All Me Fitness

You Don’t Know Squat?!

Training the prime movers of the squat is essential for maintaining fitness, a fine physique, and independence into old age. So we ALL need to practice/enhance this skill through exercise.

Squatting is an exercise that we must do everyday. I’m not talking about putting loads of weight on your back and squatting up and down in front of a mirror. I’m talking about the motion itself! We squat when we get in and out of the car, sit down and stand up from dinner or the couch, use the toilet, and in many other daily situations. We squat while doing tasks like picking something off of the ground, getting out of bed, dancing, picking up groceries, and almost any type of athletic movement. Training the prime movers of the squat is essential for maintaining fitness, a fine physique, and independence into old age. So we ALL need to practice/enhance this skill through exercise.

Squatting 101

There are dozens of ways that you can squat, and there are hundreds of people who claim to know the “best way” to squat. But for all intents and purposes the squat can be broken down into two basic forms. These two forms are the front and back squat, that can be further distinguished by three basic heights: partial, parallel, and full. Proper form for squatting requires keeping your back flat, heels on the floor, and knees aligned over the feet. And when we talk about the safety of squat variations you don’t just have to consider how far back you sit, how far your trunk leans, or how far your knees travel over the toes; you also have to consider how far you shift forward or backward with the bar relative to the feet, as this influences joint torques considerably. So everything considered, squatting can be very complex. If you want to ensure proper form, it may be worthwhile to seek professional advice.

Pros And Cons

There are many benefits from squatting in any fashion, but there can also be negative outcomes. The Back Squat is good for increasing tendon, ligament, and bone strength as well as developing speed, power, and strength in the lower back, hips, and knees. The bad news is that it can cause joint degeneration, osteoarthritis and osteochondritis, muscle strains, damage to the ACL, and knee instability.

The Front Squat may be a good alternative for those with knee pain because it is just as effective regarding overall muscle recruitment with significantly less compressive forces on the knees. However, there appears to be no difference between front squat and back squat regarding shear stress on the knee, which is actually fairly low -– a lot lower than, say, knee extensions. Squat depth has been shown to have a significant effect on muscular development at the hip and knee joints. To optimize development of the gluteus maximus (the butt muscles), squats should be carried out through their full range of motion. To target the quadriceps (the thigh muscles), a squat depth of 90 degrees appears to be optimal. Hamstring activation / development are generally unaffected by squat depth. The drawback seems to be that although deep squats seem to be safe in healthy folks, those with PCL disorders should refrain from squatting below 50 to 60 degrees, and those suffering from chondromalacia, osteoarthritis, and osteochondritis may also need to avoid deep squats. Where you place the bar can also be a factor. So after a hip injury, high-bar squats should be used at the beginning to minimize the risk of hip overload. After a knee injury, a squatting technique more similar to the low-bar technique should be preferred. Finally, research shows that box squats and powerlifting squats could be “safer” for the low back compared to traditional squats.

From Noob To Pro In No Time

In this section I will go over how to learn to squat correctly for beginners, progressively squat more for novice squatters, and how to kick it up a notch for the squat masters.

Noobies

Before you go out and throw a barbell on your back, consider learning these basic moves first if you’re a beginner.

1. The hip hinge requires flexibility of the ankles, hips, and thoracic spine and stability in the feet, knees, and lumbar spine. Therefore, hitting the foam roller, or using some preparation exercises might be required pre-hip hinge. To perform this motion, start by shifting your body backwards, place your weight through the heels, and keep a neutral spine position. Practice first with hands on the hips, then add the simultaneous movement of both arms straight forward and above shoulder height.

2. Body weight squats are next. Begin by looking at a mirror to ensure your head is in a neutral position with your gaze forward or slightly up, thoracic spine (mid back) slightly straight and mobile, lumbar spine (low back) neutral and stable, hip joints mobile and bending backward behind heels, and knees stable and in alignment with your hips and feet. Additionally, your feet should be at shoulder width, in a neutral position, with your heels are firmly on the floor. Start the squat motion by beginning with a bend in the hip joints, followed by bending knees to the desired depth while ensuring that your trunk angle (from the floor) is stable in each movement phase.

3. Functional squatting exercises are important for us all. So once mobility, stability, and strength have been developed, we can get creative! See the next section for more on this.

The novice squatter is someone with established form and proper mobility, stability, and strength. If you’re a novice squatter, you should:

1. Begin at the top by training loaded partial squats to the desired sets and repetitions. Gradually increase your range of motion while keeping in mind that the deeper you squat, the lighter the load should be.

2. Start adding more volume by increasing the frequency you squat per week. To keep it simple, squatting 3 times per week with 3 working sets per session for a total of 9 weekly sets will be plenty for the average gym goer.

3. Gradually increasing weight will be inevitable. The general rule of thumb here is to increase your load by no more than 10% each week.

The advanced squat star (squar?) will want to change things up a bit and get jiggy with it. Shake things up by going for exercises such as single leg squats, plyometric squats, squats with a band around your knees, squat burpies, pistol squats, goblet squats, and unstable squats.

Double The Metabolism Mayhem!

Today’s post is a follow up to last weeks discussion where I went over the basics of metabolism science.

Today’s post is a follow up to last weeks discussion where I went over the basics of metabolism science. As we know, our metabolism is complex and there isn’t much we can do to greatly change it. However, today I wanted to talk about how gaining and losing fat can change the way your brain regulates your body weight. This is a complex area because our body composition can be influenced by a myriad of factors including sex hormone levels, macronutrient intake (especially protein), exercise style / frequency / intensity, age, medication use, genetic predisposition, and more. No ones body defies the laws of physics. So if the calories in calories out equation isn’t working for you, it’s because the equation is more complicated than it sounds.

Calories In

This part is easy. You eat food, so you gain calories from that food… right? Well not exactly. For starters we aren’t very accurate at guessing how many calories are in foods. In fact, food labels can be off by up to 20-25%! Secondly, the amount of energy we absorb, store, and/or use isn’t even close to being uniform! For instance, processed foods (cooked, chopped, soaked, blended, etc.) are broken down plant and animal cells, which means we absorb more energy from them. Have a gut feeling that there’s something more to it? Well you’re right! The bacteria in your gut can also influence the amount of energy we take in from foods. In the end, don’t count on counting calories to correctly calculate the quantity of calories converted to energy. Say that three times fast and receive a free high five!

Calories Out

I would first like to make a correction to last weeks post where I stated “with digestion we use a maximum of 43% of energy from the foods we eat.” Although it is true that the thermic effect of eating consists of burning 0–3% from fat, 5–10% from carbs, and 20–30% from protein, these numbers actually only represent roughly 5-10% energy out. The point here remains that meat sweats are real. Protein requires a lot of energy to digest!

As a refresher, our resting metabolic rate (RMR) accounts for about 60% of our calories out per day. But guess what… that figure can be off by about 15%! That means while I’m a 200-pound guy with an RMR of 1905 calories, another guy just like me might burn 286 more (or fewer) calories each day with no more (or less) effort. Tack on variable from the last two sources of energy out (physical activity and NEAT), and now have a 50% disparity between what can be calculated to calories in and out vs. reality. Ultimately the Energy Balance Equation will look like this.

Damage Done

Because our bodies enjoy consistency (homeostasis), it will respond negatively when you restrict your calorie intake. So what happens when you go on a restrictive diet? The thermic effect of eating goes down because you’re eating less. Resting metabolic rate goes down because you weigh less. Calories burned through physical activity go down since you weigh less. Non-exercise activity thermogenesis goes down as you eat less. Calories not absorbed goes down and you absorb more of what you eat. Hunger signals increase, causing us to crave (and maybe eat) more. A rise in cortisol from the stress of dieting can cause our bodies to hold onto more water. Bad things also happen when you over exercise as well. For instance, over exercising can cause an increased appetite and more calories eaten, absorbing more of what we eat, decreased RMR, and decreased NEAT. YIKES! The good new is that losing weight won’t “damage” your metabolism. Your body simply makes adaptations in response to fat loss (to prevent that fat loss, in fact).

The Bottom Line

– How your metabolism reacts to changes in energy balance will be unique to you.

– Food labels are way off, so 1,600 calories eaten daily could really be 1,200… or 2,000.

– By eating a diet rich in whole, minimally processed foods, the number of calories you absorb can be significantly decreased and require more calories to digest.

– Eating lots of highly processed foods will increase the calories absorbed, burn fewer calories in the digestive process, be less filling, more energy dense, and more likely to cause overeating.

– Energy out for those who have lost significant weight will always be lower than for people who were always lean, so keep in mind that exercise provides tremendous health benefits and should be done for more than just weight loss purposes.

– Losing weight, and keeping it off, is accompanied by adaptive metabolic, neuroendocrine, autonomic, and other changes.

– Even if your body might defend against weight loss, you can still lose weight, gain muscle, and dramatically change your body.

– TAKE ACTION by eating plenty of protein, eat a wide variety of fruits, vegetables, quality carbs, and healthy fats, adjust portions as you plateau, or to prevent plateaus, create an environment that encourages good food choices, do a mixture ofresistance, HIIT, cardiovascular, and recovery activities, find ways to increase NEAT, create a nightly sleep routine and manage your stress, and eat slowly to enjoy your meals and decrease the total amount of calories consumed.

The Importance of Life Changes

You can’t change your past, but you better believe that you can learn from it.

As I celebrate the arrival of my first child, I have had a lot of time to think about how I got here. All of the life events, choices, friendships, decisions, and other influences that I don’t even realize happened. Because as I gaze into my daughter’s precious sleepy eyes, I know that every single decision I’ve ever made since the time I was born has culminated into this moment of pure bliss. I know that I won’t have a great deal of time to spend with her as a newborn so I want to make every moment count. At the same time, I am overwhelmed with excitement to see how she will grow and develop.

Now take a deep reflective look at yourself (in a mirror or otherwise), then take all of the words describing my child, and replace them with your personal health and fitness goals. The paragraph above could be describing your body weight, strength, muscle size, or even something about your general health. And while the core message will remain true, you may not be looking at yourself and be happy or excited about how your goals are growing and developing. You can’t change your past, but you better believe that you can learn from it to make your next look in the mirror blissful.

The “Why”

If you haven’t done so already, do yourself a favor and read the book “Sart With Why.” It’s a leadership book, but it has some great take home messages that get to the core of what can help us feel fulfilled. When it comes to our health and fitness goals, many of us want to get there without making changes. Sure, going to the gym a couple times per week, drinking less, and saying no to candy bars is great. But I can honestly say that in the 7 years I’ve been doing personal training, I can count on one hand the number of people who were willing to exit their comfort zone to get to where they wanted to go. We all fall into these comfortable patterns of daily living that draw us in like warm cozy beds on a cold damp Sunday morning. We may be able to escape for a little bit, but we fall right back in when we get too uncomfortable.

Homeostasis —–> change —–> Chaos —–>Homeostasis

I think that’s why so many people do those 30-day diet/exercise challenges. They know that once it’s over, they can go right back to their comfort zone. The problem is that our end goal motives can be internal behavioral causes, such as instincts, impulses, needs, resolutions and desires as well as external behavioral causes, such as rewards, commendations, approval or disapproval. But the individuals that do the best, are those who are engaged in an activity for the pleasure the process provides (1). So if my goal is to get out of the cozy bed (get in shape), and stay out (stay in shape forever), I’m much more likely to do so if I’m playing with my daughter (healthy habits I like) rather than having to do chores around the house (nonsense health fads like eating kale) (2). When setting goals, the “why” should be something that makes you enjoy the ride.

Past Mistakes

The best lessons in life are learned through error. Whether they are mistakes we make, like leaving out a box of cookies on the table and expecting to have enough discipline not to eat them all by the end of the day. Or learning from others, like not to poke the bear. If you have tried and failed in the past, don’t go about things in the exact same way. It’s the reason why I talk to people on the treadmill at the gym. Typically, people do cardio to lose weight. However, cardio and dieting alone without strength training is a terrible way to lose weight, especially over a long period of time (3). But people try that route over and over again expecting weight loss to come. And when they don’t see that goal come to fruition, they get bummed out and quit for a few months. However, goal attainment is synonymous with behavior change goal feedback and tracking focused on accomplishments, resulting in enhanced self-efficacy for the goal (4). In other words, change what you’re doing (i.e. habits), document the positive results, and be happy with who you are and that you’re progressing!

References

DECI, E. L., & RYAN, R. M. (2008). Facilitating optimal motivation and psychological well-being across life’s domains. Canadian Psychology/Psychologie Canadienne, 49(1), 14-23. doi:10.1037/0708-5591.49.1.14
Wisdom, J., Downs, J. S., & Loewenstein, G. (2010). Promoting healthy choices: Information versus convenience. American Economic Journal: Applied Economics, 2(2), 164-178. doi:10.1257/app.2.2.164
Dulloo, A. G. (2017). Collateral fattening: When a deficit in lean body mass drives overeating. Obesity.
Héroux, M., Watt, M., McGuire, K. A., & Berardi, J. M. (2016). A Personalized, Multi-Platform Nutrition, Exercise, and Lifestyle Coaching Program: A Pilot in Women. Internet Interventions.

Metabolism Mayhem!

Almost everyone has heard that our metabolism does… something.

Almost everyone has heard that our metabolism does… something. If you have a high metabolism, you can eat a lot and stay lean. Or maybe, you put on weight just looking at a piece of cake because you have a slow metabolism. But what the heck is the metabolism anyways?!?!?! Well that’s what I’ll be answering today, and I will go over some common misconceptions that I hear all too frequently.

The Ins & Outs

Calories enter your body one way (om nom nom!), but there’s many ways for them to leave it. Basal metabolic rate (BMR) accounts for 60–70% of daily calories burned and included doing things like breathing, thinking, filtering waste. You know… bodily functions required for living. However, your BMR can be subject to many things including your size, composition (body fat%), age, genetics, hormones, and health status. This means even the most accurate way of calculating your metabolic rate (Mifflin-St Jeor equation), can still be about 10% off! Other ways we burn calories include food thermogenesis (digestion) which accounts for 10% of daily calories burned, and physical activity which accounts for 20% of daily calories burned.

Magic Bullets

For health “Guru’s” each area of metabolism is a way to sell a particular magic bullet for fitness or weight loss. But magic bullets don’t exist, so here are a few common myths that have cropped up over the years.

More Meals = More Metabolic Burn – The thought behind this is that if we burn calories by eating, then eating more frequently will burn more calories. While this, in part, is true, it is also very far off point. This is because to help with digestion we use a maximum of 43% of energy from the foods we eat (0–3% from fat, 5–10% from carbs, and 20–30% from protein). In short, eating more frequently means we are doing nothing more that increasing the total amount of calories we eat throughout the day. So if your goal is weight loss, this myth is busted.

I Moved More = I Eat More – This may be the worst myth because it creates a bad habit! While movement is about 20% of our metabolic demand, only a small portion of that (7-9% daily) comes from the gym! This means if you reward yourself for going to the gym you are doing nothing more than consuming more calories than burned. Most of the calories burned from moving are from doing NEAT things like walking, doing chores, and even fidgeting.

More Muscles = More Food – Another common myth is that as you grow more muscles you burn significantly more calories. Again, a partial truth that has been blown out of proportion by the likes of Dr. Oz, fitness magazines, and other nonsense peddlers. They have claimed that 1 pound of muscle burns an extra 50 calories a day. In reality, a pound of muscle burns 6 calories a day at rest and a pound of fat burns about 2 calories a day. So getting shredded doesn’t mean you have the luxury of eating everything in sight!

Fat Burning Exercise = Weight Loss – As we exercise our body metabolizes fuels like carbohydrates and fats. Someone had the great idea to start burning fat instead of carbs to lose weight! But that’s not how it works. Our fuel source for exercise doesn’t matter at all if you are eating more calories than you are using on a daily basis. So don’t pay any attention to the “fat burn” settings on the cardio machines or fat burning supplements. Just make sure you are working hard to burn as many calories as you can while exercising!

Taking Metabolic Actions

Before you get too down on yourself and think there is nothing that you can do to help stay metabolically fired up, there are a few simple ways to “boost” metabolism. The first thing you can do is simply move more. Take the stairs, park far away, exercise regularly, even standing more will boost your metabolism throughout the day. My second tip is to eat more protein. This simple action will increase thermogenesis as well as muscle mass which are two small things that when put together will have enhanced results. But more importantly, increasing total amounts of protein will make you feel fuller more quickly/longer which will decrease your total caloric intake! Finally, having the perspective of “you lose weight in the kitchen, you gain health in the gym” will help you avoid scams and place focus on the things that are most important.

Too Good To Be True

Common myths/old wives tales/scams that I commonly see in the health and fitness industry.

Today I wanted to talk about common myths/old wives tales/scams that I commonly see in the health and fitness industry. But first, a story. When I was a child I remember seeing an advertisement for Sea Monkeys. It was awesome. A promise of getting these little buggers in the mail and doing nothing more than adding water then BOOM! I would have these little guys to play with and train to do tricks. Of course when I hatched the Sea Monkeys I got stinky swimming shrimp that did nothing but poop. I learned a valuable lesson from this. If it seems too good to be true, it probably is.

As a disclaimer, this is not the end all be all on these products. In fact, I have used/followed some of the things I’ll be going over. Information is constantly changing, so it is important to view things from a critical point of view. And if you disagree with me on anything, I welcome your feedback and any information to go along with it from a credible source. Disagreeing is not a bad thing. It’s how we all learn!

A * denotes a source that includes foul language

Supplements

Supplements are a valuable tool for many reasons. However, not all of them hold water when we take a close look at what the supposedly do. In my opinion, the worst of the supplement industry scams are spread by celebrities, “natural” practitioners, “ancient remedies“, and of course word of mouth. All of these methods often push detox cleanses. In short, cleanses* DO NOT WORK. Your body is well equipped to rid itself of toxins, so don’t waste your hard earned moola. And with flu season ramping up, I would also like to mention that vitamin C and zinc won’t do squat to get rid of those sniffles. Get your flu shot*, wash your hands, and stay away from sick people.

So what does work? Well lots of supplements do! However, it’s important to ask a few questions before diving in. A good example is vitamin D. It’s very widely used, but asking “why” will determine if it, or any other supplement, is right for you. Check out this link for more info. Another question to ask is “is it worth it?” Lots of supplements claim to have a benefit. However, they can also come with risks. St. Johns Wart, for instance, may help with depression symptoms, but it also produces adverse reactions when taken with almost any drug. Talk to your doctor before starting any new supplements. Finally, supplements don’t have to label exactly whats in them. So make sure you buy high quality, do some research on the company, and verify the ingredients in the products you purchase.

Diet Scare Tactics & Fads

The internet is full of useful and science-backed information. It is also full of quacks and fear mongers. Here are a few example of what to look out for. Appealing to nature is by far the most common method of health advertising. But claiming something is “organic” or “natural” doesn’t really mean anything. Death cap mushroom, snake venom, even formaldehyde found in fruit is organic/natural. Conversely, chemicals are found in everything as well! And when it comes to GMO’s and antibiotics in meats… well there’s nothing to fear. In fact, in some cases GMO foods can prove to be superior or even save lives. And then there’s gluten. I can write for days on the wheat protein. For the most part, gluten’s deleterious effects are way over-hyped. It may in fact be the carbohydrates (fructans and galactans) associated with gluten causing the problem! But for those who it truly affects, there are some strategies that may be worth a try.

The Bottom Line

All sorts of fake stories and nonsense pop up on the internet every day, and it can sometimes be hard to spot the rubbish. In all, I’ve only touched on a few areas. Other oddities not included are the unreal health benefits of alkaline water, krill oil, essential oils, and the nonsense that is homeopathy. It comes down to dollars and cents. It’s the marketing* department’s job to sell a product, and that’s where a grain of truth will be stretched beaches long. So make sure you take a good long look at the credible evidence behind bigger and better health products you hear and see advertised. Because when it seems just too good to be true, it probably is.

25% Of Us Have Knee Pain Due To…

Just because it’s common doesn’t mean you have to develop it or that it will last forever. So don’t stop moving!

Our knees hate us. Or at least it can seem that way when they aren’t doing what we want them to do. Creaky, achy, and wonky knees are all too common among my friends when I ask them to help me move. And while those may be excuses for them, I bet it’s a reality for most of you. The sad part is that because the knee is so complex, it is often misunderstood. When you have a bum knee, rest is almost never the answer. This is particularly true for the 25% of us who will end up having knee pain due to patellofemoral pain syndrome (PFPS) (1). Also known sometimes as runner’s knee, PFPS is a complex issue without one true solution. Let’s take a look at why the knee cap can make us feel like knee crap!

So What’s The Problem Again?

As the name implies, PFPS is not a single problem but a group of signs and symptoms. Generally, the epicenter of the pain is somewhere under or around the kneecap, and will usually be mainly on the front of the knee. It can be caused by variations in strength, flexibility, patellar tracking, quadriceps angle, and patellofemoral joint (PFJ) morphology and even psychological issues such as depression, fear-avoidance, and anxiety (2). However, I like to think of PFPS as the knee leaving homeostasis. Homeostasis can be described as a zone, or “envelope of function”, where the tissue is capable of tolerating loads (3). So as you get stronger, you increase your envelope of function. And when you over-do it with your training, your knee may no longer tolerate levels of loading even during routine activities, such as descending stairs or previously well-tolerated running distances (4). In other words, when you over-do-it with your training or exercise, you may not be able to do half as much as you used to without pain.

How Do I Avoid/Fix The Problem?

While I would love to tell you how to screen yourself for potential red flags, there really aren’t any good predictors of injury (5). What will help you out is strengthening the quadriceps (6). By using a progressive overload scheme (aka gradually doing more over time), you can make those quads stronger and avoid pain and/or injury! Here are some exercises to try out for good quad activation and strengthening (4):

– Knee extension with a weight attached to the ankle

– A knee extension machine

– Single leg squat to at least 65 degrees of knee flexion

– Squatting between 0 and 45 degrees of knee flexion

– Leg presses between 0 and 45 degrees of knee flexion

You can also try taping (anywhere on the front of the knee) or bracing the knee to alleviate the pain. You can pretty much tape your knee however you want because it doesn’t change the biomechanics of the knee (7). Strengthening the hip muscles will be helpful for more than just bikini season because strengthening those glutes (and other muscles of the hip) can help reduce pain and improve function (8). Similar to taping and bracing, strengthening the hips won’t improve biomechanics. Hip strengthening will, however, increase the load tolerance of the knee and supportive structures (9).

For Runners

This segment is for runners, so feel free to skip it if you don’t anticipate doing a 5k anytime soon. Runners, in particular, are susceptible to having issues with their movement patterns that can lead to knee issues. Movement re-education through simple techniques can be extremely helpful for reducing knee pain. Reducing hip drop while running is a great way to help reduce knee pain. In addition to using glute strengthening techniques, mirror and verbal feedback can reduce hip drop and hip adduction (knee movement inwards) while running (10). A general increase in step rate by 5-10% can also be very beneficial for reducing knee load and pain (11). A metronome works great for achieving a faster gait pattern.

Summary

While knee pain may never be completely eliminated, there are some steps that can be taken to decrease pain and the likelihood of developing pain. Work toward having strong quadriceps, move with good technique and don’t advance your exercise routine too quickly. And while shock absorbing insoles and arch supports may be useless, throwing on a little tape or knee support may give you enough pain relief to build up your leg strength (12). For runners, watch yourself in the mirror and make sure you don’t have hip-drop and increase your running cadence. Just because PFPS is common doesn’t mean you have to develop it or that it will last forever. So don’t stop moving!

References

Nunes, G. S., Stapait, E. L., Kirsten, M. H., de Noronha, M., & Santos, G. M. (2013). Clinical test for diagnosis of patellofemoral pain syndrome: Systematic review with meta-analysis. Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, 14(1), 54-59. doi:10.1016/j.ptsp.2012.11.003
Meira, E. P., & Brumitt, J. (2011). Influence of the hip on patients with patellofemoral pain syndrome: A systematic review. Sports Health: A Multidisciplinary Approach, 3(5), 455-465. doi:10.1177/1941738111415006
Gabbett, T. J. (2016). The training-injury prevention paradox: Should athletes be training smarter and harder? British Journal of Sports Medicine, 50(5), 273. doi:10.1136/bjsports-2015-095788
Willy, R. W., & Meira, E. P. (2016). CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN. International Journal of Sports Physical Therapy, 11(6), 877.
Whittaker, J. L., Booysen, N., de la Motte, S., Dennett, L., Lewis, C. L., Wilson, D., . . . Stokes, M. (2016). Predicting sport and occupational lower extremity injury risk through movement quality screening: A systematic review. British Journal of Sports Medicine, , bjsports-2016-096760. doi:10.1136/bjsports-2016-096760
Kooiker L Van De Port IG Weir A Moen MH. Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: A systematic review. J Orthop Sports Phys Ther. 2014;44(6):391-B391.
Whittingham M Palmer S Macmillan F. Effects of taping on pain and function in patellofemoral pain syndrome: A randomized controlled trial. J Orthop Sports Phys Ther. 2004;34(9):504-510.
Lack, S., Barton, C., Sohan, O., Crossley, K., & Morrissey, D. (2015). Proximal muscle rehabilitation is effective for patellofemoral pain: A systematic review with meta-analysis. British Journal of Sports Medicine, 49(21), 1365-1376. doi:10.1136/bjsports-2015-094723
Willy RW Davis IS. The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. J Orthop Sports Phys Ther. 2011;41(9):625-632.
Willy, R. W., Scholz, J. P., & Davis, I. S. (2012). Mirror gait retraining for the treatment of patellofemoral pain in female runners. Clinical Biomechanics (Bristol, Avon), 27(10), 1045-1051. doi:10.1016/j.clinbiomech.2012.07.011
LENHART, R. L., THELEN, D. G., WILLE, C. M., CHUMANOV, E. S., & HEIDERSCHEIT, B. C. (2014;2013;). Increasing running step rate reduces patellofemoral joint forces. Medicine & Science in Sports & Exercise, 46(3), 557-564. doi:10.1249/MSS.0b013e3182a78c3a
Bonanno, D. R., Landorf, K. B., Munteanu, S. E., Murley, G. S., & Menz, H. B. (2016). Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: A systematic review and meta-analysis. British Journal of Sports Medicine, , bjsports-2016-096671. doi:10.1136/bjsports-2016-096671

Everything In Moderation

Common causes, injuries, and solutions to the problem.

This week I wanted to talk about over-training and injury. This topic is particularly important to me because, well, it’s a big part of why I went to school to be an Athletic Trainer. In High School I played a lot of sports, and as a result, sustained a lot of injuries from over-training. So today I will share common causes, injuries, and solutions to the problem.

The Problem

Over-training is a complex beast. It’s determined by an imbalance of pro- and anti-inflammatory factors, and can rear its ugly head at the worst of times. When it comes down to it, over-training occurs when the body doesn’t have enough time to recover, and can manifest in the following ways:

elevated resting heart rate and blood pressure

loss of appetite and weight loss

chronic fatigue, workouts described as draining

chronic soreness/slow recovery rates

an increase in colds or infections

a decrease in performance, or an inability to reach training goals

lack of enthusiasm, psychological staleness

Injuries

It’s important to note that while experiencing muscle pain is normal, not all pain is good pain. Make sure you know the difference before you run to the doctor with every little nagging problem, or conversely, avoid the doc when you do have an issue.

As a result, injuries can also pile up. I commonly see injuries of the shoulder, lower back pain, and even shin splints due to over-training just to name a few. In particular, the shoulder can be fickle. From weight lifting, to swimming, or even throwing a ball around, the shoulder is the poor joint we love to overuse. Some symptoms to look out for include an obvious deformity, it gets popped out of place, difficulty lifting the arm, clicking or popping sensation deep in the shoulder, and/or pain reaching across your body. These symptoms warrant a trip to your favorite doctor, but the good news is that many shoulder injuries DON’T require being sliced and diced to fix them.

Solution

To avoid missing long stints of exercise, you will want to treat over-training by doing… well… nothing! One of my favorite sayings is “you don’t build muscles in the gym. You build them in bed.” The key here is to make sure that you are getting enough rest and proper food to support your physical activity. You should also make sure you shake things up here and there. Doing the same thing over and over again can be stressful on the body and mind, so moderation is crucial. In fact, doing a mix of cardio, weight lifting, and HIIT (join me Monday nights at 6:15 for our HIIT Grit team training) is optimal for reaching almost any goal. On that note, it’s important to remember that you will want to increase intensity carefully. You should make small steps every day toward those goals, one pound or mile at a time. Finally, you will want to take a chill pill. Everyday stress can affect our performance in the gym, so grab a stress ball (or a beer), take deep breaths, and smile more often to feel more refreshed.

How’s That Resolution Going?

You don’t have to be perfect to get perfect, the best exercise and nutrition programs, and how to be realistic with what you’re going after.

Right about now, I bet many people are starting to say, “screw it” when they think about their 2017 resolution. And while this is indeed a shame, it’s not an eventuality. It is something that can be avoided by a little kick in the rear. Which is why I’m going to talk about how you don’t have to be perfect to get perfect, the best exercise and nutrition programs, and how to be realistic with what you’re going after. So buckle up for a quick read on how to resolve your resolution disillusion!

What Do You Mean You’re Not In Perfect Shape After 3 Weeks?

One big reason why people give up on their health and fitness resolution so quickly is that they don’t see immediate returns on their investment. In fact, when we exercise, we often see the opposite. We are achy all the time, more tired than usual, stink with sweat (at least I do), and I feel like the list goes on forever. But, all that stuff goes away (invest in quality deodorant) once you push past the first month or two. The trick is really not to expect perfection. Not only do we all have flaws, we all have lives that don’t revolve around having a perfect body. Which is why, at the end of the day, it’s more important to be satisfied with what you’ve accomplished rather than be disappointed with what you didn’t. So, instead of going home and being bummed out that you didn’t get in the greatest workout, use techniques such as positive reframing, acceptance, and humor to be happier and more satisfied with how your day went (1). Be happy that you got any exercise in at all, and be satisfied knowing you truly made an effort to eat better that day.

You Already Know What The Best Exercise & Diet Are

People always want to know what’s the best exercise to do, or what diet works the best. The answer will forever and always be… the one that you will stick to. When it comes to your nutrition, none of the major diets reigns supreme. There is no clear cut winner when we compare any diet plan to another. As long as you can stick to it, any diet will do (2). One quick thing to note: In the short term, you will need behavioral support for friends, family, and possibly a professional for both nutrition and exercise (3). And in the long term, the effects of exercise will be more pronounced if you’re lifting weights (4)! But remember, your training program shouldn’t make you miserable. Which leads me to my last point.

Get Real

You aren’t going to look like a Spartan after a few weeks just because you did the “300” workout you saw on the internet. You need to set realistic goals for yourself… which can be tricky. For some, just asking yourself, “will this make me better?” is enough. For others, you may need hard and fast numbers to go by. In general, if you’re looking for fat loss, here is a formula to figure out how much you should lose per week (5):

Body fat percentage ÷ 20 = percentage of your current bodyweight you should aim to lose per week.

If you’re looking to gain muscle, you can expect to gain 4-7lbs within the first 3 months (6). And while muscle does weigh more than fat, it’s not by much. The density of muscle is about 1.06kg/L, and the density of fat is about .9kg/L. In other words, muscle IS denser than fat, but only about 15% denser. Below is a picture of what two pounds of each looks like (7).

What I’m trying to say is, don’t get caught up in how much you weigh for the first few months, and don’t overestimate how much muscle you will gain either. Just know that if you’re doing the right thing on a day to day basis, both metrics will improve. So don’t give up just yet if you’re not satisfied with the way you feel, what the scale says, or by how much you can lift. Everything will get better in due time as long as you stick with it!

References

Stoeber, J., & Janssen, D. P. (2011). Perfectionism and coping with daily failures: Positive reframing helps achieve satisfaction at the end of the day. Anxiety, Stress & Coping, 24(5), 477-497. doi:10.1080/10615806.2011.562977
Johnston, B. C., Kanters, S., Bandayrel, K., Wu, P., Naji, F., Siemieniuk, R. A., . . . Mills, E. J. (2014). Comparison of weight loss among named diet programs in overweight and obese adults: A meta-analysis. Jama, 312(9), 923-933. doi:10.1001/jama.2014.10397
Zurlo, F., Larson, K., Bogardus, C., & Ravussin, E. (1990). Skeletal muscle metabolism is a major determinant of resting energy expenditure. The Journal of Clinical Investigation, 86(5), 1423-1427. doi:10.1172/JCI114857
Zurlo, F., Larson, K., Bogardus, C., & Ravussin, E. (1990). Skeletal muscle metabolism is a major determinant of resting energy expenditure. The Journal of Clinical Investigation, 86(5), 1423-1427. doi:10.1172/JCI114857
Alpert, S. S. (2005). A limit on the energy transfer rate from the human fat store in hypophagia. Journal of Theoretical Biology, 233(1), 1-13. doi:10.1016/j.jtbi.2004.08.029
Damas, F., Phillips, S. M., Libardi, C. A., Vechin, F. C., Lixandrão, M. E., Jannig, P. R., . . . Ugrinowitsch, C. (2016). Resistance training-induced changes in integrated myofibrillar protein synthesis are related to hypertrophy only after attenuation of muscle damage: Muscle protein synthesis, hypertrophy and muscle damage in humans. The Journal of Physiology, 594(18), 5209-5222. doi:10.1113/JP272472
Wernbom, M., Augustsson, J., Thomee, R., Sahlgrenska akademin, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Institutionen för kliniska vetenskaper, sektionen för anestesi, biomaterial och ortopedi, . . . Göteborgs universitet. (2007). The influence of frequency, intensity, volume and mode of strength training on whole muscle cross-sectional area in humans. Cham: Adis International. doi:10.2165/00007256-200737030-00004

Health And Happiness

With most of us becoming fitness slackers during the long Christmas and New Years vacation time, I thought I would summarize some of the best tips on how to not gain weight.

With most of us becoming fitness slackers during the long Christmas and New Years vacation time, I thought I would summarize some of the best tips on how to not gain weight. I use the term not gain for a reason. During this time of year you should be able to enjoy the foods you want to eat, drink the alcohol you want to drink, and cherish the precious time with your family without feeling any guilt. So today I am going to go over the best fitness, nutrition, and lifestyle choices to make to get you through the season sane and slim!

Fitness

If your goal is to get buff during the holiday season… well then the best of luck to ya! I personally aim to maintain my fitness level. Health and fitness should rightfully take a back seat to the enjoyment of friends and family during this time of year. However, this does not mean you should stop exercising completely. In fact, it’s the best thing you can do to not gain weight! So here’s what you should do.

1. Make physical activity a part of your holiday routine. Don’t be a lemming. Just because everyone else wants to be lazy doesn’t mean that you should be lazy too.

2. Eat the friggin delicious holiday food. Just be mindful to not eat everything just because it’s in front of you.

3. Plan around the obstacles. Not having equipment and traveling shouldn’t be your downfall. Follow the links here and here for exercise programs you can do anywhere.

Nutrition

Absolutely nothing can replace the joy of eating grandmas famous Christmas cookies (at least for me this is true). So any advice you get telling you not to, will simply rob you of joy in my opinion. This is because, medical conditions aside, carbs aren’t inherently bad for you and they certainly wont make you fat. They can do harm when over consumed, just like proteins and fats will, but they won’t mess with your insulin causing fat gain (again medical conditions aside). Just don’t go nuts on the macadamia cookies and you will be okay. This goes for the prepackaged stuff as well. Because “eating clean” really isn’t all it’s cracked up to be, so don’t fear the not so home made apple pie. And when it comes to alcohol, the message is the same. Moderation is crucial, and there’s no need to worry about gaining weight or losing those guns you worked so hard to polish.

Lifestyle Choices

There are plenty of bloggers claiming to know the secret to the perfect lifestyle. But in reality, you are the only one who knows what’s best for you. Making good responsible choices is a complex process. In my opinion there are many things to consider outside of your immediate actions on you overall health. Think about what brings you joy over the holidays. Think about the choices you make, and how you make them. Savor the moments by take the time to “check in”, pay attention, and be present. Reach out by connecting with friends, family, and whoever else you consider your “tribe.” Consider how you might be able to share good health and well-being with others during this important time of the year. Here are an additional seven things to consider when trying to stay on track over the holidays.

1. When you’re feeling stressed (which has been known to happen when around a lot of family), take a big belly breath or eight.

2. Eat slowly, with moderate pauses between bites. The saying “savor the flavor” reigns true for this one.

3. Be mindful of hunger. Don’t just eat because it’s time to eat or there’s something in front of you. Listen to your body and it will tell you when to eat and when enough is enough.

4. Make mindful choices. Similar to being mindful of hunger, your body will tell you what to eat. Pick out only the thing you want, and when they are on your dish you can choose to eat what tastes good and leave the rest on the plate, or try something else.

5. Distinguish between desire and craving.

6. Practice generosity. Cook, eat, and share food with other to truly get the most out of this holiday season.

7. Express your gratitude. According to research, this simple action increases our inclination to be caring, compassionate, honest and respectful.

I truly hope everyone has a wonderful time with their friends and family over the holiday season.

I Know Less Now Than I Did a Year Ago & Why That’s A Good Thing

The more you learn, the less you know.

For most people, the word “maybe” often indicates a lack of confidence in the answer to a question. For me, it’s become the standard answer to just about any health and fitness question. Because I have learned, time and time again, that there is no such thing as an absolute certainty anymore. When I first came out of school with my undergraduate degree in Athletic Training, I was very confident in myself and my skills. Like most young professionals, I thought I was the best and brightest wherever I went. Of course, now I know that what I learned then was only the tip of the iceberg. During graduate school, I became a lot less certain of how much I knew. And as I sit here and write this today, I realize that I am John Snow. Because the age-old saying is absolutely true… “the more you learn, the less you know.“

It’s Not Me, It’s You

I have a love-hate relationship with learning. I love to find out the right answers to questions, but I hate that the process inevitably adds more questions that need to be answered! It’s a positive feedback loop that drives some people to do crazy things like getting PhD’s. But what’s even more frustrating, is the fact that there are so many bad sources of information which are not always easy to sniff out. By now, most of us know some basic red flags to look out for such as:

If it sounds too good to be true, it definitely is.

Specific results promised within a specific time frame.

You must do THIS exact thing to see results.

A magic pill, shake, supplement, etc without changing anything else in your life.

Using the phrase long and lean.

And the classic standby nonsense word Detox (1).

In academic research, there are no guarantees as well. One major issue in research is that people don’t like to change. So if you have been doing something for years, you don’t want to be proven wrong. This can lead to instances where studies may often be simply accurate measures of the prevailing bias (2). This can be done by the misuse of statistics sometimes called “p hacking” (3). This is especially true when a study is funded by an industry, such as a food or supplement company (4). Study participants can also throw things off as well. For instance, we suck at reporting how much and what kind of food we eat (5). This makes it extremely difficult to accurately determine what dietary guidelines are appropriate (6). It’s why cholesterol was the worst thing for us a few years ago, but now it’s no big deal. Not to mention how the media will take a study and blow it way out of proportion. Remember when resveratrol found in red wine was said to be as good for you as exercise? Well, it turns out not to be true because humans react differently than animals do when it comes to that particular compound (7).

What I’m trying to say, is that we are all responsible for the quality of information out there. From the researchers to the study participants, to us the consumers of information, we can all do better at getting and creating quality information. Fortunately, there are organizations out there who are keeping track of the poor studies that should never see the light of day. And there are high-quality organizations who just want to help and aren’t looking to sell you anything.

The Upside

Don’t get all bummed out about what you just read. The whole point of writing this is to tell you YOU’RE AWESOME! Taking time out of your day to read this means you’re willing to do what it takes to better yourself. You have a thirst for knowledge which is ultimately going to make you better! This leads me to my last point, we all need to be willing to change our minds instead of digging in. Recognizing the error of our ways can be difficult. However, admitting we were wrong about something and changing our ways is how we change for the better. Because as Ben Franklin put it, “When you’re finished changing, you’re finished.” I don’t want to be done with discovering and growing as a person. I’m not finished with my pursuit of education. I don’t know as much as I did a year ago because I spent so much time learning.

References

Klein, A. V., & Kiat, H. (2015). Detox diets for toxin elimination and weight management: A critical review of the evidence. Journal of Human Nutrition and Dietetics, 28(6), 675-686. doi:10.1111/jhn.12286
Ioannidis, J. P. A. (2005). Why most published research findings are false. PLoS Medicine, 2(8), e124. doi:10.1371/journal.pmed.0020124
Misinterpretations of the ‘p value’: a brief primer for academic sports medicine Steven D Stovitz, Evert Verhagen, Ian Shrier Br J Sports Med bjsports-2016-097072Published Online First: 24 November 2016 doi:10.1136/bjsports-2016-097072
Colquhoun, D. (2014). An investigation of the false discovery rate and the misinterpretation of p-values. Royal Society Open Science, 1(3), 140216-140216. doi:10.1098/rsos.140216
Schoeller, D. A., Thomas, D., Archer, E., Heymsfield, S. B., Blair, S. N., Goran, M. I., . . . Allison, D. B. (2013). Self-report-based estimates of energy intake offer an inadequate basis for scientific conclusions. The American Journal of Clinical Nutrition, 97(6), 1413.
Ioannidis, J. P. A. (2013). Implausible results in human nutrition research. BMJ (Clinical Research Ed.), 347, f6698.
Fernández-Quintela A, Carpéné C, Fernández M, Aguirre L, Milton-Laskibar I, Contreras J, Portillo MP. (2016). Anti-obesity effects of resveratrol: comparison between animal models and humans. J Physiol Biochem.[Epub ahead of print]PMID: 27981508 DOI: 10.1007/s13105-016-0544-y