Tuesday, February 6, 2018

Achillies Tendon Rupture: Post Surgery Weeks 3-8

The cast came off and the CAM boot went on in week three.  The CAM is just a fancy boot that locks in certain degrees.  I had the CAM set at 20 degrees of plantar flexion for weeks 3 and 4.  10 degrees for weeks 5 and 6.  Weeks 7 and 8 I was supposed to be at zero degrees, but decided I would just go to my zero degree weight bearing boot.  The zero degree weight bearing boot was supposed to be for weeks 8-10.  


Since I skipped the last two weeks of the CAM boot and went to the weight bearing boot, my heel was getting incredibly sore.  I purchased some soft gel heel cups and put them in my shoe or boot and this helped.  My feeling after being in the weight bearing boot for a full day of work, is that my heel would actually be better off in just a plain tennis shoe.  Instead of being in a boot for another month I just made the call that I was better off without a boot and went for the tennis shoe and a heel cup.  (It is now very evident we walk around in a type of high heeled shoe, as this was less aggressive then my weight bearing boot)  

It felt great to be free from the boot.  Since I no longer used the boot, I decided it was time to take the dreaded measurement to see how much calf atrophy had taken place.  Pre achillies, my left calf was 40.5 cm, right calf was 42.5 cm.  Post boot, my left calf was 38.5 cm and my right had grown to 43 cm.  There is definitely some work ahead in the hypertrophy department.  (post in the future on the science of hypertrophy)

Weeks 3 and 4 I had been training in a high heeled Timberland boot doing everything that I could think of that didn't cause discomfort, but put a load into my legs/hamstrings/calf.  About week 5 I switched to an Olympic Weight Lifting shoe.  Things like heavy KB swings felt great in them.  Squats and all the variations of squatting you can think of.  Trap bar deadlifts with a more neutral shin angle.  The big breakthrough in week 6 is I specifically started doing heavily assisted calf raises. At first these seemed uncomfortable (not painful) with me relying on strongly assisting my bodyweight.  Straight leg raises with the gastrocnemius doing most of the work is much, much harder then the seated work, where the soleus does most of the work.  This goes along with the atrophy, my lateral gastroc is gone.  My medial soleus was much stronger and bigger in comparison.  

Week 6 also brought the breakthrough that I can put on my bike shoe and pedal my bike on an indoor trainer.  While higher resistance at the time didn't feel great, it was doable.  It was nice to be back on the bike!  Week 6 and 7 I basically started to do as many seated and standing assisted calf raises as I could.  I rode the bike almost every day for 20-60 min.  The end of week 7 saw a 2x10 min interval at 200 watts.  (don't laugh bikers, this is good for me)  I deadlifted in a flat shoe 3x2 at 295 pounds.  My brain put the kibosh on 335, I just couldn't budge it.  The next day, I was nailing unassisted standing calf raises though.  Interesting that it happened after that.  Neurally speaking, I think my brain took some of the breaks off and my calf responded.

I'm still dealing with some swelling around the heel and the lateral heel in particular.  I am using floss bands and ankle pumping to try to address this issue.   By end of week 7, I was getting almost 5-10 degrees of dorsiflexion without ever stretching, just walking (limping), biking and strength work.  I assume this will improve with more motion.  I work the tissue of the lateral calf area into the lateral ankle with my MOBI every day for a bit and this really cleans up my gait.

My follow up appointment with my surgeon was exactly 8 week from the surgery.  Happily the stuff I had been doing is paying off.  It's hard to really know when it's your first achillies rehab and you only are going by what you can find.  He was blown away by the lack of atrophy, the ability to raise up on my toes, the thickness of the tendon (this was good)  the mechanics of the ankle and the strength of the muscle.  He stated it was the worse achillies he had done, but it was easily the best he had every seen someone respond.  He even called in another surgeon to see me do a calf raise.  She was shocked.  They both now will have a new set point on what they can tell their patients on what to do minus just wear a boot.  (that was the guidance I was given)

The journey so far has been about doing what we know to do and applying it.  Getting creative to figure out ways to exercise and also keep it from being monotonous.  Rehab can be discouraging if you do the exact same things every day.  Find new methods, but keep your principles.  I'm still a long way off from heading to the track for a sprint workout.  But, I'm closer then I was 7 weeks ago, and way ahead of where I would be if I was still scooting around in a boot.

I post a lot of the variations of rehab videos in a timeline on my Instagram drjasonross   You will have to wade through a few (ok lots) of pictures of coffee and an occasional picture of my kids.  But, I'll be posting more training videos in the future as well.

Wednesday, January 24, 2018

The Science of Muscle Atrophy from Immobilization

An achillies tendon rupture I experienced last month had me in a cast for two weeks and a non weight bearing boot for another 4.  With any injury, you have to define your plan of recovery and the goals for the process of healing and the big concept of return to play.  The biggest goal for me right off the bat was to limit atrophy as much as I could.  Better to preserve muscle then spend months trying to reacquire it.  The last few months of rehab in an achillies rupture is getting the size back to essentially have enough cross sectional area to give the strength back to plantar flexion.  The goal became to fight off atrophy.  Learn your enemy, his tactics and weakness.

What is atrophy?

Atrophy can occur from a few mechanisms.  They are immobilization, spinal cord injury, loss of gravity( space) and aging.  For most of this post will be dealing just with immobilization.

The opposite of atrophy is hypertrophy, or get that muscle bigger.  There is quite a lot of science that shows the model for this, on the contrary and a bit surprising, there isn't a clean model for atrophy.  This is because a chronic decreased use is hard to come by to study.  Most of the research is with rats and dogs.

Immobilization

Limb immobilization has been used for a very long time to protect a broken bone or injured tissue from further injury.  Essentially, one is creating a barrier from movement.  The most common negative consequence of this is muscle atrophy from decreased use.

Muscles respond to the tension they are placed under.  Electrical activity, tension and slight motion can still occur while immobilized, just not gross movement.  Muscle tension hasn't been measured in an immobilized state.  Think of immobilization as reduced, not disused.

(most of these notes will be from the excellent textbook "Skeletal Muscle Structure, Function, and Plasticity" by Richard L. Lieber

There have been some studies that have studied the EMG of muscles in an immobilized state.  One example (that I found especially relevant for my achillies rupture) was implanting  electrodes in a fast twitch medial gastrocnemius and slow twitch soleus muscle of rats.  There was decrease in EMG after just 1 week, greater decrease in the slow twitch medial soleus then the fast twitch gastroc.  The take home for this study was that EMG had nothing to do with atrophy changes.  Just because there was a decrease in EMG didn't mean less atrophy.

There was some interesting relationships between being immobilized in a lengthened, shortened or neutral position.  The soleus immobilized in a neutral position showed 50% atrophy, in the lengthened position it showed no decrease at all, those in a shortened position atrophied the most.

Most of the disuse models have shown that slow twitch muscles atrophy to a greater extent then fast twitch muscles.  Soleus will atrophy more then the gastrocnemius and anti gravity muscles atrophy faster then their corresponding antagonists.  (gastroc will shrink more then tibialis anterior)

A few interesting points regarding immobilization of the quadriceps.  Comparing rectus femoris ( a two joint muscle) the vastus lateralis and Vastus medius.  RF underwent the least, this was theorized because it was more "active" as it had access to two joints.  Vastus medius had the greatest atrophy as it had the greatest percentage of slow twitch so it had the greatest response to the decreased use.  For ACL or knee immobilization the vastus medialis traditionally shows the greatest atrophic response.

The takeaway from this is that muscles that are used quite a lot will have more slow twitch muscle fibers and if they are immobilized, expect it to have a greater atrophic response then a fast twitch muscle, or a muscle that was used less on average.  There is also seen a change in fiber type from slow to fast after immobilization.  (This really surprised me)

Muscle power seems to be a direct relationship to the cross sectional area.  Atrophy definitely brings strength loss with it.  Remobilization after the immobilization then brings the therapy goal of  hypertrophy.  There are not a ton of studies done on how long it takes to bring back the tissue to pre immobilized size.  The data just says it takes longer.  (Big help!)  One dog study showed that 10 weeks of immobilization and 4 weeks of active recovery brought with it a 30% reduction from the original size/characteristics.  The fiber type changes are expected to change back.  Extracellular connective tissue also returns to baseline.

At the cellular level muscle protein turnover is occurring.  Degradation is happening faster then synthesis.  After only one day of immobilization the soleus muscle can decrease their protein synthetic rate by 50%.  This decrease is seen continuously for around 30 days, then the muscle mass stayed around constant.  In other words it took about a month for the muscle to reach homeostasis.

Two genes have been credited with universal regulation of atrophy, MuRF1 and MAFbx.  These enzymes are used to mark proteins for degradation.  ( In the future, maybe they will be used to prevent atrophy!)  The number one player for the regulation of these enzymes is the transcription factor Foxo.

Foxo, interestingly, can be used for atrophy and hypertrophy.  Things that cause atrophy, like immobilization, activate Foxo to upregulate MuRF1 and MAFbx and stimulate protein degradation and thus atrophy.  Things that stimulate hypertrophy, exercise, electrical stimulation, overload, cause an activation of another factor called akt, which inhibits Foxo and stimulates protein synthesis and thus hypertrophy.

The take aways are if you have the ability to cast or immobilize in a lengthen state do it.  If you can get moveing before the 30 day window do it.  Create muscular movement even if the joint can't be moved.  ISOMETRICS.  If there is a way to use electrical stimulation do it.  Work the contralateral limb.  Upping some protein intake probably won't hurt.  The balancing game of introducing movement and load to protecting the original injury is not a cut and dry situation and is an under studied field.





Sunday, January 14, 2018

Why Do Self Myofascial Work

We live in an age where your health is in your hands.  No longer is inadequate information, tools, or ability an excuse.  Relatively speaking, self myofascial care is one of the biggest health returns for your money and high return on investment from a time/money perspective.

Self Myofascial care is when a person uses a tool or object to influence the muscles, nerves, blood vessels, bones, lymphatic system, and fascia.  Fascia is a big deal as it is literally everywhere in your body.  It covers your body, it's embedded into the muscles, it forms "structures" or thickened areas. It has the ability to contract, relax and move.  It can be dehydrated.  When we target an area, we are essentially working all this stuff and this is globally referred to as connective tissue.

A person can experience restrictions in the connective tissue.  This means that areas, such as between muscle bellies, that should have a slight glide or wiggle room, no longer wiggle or move as smoothly as they should.  Over time, this can lay down fibers that further increases the inability to glide smoothly.  This can also mean these areas are less hydrated.  Dehydrated tissue is one mechanism that can be thought to contribute to muscles strains.

Certain areas of the body can also experience trigger points.  Trigger points are areas that are super sensitive when applied pressure too, and can even express pain at sights elsewhere in the body.  For example a trigger point in the glute medius, a hip muscle on your side, can express pain in the lateral calf and even into the lower back.  Trigger points can be active or latent.  Active means you know this hurts, latent means you were unaware that it hurt until it was pressed on.  Trigger points, while controversial, have been studied and shown that when blood was taken from them a much higher (H+) was in them.  It was more acidic.

Restrictions in movement can also start to lead to congestion from a lymphatic system perspective.  Remember, the lymphatic system works on the muscles actively contracting.  If they can't contract as strongly as they are capable of, the lymphatics can be congested in certain areas.  There is some evidence that this creates muscle inhibition.  (It makes us unable to express the strength we should be able to)  Muscle weakness.  

When the body starts having restrictions in how muscles contract or move and trigger points that unconsciously affect how we feel, we will start to move differently.  This compensation pattern may last weeks or years.  But eventually, this too will have it's own restrictions and inadequacies.  How often do we just chalk it up to moving poorly or sore when we wake up or an increase in nagging injuries to just old age.  Perhaps our connective tissue is just in poor shape?

Do you brush your teeth twice per day?  What did you do for your connective tissue today?

WHY DO IT!

1.  Keep from developing or start to break up the restrictions.  This is going to help you move better.  More easily.  Increased Range of Motion!

2.  Stop Trigger Points, but also become aware of latent ones.  This is going to start to get rid of unconscious avoidance of movement or positions.  It can also drop down peoples pain!

3.  Increase lymphatics and blood flow.  This brings more blood flow (more oxygen) to the tissues, but also gets rid of the metabolic waste products.  Win, win.  It can create stronger muscular contractions!  

4.  It can help get rid of the delayed onset muscles soreness that can be present after hard workouts.  Increase recovery!

HOW IT DOES IT!

1.  It increases circulation of blood flow.  Blood flow is the reason tissues can heal.  Sometimes people have surgeries just to get blood flow to an injured area.  This in itself is such a big reason it can not be overstated.

2.  Connective tissue heats up.  Some famous fascia researches state that when the area hits a certain temperature from myofascial work, the area will move better and have better contraction ability.

3.  Tissue tension changes.  The connective tissue can relax for a bit.  Often times when one area of the body relaxes another area adjacent becomes more active or "stronger."  This is called reflex neural inhibition.  Work your quadriceps and often the lateral hips will feel stronger.

JUST DO IT!

At the end of the day regardless of everything you just read, I believe there are two very unscientific reasons why we should do a self care on our connective tissue.  One, it just feels good.  You will get up and feel better.  Two, it's a gateway habit.  Ever hear of the concept gateway drug?  Haha...yea, gateway habit.  When you start to do self care, I believe it bleeds into other areas of your life from exercise to nutrition to self image.  The snowball effect.

Minutes a day at minimal cost can create huge healthy and lifestyle benefits.  As a plug in we created the MOBI to address all the soft tissue needs for a self maintenance program.  It replaces the foam roller, the ball, the stick and every other odd object you have collected to hit different parts of your body.  It's also a nice self defense tool if the zombie apocalypse hits.




2018 should be the year you develop your Self Myofascial Care Program, your body deserves it, and you only get one of them.

Thursday, December 21, 2017

Achillies Tendon Rupture: Post Surgery Week 1-2

On Dec 2 in a Cyclocross race my left achllies tendon ruptured.  On Dec 5th I had surgery to repair it.  I took that week of work off between doctors appointments and surgery and used the guidance of elevatation to help to control swelling.  I went back to work the following Monday and worked a regular schedule with the help of a knee scooter.

The doctor told me it was the worst achillies rupture he had ever repaired.  In his words there must have been a previous tear in there.  Because of the extensive damage he decided to put me in a cast for 12 days instead of the normal 3-5.  Being in a cast wasn't that bad until a week in and the itching started.  Nothing you can do about it.  Those were some sleepless nights.

I got on an air dyne that evening after surgery to help try to get whatever residual anesthesia may be in my system and get some blood flowing.  I used a Marc Pro a minimum of 2-3x a day for 1-2 hours each for the first week.  I continue to do that at least once a day.  Here is a timeline of modalities used and why.

Day 0 surgery.
Introduced air dyne.  10-20 min easy effort.
Marc Pro 3 sets of > 60 minutes
Kept the foot elevated
Wrapped blood flow restriction band (BFR) around upper thigh and did bodyweight leg extensions.
Did Glute ISOmetric holds for time.  Both sides.
Hip Flexion, knee rotation CARS
Side planks with Active Movement



Day 1-3
Pretty much did the exact same protocols.  But did this 3x a day.
I added in bone both with gelatin and 3-5 grams vitamin C in a drink that I slugged down 30-60 min before I rehabbed.  Who knows if this will help, but it can't hurt.
Reverse Hyper without any weight with Slingshot around my knees.  My thought process is that I was getting some type of stimulation into the calf perhaps.
Regular GYM work for what I would do for upper body, lots of extra pulling work.

Day 4-7
Started pushing through the heel of my cast into the air dyne pedals.  This felt good.
Extra seated work at the SkiERG
Light band resisted knee extensions with BFR on upper thigh.
Stopped taking the Ibuprofen they recommended.  I felt like I was controlling inflammation well with exercise and the research seems to say NSAIDS delay tendon healing.
Still taking baby Aspirin morning and night to help prevent any clotting issues.

Day 8-12
Lack of showering under my cast is starting to feel it.  Itching.  Nothing you can do about it.
Kept up all the same work as previous days.
Got the cast off!

My doctor walked in looks at me and states,  "You tore the shit out of it."  But it looks like it's healing well."

I was shocked at how swollen my foot looked.  I thought I had been doing a pretty decent job of elevating and movement when I wasn't working.  Now I'm in whats called a CAM boot now.  Locked in Plantar flexion of 20 degrees for 2 weeks and then 10 degrees for two weeks and then at a month at neutral or 90 degrees.  It just feels awesome to be able to take it off.  I've found that If I put half a deck of cards in my Timberland boots it makes for a secure workout bike riding boot.  I can ride much more aggressively and really drive through the foot with no pain.  Thats big.

Day 14
Holding ISOmetric lunges with the left leg forward for repeated sets of 20-30 seconds.  I can raise up out of it for 2-3 inches with minimal pain.  Going to start doing LOTS of this.

The next few days, I'm going to feel out, band assisted bodyweight box squats, hip thrusts loaded,  Seated calf raises and some alactic/aerobic work like 10/50 work to rest for blocks of time.

There is nothing like skin in the game to start really reading and applying something to your life.  All injuries have reasons.  Do we ever figure them out is another story.  But, I've come to accept that this one is 90 percent my fault and 10 percent shit happens.  This achillies has a history of bothering me.  I would do some eccentric calf
raises for a few months, bring back some jump roping and by fall it would be feeling pretty good again.  Winter comes, I don't do a much of that stuff and I think my tendon, which had a small tear in it apparently already, would get cranky from "spring enthusiasm" and be sore in the summer, start to rehab it, be good by fall.  Cycle starts again.  This year I got more into biking and spent most of my time biking.  After chasing a 1/2 mile time I wanted to beat, it got sore, but instead of rehabbing, I just biked more and avoided it, I believe without the loading, my tendon got weaker.

I didn't do the work.  Tendons need load, not rest.  Things I knew, but didn't apply.

"Knowledge without application is simply knowledge.  Applying knowledge to ones life is wisdom, and that is the ultimate virtue."  Kasi Kaye



Tuesday, December 5, 2017

Achilles Tendon Rupture: Pre Surgery Day 1-3

When it comes to injuries, hindsight is 20/20.  It's easy to look back in time and create the why.  It's also easy to chalk up injuries to bad luck.   As a Strength coach and Chiropractor/therapist I want to know the why's.  I don't believe in bad luck.  There are reasons.  I don't know all of them, but we do our best to learn and move on.  We also have to be careful to not just create reasons because it fits with our need to have answers.

Sunday morning I had a complete rupture of my left achillies tendon.  I somehow saved my bike from a slide out, I must have used my leg as a kickstand and I felt someone run into or kick my calf.  I looked behind me to see who was there, and in that matrix like moment, time slowed, I saw no one, dropped an f bomb and knew.  I knew instantly when I didn't see anyone behind me.  In the seconds that processed through my brain I thought, here comes the next year of my life.


I've had on and off pain in this achillies tendon for over 10 years.  So chances are there are some decent amount of degeneration in the fibers before the rupture.  From a mechanics stand put, this ankle has lacked as much dorsiflexion in it since a pretty bad ankle sprain that limited life for about 6 months as a freshman in college, jumping over a wall and landing on a parking berm.

Take Care of Your Joints.

It would come and go the inflammation around the achillies.  One thing I've neglected is dynamic loading when I was feeling good.  We know you need to use the qualities you want to keep.  Healthy tendons need load, eccentric strength and must go through stretch shortening cycle.  This had started to fade over the years.

Variable Loads Are Needed.

I normally take my HRV every morning, but I had just finished getting over a weird cold that seemed to last 18 days and had gotten out of the habit.  It had left me with good power in terms of strength, but anything over 160 heart rate I was wiped out.  Part of me thinks I was still fighting something, had extra inflammation in my system when this all when caput.

When I got home from the ER, that Sunday reached out to a bunch of friends and got some surgeons names that were recommended.  I was able to see my Doc Monday morning and he stated it was a bit higher then normal.  I said, great more blood flow!  He said yes, but less tendon to work with.  (here's hoping I'm right)

A good friend sent me to the website of Dr. Amol Saxena, one of the leading foot/calf guys in the world.  He performs lots of achillies surgeries on athletes who's livelihood depends on it.  He lays out a great rehab protocol.  Week by week.  Post Op Rehab Achillies

Nutritionally I'm going to do a very high protein, high fat, low carb diet for at least a month.  Essentially eat no junk and try to limit inflammation.  Bought a bunch of high quality bone broth to drink multiple times a day to see if I can maximize connective tissue health.

Have a Plan

ALTIS just posted a nice recap of their Coaching program and one thing that stuck out was this from Matt Jordan.  1.  Know what matters.  2.  Measure what matters.  3.  Change what matters.  Dr. Saxena has seen hundreds through to the return to running and 3 things matter.  1.  Perform 5x25 single leg raises with 15 seconds rest between sets.  2.  Have a post operative limb within 5mm of the good leg.  This is tricky as mine was already 1.5-2 cm smaller from when I had a back injury to the left.  My goal will be to get as close to the size pre surgery.  3.  Have ankle dorsiflexion and plantarflexion of 5 degrees of the good limb.  If access to an AlterG run 85% bodyweight for 10 minutes.

Be Abel to Measure Your Plan

Surgery is in the morning.  Then the fight begins.  It's been humbling to feel and hear all kinds of support from family and friends.  My wife has been amazing.  Funny, after my first thought of oh shit I tore my achillies, my 2nd thought was, Kelly is going to kill me!  lol

Instagram @drjasonross


Wednesday, November 29, 2017

Developing a Template and Momentum for 2018

When you watch a lot of sports you get a sense of the power of momentum.  It's a very weird thing to witness.  One team seemingly has control, but one play later and things can change.  That one play leads to another.  Everyone can feel it.  Players that weren't making plays, start making spectacular plays.  The ball starts bouncing their way.   Momentum is powerful.

"Momentum solves 80% of your problems. "  John Maxwell

This is about building some momentum going into the new year 2018.  People want to think that a new year is a new you.  There hoping that some extra magic happens because they watched a glittery ball drop.  

Instead of starting from scratch, prepare, get it going.  Preparation is the key to getting where you want to go.  Most peoples new year resolutions revolve around being more healthy.  That is hard to define.  So take the time to define it.  Perhaps it means losing 15 pounds.  Getting your blood pressure low enough to get off medications.  Complete a 100 mile bike race.  Do your first 5k.  Walk a 12 minute mile.  Eat 3 servings of vegetables a day.  The list is endless. 
 

Step 1.  Define in very specific details what you want to accomplish.  
This needs to be written down.  Research has shown that what gets written by hand is a much more powerful way of doing things.  Buy a journal/writing pad that can be used daily for a year.  Get a pen with blue ink.  Research says we remember blue ink better then black ink.  (It can't hurt!)

Now, one can have more then one goal, but it's hard to have 3 or 4 specific and different goals.  But, some goals become very similar when you break them down.  I'll have several people tell me they want to get to the gym more, eat better, lose some weight.  At the end of the day, they are all kind of the same goal.  Write a book, lose weight, attend all my kids games, make more money.  These are all very different goals.  So choose wisely.  

Step 2.  Figure out what you are going to give up.  This is the power of negativity.  Example is giving up smoking.  Your not doing anything extra, but your stopping doing something that isn't healthy.  Perhaps it's giving up your happy hour with friends or one night out a week.  Giving up TV, cable.  Giving up buying a treat with your coffee.  Make some time for what your trying to do.  At the very least, by examining your week/day hour by hour, you will be much more conscious on how you are spending your time.  

"How we spend our days, if of course how we spend our lives.  What we do with this hour and that one is what we are doing."  Annie Dillard 

Step 3.  Make a list of all the Micro things it takes to accomplish your goal.  
Take the Micro and make it Macro for awhile.  I call this the consistency beats intensity.  We all know the person that is gung ho for a few weeks and then fades like a shooting star 3 weeks in.  They stuff every possible new habit into the day.  Wake up early, eat a crazy smoothie, hit the gym, run, cook every meal, do yoga, no TV, go to bed early, read that book.  3 weeks later, they are stressed out and burned out.  

Take what you envision to be your ideal day and mold that day into a week.  Instead of cooking every day, pick one dinner out of 7 and cook that one.  Get that one meal down.  What to buy for it, what to keep in your fridge to make it.  Did you cook that one meal one time in the week.  That is a check mark in your journal.  

Instead of hitting the gym everyday.  Get to the gym one time. (Gym is just a word for lifting weights)  Work out for 45 min doing something you enjoy.  Did you do that one time this week.  Check it off in your journal.

Did you floss your teeth one time this week?  Did you elevate your heart rate for 30 min one time this week (aerobic stuff).  Check those boxes off.  Wake up early one day, go to bed early one day.  Check those boxes. 

The idea is to make a checklist of what your vision of a perfect day is.  Then expand your day to a week.  So it's not about burning out day to day, it's about building slow growth over the course of that week.  Get momentum, (there's that word again).  Create consistency with smaller commitments that will most likely bleed into bigger ones.  Also check those boxes, for real.  Are brains are wired to achieve pleasure in marking off things done.  They are victories after all.  

Step 4.  Remove Restraints
Listening to Freakanomics Podcast on Behavior Change and they interviewed Daniel Kahneman.  He had a great idea that he credited to Kurt Lewin, that peoples behavior is driven by two main forces.  Restraining and Driving and our behavior is the equilibrium between these two.  There are two ways of going about influencing behavior.  Get rid of the restraining forces or increase the driving forces.  Increasing the driving forces is a poor choice, getting rid of the restraining forces is the key.  

Instead of trying to figure out how you can eat more vegetables, figure out why you aren't doing it in the first place.  This goes for everything.  At the end of the day, we all have more then enough information.  We need more application.  One by one address the answers that pop up with the question why not.  Remove the restraints to make moving forward easier.

I never have vegetable in my fridge when I get home from work.  (Every Sunday I'll buy vegetables)
I go to make them and they have gone bad.  (Ask the groceries or Google what are the best vegetables that last a full week or how to store vegetables.  
They taste bad.  (two recipes on google with spices that create an enjoyable eating experience)
Clean up is annoying and tiring (aluminum foil on a cookie sheet)

Step 5.  Create Discipline
Look at your week and write down when you are going to do what.  Obviously make sure that it's a real time commitment.  Can't hit the gym at 530 if you routinely get out of work at 545.  No matter what, commit to what you put in writing no matter what you "feel."

Feelings at the end of the day are irrelevant.  I don't feel great, so I'm going to skip the gym today.  I feel tired, so I'm not going to cook tonight.  We have all said that and done that.  How many of us have said I'm still tired I'm going to lay in bed and not show up to work?  My kid is really bothering me today, I don't think I'll take the time and get dinner for him.  Can you see how silly that sounds.  We can keep commitments when they are obvious.  Just eliminate feelings as a choice. This is how discipline is created.  Doing what you said you would do.

"Discipline Equals Freedom"  Jocko Willinck

Get started now, create momentum to hit the ground running in 2018.  Don't wait for the glittery ball to drop.  

Wednesday, November 8, 2017

Patience in 2.5 Unit Increments

There are a lot of quotes on patience.  A quick google search will brings hundreds of memes that extol patience.  We all know we need it, very few of us want to use it, even fewer of us want to be in situations that require it.  I speak from experience.

 We all know it's useful but unless there are concrete actionable steps to take, be patient becomes just another saying.  Want to be successful, early bird gets the worm.  Cool.  Wake up early and then what?  See what I mean, memes and saying look nice on a quote board, but unless a plan is in place, sayings are just poems.

I came across an article about a man learning to use the 2.5 minute rule with his kids.  Every task, partition an extra 2.5 minutes because kids are slow, less dexterous, and some things aren't memorized motor tasks.  Ask them to put their shoes on, extra 2.5 minutes.  We can slip our shoes on literally in a few seconds.  Not so much for young kids.  Tasks like this.  Give yourself and your kids this leeway.

I learned early on that you need to partition extra time when you are taking your kids somewhere.  I learned it so well almost 6 years in with kids, that I'm only late like 3 out of 5 times.  Of those 3 times, I'm sure I was a bit stressed and I'm sure I stressed them as well.

There was no plan.  If you don't have a plan, you ultimately don't succeed often, when you do, it's probably by luck.  Give your self "extra" time is just arbitrary.  2.5 minutes is concrete.

When I first started lifting weights.  The only principle I understood was that if I put more weight on the bar then the last weeks effort, I was getting stronger.  If I kept doing this, I'd get to where I wanted to go.  So I used those small 2.5 pound weights every single time for my last set.  If I beat my last weeks effort, I'd go up 2.5 pounds on each side the following week.  If I didn't I stayed there.

Those 2.5 pound weights got me where I wanted to go.  They also taught patience.  You don't go from squatting 135 pounds to 405 pounds in big increments.  Your body needs time to build up connective tissue, motor unit recruitment, cross sectional muscle development, vascular networks and loads of other physiological adaptations.

One of the things I've noticed with myself is the lack of patience with some of my bigger lifts in the last few years.  I've also noticed lack of progress.  Part of it, is just being content at staying at a certain weight.  Part of it, was just lack of patience.  Wanting to just get
in get a lift in, but not having the patience to commit to slow progress.

With winter coming, patience in 2.5 unit increments is becoming a concrete goal.

"The two most powerful warriors are Patience and Time."  Leo Tolstoy