The War On Metatarsalgia

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If there’s a foot problem then I’ve either had it or I’m going to get it. Currently, I’m battling a tasty little bit of metatarsophalangeal joint pain in my left foot. My symptoms are described to a T in this article from Merck.

I am frustrated but I can overcome it. I’ve overcome a host of other frustrating aches and pains. On that note, I’ve found a series of strength and mobility drills that I’m going to play with and see what happens. It’s from the innovative people at GMB.io. The full article is here. There are three videos in the article. I’m exploring this one now:

Conflicting Back Pain Information

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It’s easy to get confused when reading and listening to information about health, wellness, fitness, and exercise. We are often caught in the collision between valid science and pseudoscientific snake oil mumbo jumbo. Even when good research is discussed in the press it’s often reported without nuance by reporters who don’t understand the statistical methodology.

With that in mind, here are three recent articles which overlap in their coverage of back pain. Two reflect the current evidence on back pain. The other, in my opinion, is off the mark and may actually help reinforce back pain and the fear of pain.

Posture has little to do with pain

I like the article titled Are you sitting comfortably: the myth of good posture. I recommend you read it because the sources discuss the current evidence around posture and back pain. Pain researcher Dr. Peter O’Sullivan is one source. He says,

“O’Sullivan says that rather than focus on the right posture, the ability to vary it and shift easily may be more important: ‘While it is appealing to think that if you sit up straight you will not get back pain, this is not supported by big studies across many countries.’ Indeed, while many websites swear that bad posture (usually defined as slumping, leaning forwards or standing with a protruding belly) causes everything from back pain to varicose veins and indigestion, there is no evidence that it causes general health problems.”

“…If you don’t have back pain, then do not give your posture one second’s thought – think about being healthy. Sleep deprivation and stress are more important than the lifting you do. Stress has a strong inflammatory role; it can make muscles tense. Most people don’t get that their back can become sore if they are sleep deprived.”

One thing to think about is the chicken-or-egg paradigm. That is, does “bad” posture cause back pain? (Evidence suggests it doesn’t.) Or could pain force us to adopt a certain type of posture that looks bad? My bet is on the latter. Related to low-back pain misinformation is the fearmongering around the myth of “text neck.”

Misguided treatment

If our concept of what causes back pain is misguided then it’s no surprise that many diagnostic and treatment strategies are ineffective. An article from the BBC titled Many back pain patients ‘getting wrong care’ discusses guidelines from a series of papers written by pain experts for the Lancet, a British medical journal. Several points to consider:

  • Strong drugs, injections and surgery are generally overkill, they say, with limited evidence that they help.
  • Most back pain is best managed by keeping active, they advise.
  • UK guidelines recommend a mix of physical exercise, advice, and support to help patients cope with symptoms and enjoy a better quality of life.
  • Health staff should not treat back pain or sciatica with equipment such as belts, corsets, foot supports or shoes with special soles.
  • They should not offer acupuncture, traction (stretching the back using weights or machines), or electrotherapy (passing electric current or ultrasound waves through the body), says the National Institute for Health and Care Excellence.

My favorite is this list of 10 Things You Should Know About Your Back:

1) Your back is stronger than you may think – the spine is strong and not easily damaged, so in most instances, the pain will be down to a simple sprain or strain.

2) You rarely need a scan.

3) Avoid bed rest and get moving (but avoid aggravating activities).

4) Do not fear bending or lifting – do it in a way that is comfortable, using the hips and knees.

5) Remember that exercise and activity can reduce and prevent back pain.

6) Painkillers will not speed up your recovery.

7) Surgery is rarely needed.

8) Get good quality sleep if you can, because it will help you feel better overall.

9) You can have back pain without any damage or injury.

10) If it doesn’t clear up, seek help but don’t worry – book an appointment to see your doctor or physiotherapist if the pain persists.

Questions about bending and lifting

Lost Art Of Bending Over: How Other Cultures Spare Their Spines comes from National Public Radio. I am a little bit conflicted about it.

The article suggests that we in the US bend forward “incorrectly” and thus we suffer more back pain than agrarian societies where they bend forward “correctly” and thus suffer less back pain. Is this claim true? Do we suffer more back pain than less-developed countries? Do people in other cultures bend forward differently than we do? The article offers no evidence beyond the writer’s casual observations to support the claims. Ironically, the article shows a picture of two rice farmers in Madagascar. One is bent forward “correctly” with a hip hinge, the other is bent “incorrectly” more through the low-back. I’m not sure how to interpret that picture.

My problem with the article is that it suggests there is a wrong way to lift and implies that doing so is a direct cause of back pain. Such fears lead to fear-avoidance beliefs (FABs).  I’ve experienced this phenomenon and I’ve seen it in others.

With FABs, we tend to believe that adopting certain “bad” postures or using “unsafe” lifting strategies will certainly equal pain. As a result, we brace our backs with extreme rigidity and we use a super-strict technique to lift everything from heavy objects down to something small and light like a pair of shoes. The irony of FABs and the resulting extreme diligence is that we are actually at greater risk of incurring more pain. In other words, the fear of pain is more of a problem than the biomechanics of lifting.

Recall that in the first article I discussed, we learned that sitting posture doesn’t relate much to back pain and that in fact emotions and lack of sleep were stronger predictors of back pain. My bet is that we might see a similar dynamic with regard to lifting posture.

Some of the information is useful, specifically the instructions on hip-hinging (a technique I regularly teach to clients) are worth knowing. By using a hip-hinge method to lift things from the ground, you will engage the glutes and hamstrings which are big, strong muscles. The hip hinge should allow a lifter to generate more force so he or she can lift a heavier object. The hip hinge also effectively distributes the forces of the lifting of a heavy object throughout the body rather than concentrating it in one place.

As a counterpoint to my own statement though, look at this. It’s Austrailian strong-woman Sue Metcalf picking up 246 lb. atlas stone with a technique that the NPR article would call unsafe.

I think that if lifting a heavy object, then it’s prudent to use as many muscles as possible to do the job and to generally be careful. Nothing wrong with that. But if bending down to pick up a pen, a shoe, a ball — or possibly a giant atlas stone— and if there’s no underlying acute injury, then we should feel free to move the spine. The spine is comprised of 33 bones, 24 of which are moveable. So why not move them? I wish the press were better at discussing these nuances.

Extra credit

If the problems inherent to bad science interest you, then you might want to pay attention to the words of  Dr. Ben Goldacre, epidemiologist, has to say.

My Race Schedule & I’m a Professional Writer!

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Time to trail run

Springtime is hurtling our way and that means it’s time to trail run! I’m working up to what is for me a pretty giant bite of a trail race this fall. I have several races on the schedule as I work up to the final big event in September. They are these:

  1. Dirty 30, June 3, Golden Gate Canyon, CO – I’m running the 12-miler
  2. Under Armor Mt. Running Series, July 14, Copper Mountain, CO – I’m running the 25k (about 16 miles).
  3. Pikes Peak Ascent, August 18, Colorado Springs – 13.32 miles. I’m not running the full marathon, I’m only “running” up to the top.
  4. The Grand Traverse Run, September 1, Crested Butte to Aspen – 40.7 miles!? My god, is that right?! Amazingly, 40-ish miles is sort of small potatoes in the world of ultra-running.

The best part of this is that I love trail running and I love the process! I love the training I did last year for the Imogene Pass Run. Being in the mountains is… exquisite. Language doesn’t suffice… It’s more than fun. Trail running is a deeply spiritual thing for me. I have enormous enthusiasm toward the preparation for the Grand Traverse, and I’m grateful to get to do it.

Time to suffer

I’m reading Endure by Alex Hutchinson. It’s an excellent book. An ever-present concept, maybe the foundation of the whole book, is the experience of suffering. Suffering defines endurance. We don’t have to endure that which doesn’t induce suffering.

As it pertains to my races: There will be suffering…. especially in the Grand Traverse. I’ve suffered in two marathons and the Imogene Pass Run. I suffered through a bad half-marathon. I’ve biked up Mt. Evans twice. There’s some suffering. Two-a-day football practice in the Texas summer = suffering. The Grand Traverse is almost 41 miles, about 6200 ft. of climbing and 7000 ft. of descending. That equates to more suffering than I’ve ever experienced. I will suffer for many hours. Every bodily fiber from my toes to my eyebrows will be in agony. I will despair, get angry, and maybe feel hopeless. I’ll want to quit, maybe multiple times. How do I get through that?

Hutchinson discusses the idea of preparing to suffer. How will I react? Will I succumb to negative thoughts? Or will I employ a strategy like positive self-talk, a touchy/feely sort of thing that actually has quantifiable positive effects on performance? Maybe I’ll deliberately smile to myself which has been demonstrated to reduce perceptions of effort.

One thing I won’t do is try to ignore the pain. It can’t be done. Research has shown a more effective way to manage pain and suffering is to inspect your pain in a clinical way and have a calm conversation about your suffering. There’s a difference between pain and the emotions we feel about pain. Awareness and examination of this divide can help lower the perception of pain and suffering. I am in control of my thoughts on pain. This will help.

Much of Endure compares “mental” vs. “physical” endurance. (In truth, there is no difference between mental and physical. It’s all atoms and molecules. It’s all connected. There should be no delineation. Try having a mind without a body or vice versa. Rene Descartes was wrong. Maybe it’s useful to say “psychological” vs. “mechanical” endurance to indicate the perception of pain by the brain vs. the muscles’ inability to generate high force.) I’m learning about the multitude of ways and the degree to which the brain generates feelings of effort, pain, and suffering during exertion. The best athletes don’t suffer less than everyone else. They are able to suffer more and manage their suffering better than the rest of us. Hutchinson gives evidence that we are probably capable of far more effort than we believe possible. Based on my learning, I plan to make my difficult runs very difficult. I plan to push myself harder than I have in the past when the time is appropriate. The idea is to get intimately acquainted with a high level of suffering That’s not to say most of my running should be grueling. That’s not the right way to train. But when it’s time to push hard, I’m going to push hard. I’ll be testing this strategy in the races leading up to the Grand Traverse. I need to find out how hard I can push, how hard I can suffer.

Oohhhhhh this is good… Ultra-Marathons: The 15 Stages of Suffering tells it like it most certainly is. It conjures up explicit memories of prior suffering. I’m nervous, and I can’t wait to do it.

I’m being published

Also, in 2-3 weeks I’ll have an article appearing on Tnation.com — and they’re paying me for it! I’m not sure I’ll win the Pulitzer but I’m very excited that I can technically call myself a professional writer. I’ll post a link to the article here when it comes out.

Posterior Tibialis Tendinitis: The Resolution

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I wrote recently about my experience with posterior tibialis tendinitis. This post continues the analysis of the problem and solutions that helped resolve the problem.

Posterior tibialis actions

The posterior tibialis (PT), and the gastrocnemius, soleus, and plantaris, (all muscles that attach to the Achilles tendon) overlap to some degree in how they function in gait. What do those muscles do you ask?

  • Concentric function (when the muscle contracts and shortens): plantar flexion (points the foot), inversion (sole of the foot turns in)
  • Eccentric function (when the muscle lengthens): decelerates dorsiflexion (bending of the ankle), decelerates eversion (sole of the foot turns out)

Gastrocnemius/soleus/plantaris actions at the ankle

  • Concentric: plantar flexion
  • Eccentric: decelerates dorsiflexion
  • The gastroc and soleus attach to the heel via the Achilles tendon.

In the case of my Achilles pain, I found relief from strengthening those calf muscles through doing a lot of slow, controlled heel lifts. I thought the same approach would resolve my PTT. I was wrong. I believe that my efforts at strengthening the PT and the PT tendon aggravated the problem and caused more foot pain. I believe my PTT was rooted in a rigid left arch and rigid plantar fascia.

Plantar fascia flexibility, pronation, and force distribution

For years I’ve noticed that my left arch doesn’t pronate (collapse) as much as the right. I believe this lack of movement is part of my problem. In my prior post, I asked the question, “Do you have the mobility to get into the position required by your activity?” As it regards my left arch and running, my answer was, “No.”

Among many runners, the word “pronation” equates to “bad.” That’s wrong. (Uncontrolled or excessive pronation is bad.) Pronation is a necessary movement that contributes to deceleration of the foot, lower leg, and the rest of the body during foot strike. As the arch collapses, the plantar fascia acts as a leaf spring, storing then returning valuable energy that helps propel the runner forward. This energy return occurs as the foot supinates with the arch lifting as the runner pushes away from the ground.

The plantar fascia isn’t the only participant in this process of energy absorption and return. All the muscles and connective tissue throughout the body contributes to the process. The tendons of the lower leg, such as the Achilles tendon and the posterior tibialis tendons, are highly active during this process. If everything is moving correctly, in control, and in a coordinated fashion then the impact forces of running are distributed efficiently among all of the muscles and tendons.

Now imagine if some link in this kinetic chain isn’t moving the correct way. If that happens then other regions and other structures of the body will be forced to handle more than their fair share of the load. Some sort of overload, injury, and pain is likely in this scenario. Specific to my case, I believe the lack of mobility of my left plantar fascia has contributed directly to my past Achilles tendon problems, plantar fasciitis, and to my recent bout with PTT. Plantar Fasciitis and the Windlass Mechanism: A Biomechanical Link to Clinical Practice is a literature review from the Journal of Athletic Training. This review provides the following pertinent comments:

“Researchers have also reported faulty biomechanics and plantar fasciitis in subjects with a higher-arched foot.1618 A higher-arched foot lacks the mobility needed to assist in absorbing ground reaction forces. Consequently, its inability to dissipate the forces from heel strike to midstance increases the load applied to the plantar fascia, much like a stretch on a bowstring.4

“A review of the literature reveals that a person displaying either a lower- or higher-arched foot can experience plantar fasciitis. Patients with lower arches have conditions resulting from too much motion, whereas patients with higher arches have conditions resulting from too little motion.4,16,19 Therefore, people with different foot types experience plantar fascia pain resulting from different biomechanical stresses.” 

(The article is thorough and informative about foot mechanics. If you’re a runner suffering from foot problems, a running coach, or a clinician who treats these issues then I think it could be valuable to you.)

Exercises that helped

  • I foam rolled the calf. You probably know how to do that. If not, look on Youtube.
  • Band eversion/dorsiflexion: It’s one of the exercises discussed here. I did and continue to do the exercise with very high reps. It looks like this:

    Plantarflexion/Inversion

    Plantarflexion/Inversion

Dorsiflexion/Eversion. Think of pulling the pinky toe to the outside of the knee.

Dorsiflexion/Eversion. Think of pulling the pinky toe up and to the outside of the knee.

  • Bent-knee heel raises: I used high reps but there is probably benefit to using heavier weight with fewer reps. There are machines for this exercise at many gyms. I don’t have access to such a machine so I did it by stacking up some sandbags under the front of my foot and putting a dumbbell on my knee. I worked to high exertion for several sets:
    IMG_5143 IMG_9065
  • Arch mobilizer: It takes time to make changes to tissues so I do this frequently throughout the day.

  • Gait check: This is HUGE! In my first meeting with running coach Andrew Simmons of Lifelong Endurance, he noticed several problems with my gait. These were problems seen in the past with my gait.
    (This illustrates the immense power of working with a coach. I don’t know what I don’t know and I can’t see what I can’t see—and neither can you! My technique had slipped and I didn’t know it.)

    • My ground contact time (or how long my foot was on the ground) was too long. Thus, my feet and lower legs spent a lot of time transmitting stress through my lower leg. That may have been a part of overloading the PT tendon. This long contact time was probably a result of…
    • A low-energy gait. My legs weren’t rebounding off of the ground sufficiently and the whole gait cycle was sluggish. Now, as I run, I think of a strong, quick, powerful push into the ground. I drive the leg behind me, and I push the ground behind me.When I run correctly, my foot spends less time on the ground and the tissues spend less time under stress and I’m more efficient. Read How to Run: Running With Proper Biomechanics by Steve Magness for details on running technique including the need for hip extension.

Finally

Solving the riddle of the sore left foot has been a prolonged, tricky struggle. Every time I find relief I think I’ve solved the problem only to have some other problem pop up later. That said, I now think I’ve figured it out. I could be wrong. Maybe some of this information will help other runners overcome their foot and ankle troubles too.

Two Movement Questions

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1. Do you have the mobility to get into the position required by your activity? 

For example, if you’re a powerlifter, can you squat to the depth required for competition and maintain the posture required to keep the bar on your back?  Or, if you’re an Olympic lifter, can you drive the bar directly overhead during the jerk? If you’re deadlifting, cleaning, or snatching, can you get into the start position without excessive rounding of the spine? If you work in the garden can you kneel down to the ground and get back up without pain? If you swim or play tennis then can your shoulders move through the overhead position needed for a swim stroke or a tennis serve?

Why is this question important? If one joint doesn’t have enough mobility for your chosen movement, then you’re still going to perform the movement somehow. The poorly moving joint(s) will steal movement from your healthy joint(s). If that happens then it’s a set-up for pain and weakness as the victimized joints and tissues will be overstressed and your ability to move will be compromised. That ain’t good! If you can restore range of motion to those limited joints then you’ll feel better, move better, and you’ll be stronger.

2. Can you control the mobility that you have?

Can you control your knees at the bottom of the squat, or do your knees crash inward suddenly? During a lunge, can you step out and come back home in control, or do you lose balance during some portion of the movement? While bench pressing, dipping, or pressing, do your elbows stay in alignment or do they flare and wiggle around during some portion of the lift? During any lift, are you in control of the weight or is the weight controlling you?

I compare poor movement control (aka motor control) to a door hanging on loose hinges. The door can still open and close but the door bangs around, the hinges and the wall sustain damage, and eventually, the door falls off. Similarly, if you’re not controlling your limbs then your joints and connective tissue will take a beating and eventually you’re going to hurt.

Lack of control is often seen at the end-range of motion. (End-range is where you feel a big stretch.) If you follow the work of physical therapist Gary Gray, then you may know end-range as  the “transformation zone.” That’s where a limb stops and changes direction. For example, think of a weightlifter at the bottom of a squat before he/she drives back up. Or think of a baseball pitcher or a quarterback with his arm cocked back right before he brings the ball forward. Two dynamics are at play at end-range.

 

First, we don’t spend a lot of time at end-range of motion. End-range is where our nervous system has the least experience and thus the least ability to control our limbs. It’s sort of like being in an unfamiliar city and not knowing how to navigate.

Second, we have the fewest number of cross-bridges available for muscular contraction at end-range. Fewer cross-bridges means our muscles can’t generate as much force as they can at mid-range. That makes it more difficult to control end-range

Ask yourself these two questions as you workout and move through your day.

Posterior Tibialis Tendinopathy = Aggravation x 10

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The upside to adversity is that I get to learn something. If that’s true then I am an expert genius on problems with my left foot and lower-leg. I’ve fought various aches and pains in my left foot region and the war continues! I am grateful to be on the very tale end of a successful battle against posterior tibialis tendinopathy (PTT).

Ouch.

Ouch.

Why does a tendon hurt?

The injury mechanism is that the tissue has been stressed beyond its ability to recovery. Too much stress/too fast/too often is the problem. Thus, the tissue must be unloaded and rested enough that it heals. Tendons, compared to muscle and skin, don’t get much blood flow so they need longer to repair than blood-rich tissue.

Time off?!?!

I took the whole month of January off. Every runner — probably every athlete or fitness enthusiast in any discipline — shudders at the idea of taking time off, especially a whole month. “I’ll get out of shape!” or “But I have a race in X-number of weeks!” we say. Well, here’s some news for you: If you’re injured then you’re out of shape. Let’s say that together: IF YOU’RE INJURED THEN YOU. ARE. OUT. OF. SHAPE! You’re busted. Broke. Lame. Dead in the water. Out of the race. It’s the agonizing truth.

If you’re injured then you’ve dug your way into a hole. Trying to run your way out of a running injury is like trying to dig your way out of a hole.

You get what I’m saying? 

If you don’t want to prolong the condition, if you want to get back to serious training (as opposed to piecemeal, sporadic, painful, crappy training) sooner rather than later, then STOP RUNNING RIGHT NOW! Bite the feces-covered bullet and prepare to take several weeks off. This is a test of your discipline. You may think you’re disciplined because you do all this running but discipline isn’t doing what you like to do, discipline is doing what you need to do.

Or, just like me and a bunch of other runners, you can believe you’re the exception, you’re made of magic, you’re different from all the other humans and your PTT will resolve in miraculous fashion. I took a few days off, tried to keep running, and I was still hurt. I did that a couple of times. Reality, in all its brilliant, gruesome glory was sitting on my chest, trying to kill me. But January was a better month to take off than all the other months coming my way and I decided it was time to stop being stupid.

You’re a grownup. You’ll make your own decision but guess what: At some point you’ll stop running. You can either make the choice or it’ll be made for you.

(I’m an expert at dispensing this type of advice but it’s as painful and difficult for me to follow as it is for anyone else. Let me make the dumb mistakes so you don’t have to. Also, for a big pile of woe, read the Let’sRun.com forum on PTT, where you can read about people who’ve dealt with this curse for months and years. My bet is they haven’t taken sufficient time off. But if you read about those who overcame PTT, you’ll see most of them took a significant break from running.)

Fortunately, I could bike and lift. Those aren’t perfect substitutes for running but what is? I was able to keep my body in decent shape. I found peace of mind, and a sense that I wasn’t helpless. The good news is I improved my cycling and my numbers went up on the weights. Hooray me.

Some useful resources

Dr. Nick Studholme is always helpful when I’m hurt and can’t figure out why or what to do about it. He showed me how to use Dynamic Tape to help unload the tendon. He also provided me with the following two resources.

Return to Running Rules of Thumb – Are you ready? This contains specific bench marks that you should be able to hit before you return to running. Some of the terminology may not be familiar to you if you don’t have an education in kinesiology. Do your own research, contact me, or contact a physical therapist for help understanding this information. If you pass these tests then you’re ready for…

Zeren PT Return to Running Program. I like the specific, progressive instructions here. Even though I’m a fitness professional, it helps if I get outside guidance and rules to follow. As the saying goes, “The lawyer who represents himself has a fool for a client.” Might as well replace “lawyer” and “represents” with “coach” and “coaches.” If left to my own guidance then I’ll tend to do too much too soon too fast and I’ll get hurt again.

4 Ways to Prevent and Treat Posterior Tibial Tendonitis is from Runnersconnect.net. This is a thorough, well-researched article. In it you’ll find various strategies to address PTT including pictures, exercises, and specific exercise protocols. I used a lot of the information here.

Below is a taping strategy that can help unload the posterior tibialis and support the arch. Dr. Nick Studholme used Dynamic Tape on me. I’ve been taped with KT Tape and Rock Tape before and I can say for certain that Dynamic Tape provides more resistance than either of the other two and it stays on longer. Also, I tried doing it on my own and it doesn’t work. Get a friend to help or have your physiotherapist do it.

Running technique

In the past, fixing my technique was the key to overcoming a collection of running-related problems and pains. I believe a regression in my technique is what brought on this PTT. I know how to run. I help my clients regain good running form — but I’m not perfect and I can’t watch myself run. My technique slipped and I didn’t know it until I got some expert eyes on the case.

I’m enormously grateful for the help of my new running coach, Andrew Simmons of Lifelong Endurance. Through his guidance I’ve shored up my technique. The first time we met he videoed me running and we saw some faults. I won’t go into the specifics here but he helped me bring awareness to what I was and wasn’t doing correctly and now I’m running better. I believe good technique will help keep my tendons healthy.

If you’re dealing with nagging running injuries then perhaps the way you’re running is the problem. I highly recommend time with a coach. You don’t know what you don’t know. The right coach does know. It’s money and time well spent.

Up next…

My PTT was similar in some regards to achilles problems I’ve had in the past, but it was different in its tenacity and response to treatment efforts. In the next post I’ll discuss my rigid arch and why I believe it has contributed to my foot problems. I’ll also demonstrate a mobility drill, foam rolling techniques, strength exercises that helped, and some running technique points.

Fructose and Liver Damage

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Diabetes and obesity-related illnesses are rife in the modern world. What we eat and how much we eat seem to be culprits. Recent research suggests that specifically, too much fructose is a significant problem for the human digestive system. An article from The Economist titled How too much fructose may cause liver damage discusses research in the journal Cell Metabolism.  

The article states:

“Specifically, Dr Rabinowitz’s work suggests that fructose, when consumed in large enough quantities, overwhelms the mechanism in the small intestine that has evolved to handle it. This enables it to get into the bloodstream along with other digested molecules and travel to the liver, where some of it is converted into fat. And that is a process which has the potential to cause long-term damage.” 

It seems that small amounts of fructose are digested safely. Too much fructose consumption is a problem. If you look around you, you’ll see A LOT of food sweetened with high-fructose corn syrup. Think that might be a problem?

You may also know that fructose is the primary sugar in fruit. So is fruit dangerous? The article doesn’t discuss fruit but I have a couple of thoughts on any potential harm posed by fructose from fruit:

First, my bet is the amount of fructose one would get while eating fruit is far less than one would get while drinking soda or eating processed food sweetened with fructose. Who among us would sit and gorge on fruit? Ever eaten more than one apple or orange? Doesn’t happen very often. (I’d like to meet the person who managed to become unhealthy by eating too much fruit.)

Second, the fiber in the fruit slows the digestion and thus probably slows the release of fructose. That results in less fructose to deal with per unit of time. That dynamic should help make fructose digestion tolerable. In contrast, most fructose-sweetened foods have little to no fiber, (soda and fruit juice are liquids) and thus creates a big turbo-shot of fructose which is something with which the human digestive system doesn’t have much experience. To that point…

Humans haven’t had access to refined sugar until recently in our long history on earth. Fruit is seasonal. It doesn’t sit around for long. In our past, we had to compete with all the other animals in the forest and the jungle to eat the stuff. Either that or it would fall off the tree and rot. Honey, as you know, is guarded by little stinging monsters which makes acquiring that source of sugar a bit costly.

The candy business started in the early 20th century. A hundred years may sound like a long time but in terms of evolution and the human digestive system, it’s an incredibly short amount of time. So our digestive system—a system refined over millennia of natural selection—has suddenly been deluged by sugar. We’re unequipped to deal with this recent development, so we see the problems described above.

Got Shoulders?

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The shoulder joint is the most mobile joint in the body. That’s a good thing! When combined with good spine mobility, our shoulders allow our arms to reach, throw, pull, and push from all sorts of angles.

A consequence of being mobile is the possibility of being highly unstable. Instability, or the inability to control a limb, may lead to the common aches and pains that many of us experience in our shoulders, elbows, and possibly even the wrists. Why might instability and pain happen? (My answer will be limited to chronic pain, not acute injuries such as fractures and dislocations due to falls and other accidents.)

My belief is that shoulder problems (and most other movement problems) are rooted in a use-it-or-lose-it dynamic. Our modern lifestyle is characterized by limited movement. As adults, we rarely crawl on the ground. As modern humans, most of us don’t have to climb trees or pick up heavy things and put them overhead. We typically sit with our arms in front of us as we type on keyboards, drive cars, and operate TV remote controls. Thus our movement skills stagnate. Our brain and nervous system loses the ability to coordinate the many movements available to us. But then we might decide to swing a golf club, swim, lift weights, attempt pull-ups, pushups, throw a ball, or reach into the back seat from the front seat. Unfamiliar movements—especially if done with high force, high speed and/or done at end-range—may be too much to ask of our deconditioned shoulder complex. Then we get pain.

The following videos are designed to help restore mobility and stability to the shoulders. Pay attention to how you move as you do them. Don’t speed through them. Always be in control of the exercise, don’t let the exercise control you. If it hurts then back off or stop. None of these drills are guaranteed to fix any specific problem you may have. You may need to see a physical therapist or some other injury rehab specialist.

For the corner stretch, keep you eyes up a little bit. Don’t let your head and neck flop forward.

For the rotator cuff complex, use high reps, maybe 15-20 reps.

The halo can be varied in some ways not shown in the video. Try the halo while in a hip-hinge or deadlift-like position. Use a light weight.

New Year’s Resolution Part VI: You’ve Achieved Your Goal! Now What?

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The end is nigh for this dissection of the always popular yet often daunting new year’s resolution. The real key to a successful resolution isn’t a particular workout or diet, it’s getting your mind right. The target isn’t your butt or you gut, it’s your brain. To recap, I suggest you consider the following:

From where you are, to where you want to be

  • Ask yourself why exactly you want to achieve your resolution. You must connect to your goal on an emotional level. It must be meaningful to you.
  • Motivation is crucial to your success. Motivation is the only thing that will keep you moving forward. Intrinsic motivation (motivation from within you, not without) is optimal.
  • Have a plan and set SMART goals. This will allow your motivation to drive you in the right direction.
  • Set objectives. Objectives are the steps that take you to your goal. If you focus on the objectives then you focus on the process. The process will take you to your goal.
  • Get specific about details. If this resolution is important then it’s worth taking some time to think about when you’ll exercise, where you’ll exercise, what you will and won’t eat, how much sleep you’ll get, plus several other vital questions.

Now the journey continues.

If you’re one of the diligent few who actually perseveres and reaches your new year’s resolution, then congratulations! I hope you’ll pat yourself on the back and revel in your significant achievement. Your motivation, your planning, and your hard work have all payed off. My bet is you want to maintain those impressive results. If so, please recognize that the resolution must continue!

My sincere hope for you is that you’ve not just gritted through an arduous, monotonous process, but that you’ve taken on a healthy lifestyle comprised of enjoyable, sustainable habits. Recognize that fitness is an ongoing project that’s never finished. It’s worth reflecting on the emotions that motivate you. It’s a good idea to revisit your fitness plan and revise it so you can achieve another exciting goal.

As part of this wrap-up, I want to re-emphasize the power of being process-oriented in the pursuit of your resolution. This concept is discussed in Big Goals Can Backfire. Olympians Show Us What to Focus on Instead. It’s an excellent article. Here’s part of it:

“A process mind-set creates daily opportunities for little victories, which help sustain the motivation required to accomplish long-term goals. A handful of studies, including one in the prestigious journal Nature, provide insight into why this is the case. Researchers have found that when mice accomplish micro objectives on the path to distant goals (e.g., making a correct turn in a maze), their bodies release dopamine, the neurochemical associated with motivation and drive. Without hits of dopamine, the mice become apathetic and give up. Although these studies cannot be safely replicated in humans, scientists speculate we operate the same way. Process promotes progress, and progress, on a neurochemical level, primes us to persist.”

Finally, please let me know if you’d like to discuss your fitness goals. I would love to help you get moving in the right direction. I’m available for a free consultation. You can contact me at DenverFitnessJournal@Gmail.com.