Wednesday, December 15, 2010

Avoiding Injury


Working in a physical therapy clinic, you see a lot of injured people.  No surprise there.  But in previous professional settings I witnessed a fair share of pain, tightness, inflammation, and sufficient discomfort to prevent the proper function of people’s limbs.

One of the areas I specialize in is called Functional Movement Screening.  The most important information that comes out of the screening is an injury risk assessment.  Having a previous injury, having a sedentary lifestyle, being obese…all of these are predictors of a high likelihood of future injury.

If having a previous injury makes one more likely to have a future injury, then it seems we need to do a better job at rehabilitation.  If therapy can bring you to a pain-free condition, but we don’t go a step further and return you to optimal muscle balance and muscle/joint function, then we haven’t gone far enough.

Can exercise do that?  Can it correct your muscle balance and improve your muscle/joint function to reduce your risk of future injury, post-therapy?  Yes indeed, it can and does.

I can take you through a screening and get a pretty good idea of your injury risk.  Then I can look at your everyday activities, your recreation or sport, and your exercise plans (or lack of all of the above!) and get a pretty good sense of which activities contribute even more to your injury risk.  Finally, we can work together on a progression of exercises to correct what is likely to be either a muscular mobility or stability problem and move toward injury prevention.

Even if you aren’t sedentary, and being up on your feet and climbing stairs and hauling things around all day is part of your normal routine, you can benefit from a mobility, stability, and strength building program. People wonder, if they are busy with a very active job or active lifestyle, why they may still suffer from a creeping weakness or loss of function over time.

Aging (which is a good thing in and of itself if you enjoy being alive) has this nasty way of causing your muscular strength to wane, your endurance to fade, your posture to become lopsided.  Whatever your activity level.  If you are sedentary the consequences tend to arrive quicker and be more debilitating.  But the fact is your body is amazingly adaptable and sets a “status quo” based on your routine.

So if you want to stay strong, maintain your stamina, remain in good posture and balance, and thus avoid injury, you need to dedicate specific efforts toward those goals.  Your body needs to be pushed harder than normal in order to keep your “status quo” from falling.  Dr. Mark Hyman, author of the books Ultra-Prevention, Ultra-Metabolism, and The Ultra-Mind Solution among others, calls it training like a caveman.  But in order to make sure your body is prepared for training, and to be sure you are not piling resistance on top of poor function, start with a functional movement screen.  When do we get started?

Yoda Wisdom


Here’s some Yoda wisdom.  A few mantras to run through your head to keep you motivated, in the event your I-pod isn’t doing it for you.  (If you don’t know who Yoda is, join Netflix and get caught up on the early Star Wars films.)

Frank Oz of Muppets fame (he gave voice to Fozzy Bear, Grover, and Miss Piggy among others), and for many years now an excellent film director, provided the voice-over…glorious work in its time.

But I digress, so let’s get on with:

Yoda says:  “Try not.  Do.  Or do not.  There is no try.”

Trainer Jane says: We all know how Nike expresses the same theme….

Y: “If you choose the quick and easy path, you will become an agent of evil.”

TJ:  Ouch.  Evil, he says.  Well, Fitness and Wellness and Optimal Health are truly an investment and a journey.  It takes time, it takes effort, it takes endurance to change your life for the better.  Shortcuts aren’t good for you.  You are going to love the results of what is good for you, though.  You might even enjoy the journey!

Y:  “Named must your fear be before banish it you can.  [Luke:] I can’t believe it. [Yoda:] That is why you fail.”

TJ:  And how about Yoda’s syntax?  And his penchant for holding up the mirror to his student.  Are you afraid of sweat?  Are you afraid of hard work?  Of injury?  Of  being different from your friends or family?   Of not being the best?  Or, are you afraid of success?  Name it, face it, then let’s conquer it.

Y:  “You will find only what you bring in.”

TJ:  I had an extroverted version of the same concept posted on the ceiling of my training studio back in the day (to inspire us while we lay on our backs doing crunches):  The person on top of the mountain didn’t fall there.  The more you put into it, the more you are rewarded.  Yes, small steps will make small changes… and when you accumulate more steps you will experience more change and more betterment.  Bigger commitments yield bigger results.

It all keeps coming back to you.  Put quality in, like with clean whole foods and fresh water and smart movement, and you get quality back in the form of a healthy and strong body and mind.

Take the Yoda path.  Happy, healthy, prosperous New Year, everyone!

A Nutritional Journey


You may or may not know that I have followed, and frequently recommend, the research and writings of Dr. Mark Hyman.  I received a blog from him today that kind of snapped me into focus, and I want to pass it along to you and invite you to participate in my journey.

A majority of the time (let’s say 80%), I follow Dr. Hyman’s nutritional recommendations as outlined in his book “Ultra-Metabolism.”  Minimal sugar, minimal flour, minimal trans-fats, minimal dairy, more whole fruits, more whole vegetables, more fresh herbs, more bio-available supplements, more organic meats, more gluten-free grains.  I have a personal history and a family history of inflammatory disorders, from digestive to cardio-vascular to metabolic, and so this anti-inflammatory approach to eating has served me very well.

Ah, but there’s always room for improvement.  I have always adored dairy products.  As my friend Paul is fond of saying, “Cheese… I could make a meal out of cheese!”  But there’s no doubt I could feel better with less of it in my system.  Lately, in fact, I’ve been acutely aware of digestive and sleep disturbances that deserve my attention.

When I received Dr. Hyman’s blog today, I announced to myself… and a couple of clients… that now is the time for me to knock out the dairy completely for two weeks.  See what happens, then see if I can tolerate bringing back organic unsweetened yogurt, which is a real staple food in my house.

No more cow’s-milk cheese on my homemade gluten-free-crust pizzas.  No more cheese on my sprouted-wheat-tortilla-wrapped enchiladas. (Are you rolling your eyes yet?)  No more cheese on my organic black bean chili.  No more cream in my Starbucks tall half-caff/half-decaf.  Here’s where we get into the 20% of the time that I eat “freestyle”… no more cheese grits.  No more once-in-a-blue-moon pub cheeseburgers.

Thanks to Ann from my Women on Weights class, who wisely reminded me to add some calories back in with some other healthy choices so I don’t get emaciated.  Welcome to my world!  I remember with such clarity what it was like to have trouble losing weight, that I forget my new problem is keeping weight on.  Which nobody cares to hear about, huh?  Either way, underweight or overweight, believe me, it’s a frustrating problem to be uncomfortable or unhealthy in your own skin.

If you are interested in learning more about how your unique genetics and “body chemistry” are affected by your food choices, I have a very interesting questionairre, used with permission from “Ultra-Metabolism.”  You may find it very enlightening.  It points out the tangible side effects you can really feel when your eating habits impact your health in seven key areas, among them toxicity, oxidation, inflammation, and metabolism.  Let me know if you’d like to schedule a session to review it together.

Here’s the link to Dr. Hyman’s blog to learn more about the research behind his assertion, in which he frequently cites another favorite doc of mine, Dr. Walter Willett of the Harvard School of Public Health:

No, I don’t receive a commission from Dr. Hyman.  We have shared clients/patients and respect each other’s work.

And if you care to join me in this endeavor, I’d really appreciate your feedback at the outset and along the way!  :-)

Be Well!

Breast Cancer Recommendations

It has been the wellness-talk of the treadmill for the past couple of weeks.  I’m talking about the breast exam recommendations released by the United States Preventive Services Task Force. 

To sum it up, the USPSTF suggested baseline and follow up mammograms begin at age 50, instead of the current standard of 40, and to give up on Self-Breast-Examination (SBE).  Some folks have said that it’s high time we put the brakes on the aggravation and expense of — now what’s the term they use in the courts?  Ah yes, “frivolous” — screenings and scans.

After Thanksgiving dinner, as my cousins and friends were gathered round chatting about the matter, it came to our attention that four of the six women present had either found a cyst or found a malignancy.  Three out of four of us made the discovery before age 40.

The debate takes me back to a TV health show I participated in, right after the results of a Chinese study were released in 2003.  My friend Benita is a TV anchor for a local network affiliate, and also hosts a health talk show on public television.  When she called me and asked if I knew anyone who had been diagnosed with a breast cyst or breast cancer, and when she learned I fell into the former category, I became part of the talk show panel.

Here are the details of the 2002 study we discussed: 266,000 female factory workers in Shanghai (where mammograms are rare) were divided into two groups.  One group was taught how to perform SBE and reminded to do so regularly, and the other group was never even taught. After 11 years, there was no difference in the groups’ mortality rates due to breast cancer.

No difference in mortality rates means the group who enjoyed early detection had the same death rate from breast cancer as the group who didn’t.  Scary statistics.  We danced uncomfortably around that conclusion in our panel discussion, and stuck with beating the drum for early detection, support groups and accessible screening programs.

But scientists have known with some clarity for at least seven years now that SBE doesn’t improve your odds of surviving breast cancer.  You are just aware that you have it that much sooner.

That’s with SBE.  Now the task force says to put off the baseline screening for average, healthy adult women until 50 to avoid the discomfort, anguish, and over-treatment associated with repeat screenings and false-positives.  This is anecdotal evidence, of course, but my experience leads me to believe awareness is worth the anguish…especially if it leads to healthier lifestyle choices!

Quoting the chief medical officer of the American Cancer Society, Dr. Otis Brawley, “The USPSTF says that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group. Yet USPSTF also says screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile. The American Cancer Society feels that in both cases, the lifesaving benefits of screening outweigh any potential harms.”

So what say you?  Think about your sister, your daughter, your wife, your mother, your friend, yourself… your comments are encouraged.

Walking with Weights

A physical therapy patient had a question for me:  Which of these exercises is better for building strength, the treadmill or the bicycle or swimming?

Let’s talk about what strength means to you, I said, because all those exercises are great for strengthening your heart and lungs and building endurance in your legs (while swimming also builds endurance in the trunk and arms).  So what do you mean by strength?

Here is a woman who owned a greenhouse and nursery business, who was used to performing a lot of heavy lifting.  Since retiring, she has lost a lot of her lifting ability.  So building muscle strength, as opposed to muscle endurance, would restore her ability to lift heavy stuff, and that’s what she wants. 

Certainly, even as a retiree, it’s not too late for her to do that.

Move it or lose it, that’s what happens with muscle endurance and muscle strength.  But it matters a great deal what movements you choose in order to help you reach the goals of increasing endurance or strength.  Rather than getting into the technical biochemical aspects of which energy systems your body uses to generate endurance or strength activity, let me sum it up this way:  Keep moving for 10, 15, 20 minutes or more and you are building endurance, and; keep moving to a point of failure at a minute or less and you are building strength.

Over-simplified but true.  And interestingly, I recall from a continuing education seminar I attended 18 years ago that researchers have determined you can build some muscular endurance by following a strength conditioning program… but the reverse does not occur.  Especially as you age.  So the older you grow, the more crucial it is to pursue strength as a fitness goal.

Which brings me to walking with weights.  While I was jogging a couple of days after Thanksgiving, I passed a man walking briskly with  dumbbells in his hands.  Judging from the size of the weights I’d say they were at least six pounds each.  If he was planning to complete, as appeared likely, the entire two-plus mile loop of the neighborhood, he’d have spent at least 30 to 40 minutes pumping those arms along as he walked.

So based on my overly-simple guidelines, he was building muscle endurance in his legs and arms, and placing a greater burden on his heart and lungs to increase his cardio-vascular effort — but with little muscle strength to be gained, and all this at a terrific bio-mechanical risk of injury to his shoulders, elbows, wrists, and hands.

We’ve known about the injury risk associated with this practice for over 20 years, everyone.  Instead, limit yourself to a one or two pound weight in your hands.  To give your cardio-vascular system a little more challenge, use what I call “choo-choo“ arms, bent at the elbows with hands kept at waist height or higher.  This arm position can help you move your arms faster, which automatically causes your feet to speed up.  And it minimizes excessive wear and tear on the elbows and shoulders when you‘re walking fast or jogging.  Better yet, just leave the wrist and ankle and handheld weights at home when you’re out for a brisk walk or jog.

Please share your specific questions about strength exercises here on the blog, or email me directly.  Keep moving!

Enmark Bridge Run 09!

I LOVE the Enmark Bridge Run!  My first time and I'm very psyched about it!

The words of my USA Track and Field Coach, Jim Bowles, keep ringing in my ears when I start training for a hilly course:  “We train to race, we don’t race to train.”  This advice resonates on so many levels, but I just want to illuminate a couple of points.

One of the Bridge Run registrants invited me to train by running over the Talmadge Bridge and back, over the race course.  But since it has been months since my legs have even seen a hill, much less run one, my response was, “Let’s do hill drills first.”  With a few weeks to go before race day, I felt confident that I would have ample time to prepare for a visit to the course itself.

So in the same manner in which we train for more speed, with short intervals of race pace or higher, we can also prepare to endure inclines with short intervals of hill climbing.  Push to fatigue and recover – push to fatigue and recover – repeat ad nauseum!  No, no, just kidding, don’t push ‘til you get sick!  But hill drills are much more efficient for building your performance than putting out an all out race effort on a training day.

Here’s the quick and dirty How To:  Start with a good long warm up jog, at least 10+ minutes for you 5K folks, 20 minutes if you’re 10K ready.  Hit that hill for 50-60 seconds, turn around and jog back down…repeat 6 to 12 times.  If you get so tired that you can’t complete a charge up the hill for the full 50 seconds, then you know you’ve done your last repeat.  That’s the simplest way to drill hills.  Coach Jim makes us run back down with the same effort as the climb, then recover for a minute before the next climb…now there’s a good way to wreck any fondness for downhills!  If you want individualized recommendations for your finish time goals, or heart rate targets during your intervals, email me and schedule a personal training consultation.

“…we don’t race to train.”  This also speaks to the rush to prepare.  Is this your first 5K? Or your first 10K?  Or your first double pump?  I sure hope you have given yourself a couple of months to prepare.  Rushing to race readiness can increase your risk of soreness, fatigue, and injury.  I can count on one hand the number of people I have known in my 20-year career who could comfortably double their running distance in the space of a few days or weeks, though I have known dozens who have tried.
 Give your body the time it deserves to adapt to new demands.  Even your ability to tolerate a climate shift of 10 or 20 degrees hotter or cooler, not unusual in Savannah this time of  year, will be better when you gradually progress your preparation and your distance.

Be Well, see you at the Enmark Bridge Run on December 5!

Let's Get Started!

I have some archiving to do here.  Been blogging under a different URL for over a year now, but I am going to repost each of those previous blogs here and rebuild my archive for you, so all my compelling ;-) thoughts are easy to find in one location.  A little minor editing, and away we go!

Welcome!  I invite you to discover a state of well-being, where everybody wants to move!  Within these borders (all puns intended) you will find very do-able ideas, strategies, education and tools you need to feel better, perform better, get healthy, and adopt Optimal Fitness into your everyday life!

First Question… I look forward to answering lots of your questions, by the way… Who Needs a Personal Trainer, Anyhow?

What if I told you that you can boost your energy and your sense of well-being, and feel better than you’ve ever felt in your life in your own skin?

What if I shared the training “secrets” with you that health and medical experts around the country agree would be the very best prescription for your health?  If they could put it in a pill, it would be a top seller, for sure!

I don’t actually use “secrets,” I use readily available research-based recommendations which are safe and which get great results!  It’s just that I have devoted a lot of time and education to developing motivating ways to put all this research into practice.  And I don’t want to keep this education to myself.

I often hear people say, “It’s amazing how good I feel…” and then, “…my bloodwork from the lab came back so much better, it’s like magic!”

Is it a miracle?  A true blue spectacle?  Well, no.  I’m sorry, in a way, that your expectations of the great effects of fitness are so low, because there’s nothing magic about it.  Exercise Is Medicine®.  The American College of Sports Medicine, providers of the gold standard for fitness and sports education, have registered that slogan because it gets attention, and it’s so true.

Maybe you’re like Kevin, a busy professional with a long-term back problem who wanted to be able to play with his young kids, pain free and with plenty of energy.  Maybe you’re like Charlie, who wanted to complete his first marathon at age 60, and did it without injury!  Then again, perhaps you’re like Lenore, who wanted to reduce her dependence on medication to treat her diabetes.  That’s right, she did (with her physician’s approval).  Or Daniel, who wanted to reduce his sleep apnea symptoms, and improve his posture, and lose weight, and reduce his blood pressure medication.  A few months later, his sleep study readings had so improved, he was nearly in tears.

Why?  He was overwhelmed that he had it in himself to make those changes, with a little help from his trainer.

So if you are overdue for a visit to the state of Optimal Fitness, climb aboard right here and let me be your tour guides. If you’ve never been to visit before, or if you haven’t been lately, or if you know there’s new terrain to see but you just aren’t sure how to get there…then you need a personal trainer!