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
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.
Sharing a breakdown of what I have discovered and read this past month. There is a little something for everyone here. Although there is a lot out there, these four articles (2 sports medicine, 2 performance) are my favorites. All have something unique, progressive or surprising about them. Enjoy!
Muscle Force Output and Electromyographic Activity in Squats with Various Unstable Surfaces, from the latest JSCR.
When progressing through rehabilitation programs the practitioner consistently battles the question of priority: improve strength and risk pain, set-back? Do we focus on balance and have slow progression to strength development? Can we super-set strength with balance? Can we go hard strength one day and light balance the next? Here’s a novel idea (sarcasm), let’s do both at once.
Saeterbakken and Finland measured muscle force output through on stable and unstable surfaces. The measurement was done through surface EMG, and, yes, I question reliability of surface EMG, but it is the best option out there. What the authors found was surprising and useful. Performing isometric exercise on an unstable surface (BOSU Ball) produced lower force output, but muscle in the trunk and lower limb was similar when compared to the stable surface.
Why is this important? We have a solution to the aforementioned dilemma. We can overload the muscle to stimulate strength gains, while avoiding the load. This allows practitioners to meet obtain strength gains while avoiding the risk of set-back associated with high loading.
Full reference: Saeterbakken, AH and Finland, MS. Muscle force output and electromyographic activity in squats with various unstable surfaces. J Strength Cond Res 27(1): 130–136, 2013
Assessing Post-surgical ACL Postural Control using a Wii Board was an article I came across Sports Med Research BlogSpot.
At first I was tepid on this article figuring it was just another article showing how Wii can be used as a modality to improve balance control. I quickly jumped to the conclusion and began saying “people, it’s not the Wii board; it’s the task of balancing and stressing local and global neuromuscular control mechanisms to improve postural control.” To my surprise I was wrong.
The authors did something rather unique and plugged the Wii board in to a laptop and utilized a customized software program to assess postural control. The authors received high-quality data that may help clinicians objectively quantify postural control and neuromuscular inefficiency. Few assessments exist that provide objective, reliable data. I would love to see the authors do another study to examine the specificity and sensitivity of assessment.
Full reference: Howells BE, Clark RA, Ardern CL, Bryant AL, Feller JA, Whitehead TS, & Webster KE. Br J of Sports Med. Epub ahead of print Dec 25, 2012.
EFFECTS OF COMBINED CREATINE AND SODIUM BICARBONATE SUPPLEMENTATION ON REPEATED SPRINT PERFORMANCE IN TRAINED MEN, from the latest JSCR.
When working with athletes on maximal speed or speed endurance, human physiology is our biggest limiting factor. Training allows body adaptation and physiological changes to improve performance and curb fatigue, but physiology is physiology – it can only be altered so much. Thus, supplements exist to cheat human physiology.
First a quick exercise physiology review. When performing maximal exertion activity the phosphocreatine system kicks in. Our cells gobble up free floating phosphocreatine stores as our primary source of energy. This energy supply gives us a maximum of 10 seconds worth of energy. Quickly our body begins breaking down glycogen stores so our body as energy to keep producing movement. After 60-90 seconds though if our intensity is still too high we hit our lactate threshold – the period where lactic acid build exceeds the cells removal rate – causing increased cellular acidity. Acidity inhibits enzymatic function and if you recall on your exercise physiology class; enzymes are responsible for breakdown of substrates to energy. So, 2 physiological factors inhibiting performance; 1- depletion of phosphocreatine, and 2- increased acidity causing enzymatic inhibition.
This study examines the combined effects of creatine and sodium bicarbonate (to retard acidic effects) supplementation of sprint performance. To no surprise the authors found that the combination of these supplements increased peak / mean power and attenuated the decline in power. Alas, we found a way to cheat human physiology.
Full reference: Barber, JJ, McDermott, AY, McGaughey, KJ, Olmstead, JD, and Hagobian, TA. Effects of combined creatine and sodium bicarbonate supplementation on repeated sprint performance in trained men. J Strength Cond Res. 27(1): 252–258, 2013.
EFFECTS OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION STRETCHING AND STATIC STRETCHING ON MAXIMAL VOLUNTARY CONTRACTION, from the latest JSCR.
A study done a few years ago demonstrated static stretching reduced power output and performance. Since then, there has been a lot of debate and negative press on static stretching on maximal voluntary contraction (MVC). Suddenly performance experts are saying “Static stretching is the worst thing you can do.”
This is not true! First the performance declined occurred after 45 second static holds. When a stretch was held for 30 seconds or less – as recommended – there was no performance loss. This was supported by a systematic literature review done Kay and Blazevich, published in Medicine and Science in Sports and Exercise last year (Jan 2012). This current study examined effects of Proprioceptive Neuromuscular Facilitation and static stretching on Maximum Voluntary Control.
Unfortunately, the static stretch protocols were to perform static stretches for 5 repetitions of 45 seconds. These parameters exceed the recommended static stretching variables of 2 sets of 30 seconds. As expected the authors came to the same conclusions – that static stretching decreased MVC. Although this is a good study, you must take the data for what it is. Static stretching reduces MVC if the stretch variables is held for 45 seconds. Before you start knocking static stretching understand the data you are interpreting.
Full reference: Miyahara, Y,Naito, H, Ogura, Y, Katamoto, S, and Aoki, J. Effects of proprioceptive neuromuscular facilitation stretching and static stretching on maximal voluntary contraction. J Strength Cond Res. 27(1): 195–201, 2013.
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