitamin C

Known for it’s ability to boost the immune system, vitamin C is widely used and found as an additive to many foods. That said the research to support these claims are suspect at best. Vitamin C is also known as an effective antioxidant for its ability to reduce oxidative stress, through removal of free radicals. As a water soluble vitamin, excess Vitamin C is excreted in the urine, however, there is a  risk for diarrhea and in rare cases the formation of kidney stones is possible.

Eat This! Citrus Fruits

Rich sources include oranges, peppers, grapefruits, peaches, papayas, pineapples, broccoli, strawberries, tomatoes, and melons.

Don’t Take That: Protein Supplement

Protein supplements, particularly, meal replacement shakes with a 4:1 carbohydrate to protein ratio taken 15-45 minutes after exercise, has significant benefits for refueling lost energy stores. Sadly, most will take protein supplements throughout the day – even when not exercising. Very little quality evidence exists showing positive effects of more than 2 grams/kg body weight of protein per day. Most literature recommends 1.2-1.8 grams / kg of body weight per day.  Then there is the other theory that our body can only digest a certain amount of protein per hour – so excessive amounts gets converted or is passed through. So why spend the money?

Eat This! Meat, dairy, some plants

If you are exercising a post workout protein shake might be beneficial. If you are skipping meals, a protein shake might be beneficial. Otherwise save your money, eat  lean meats such as turkey, chicken, pork, and fish. In addition, dairy products, and beans are good protein sources. It’s cheaper and tastes better than chalk flavored milk.

Don’t Take That: Energy Gummies

These have become the rage for long distance endurance athletes. Energy gummies are filled with electrolytes, antioxidants, and amino acids to combat breakdown, fatigue and provide long lasting energy. Great right? Sure, but why spend the money if something cheaper works just as well or better.

Eat This! Raisins

A study published a few years ago compared raisins vs. energy gummies. There was no difference in performance between the raisin group and the gummy group. In addition, the raisin group showed a lower insulin spike when compared to the gummy group, a win for the raisin. Plus, the raisin group demonstrated higher free fatty acid content in the blood post activity. What does this mean, for the same performance gains, raisins allowed for more fat metabolism vs. gummy candy – most of us could stand to lose fat.

I know I will catch flack for this. Many of my friends are big supplement supporters. Yes, supplements do serve a purpose, but only in moderation and only if you need it. If you question whether or not you need a supplement, seek consultation from a registered dietitian – they will evaluate your diet and tell you exactly what you need.

Postactivation Potentiation (PAP)

For years there has been a gap between performance enhancement and injury management. Strength coaches fail to address rehabilitation  and injury prevention during performance training whereas health care practitioners (ATs, PTs, OTs) fail to address performance training during injury management. There are some who continually seek to merge the two disciplines, by utilizing the unique training principles from each side. I am not saying ALL fail to bridge the gap, but it certainly is the majority.  Health care practitioners could be a bit more boundaryless and integrate performance enhancement concepts and protocols into injury management programming. One method we can use is Postactivation Potentiation or (PAP). Continue reading