Should We Chase Efficiency

The last few months I've been thinking a lot about the concept of efficiency.  Don't waste time.  What is the most efficient use of time?  Chasing efficiency.  What part of this procedure could I cut out to still get the desired results.  Cut the fat.

In some ways, I think this is a good filter to use, what is redundant.  Chasing after the efficiency idol is a slippery slope though, it can bleed into other areas of your life where efficient starts to mask the good stuff.  

Another word that can be used is optimization.  Optimize and efficient started to mean the same thing to me, and that I believe is a problem.  

Efficiency can produce (not always) fragility.  A hiccup comes up and your assembly line of well intentioned, perfectly timed dominoes fall.  Stressful.  For example, If I packed my schedule and one patient shows up late, my day will snowball late.  If I put a buffer of an open slot in there, (inefficient) I can withstand some late visits.  

There is all kinds of optimization for your sleep now.  In fact, I do quite a few of them.  Dark room, limit blue light, no caffeine after 4, take some magnesium, cooler room.  But, in a way, we are learning to rely on these things for a good nights sleep.  The first time you have to stay in a hotel that is different from your routine, can you sleep?  Before a big race? Perhaps there is some value in not optimizing all the time, even if it results in a few more tired days.

I rode my bike at a winter groomed trail today.  A lot of gear to be able to ride in a Michigan winter.  Between driving there and home, the packing and the gear retrieval it was a two hour commitment.  I rode for about an hour.  I could have literally walked into my basement and cycle on my trainer for two hours, and achieved a better workout.  It was an incredibly inefficient use of time.  

How do you measure being in nature, stumbling upon a herd of deer and chasing them on the trails.  Alone with your thoughts, not another human for an hour, like a private playground.   Snaking around a few corners and keeping the bike upright.  Chatting with one of your best friends in the parking lot.  These are all things that created a great experience and made for a wonderful use of time.  

What is fitness?  Getting more and more efficient at the task you ask to achieve.  Training is just biology adapting to the averages you stress it to.  The more you do something, the better, more efficient you get at it.  Performance is great, but perhaps training should have some inefficient tasks in there as well.   

The thoughts for this blog came into my head on the way home.  I had been thinking about efficiency and fragility for some time, but this seemed to cement them.  Don't chase. Evaluate. Don't let efficiency become your only filter.  You will miss out on art, life and the good things that it composes.  

Amish Pizza

 I started traveling to an Amish farm around 7 years ago, treating all my Amish patients at once.  This allowed them to not have to pay a hundred dollars to get a driver to come see me, and only have a few at at time at that.  

My first time there they asked if I would stay for dinner.  Picky eater, by nature, I didn't really feel like staying and trying to eat something I didn't really like.  Then I heard, we are having pizza.  Pizza!  Easy.  Pizza with the Amish, what a great story.  

What came out was not pizza!  It was loaded with vegetables on top of some type of cream cheese(?) on top of some soft bread.  It did have a bit of shredded cheddar.  But to call this pizza was a stretch.  A big stretch at that.  It was actually pretty good though.  

Through the years, I've stayed for dinner after every visit.  I've had close to 10 variations of "pizza" none of which would be classified as pizza to the outside world.  Fruit pizza, ground beef pizza, mashed potatoe pizza to name a few.  

Over the years, I've asked many questions on different aspects of their culture.  They ask questions about my travel with sports teams and countries I've visited.  I ask questions like taxes, school, marriage and work.  One thing I never asked was about the pizza.  

I've told many friends about the pizza, and my basic comment was that if it has cheese on it, they call it pizza.  A misunderstanding I never corrected.  Until this last weekend.  

I always have loved the Origen Stories they do in movies now.  I now know the Origen story of Amish pizza.  

My host that does all the cooking is probably in her early 60's.  We sat down to eat some fruit pizza and she asked if their was any foods I didn't like.  "I hate onions.  In fact, when I was traveling in Germany with bobsled, the only German I learned was Nine Zwiebel.  No onion."  

She responded by saying that her Dad, since passed,  also hated onions.  The only time he had pizza it was loaded with onions, and he told his daughter, my host,  how disgusting pizza was.  My host would not have a real pizza until she was 20 and she goes, "it was so delicious". There was no onions on pizza!

About 15 years ago, she was gifted a recipe book of all the different pizzas you could make.  Over 50.  She started cooking them for her dad before he passed.  The myth of Amish pizza died.  Misunderstanding was cleaned up.  

In this story is something I hope to remember.  Ask questions.  Sometimes it is just pizza.  Sometimes it is much bigger then that.  How often do we think "onions" ruin a thing and think that is for everything?  

Keep digging.

Stress, World Championships and Life

Elite athletics has always been a place to showcase the best and worst of human qualities.  It's a microscope on all the things we love and hate.  It has inspiring performances and also humbling ones.  They can't exist without each other.  The classic yin/yang.  Can we learn from them?  That is always the part that interests me, and I think deep down that is why "people" are still drawn to sports.  That is why something that is live always has bit more interest than if it already happened, even if you don't know the outcome.  

The saying "that's why you play the game" resonates.  All of us want to see the underdog win, or the favorite succeed despite the pressure to perform, or some unknown surprise the field.   Human potential, put on display, to actualize that potential is riveting.  

World championships are one such event.  It is basically an Olympics.  Medals.  Rounds.  Days of competition.  After every major event, I always try to sit back and think about what happened after a little bit of time has gone by and the emotion has left the room.   Coach Dan Pfaff calls this a debriefing.  He would do it with athletes.  I do it for myself.  What went well, what went poorly.  Everything from operations, like meal timing, travel, sleep, to the actual event.  

The thing I kept coming back to this time was the management of stress.  Perhaps that is all there is.  Again, these are just my thoughts. 

The Great Ones are stress managers.  Imagine every human has an energy score.  Let's make up a number and call it 100.  Let's make up some other arbitrary numbers as well for this example.  Zero is death.  We can almost never obtain 100 it's mythical, kind of like Madden football.  99 is coveted and only a few people ever will get it.  The 99 doesn't always happen every year either, keep that in mind.  40 is sickness, like the cold.  You hit 40 and you get a cold.  50 is some nagging injury.  

If we want to make it a little more complicated lets robustness of the athlete has a genetic component and some will have 100, but some will have 90.  Again, these are made up. 

Training is 30 points.  Every day, if you were to train the maximum amount of your ability it takes 30 points. 

How do you recover points after training.  Sleep, nutrition, mental health, social bonds, ect.  all the things most people have heard of.  Have you ever thought of it from a performance perspective?  Does my off training periods align with my truest recovery.  I'm bringing a 26 instead of a 30 to my training every day.  Every day.  Over the course of a year, that little bit less adds up to that coveted few pounds on the bar, few tenth or seconds off the clock, a few more percentage points at the plate.  

The scary thing is that athlete, that coach, they all think he or she is at their optimum.  Unrealized potential.

The other side of the coin is that they recover enough to bring the heat when they need to bring the heat in the workout but the ability of the body to adapt to stress (training) is always a function of how healthy the body is.  Recovery is impairing the work they are doing.  Their recovery score is 27 instead of 30 consistently.  Again, they recover enough to train at maximum, they are improving.  But not at the rate they could be.  Unrealized potential.  

At the most elite level, it's not just showing up and training hard with talent.  It's everything.   The 21 hours per day are just as important as the 3 hours of training.  Perhaps even more important.  The more lifestyle stress you accumulate the less stress you can put into your training.  The more lifestyle stress you accumulate the less stress the body can adapt to. 

The better you are at the total picture, anxiety becomes nerves.  Nerves are good.  Nervousness is free energy, the butterflies, it's a symbol that you care about what is about to happen.  Anxiety is the man in the mirror test.  It's showing up with perhaps a subconscious pattern of knowing you didn't do all that could have been done, or perhaps you are coming with less than ideal circumstances, sickness and injury come to mind. 

The great ones are not great by accident.  They are great managers of stress.  Look at your lifestyle when things don't go your way or when they do and a record is broken or an achievement is made.  It works both ways.  Where was my head and life the months leading up to a break through moment.  Obsess over the other 23 hours of the day.  

Weekly Learning: Number One

 I might try a new weekly or semi regular installment of a concept called weekly (even if it isn't) learning. Mostly thoughts on what I've read or experienced in clinic.  I'll see how it evolves.  I've been thinking that it would be good practice to sit and think about the week.  

A win:  Had a patient that was getting repeated knee pain for months after exactly half mile of running.  Swelling on the outside lateral knee.  I had treated the foot and hip and knee in all various combos.  Big rocks were checked and rechecked.  One evening I sat and throught through the anatomy and reviewed some old French Anatomy notes I have.  Taken from the 1800's before Fascia wasn't eliminated.  I reviewed an old Guy Voyer video and throught through some joint jumping techniques that I have learned from a Guy seminar taught by the amazing Brian Murer.  Some individuals will have a lateral sesamoid bone and can have various IT band attachments (up to 5).  I worked the tissue and joint pumped the joint in various ways.  Two days later I got a text he had run 5 miles with no pain or swelling!  Pretty cool.  

A Loss:  A profesional runner I have worked with retired from foot pain.  It was a frustrating experience for him, to state it mildly.  I'd get to check it every 5-6 weeks.  I have probably read more about the foot in the last year than any other anatomy to try to figure this out.  Worked on trying to create exercises to emphasis better control in the foot and in the body.  Just nothing ever clicked.  Very bummed for him.  The goal for any athlete is to retire because they aren't good enough or they have accomplished what they wanted to.  Not to let injury decide for you.  Very humbling to know you couldn't help.  

But it also puts into clarity the importance of keeping learning, keep thinking, keep tinkering.  I'll cross paths again with injured athletes from various things.  I owe it to that future athlete to get better.  When an athlete trust their career and dreams to help keep them healthy,  it's not a thing to take lightly.  Keep learning, get better.

The Adductor Magnus really has 4 parts if you take the blood vessel areas as zones.  Zone one acts as a hip stabilizer, 2 and 3 are middle zone and are conductors of movement.  Zone 4 is basically acting like another hamstring.  Interesting stuff.  

Why Do We Train

Why do we train?

To answer this question becomes the foundation for the rest of the story.  Get this wrong and your trajectory is off and you will miss the mark.

Better to go slowly in the right direction than quickly in the wrong.  

Filter One:  Why do we train?

Here are some common answers.  To be better at my sport.  Let's break this down a bit further.  To be a better football player, would be completely different than being a better runner.  Does a better runner mean I run faster or run further? 

To be healthier.  What does health mean to you?  Less body fat, more muscle, better cardiovascular capacity, better bone density? 

To look different.  Growing up as a kid in the 80's I wanted muscles like Rocky.  Some people want to get bigger, some people want to get smaller.  

To Feel better.  Training has a calming, almost euphoric result.  Brain producing BDNF produces less anxiety.  Some train to deal with depression or sadness.  Mental health from training can be just as great as the physical. 

Filter Two:  What is the most precise description to the answer of filter one.  Example.  To better at sport.  Football.  I'm a little small.  I need to get bigger.  Fat don't fly, so I need to put body armor on.  AKA...muscles.  My goal is hypertrophy.  

Example.  I want to be better runner.  I want to run faster.  How do I run faster.  This can be a bit more complicated.  Lets go through a few scenarios.  I get niggles here and there that disrupts my training blocks.  Training for this scenario is figuring out why you can't handle load.  My goal is capacity of my tissues.

Am I to big?  Again, fat don't fly, so perhaps better body composition is in order.  My goal is better body comp.  

I am generally weaker than the accepted norm for my level of compotition.  But as a runner/biker/climber/ weight gain may not be desirable.  My goal is strength without the additional hypertrophy.  

Filter Three:  What are the best exercises to choose to reach the desired outcomes.  Best becomes individual.  Individual aspects will vary widely.  Mobility, technique, training history, injury history, limb size will all provide unique data points to consider.  Most importantly, does it get a yes from the first two filters.  

Example.  Is the lying leg curl a good exercise.  Strength.  Probably better choices.  Hypertrophy, I might keep this.  Running faster, def better options.  Rehabbing a hamstring strain, I might keep this one in.  

Common pitfalls to better training.

As Dan John says "keep the goal the goal."  Losing focus on why you are in the gym is easy to do.  We get enamored with toys, exercises we saw on social media, or what are friends are doing. 

We get caught up in a certain exercise.  A barbell is only a tool.  A back squat with a straight bar, deadlift or bench has come to be the holy trinity.  Please remember, those are a sport in and of itself.  Even powerlifters have now devised bars that are more ergonomically designed to support the gain of strength without risking joint health.  Being dogmatic with a straight bar is foolish.

Being stuck with prescribed ROM.  I never was able to figure out why a 45lb weight plate is 17.72 inches in diameter.  Why the barbell is 8.5" off the ground.  Manipulate the ROM for your best health and for the desires of your goal.  Perhaps raising up the plates by 6" allowing the bar to be 14.5" off the ground is the best for your hypertrophy goals?

Going from one thing to another.  Not sticking with a thing long enough to see it through the end.  

Sticking with something to long is the other end of that quandary.  How you became a 400lb deadlifter, will not be how you become a 500lb deadlifter.  Training and special exercises will most likely need to change. 

Mistaking getting good at an exercise for thinking that it has proper carry over.  This probably gets filed under picking better exercises.  Thinking that you put 40lb on your bench and thinking that you will be a better football player is very rarely true.  

Seeking fatigue.  I think this is one of the biggest pitfalls.  People think that getting tired is a good thing.  Just because you get tired, doesn't mean you had a good workout or that something positive happened.  Just like busy doesn't equal productive.    

Training like you have always trained.  For a few years after I was done with bobsledding, I found myself still training like I was going to push a bobsled.  Except I wasn't.  My mobility was deteriorating, my aerobic base didn't exist, and I was starting to feel beat up.  But it was what felt comfortable.  I still felt "strong" because I could lift a lot of weight, but it was not improving my quality of life, in fact it was hurting it.  My filter was still in "to be better at a sport, when I needed it to be healthier, 

How we train should change when lifestyle, goals and circumstances change.  How we did something should not be the reason for how we do something now.  Use these three filters to devise a better plan.  Be wary of the pitfalls, and above all have fun in the process.  Training should never end, so if it's not fun, it will.

Track, Travel, Thoughts

 A few weeks ago I got the chance to travel to Serbia and work with the New Zealand National Track and Field athletes that had qualified for the Indoor World Championships.  The event was held in Belgrade, Serbia. 

Getting off the plane into Belgrade and was immediately hit with the smell of cigarette smoke.  It has been over a decade since I have been around the smell, so it was a bit startling.  All the countries seemed to arrive at once, so there was a bit of chaos into getting to your hotel.  Luckily they had a Serbian volunteer that helped with all the logistics.  

We stayed at a hotel that allowed you to walk to the Arena.  The fresh air was appreciated.  It was hard to not be stuck by the giant concrete apartments buildings.  They were all around.  I've read research where the building style was purposefully built to drain your emotional well being.  To create a type of depression.  It works.  Graffiti and trash peppered the landscape.  Full disclosure:  I never had the time to go into old town.  I'm sure that was much cooler and full of history.  

We took a bus trip to the practice track and witnessed a mass of riot police in full battle regalia lining the streets.  We are talking hundreds and hundreds.  Apparently they were preparing for a soccer game to start and finish.  I was told Serbian Soccer games have a reputation for violence.  Such a strange thing to witness.  

The event and arena was great.  Held in their national basketball arena.  It held a lot of fans.  The track had a fast middle straight for the sprinters and a comfortable, but not fast track for endurance events.  The warm up area was excellent.  

Hours spent in the warm up area working on the athletes I was with and watching various events warm up, I had some thoughts.  Americans love warm up drills.  Foreign athletes like games and easy going style of general preparation.  The medal contenders are just physically different.  No matter the coaching/training, to win medals, you have to be blessed with that extra.  Listening to Marcel Jacobs do block starts had a different sound than all the others.  The power was audible.  The finalist had a different sound than the athletes that didn't make it out of the prelims.  Grant Holloway, the same.  I don't think you can achieve a medal without hard work, but I don't think you can get a medal with average talent and incredible work.  They are special.  It is easy to recognize the unicorns.  Also, why I think travel sports are a bit on the silly side when it comes to kids under 14.  Play lots of sports, lots of experiences.  Cream rises no matter what. You can see special in a few minutes.  If you have to ask if your kid is special, they are not. (harsh, but true).  

You didn't see the open support of Ukraine in any of the places we were.  This could be that it is very real there, or life is hard enough and you just don't have time to worry when life has enough problems in the current day.  It raises the question if things like sport matter when things like war is going on.  I think they do.  Sport lets you see what humans are capable of.  It lets the young dream and the old reminisce.  There is a joyful escape in seeing effort.  A respect for the work and sacrifice.  There is something about wondering how far you can run, how fast you can do it, how high you can jump, how far can you throw that will always bring a sense of wonderment and curiosity. 

Art is important.  It strikes you when it isn't present.  Even graffiti could be described as a impulsive call to break up the grey monotony of the concrete.  Concrete, a feeling of being stuck.  A lack of motion, we are, I am, not going anywhere.  Sport and Art have a way to inspire and transport.  The ability to create motion, to spark imagination.  It's a shame that it is being cut from schools.  

"The arts are not a way to make a living.  They are a very human way of making a life more bearable.  practicing an art, no matter how well or badly, is a way to make your should grow, for heaven's sake.  Sing in the shower.  Dance to the radio.   Tell stories.  Write a poem to a friend, even a lousy poem.  Do it as well as you possibly can.  You will get an enormous reward.  You will have created something."  -Kurt Vonnegut

Attaining Health Quickly: What To Do

 There is not time to get healthy.  I heard this a lot a few years ago.  Health is not something that can be attained in a few weeks or even months.  You can't rush your fitness or health, but are there things that can actually make you healthier instantly?  More specifically, are there things that can be done today, that will make you healthier today or tomorrow?

"The best time to plant was 20 years ago.  The second best time is today."

If you walk for 30 min at a comfortable pace outside your Natural Killer cells and your T-Cells go up.  Simply put, your immune system is raised up and has shown to have less overall sick days and respiratory illness over a winter.  Several studies support this.  This is immediate.  Can you imagine if this was a pill, how many people would be clamoring to take it!

Staying with walking, as little as a 10 min walk after eating, has been shown to keep your glucose levels down.  Regulating blood glucose levels is how we can go from pre-diabetic state to a healthy range.  This is regardless of what you eat.  It's not even saying, change what you are eating, just walk a bit afterwards!  (Side note:  The words comorbidity has been thrown a lot around recently, pre-diabetic blood sugar levels, is a comorbidity, you may look and feel great, but your body is essentially rusting.) 

Speaking of dietary changes.  You can change your gut biome in as little as 4 days.  A fast food diet of burger and fries were compared to a Mediterranean diet for 4 days.  There was 4 days in between each diet.  Fast food diet showed an increase in the bad bacteria in the gut and Med. Diet showed an increase in the good bacteria.  This was after 4 days!  Imagine what a month could do.  A few more fruits, vegetables, olive oil and quality protein.  Dump the fried foods. 

Vitamin D levels is a very important parameter for overall human health.  Immune system, muscular recovery and mood are just a few but important areas it impacts.  10 min in the sunlight on your skin is about the equivalent of 10,000 IU of vitamin D.  Supplementing with Vit D can serve as a great adjunct on days there is no sun or you are stuck inside.  

Sleep is a big deal.  A good nights sleep drives a healthier innate immune system.  It enhances recovery.  Your biomarkers that fight infection are improved.  Your inflammation goes down (or up if you sleep poor).  The response to vaccines is improved after good nights sleep! (what do you think this means if you sleep pretty poor consistently?).  A lot of what we know on how to attain a good nights sleep drives from understanding the circadian rhythm of our bodies.  Here is the easiest guidelines.  Let your eyes see the sun in the morning.  It basically is the physiological wake up signal.  Light on the retina.  Eat something.  Have some movement in your day.  Stop caffeine before noon (for most people).  Cut out your phone and blue light 2 hours before bed.  Blue light stops the melatonin hormone.  Yea, you say you can fall asleep but your sleep is disrupted, which means you wake up!  Your sleep was disturbed.  Take Magnesium an hour before bed.   This has been a game changer for so many patients of mine.  Go to bed at the same time, yes even on the weekends.  

Breath deep for a few minutes.  Inhale through the nose, hold for a few second.  Exhale for a few seconds. Hold for a few seconds.  This is called box breathing.  Repeat for a few minutes.  This will literally drive you into a parasympathetic state.  Less cortisol, which means less inflammatory response to stress.  Breathing is like the remote control to your nervous system.  It works that quickly.  

Drink water with some electrolytes.  We are water.  We are electrical beings.  Better hydration is better function.  

Socialize with people you like.  This I found quite ironic.  Social isolation or a perceived social threat produced more inflammation and decreased anti viral qualities.  While the opposite was also true.  Positive social interactions showed decrease inflammation, and bolstered anti viral responses.  

There is time, there was time.  Today can be that day.  Acute can become chronic.  Your body will change, wether you do something or not.  You can decide how.  Health can be improved today.  Don't let anyone convince you otherwise.