Saturday, December 29, 2018

Season of Discontentment and Confusion: Evaluating Life Choices

Discontentment can be defined as dissatisfaction with ones circumstances.  There can be an unhappiness and even some resentment that can be subtly put up with.

The discontentment is enough perhaps to drive change, but instead of change, we get confusion.   In confusion we get genuine ignorance, paralysis by analysis and most deadly a life of a hypocrite.  This then eventually leads us back to discontentment.

How does this cycle be broken?  How do we get clarity?


Intention is paying attention to your thoughts and your actions, but most important, defining your beliefs.  What do you hold valuable and true?  Then we choose our actions with intent to live out those beliefs.

I would suggest that all your new years resolutions take a back seat to sitting down and writing out not goals, but things you believe in.  It is a time to define your values.  They can be big or small, but it should be written down and evaluated.

How do we evaluate?  We use the simple filter of a question.


First, define why you think it's important.  Then,  the much harder question, why you have not been doing it.  Judge your reasons.

1.  Make a list of things you believe in and find important.
2.  Why is that important to you.  Give it a story.  Story is what we tell ourselves deep down behind your reasons.
3.  Did you do this?  Yes.  Great job, move on.  No.  Why?  Figure out a few reasons.
4.  Make a plan to make a No a Yes.
5.  Look at your list 2x a Month

For Example from my own list.  
1.  Drink 100oz of water per day.
2.  Water is important for healthy body and muscle tissue.  My story.  I think better when I drink water.  I hate that feeling of a slight headache I get when I haven't drank enough.  I feel like I'm more prone to slight muscle strains when I don't drink as much and I have a way better emotional balance when I get to train unimpeded.  I'm just happier.
3.  Yes.

1.  Eat 2-3 serving of vegetables per day.
2.  Veggies supply a ton of micro nutrients that will be missing from your diet if you forgo.  My story.  I have less belly fat when I eat veggies.  It's pretty much filling up on good stuff more then bad stuff.  But deep down, it's probably more for vanity.
3.  No.  I pretty much sucked at this for the last few months.  I think I got derailed when I tried to do the vertical diet over late summer.  Except, I didn't give up any of my vices, beer with friends, donuts with kids, or the best burger in Grand Rapids (Louis Earl Butchery) by myself.  I had given up salads and cooking veggies in the oven.  Deeper, it's easy to be lazy.
4.  They say Americans eat the same 5 Veggies in their diet and they should be in the 20-30.  Going to make it an exploration game to get 2 new veggies per week till I get to 20.
5.  Keep track that at the end of the month I've attained new veggie exploration badge.

There are two examples to show how this process is done.  The more the beliefs we state are important match up to our actions and life, the more we can live in harmony with ourself and our world.  But, the opposite is also true.  The more we state something is important and the more we don't do what we think is true, the more discontentment arises.  Discontentment can be a good thing if it drives change. When we don't have intention, when we just keep going forward to tomorrow,  we will start to be a person that we probably won't like in the mirror.  If the discontentment does drive change, but we haven't taken the time to figure out why we aren't living our beliefs, we will invariably be in confusion and just go back to the status quo, thus driving the discontentment deeper.

Take a week if need be.  Look at your typical day and all the things you do now.  Evaluate all of them.

1.  Get 8 hours of sleep
2.  Drink water and pinch of salt on waking
3.  Drink 3 shots of espresso
4.  Be positive with the kids, no yelling at them.
5.  Eat only protein for breakfast
6.  Offer up something healthy to the kids, but be content with eating anything.
6.  Shower
7.  Go to the bathroom
8.  Brush teeth
9.  Don't listen to music in the car if I take the kids to school, so we have a conversation.
10.  Walk the dog if I'm not taking kids to school
11.  Enjoy the work day.  Become better at my craft.
12.  Be present with every single patient.  Learn something each encounter.  Why did last visit work or not work.
13.  Return 2 emails
14.  Drink lots of water at work
15.  Healthy snack somewhere in there at work.
16.  Cook dinner
17.  Hang with kids
18.  Read/write/recovery
19.  Hang with Friends 1-2x a week
20.  Night vitamins

These are what popped in my head quickly.  Each day for some people will be unique.  Mine is pretty much routine every single day.  Then evaluate what you wrote down.  Some will be beliefs like for me, drinking water upon waking.  Some will be responsibilities, like take the kids to school.  But from that task comes a belief.  That the time with them is important and great conversations can come from that time.  So I don't turn the radio on.

The more we can line up all our choices with our beliefs, the more congruency we will have and the more peace our days will enjoy.  Hopefully in 2019 you will be living a life of intention and clarity.

Blessing for 2019

Saturday, December 22, 2018

Seminar Recap: Frans Bosch, John Pryor and Leigh Egger

A few weeks ago I was able to attend the Rehab and Injury Prevention seminar by Bosch, Pryor and Egger.  It was held on the campus of University of North Carolina.

I first came across Frans Bosch with his book Running a few years ago and his book Strength Training and Coordination most recently.  Both books are excellent and should be read.  With that being said, the Training and Coordination book, If you are like me, needed several rereading of chapters.  I'm happy to say, that after the seminar many of the concepts became much clearer.

I'd thought I'd share a few concepts and notes that I'd written down and my overall take aways.

Mortal control is having enough stability.

One of the best explanations of Dynamic Systems theory is the self organization of high variability (start) with (middle) synergies (cooperation between a number of components that correct each others errors) to a stable end point (finish).

This then becomes a map of how to define training and rehab.  (my personal interpretation)

For example:  Self organization at the intramuscular level.  Fiber variability (using more) to fiber synergies, to a stable contraction.

Self organization at the intermuscular level.  Force variability to force synergies to stable contraction.

Analyze the mid stance in gait as it's the most stable.  Not push off.

Fundamental:  Experts have the most variability to reach the most precise endpoints.  The less variability you have to get to an endpoint, the more likely you get injured.

Slow twitch muscles have actually bigger elastic component.

One of the more interesting topics to me was the concept of muscle deformation and muscle gearing. This is a topic I've tried to read on and didn't come up with much.  Now,  knowing the main researcher was Roberts and how shape of the aponeurosis changes with pennation has lead me to really cool articles like this one.  Muscle Fiber angle, segment bulging and architectural gear ration in segmental muscle. 

I think the aponeurosis being able to expand on contraction freely is potentially one way manual therapy has an influence on muscle health.

Muscle gearing is a way for force sharing and helps to not allow shear to come into play.  Shear creates muscle injuries.  (deep dorsiflexion produces shear)  So training is designed to eliminate that position.  Resist it!

On contraction there is lateral expansion, (think trying to compress water)  lateral push forces, the aponeurosis gets tight and we get stability.  The aponeurosis bulks out.  Best way is isometrics.

Zooming out of this micro to macro is joint coupling.  Biotensegrity, the push and pull of forces combined build into bigger units.

Ankle stiffness is super important.  Can't be world class if there is dorsiflexion.

Running on grass will teach you to use the tendons better. (running over slightly different surfaces is one type of variability that is taught to teach better running)

Free hip needs to be higher in running.  (this will be a foundational drill)

Concepts of Co-contraction are big.  This is multiple muscles contracting to produce coordination as well as reducing degrees of freedom.

3 P's to Train Co-contractions.
1.  Pretension: Reduces slack to co-contracting
2.  Perturbations: Solve context related variability by co-contracting
3.  Pressure (time)  Solves slow feedback loops by co-contraction

Create the environment for both coordination and conditioning.  For example:  Run 20 meters with the weight plate out in front of you, looking through the hold.  At 20, stick it out to your side, keep running forward and keep looking at it through the hole.

Don't coach the process, coach the outcome.  (big deal)  Allow the athlete to figure it out.

Co-contraction is a skill that must be trained.

Wear marks on shoes are irrelevant.  As first contact has no substantial ground reaction forces, no change in muscle activation.  Early heel off is where the important stuff lies.

Running injuries at toe off is most important.  Looking how to stability can change.  Hamstring is a huge storage vest for elastic energy.  Lack of pelvic control = hamstring injuries.

Imbalances in muscle activity lead to shear.  (my take, this is potentially another place where manual therapy plays a role)

Swing leg retraction as quick as we can.  Think of closing the scissors.  Very important.  Running is done in the air, not on the ground.  You want the swing leg knee to be in front of the stance leg on foot strike.

Key to sprinting is putting the horizontal component into the sprint.  Christoph Lemaitre was given as an example as he has sprinted very fast times and is remarkable weak.  (I wonder if he knows he's being bashed ...ha ha)

80% of glute max is inserted onto the IT band.  Glute is a stabilizer.  IT band stores and recoils energy.
Soleus to the Achilles as is glute to the IT band.  Muscles to the tendon.

If your locked into anterior tilt of the pelvis you can't get frontal plane movement.  (PRI and more importantly Pat Davidson does an amazing job of getting stability into frontal plane)

This is important for therapists whose patients ask why are they hurt or in pain.
Why do we need variability?  Because we need to cope with an environment of variability.  Why do we get imbalance?  We have removed the variability in our environments.
Also why I think distance runners need to run trails.  (soapbox)

 Injury changes motor control.  You get receding peripheral control.  First, when you are injured you get receding co-contractions.  1. Intention is the crude signal.  2. Coordination at the spinal level.

Receding proprioception is the 2nd thing when injured.

Examples of dumb training.  Jumping with resistance bands as resistance as your body doesn't need to produce the co-contractions, it can just lean on the antagonists.

Injuries lead to reduced variability.

Joint angle velocity is an important concept.   It allows us to remember movement patterns and is body independent.  For example, learning to snowboard as a kid, it will come back years later even though the body shape has changed.  Movement patterns that can used everywhere, the body wants to store them.

Teaching the Intrinsic training.
1.  Unexpected Perturbations. (Use of water sloshing logs on certain exercises)
2.  Environmental cues.
3.  Using time pressure.
4.  Using differential learning.  (batting on a mattress, ruby hooker throwing in on different surfaces
5.  Using endpoint focus.  Finish with your foot here on the wall
6.  Using double tasks.  Combining different methods

Don't allow counter movement in training.  The body gets used to slack.  This means like jump from a static position.  (crazy how bad I was at this at first)

Elasticity only works under isometric conditions.

Examples of Poor Hamstring function in running.  (why high speed sprinting isn't enough to improve hamstrings)
1.  poor ant-post pelvic control leading to poor proximal loading
2.  lower leg doesn't travel out far enough to apply stretch
3.  leads to lazy hamstring and loading of other muscles, such as gastroc, glute and adductors.

Hamstrings must be trained with 1. speed 2. strength (isometrics ) 3. Robustness (perturbations)

Body is interested in forces.  Perhaps rehab has it all wrong?  Don't start with the little bands to rehab a shoulder but a heavy load that it can resist with high force.  The minimum Jerk Principle (To find the place where the body has the least jerk, but the most challenge w the Jerk.

You don't learn from movement, you learn from the sensory information you get from that movement.

High EMG reading with low force = Insufficient.  Low EMG reading with high force = Money!  An example of what we don't want is the barbell hip thrust.  High EMG, low force.

Why Tennis players rarely blow their ACL.  The hitting of the ball requires trunk lean, this protects the knee, also the hind leg catches up quickly.  Take away is teaching the trunk to land over the plant leg...IE volleyball landing as well.

Differential learning basically means mix it up.

For myself, I learned more about muscle gearing and where to keep looking, I want to learn more about Riemannian geometry and further figure out what that means for therapy and training.  It really cleared up some concepts with the 3 P's in training.  I do enjoy learning from different pools of thinking and the more I learn the more I can see some crossover and linking of people.  Pat Davidson with his PRI background does awesome work with his frontal plane training.  Functional Range Release and Spina and Chivers lectures were and still are, ahead of the curve with some of the science.  I got to hang out with an old friend Jonas, who I first met back in the bobsled days, who is now the UNC mens basketball strength coach.

This was an outstanding seminar.  The lectures either hit on topics I wanted to learn more about or stimulated new thoughts.  The practical was unbelievable.  John Pryor and Leigh Egger did a remarkable job of taking the science and making it practical.  There were several concept drills I thought I knew and didn't ( I was teaching them wrong, sorry athletes)  There were some that even after reading and understanding, needed a different way of being taught for me to get the Ah ha moment.  Time pressure was big for me, feeling it.

Hopefully if you had an interest, after reading through my notes and ramblings you will be convinced to check it out.

Wednesday, September 12, 2018

Foundation of Success By Developing Flow

"Hard times create strong men.  Strong men create good times.  Good times create weak men.  Weak men create hard times."
G.Michael Hopf

A few months ago, I sat and watched the NFL Hall of Fame speeches.  I'm not usually one that enjoys, let alone pays attention to this type of thing, but the Hall of Fame speeches are always a bit different.  I'm continually struck at the hardship of childhood for almost all these legends.  Growing up hungry, bounced around, poor, lacking in almost every area of life.  Single parent households, witnessing struggles in a harsh environment.  I think this probably describes 70% of the speeches.  They will let you know what it was to overcome that.  Someone reached out to help, wether parent, family member, or coach.  They gave them an outlet of sport for a grasp of hope for a better future.

But how much did the environment have with shaping the grit and drive to succeed?  No one will ever argue those athletes were born with supreme physical talent.  But, no one will also argue that there are more supremely talented athletes that never make it or never come close to the level of success they should have achieved.  No one will argue that those athletes that make it to the top work extremely hard at their craft.  But again, their comes almost an obsession with being great.  Is this a product of the environment?

It's a question that probably can't be answered.  Because, there are athletes that succeed that are in all intents and purpose from a "soft" or privileged life.  It still bears to question though, how to create the best environment for success from an athletes development as well as parents perspective on raising kids.

One of the books I just read through was called the Gold Mine Effect.  An author travels and discovers the hot beds for athletic talent.  Sprinters from Jamaica, endurance runners from Kenya and Ethiopia, tennis players from Russia and women golfers from South Korea.  What he finds is a culture of extreme hard work in an environment that suggests no matter how hard sport is, life is that much harder.  

The former track coach for some of the Jamaican Sprinters is named Stephen Francis.  He, even after great success, still kept his training MVP group fairly low budget.  Performance centers were not glamorous on purpose.  He wanted athletes that wanted to be there because of their desire to succeed. Not to be coddled with the latest and greatest.  Here is talking about his personal opinion that an athletes should be 80% uncomfortable.

As a parent there is a concern and great trepidation of raising a "spoiled" child.  My definition of spoiled is wanting with out working.  Success without failure.   Attainment with out gratitude.
As a parent it is fun to be able to take your kids to places you may not have gone as a kid yourself.  It is fun to go out to eat.  Fun to buy them presents or shoes that they like.  Fun to have experiences with them.  Where does fun go from just that, to crossing into entitlement or even worse killing whatever drive they have to achieve themselves.  When creating performance culture or family, how much do we allow the athlete or child to be given, how much do we let them struggle?

When dealing with performance cultures such as New Zealand All Blacks, there are clues.  The players sweep the sheds after games.  The most talented sweep floors.  There is tremendous amount of competition with in the program.  No players job is safe.  There is no complacency.  Culture of teamwork, not one person is above the team.  When creating performance culture or family, how much do we allow the athlete or child to be given, how much do we let them struggle?

Life is perhaps best when it follows what we know about skill acquisition.  We know that with the development of new skills, to easy brings boredom, to hard brings frustration.  Both produce quitting.  The sweet spot of difficult but doable is where the brain stays engaged, we lose track of time and we immerse in the problem.  We develop interest, but we also learn, learning.  "I can figure this out."

When I first opened my clinic I saw daily levator scapulae issues.  It took months of scapula reading to figure out the best way to treat it and keep it from coming back.  (Treating the levator is almost never the answer)  I told someone what I learned.  They said cool, it worked for them when they did it.   While I condensed what I learned in a paragraph for that person,  they didn't get the months of reading and insight I gained from studying the problem.  I got better, they got and answer to a problem.

My own views currently is that it's the job of the coach, therapist, parent to guide the person, show them the end goal, but let them figure out how to get there.  Don't take away the struggle, the earning of the goal.  Perhaps this way, the achiever learns that nothing is given.  They don't "deserve" it.  No false wins.  False wins, produce eventually failure.  Failure they have not learned to handle.

Another idea, I've been playing with in my head is that perhaps everything should be periodized, not just training.  A very smart trainer opened my eyes to perhaps there is no "right way" to eat.  Periodize all the carbs, fats, proteins, kept, low carb etc...should also be periodized.  So Periodize periods of tough times, with periods of easy times.  Not quite sure how that plays out with kids, but like I said, it's my thoughts at this point.

The grandfather builds it, the son make it a success, the grandson ruins it.  It is a popular saying for a reason.  The son found the flow, not to hard, not to easy.  The grandson had everything to easy and as result, failure.

Lets help them find flow and find success.

Monday, September 3, 2018

Music, Present Moments and Training

What is Music?

At the most basic levels, music is a combination of sounds.  Sound is vibration.  We can state that all cells have vibration.  In fact, some researchers are even looking into cells vibration at the red blood cell to differentiate sickness and disease such as malaria.  Humans are composed of cells, music then can be said to move us.  In fact, even when staying still, music has been shown to light up our brain areas that are for motor control.

Music has been found in every single society of human beings since the dawn of man.  Some psychologist say that music predates language.  By these simple facts, we can say without a doubt, music is an important element of being human.  It is used to evoke every emotion a human being can experience.  Societies have been using music for enlightenment, rituals, and enjoyment.  Present day, there are music therapists that use music to heal, not only psychological issues but physical.

We have all experienced what just a simple song can do.  It can boost your energy, fatigue fades and puts a pep back in your step.  They have even shown that listening to music can decrease pain.  Because of this, it comes at no surprise that music plays such a big role in athletics.  You would be hard pressed to not find many athletes that listen to some sort of playlist as part of their warm up routine.

Zen is the art of being in the moment.  Not in the past or the present.  Music has the ability to lock you into what you are doing.  It is for this reason, I think, that music can then remind you instantly of what you were doing when you first heard a song, or how you used to listen to a song.  It has that power because you were truly in that moment and the music anchored you there.

For example, I can list every song I've ever trained to or relaxed to, from High School through Bobsled.  Spin doctors "Two Princes" was my song in a big race where I didn't want to get to hyped.  Rocky's "Hearts on Fire" for when I didn't feel like running the 400m.  Which was every track meet.  "Bulls on Parade" was my last year of College football.  Basement workouts for rugby in Chiropractic school wouldn't have been the same without a little Dayton Family "Flint Town."  I warmed up to the song "Break it Down Again," by Tears for Fears, in repeat, every single time my last year of bobsled.  When my first daughter was born, it was a struggle (for a long time) just me her and my dog.  I'd play Lupe Fiasco "Hip Hop Saved My Life."  Often times, she would stop crying, it actually did feel like, hip hop saving my life.   Just a few examples of how song become associated with memories.  Some you can't recall until the song is played and it transports you back into your memories.  Strong anchors, because you were truly in that moment.

It has been fun to watch both my daughters start to appreciate music.  My oldest loves Bob Marley, someone I never listened to, and now really enjoy.  She calls it happy music.  My youngest doesn't really know what she likes, but she instantly starts dancing.  Both are into it, one more cerebral, one more physical.  I wonder if this would be an indicator for different types of approaches to training an introverted vs extroverted approach?

Are you adapting or optimizing.  Music could be used for both.  Hard workouts where you are truly trying to do the absolute best, full recovery, nutrition supporting the workout, perhaps adding some music you or the athlete loves.  The same can be said for no music, or music that is more even keeled, for when workouts are more about adapting.  Make the psychological factors harder.  Almost like doing math problems before endurance work, mental tiredness, produces perceptually harder workouts.

Much like reading, not sure how there are people that don't enjoy music.  Find the beat that matches your goals.  Want to run faster, find music that has that 180 beats per minute.  Need a little anger for a max effort deadlift.  Find what taps into that Limbic system.  There are several ways to use music in your training.  Hope you can create a playlist that will both adapt and optimize what you are trying to accomplish.

Can you feel that vibration?

Friday, August 17, 2018

Things I Really Like Volume 1

I once heard Jordan Peterson give a lecture on a few concepts that would indeed change your life.  It wasn't vacation, that was maybe one week a year.  It was finding the common, the ordinary things that you do everyday, that when added up, become your lifetime.  He used the example of fighting your child at bedtime.  30 min everyday for years.  That was 4 hours a week.  16 hours a month.  You keep adding this up, over the course of your 80ish year life, half a year might go towards this.  Figure out a way to not fight for those 30 minutes and you have indeed improved your life.

I thought about that concept for awhile and while this post isn't directly about that, it is it's offshoot.  What kind of things have I used that have created a little more enjoyment or I have found value in.  From the mundane to enjoyment.  

Better Mouth Care.  I have been using a Hippo and Crate toothbrush  that has soft bristles, because I tend to brush to hard.  It's just a pretty toothbrush, that does its job.  But why not have more Art in a beautiful design in your life.  I started using Redmond Earthpaste toothpaste.  I still enjoy seeing the grey paste instead of white when you spit it out.  Maybe, I think it's cleaning my teeth better?  I do know my mouth feels cleaner and it doesn't have any crazy chemicals in it.  

Better Snack Game.  I am a big fan of popcorn.  One of my favorite snacks.  This thing I got for Fathers Day is the Thomas Rush Orange Popcorn maker.  It's pretty great.  Add some kernels, add some olive oil, add some salt, put in the microwave for 2.5 minutes.  Get the best tasting microwave popcorn I've ever had.  Saves me a lot of money from buying microwave popcorn and it's much healthier.  Taste, price and convenience.  

Better Food Game:  Move over slow cooker, you were great for a few years, but I'm an Instapot guy now.  What used to take 7 hours is now like 45 minutes.  Pressure makes good eats.  It also allows me to make much healthier food options.  This week I made a chuck roast with potatoes and carrots in 45 minutes.  Hard to beat.  

Better Self Care:  Shameless plus for my product the Mobi.  We invented it because it was the product I wanted to use.  I wanted a beautiful design of a self myofascial release tool that brought the best of 4-6 different tools into one.  One that was easy to have around, travel with and use.  Think of it as the toothbrush for your muscles.  We have had positive feedback from Olympians to almost every Professional Sports league.  Use it and love it.  

Better Breathing:  Nasal breath has some powerful reasons to do it.  More Nitric Oxide, better diaphragm control and use.  Controlling nervous system and heart rate.  Sometimes it can be difficult to control, it's easy to forget when your out running or biking and things get tired.  Enter 3M Micropore Surgical tape.  Easy to put on, easy to take off.  Tape your mouth shut.  Breath through that nose.

Better Learning:  This day and age of digital access, it is so easy to keep learning.  Some of the best coaches in the world have video and lectures on whatever subject you want to learn about.  Altis out of Arizona has seminars that are all online that you can access up to 400 hours of learning from some of the best coaches and therapists in the world.  Track, therapy, performance, coaching and it gets added to constantly.  Can't beat 20 bucks a month.  They even have their own app so you can learn from your cell phone.  ALTIS360

Better Coffee:  I'm really digging the Moka Pot.  I'm often up before my kids are up, so grinding beans in my espresso maker runs the risk of waking them up.  The cost/benefit of using my machine to get the magic elixir with the cost of potentially waking up my kids, was getting to risky.  Nothing beats coffee in the quite morning before the kids are up.  I had been using the aeropress, and still think it's great, but the Moka Pot has better espresso quality to it that I enjoy.  

Better Mineral Water:  I was a Gerolsteiner guy.  Now I'm a Topo Chico with Lime kind of guy.  Just really enjoy the taste at a better price.  

Anything you have added into you life this past year that has made some of your common life stuff a little bit better?  

Thursday, July 26, 2018

Science of Strength Training for Endurance Athletes

The last year or two I've been hunting down some answers about aerobic work, capacity, it's role in recovery and a few other ideas.  In listening to the Dissect podcast, Host Mark Twight mentioned a book that led me to the work of Inigo Mujika.  While I'm waiting for Mujika's book to arrive, I did find this great presentation by Mujika at the Science Triathlon Congress.  Below the video you will find my notes.

15-18 years ago, if you had scoured the research, the overwhelming consensus was that strength training wasn't that helpful for endurance athletes.  Since then, there is lots of research to support the use of strength training.  (personal note, be careful of "best evidence" coaches have been using strength training for a long time.  even when evidence in research didn't show it worked.  Real world trumps, theory)

One study showed that in running 32% replaced some training with explosive strength training, others just 3%.  Running performance only improved int he 32% group.  Main reason was the reduction in ground contact time and reduced oxygen cost.

In a very solid study, "Short Term Plyometric in Highly Trained Middle and Long Distance Runners," plyometrics versus dynamic weight training for 8 weeks was analyzed.  Both groups showed significant improvement.  Coaches should work on periodizing both.  Key takeaway was that runners with poor running economy should focus on explosive strength training intensity.  Those that have great economy would do better with increasing volume.

For Cycling, Explosive and high resistance was key.  If done with the athletes concurrent biking, no body mass was gained.  All the KM time trials improved.  16 weeks of strength training improved their power significantly.  Since lots of biking is several hours one very impressive takeaway was that at 3 hours of steady riding tempo, a 5 min time trial was done.  Those that strength trained were able to apply much more power at the end.

Heavy weight training has been shown to improve max strength, some VO2 max measure and lower leg stiffness.  It can prevent neuromuscular fatigue.  It has been shown to decrease heart rate at the end of a 2 hour cycling task.

Mujiko is also a coach and this was his personal use of strength training.
1.  A daily core circuit ( this is something I plan on implementing)
2.  General strength off circuit training and traditional work 2x week for 8-12 weeks at 30-40%
3. Hypertrophy Strength, 2x wen for 8-12 weeks at 80%
4.  Heavy Strength, 1x for 3 weeks at 90-9%%
In addition plyometric work is done during this training.  Uses Philip Saunders Program.
He states not to be afraid of gaining weight during the hypertrophy phase as the heavy running or biking will not allow this.

Stretching studies with a met analysis of 24,000 athletes had no effect on injury prevention.  The same studies shown that proprioception helped a little, but strength training helped the most.  Most interesting, when all three were done, the results were worse then just the strength training.  This was done with triathletes.

In swimming, strength training allows the swimmer to swim the first have of a race more comfortably and have better acceleration over the 2nd half.

Some concepts on why strength training effects improvements in endurance sport.
1.  increasing the muscle size or improving neuromuscular function.  This will improve rate of force development.  Improvement in RFD, improves sprintability.
2. Increase in Type 2 muscle fibers
3.  Increase in musculotendonous stiffness.  This will improve the economy of running.

A big concept that is still controversial in my opinion is the concept of molecular interference.  He even states that this is our best practice at this point and most of this has been taken away from athletes that haven't done the concurrent training for years. 

Molecular interference means you train for an adaptation, but cancel it out with other stimulus.  Aerobic work before heavy weight training.  When there is close proximity of the two.  When you increase the intensity or the volume of the aerobic work, you will have substrate depletion and residual fatigue.  This compromises the resistance training stimulus.

The biggest problem is when you are looking for peripheral adaptation of both strength training and peripheral adaptation in endurance.  The chart shows it nicely.

One big takeaway, don't stop your training during the season, if you do, you will lose your gains.  1x a week was enough o maintain them.

Friday, June 29, 2018

My Thoughts On Exercise

Exercise means many things to many people.  For some, exercise still remains a checks and balance for caloric desires.  It is a means to an end.  A common joke with bikers, is they bike so they can drink a beer after.  The joke isn't to far off on why many people exercise and why for many, exercise remains a task to be accomplished, a necessary evil.

"I run because it's the only way I can keep my midsection from getting bigger."

"Running is the only thing that works for me."

"I don't lift, because I'll grow to quickly."

"I workout a lot, because I like to eat a lot."

You hear a lot of things when you work in therapy and strength and conditioning.

Perhaps, exercise still remains in the hero workouts category for you.  If you didn't kill yourself, then it wasn't a good workout.  If your not super sore the next day, then the exercise didn't really work.

"My abs weren't sore, so I guess my core workout wasn't hard enough."

"I puked, it was an amazing workout."

"It took me fifteen minutes to get off the floor."

Exercise can still be on the other end of the spectrum for some people.  I don't need to do any exercise because I have great genes.  This category still views exercise as a means to an end, because cosmetic goals are not needed, neither is exercise.

"Luckily, I can eat anything I want and not put on weight, I can thank my Mom's genes for that."

Performance and health can sometimes be viewed on different spectrums when it comes to exercise and training.  Working with Pro Athletes as guidance I think one positive and one negative aspect should be considered.  First, pros do a great job of building volume.  They slow cook the training, to allow their bodies to handle high loads of volume, with out creating tons of soreness.  What good does it do to train so hard, that you can't have a quality workout the next day.  Training 5-7 days sometimes multiple times a day trumps a few "killer" workouts throughout the week.

This is often the opposite of what we see in the typical gym.  Train hard, get really sore, don't train for a few days, or put yourself into a super recovery mode where your energy is low for a day or too.

On the other side, Pro athletes training, you have to realize it is their job to train.  You head to a 9-5 job, they train for a sport.  After training, recovery is part of their job.  Taking a nap, sleeping 9 hours, eating, massage, therapy all that stuff makes up their day.  99% aren't pro athletes, exercise should be life enhancing.  You shouldn't need to take the rest of the day to recover.

80-90% of workouts should leave you feeling better when your done then when you started.  Lifting weights should make you feel lighter and super charged, not like your joints are going to be sore for 5 days.

Aerobic work should be accomplished so that when your done, your thinking clearer.  Your mood is lifted.

"Dad, why did you ride your bike so long that you are to tired to play with me."

"I always get sick for 2-3 days after all my races."

Exercise accomplished great things.  Makes metabolic healthy muscle tissue.  It creates a healthy vibrant brain.  It's our best defense and therapy for depression.  It creates better blood glucose control.  It makes us more resilient to life accidents.  Better odds of not getting some type of dementia.  It keeps this human body we have operating at it's best.  Makes stronger bones.  Stronger blood vessels. Healthier organs.  Gives you energy.  It's fun.  Find your reason.  Let's change our perspective from a punishment we do to stay leaner, to a joy that gives more then it takes.

No kid every hated playing at the park.  Remember that.

Monday, June 25, 2018

Rituals, Coffee, and Recovery Tools

A few weeks ago, I took on a challenge from a friend of mine.  Two weeks without coffee or hanging out in coffee shops.  More to break routines and shake up life more then anything.  I did miss it.  I love the taste.  Surprisingly, my energy really didn't change at all.  I don't ever feel jittery drinking it, and I didn't feel less "awake" without it.  I did have a small headache for about 2 or 3 days, but what I did have was a weird omission of ritual.

I'm almost done reading through a book called Dollars and Sense.  It is about our irrational, emotional spending, saving and thoughts on money.  How we are influenced by things we may not be paying attention too.  In one of the chapters they talk about the importance of rituals and how we pay for it.  In their example they are talking about food.  "What they found was that the people who engaged in rituals savored the experience of eating much more.  The was true for both chocolate and carrots.  Rituals increased the experience and enjoyment both in anticipation of the actual experience and in the moment."

"Rituals make us stop and focus on what we're doing."

Coffee is often a ritualistic tie in for me.  It's setting the tone for my day.  I'm often up before the kids and having coffee, savoring the smell, taste and warmth, in the quite, is quite enjoyable.  Start the day on a high note so to speak.  I'll often go to my favorite coffee shop and read or write.  Again, coffee helps me transition into thinking.  Without the caffeinated beverage, it wasn't the same.  It's also something I look forward to in lifes chaos.  According to the authors, we enjoy things twice, the anticipation and in the actual moment.  

A vacation a month away, we get to dream about, look forward to it.  This is often why people will play the lotto, deep down, they don't really believe they will win, but perhaps for an hour, a night, they will enjoy the far fetched idea of what they would do with all that money.  Perhaps that is worth a dollar.  

Back to rituals.  Rituals help us bring importance to events.  Prayer can be that before eating, a moment of gratitude for not going hungry.  Athletes will often have their own rituals before an event. Watch a baseball player before every pitch, you will see the same gyrations, glove fidgets, bat wiggle and foot taps.  Rituals help us focus in.  

Rituals is what I wanted to create when our self recovery tool MOBI was designed.  Something simple that could help people achieve a physical practice.  Doing simple movements to help you focus in on the workout ahead or the process of winding down after training and maybe even before bedtime.  Working on your muscles brings awareness.  It gets you connected to the muscles, whats sore, what feels good, what is less sore today, what is more sore.  Awareness is how things improve.  Daily improvements can make life changes.   

PS:  I lasted 10 days without coffee.  Then I went on a weekend family trip/vacation and whats a vacation without coffee!  

Monday, June 11, 2018

What is Your Threshold?

What is Your Threshold?

I heard a talk the other day about what level are you walking around at.  The talk was about anger and anxiety and how an event we have come to blame can trigger an outburst.  For example,  you may be driving around and not paying attention and accidentally cut someone off.  That person may give you a polite beep, or they may get sent into a road rage and lay on the horn, cursing you as they do it.  

It wasn't the event that set them off, the event was just an opportunity for them to express anger.  It gave them a "valid" reason to express the anger building in them.  They were at a 9/10 already.  Perhaps you have experienced it with your kids or a coworker, they do one wrong thing and you lose it.  The question becomes do they deserve better?  Don't your kids deserve more then 1 or 2  buffer on the anger scale?

The reason that resonated with me, is A, I think I can walk around with to high on the annoyance scale at times and B it relates to therapy quite a bit.  Self reflection can be tough.  

How often as therapist have we heard, I do this (insert anything) and my pain goes away.  That insert is an adjustment, yoga, a stretch, exercise, drink this, eat that, rub this, anything really.  But, it comes back.  So they do it again.

How often as therapist do we do (insert anything), it gets better and we think (insert anything) is the answer to everything?  But, it comes back.  So we do it again.

Lets say you are looking at 4 blocks.  They are stacked on top of one another.  At the height of the 3rd block there is a line and we get pain when we go over that line.  That is the threshold.  So 4 blocks is pain, 3 block is no pain.  2 block we couldn't tell a difference from a 3rd block.  1 block is the same, we couldn't tell any difference between 1, 2 or 3, but oh man, add the 4th and we are hurting.  

Those blocks can be anything.  Bad sleep, bad nutrition, bad emotional baggage, over used muscle, weak hip, dehydration....anything that might have a negative impact on how our body feels and moves.  We target one thing and we get better.  

We will use Joe as an example.  Joe got a new mattress, he wakes up every morning now and his lower back doesn't hurt.  Joe now believes a mattress is key along with a good night sleep.  His friend tells him he should drink more water now too.  He tries and doesn't feel any different.  His other friend say, you should walk more.  He does for a few days, but doesn't feel any different, so he stops. He goes to his in-laws and sleeps on what he now looks at as a bad mattress and wakes up with lower back pain.  He has without a doubt, in his eyes,  proven that his mattress is what keeps his back healthy.  

But, the mattress was only one block.  He didn't stick with the water to rehydrate tissue long enough, to see if sleeping on any mattress was the only key.  He didn't keep walking to build up a stronger aerobic base to see if that would help a few months in.  

We all have several blocks regardless of pain or movement.  We can all get better at dropping our levels down a notch to be more resilient, to be less fragile, mentally, emotionally and physically.  It requires self reflection and consistency.  It's great to have a (insert magic) thing to do to bring us to a good place, but lets not rely on one thing.  Let's figure out what else can be done to increase our threshold.   Let's build a bigger buffer zone.  

Friday, June 8, 2018

Time Does Tell; But Why Wait

A few posts ago, I wrote about the truth teller of time.  Often, we can only wait to find out if the choices we made today, have truth or importance years down the road.  Looking back at your life, whether it was 20 years or 20 days, how did the decisions you made that you thought were important pan out.  Were there things you didn't address that turned into a big deal?

The crux of the situation becomes how can you speed up choices?  How can you become a fortune teller?  Like Keirkegaard stated, "Life can only be understood backwards, but must be lived forwards."

There is one way...

Find those that have lived in your situation before.  Most likely someone, somewhere has sat and thought and chose one way or another years ago.  How did it go, break down their situation from similarities and differences and evaluate the outcome.  Study the greats.  Study history.  Find mentors.

If I was a coach of athletes, I'd study Dan Pfaff at Altis, Mike Boyle at Certified Strength Coaches.  If I was trying to combine big power lifts, with big endurance events, some one like Alex Viada that has done it.

Perhaps your wondering how going on a certain diet or way of eating would influence your strength.  Nothing beats actually doing it, but find someone that has done it or doing it and learn from their experiences.  Things that helped them, things that hurt them.

Someone has paved the way, most likely.  When I ruptured my achillies, I had several people I was able to reach out to that gave me a "plan."  I had a set of loose guideline that I could bounce my day and week around.  I didn't have to wait weeks to find out if I should do this now.  I didn't have to wait months to find out what I did was right or wrong.

Don't reinvent the wheel.

Look for people that studied what you are thinking about studying.  Did they find value in it?  Why did they leave a job or take a job?  Pros and Cons of living in a neighborhood, or owning a home?

Hindsight is 20/20, but lets cheat the odds and learn from someone elses experience.

Saturday, June 2, 2018

5 Needed Principles for High Performance

I have been watching a few interviews and videos that Red Bull High Performance Director Andy Walsh has been involved in over the last few days.  Andy Walsh has created one of the most unique high performance centers in the world.  He is always trying to find new and effective ways to train athletes, make them better.  Last year, you may have heard of the Stratos program, where Felix Bumgartner jumped from Space!  Regardless of going after space jumps, motor bike acrobatics, 100 mile bike rides, or soccer goals, he believes in figuring out 5 principles.

1.  Motivation:  Find out what motivates the athlete.  It doesn't matter if it is intrinsic or extrinsic.  Intrinsic would be something on the inside of the athlete.  Pride, ego, desire for improvement.  Extrinsic is things like money, fame or recognition.

2.  Repetition:  This is important for improvement.   You have to be able to practice the task you are trying to get better at.  Hard to improve a task if attempts are not made at the task.

3.  Feedback:  There must be a way for the athlete to know they are improving.  Is the repetition method working?  Without feedback it is very hard to be able to gauge if you are getting better.

4.  Progression:  Learn a skill then learn a harder version of that skill.  If progression isn't built in, boredom will most likely occur.  The athlete isn't challenged.  There won't be engagement in the long term.  With out progression, skill acquisition will stall and improvement will also become negligible.

5.  Failure:  The environment will need to be set up so that athlete does not fear failure.  Failure shouldn't be looked at as punishment, but as a learning tool.  We just learned what doesn't work.  It shows where your limits are, most important it shows where you need to put the work in.  Andy believes this is where many programs fail.

As a therapist I've been trying to figure out how to include these 5 principles into each patient/athlete encounter.  Most of the time, pain will drive someone in to see us, but the majority of the time the pain has been present for awhile.

Why Now?  Why did they decide to do something now?  This is an important element to discern.  What was their motivation.  Recently, a lady told me her feet had bothered her for years, but now she couldn't walk to church.  That was her MOTIVATION.

I thought her lack of big toe mobility was the issue.  I did some work on her big toes and we started going over some routines she needed to do several times a day (REPETITION)

She was able to walk about 5 minutes before the discomfort would set in.  Anything over this was going in the right direction.  (FEEDBACK)

Every 3rd day we upped her distance she was to walk.  (PROGRESSION)

Every Sunday she walked to church.  We were then able to gauge where she was "failing" at.  (FAILURE)

In my own rehab jumping rope has become all 5 of those principles.  It's nice to see where I can get better, where I can progress, what moves continue to hit my shins (failure).  Andy talks about skateboarders as the leading candidates for progression, feedback and failure.  They can practice tricks over and over and over again and falling is never seen as punishment or failure, just learning.  

See how you can incorporate these 5 Principles into your training and treatment plans.

Friday, June 1, 2018

Doors Closed and a Life Opened

You don't get a chance to see the big picture until a significant chunk of time has passed.  How certain forks in time, certain decisions play out over a course of decades.  Time is and always will be the greatest filter for what choices we make, for opportunities won or loss, for ideas acted upon and for ideas left by the wayside.

My first memory of football was Billy Sims jumping over a defender, juking and high stepping into the end zone.  I was probably 6 or 7.  It was the first time I had goose bumps from excitement.  I didn't watch football either.  It was something that just struck me as amazing.  It woke up something built into me.

I wanted that.

I didn't play football until 7 years later.  8th grade.  I was going to be a running back.  I was small and just started lifting weights.  I prayed every night to get bigger so that I could play football.  Every single day I had only one thought in my head, get better so I could play football.  Every time I studied for a test, it wasn't to do well on a test, it was a to get a better grade for getting recruited.  Every day I worked and prayed to make the NFL.  I went to college and even lived down South for year under the guise of an NFL developmental camp.  I had an agent and the stuff that comes from that.  Combines, workouts with teams, more lifting, more running.  Never made it.  I came to the hard but honest answer that I wasn't good enough.  I was ok with that in the end.  I had left no stone unturned.  I can look back at that time from 8th grade till one year post college and say I had done everything to make it and it didn't happen.  There is a great relief knowing I never have to whisper the dreaded two words, "if only."

Two things have brought even more peace in my lifetime.  The first was this poem shared by a friend years ago.  Push The Rock

The second was an article I read the other day.  It was one of the most honest articles about what we are discovering about post NFL life some players are dealing with.  This article about Ex NFL running back Jamal Lewis life after football, struck a chord.  I think for the first time I realized how much I may have gained by not getting the opportunity to keep playing football.  Joint pain is one thing.  Losing your brain, how you think, how you process, seems so much more....scarier.  If it changes your personality, it changes you.

It really gets into some deep philosophical questions about if your brain deteriorates and your personality changes is this flesh suite still you?  If you can't think, reason, enjoy the environment you live in, create new memories or remember the old one, are you still alive or just existing.  It's why diseases like Alzhemiers and those associated with dementia are so scary.

I've been concussed but not on that level.  I've had several minor ones, but again not on the frequency that is seen in the NFL these days.  I'm under no delusion that I would have lasted long enough in the NFL to have these severe issues, but who knows what ailments lingers with you even from a brief window of physical beatings.  We don't know.

Jamal Lewis shows where he grew up, why he viewed sports as his only avenue out of his circumstances.  He states it was the best option for him.  I grew up with way more options.  As more and more of these athletes step forward and share their stories, I think we will see more and more young athletes assess their choices.  It's very brave for these ex athletes to share their own fears about the future, even if the only thing that happens is that it gives one person a sense that perhaps that road taken wasn't the best option after all.

Wednesday, May 30, 2018

Breaking Loops and Some Book Reviews

The blog life has been seriously lacking in the last few months.  Lots of excuses about time, interest level and content.  I've always enjoyed writing though, so my goal is to get consistent with this electronic journal again.

I've realized a few road blocks.  First and foremost, it started to feel like I didn't have much left to communicate that was "new."  Why rehash old ideas?  This was a subtle nod to perfectionism.  This is bad.  Nothing gets done.   Not every post will get shared 10,000 times, but if it helps one person, then it was worth it.  Even if that one person is me.

Remember your principles for writing.  When I write, I know what I'm thinking.  Writing makes me a a better communicator.  How do I explain this concept I think is important.  Another valid reason for writing again.  You may here something hundreds of times, someone says it with a little twist and it suddenly makes sense.

It feels good to create.  Even writing this little bit, makes me feel productive.

What I have been up to since it wasn't this blog?  Reading, lots of reading.  Here's a quick run down.
Endure by Alex Hutchinson.  Really enjoyable read.  Did I learn anything new.  Not really.  But, it rehashed some old thoughts and that is a big win.  It got me really diving deep into aerobic physiology.  Any book that spurs further reading/learning/thinking is a winner.  Fatigue debate runs on, is it body and physiology or brain.  Most likely a combo.  Rate of Perceived Exertion is a big deal.

Skin in The Game by Nassim Taleb.  To be honest, I don't know If I'm smart enough to read his stuff one time and take away all his ideas.  Big idea, be careful of taking advice about anything where being wrong, the downside, no negative is felt.  Be invested with others that are invested.

12 Rules for Life by Jordan Peterson.  This may be my favorite book Ive read in a few years.  In fact, I loaned it to a friend.  I plan on reading this again in the fall.  I really believe the concepts in the book are timeless.  It is somewhat like a modern Ben Franklins 13 Virtues.

End of Average by Tom Rose.  This was recommended by a friend.  Surprisingly good, and not what you think.  It's not a self help book, more of a history of how "average"  came to be almost bad.  For example, if I described you as average looks and average intelligence, you may be offended.  Learning to quantify numbers into data, seems boring, but the examples are funny and their is some big take home points if your a parent or coach.  I will always remember, their are no below or above average learners.  We all learn at different paces.  Your child or you may need extra time to learn math, but need less time to learn grammar.  The problem is in schools you have 45 min.  It's set.  The history of the public schools are very interesting as well.  Basically, just designed to put out non thinking, obedient worker bees.  Great for factory floor workers, not so great for modern day job and life.

Salt Fix by James Nicolantonio.  Seems to make a solid case for getting more salt into your diet.  I came by this by wondering why when I was sick I always craved high sugary/carb type foods.  Why if my body is smart would it crave something that was obviously not great for your immune system.  Sugar does impede your immune system a bit.  It didn't make sense.  Enter the need for salt.  How the salt craving can be mistaken for the other white craving, sugar.  Lot of wisdom in your grandmas advice to have some chicken noodle soup and you will feel better!

Why We Sleep by Matthew Walker.  I'm only half way through this, but it is pretty mind blowing what we know about sleep now.  Get your sleep.  It literally helps every single human trait.  Every sickness, disease is less.  You live longer, get stronger, stay healthier when you have consistent 7 plus hours of sleep.  After reading this, it will really challenge you if you work so much that you can only get 6 or fewer hours of sleep.  Trading life and the life you will have, health for work/money.  Because it comes down to the simple fact that yes, you are.  Pretty easy to shut the TV off and get an extra  30 min or hour.  Joe Rogan did a top notch podcast with him.  Most of the information in the book can be found in the podcast (So far at least, but I'm only half way).

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.


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?


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!


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.


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.