Sleep: An Essential Ingredient

I’ve mentioned previously that lack of sleep contributes to obesity. (Also look here and here.) Missing sleep has also been linked to increased risk of stroke and possibly depression. Lack of sleep can predict which older adults will move to nursing homes or assisted living facilities. Finally, sleep has been shown to improve performance in swimmers, college basketball players, and college football players.

Important stuff this sleep! Sounds like we need frequent good doses of it to be healthy and perform well. We may be sabotaging our sleep though if we look at electronic screens at night before bed.

Recent articles in the LA Times and the Chicago Tribune discuss the disruptive effect of electronic “blue light” (such light is emitted by phones, computers and TVs) on our circadian rhythms. We often look at these electronic devices at night before bed with the result being poor sleep and the following host of problems. In fact, the American Medical Association released a statement on blue light saying, “that exposure to excessive light at night, including extended use of various electronic media, can disrupt sleep or exacerbate sleep disorders, especially in children and adolescents.”

Essentially, blue light is prominent during daylight. Looking at a screen–especially one like a smartphone which is near our face–seems to make our brain think it’s day time when it isn’t. I won’t go into all the details but they are interesting. Have a look at the articles for more information. As for solutions, 5 Ways to Unplug at Night for Better Sleep offers some suggestions for avoiding computers at night.

Getting away from the electronics at night is very similar to changing our eating habits to lose weight. Reward centers in the brain are triggered by our devices and the stimulation they deliver. It can be difficult to alter that pattern. I find it difficult to change my ways. I’m as guilty as anyone in looking at an electronic screen at night. Lately I’m consciously working to turn off these devices well before I go to bed. Sometimes it’s tough. A really good book can help. (If George RR Martin will hurry up and finish the Winds of Winter then it’ll make ditching these gadgets much easier…)

Fairly Profound Stuff: How to Stand

Dr. of Physical Therapy Kelly Starrett continues to put out very useful information via his site MobilityWOD. Torque and Trunk Stability Part I: How to Stand is a recent post. It discusses trunk and hip mechanics with regard to standing. Does this sound to simple a topic? Standing? Perhaps not.

As I’ve mentioned before (here and here) we often don’t walk very well. Strangely, it’s not uncommon for us to stand incorrectly or less than optimally. As with walking, it so happens we stand a lot. And if we’re doing it improperly then we very likely are moving toward injury and pain or at the very least, poor performance.

The themes in this video appear in a lot of other MobilityWOD videos (like this one on the set up for the deadlift.) The concepts of trunk stability via glute and abdominal contraction are hugely important. As is the idea of torquing or twisting the legs out in order to create stiffness through the legs and hips. (Similarly for the upper body it’s a good idea to torque out or externally rotate the arms during pressing movements.)

I’ve been using these concepts in my own workouts as well as with my clients and I’ve seen some very good results: more strength, less knee pain and instability, better overall technique. All of this is good.

If you’re one of my clients then this stuff is homework. If you’re not one of my clients but you want to perform better. Go ahead and make it homework anyway. See if it helps your squat, deadlift or sitting to standing from a chair–or the ground preferably.

“That is, once the runners were tired, their form got sloppier, theoretically raising their risk for a tibial stress fracture.”
– Runner’s World

Running while fatigued increases stress fracture risk.

I’ve discussed several times (here, here and here) the idea that if we train too hard, we’re courting injury. An article in Runner’s World gives more evidence to support this idea. The article cites recent research from Medicine & Science in Sports & Exercise. As the test subjects ran, researchers monitored several movement patterns that were indicative of tibial stress fractures. As the subjects ran and became more fatigued, these movement patterns became exacerbated.

To me, the messages are first pay attention to your running form. Running is a skill. That’s why I don’t wear headphones anymore when running. Pay attention to how you run! Second, finish your run when you still feel good. Don’t kill yourself (except during a race) when you’re training. Don’t be afraid to quit early or skip a day if you’re very fatigued.

“Liking to run, it seems, may have helped to make humans what they are.”
-NY Times Phys Ed

Running & evolution

Running for enjoyment is sort of a strange thing. Non-runners will agree with me. From an evolutionary perspective, doing something that uses up energy and exposes us to injury really doesn’t make sense. Yet many of us love it. Why? It’s this question that’s discussed in a recent New York Times Phys Ed section. Recent research in the Journal of Experimental Biology examines the matter. Turns out humans and dogs show increased circulating endocannabinoids post run. Walking however does not induce the same reaction. Nor, in this experiment did running have the same effect on ferrets. Seems that dogs and humans may have a deeply wired reward system that’s tied to running.

The question is then asked why don’t more of us run? Dr. David A. Raichlen, a professor of anthropology at the University of Arizona, who led the study answered, “That’s the million dollar question. It appears from our study that we have the evolutionary drive” to exercise. But modern man has learned to ignore it.

I absolutely believe we were meant to run. And running with a dog? There’s nothing like it in life.

I Know How to Walk and Run: Part II

In the previous post I discussed my difficulty in solving my running-related pain issues. Analyzing and changing one’s running technique is a challenging thing, but I’m going to attempt it. I’m mainly going to discuss running here but these concepts apply to walking as well. (Don’t think that poor walking mechanics don’t matter. We spend a lot of time walking. If we’re doing it wrong then we’re really hammering the body into a mangled mess.)

Really important thing #1: Let the foot drop right below you. Don’t reach out with your heel.

It’s vital to get the foot strike correct when running. I now realize that for years I was reaching forward with my leg, putting my heel out in front of me, and hitting the ground with my heel. This is bad. It promotes overuse of the hamstring muscles and de-emphasizes the glutes.

I then spent the past year to year-and-a-half trying a forefoot strike. I thought this was an effective correction of my heel strike but I was still doing several things wrong. First, I was still reaching out ahead of me. As a result I was still using my hamstrings too much and I wasn’t using my glutes enough. And though I was hitting with my forefoot and avoiding a heel strike, I wasn’t allowing my heel to settle to the ground.

Now I’m doing things a lot better. First, I drop my foot directly below me. In fact, it feels like my foot is dropping behind me. Let me emphasize the word “drop.” I passively let the leg unfold underneath me and let gravity pull my foot to the ground. I don’t actively try to do much of anything with my foot. I often pay attention to how things feel down there but I don’t try to pull my foot off the ground or push off in any particular way. Steve Magness discusses this process in is superb post How to run with proper biomechanics. I’ve bolded the key points:

Once the knee has cycled through, the lower leg should drop to the ground so that it hits close to under your center of gravity. When foot contact is made, it should be made where the lower leg is 90 degrees to the ground. This puts it in optimal position for force production. The leg does not extend outwards like is seen in most joggers and there is no reaching for the ground. Reaching out with the lower leg results in over striding and creates a braking action. Another common mistake is people extending the lower leg out slightly and then pulling it back in a paw like action before ground contact. They are trying to get quick with the foot and create a negative acceleration. This is incorrect and does not lead to shorter ground contact times or better positioning for force production. Instead the paw back motion simply engages the hamstrings and other muscles to a greater degree than necessary, thus wasting energy. The leg should simply unfold and drop underneath the runner.

I know I’m running well when it actually feels like the foot is dropping behind me. (It’s not actually behind me, it’s just dropping quite a bit further back than it used to.) I now focus on hip extension when I run, or using my glutes to drive my leg back. With this proper foot placement I can feel my glutes turn on and propel me forward. It helps to have a slight forward lean through this process.

Really important thing #2: Lengthen through the hip

This concept of what I call “lengthening through the hip” has had a massive impact on my walking and running technique and thus my pain issues as well. Denver-area physical therapist Rick Olderman helped me solve a strange little bodily riddle I’d had for years, and this hip lengthening process was right at the core of it.

For a long time I noticed that standing on my right leg was a lot different from standing on my left. When I would stand on my right leg I always sort of tipped or shifted to the right. It didn’t feel right. My balance would shift in a sort of exaggerated way. This was happening every step. Standing incorrectly on my right leg when walking and running also meant I would land badly on my left leg. Lengthening up and pressing my weight through my hip into my foot solved this issue.

This concept is a little tough to effectively describe in words but here goes: As my foot hits the ground below me, I think of lifting my trunk away from hip. In my mind the hip and the rib cage of the stance leg are separating–moving away from each other, and I’m sort of getting taller in the process. I don’t think of bounding or hopping though. I’m trying to make my leg longer below me and behind me as I move forward. A slight lean forward from the ankles helps me do this all correctly.

This movement is sort of a subtle kind of thing to grasp. Describing this process is sort of like describing chocolate to someone who’s never tasted it. It’s not like simply flexing your elbow or bending your knee. It’ll probably take a bit of practice to get a feel for this. The goal should be to take this strange-feeling novel movement and turn it into a habit. The video below should help explain this.

Stuff You Should Know About

Here are several things from food, books, exercises and blogs of which you should be aware. This is information and exercise that will improve your health and performance.

Look at this blog: MobilityWOD

MobilityWOD.com or Mobility Workout of the Day is a blog from Dr. Kelly Starrett. Kelly is a San Francisco-based physical therapist and Crossfit affiliate. His blog is chock full of how-to videos designed to improve your movement and fend off or overcome injury. Just the other day I watched Tight Ankles = Bad Squatting. I tried the drill and my years-long on-again-off-again right ankle pain was gone! Gotta love instantaneous results!

Read this book: Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann

Okay, read this book only if you’re a fitness or injury rehab professional. Diagnosis and Treatment of Movement Impairment Syndromes is a tremendously detailed text on how to identify and fix movement problems. I’m wading through it right now and it’s a challenge but the information is amazing. If you’re in the fitness/rehab industry, definitely get this book. Dr. Sahrmann’s second book is Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. I’m looking forward to that one too.

The author, Shirley Sahrmann, DPT is a pioneering, award-winning physical therapist. She’s a professor at the Washington University School of Medicine in St. Louis.

Take this supplement: Vitamin D

Vitamin D is important for a wide range of healthy human functions. Vitamin D is a key component of calcium absorption and thus bone health. Low levels of Vitamin D are associated with asthma and some cancers. It seems to offer a protective effect against multiple sclerosis and it boosts immune function. Unfortunately Vitamin D doesn’t show up naturally in too many foods. Some foods are fortified with Vitamin D but supplementation may be the best way to ensure adequate Vitamin D intake.

Humans with sufficient sun exposure have the ability to manufacture Vitamin D. It’s still cold in much of the country so that means minimal sun exposure–so there’s a good reason to supplement. (Interestingly, using to much sun screen too often may be problematic in Vitamin D production. Like many things, eliminating sun exposure may be unhealthy. Don’t be terrified of the sun.) Further, people with dark skin and older folks have a tougher time manufacturing Vitamin D.

Recommendations vary but it’s from 2,000 and 5,000 IU per day from supplements and sun is a good idea. Big men need more Vitamin D than small women.

Do this exercise: the deadlift

Picking up heavy things off of the ground is something homo sapiens have been doing since… well… before we were actually homo sapiens. As long as there’s gravity we’ll keep doing it. That’s what the deadlift is: pulling a weight off of the ground from a dead stop. The deadlift isn’t just for powerlifters either. It’s a tremendous total-body strengthening exercise that anyone can do with proper coaching. If you learn to deadlift then you’ve learned to use good body mechanics to lift an object.

Here’s a good instructional article on the deadlift from Stronglifts.com. And here’s a rather poetic video on the deadlift from Crossfit.

Eat this: coconut oil

Coconut oil seems to carry a whole raft of health benefits. Weight loss, improved immune function, better digestion, favorable cholesterol profile are a few of the likely benefits of coconut oil consumption. You can cook with it, put it in smoothies, rub in on you skin and put it in your hair. What other product is so versatile?

Thoracic Mobility

This will sound odd but without reservation I can tell you that I’m all kinds of giddy over the thoracic spine (aka t-spine)! I’ve been reading quite a bit lately about the t-spine and learning about the implications of proper t-spine mobility and strength. Bret Contreras has a good article on the topic. Mark’s Daily Apple has two articles on the topic, this one and this one. This PDF from Mark Buckley is very informative. And Nick Tuminello discusses the do’s and don’ts of the spine in general in How Not to Warm Up. I’ve got a few drills to show you that should be done by any modern Westerner–that is, anyone who sits for a living, drives a car, watches TV and/or bicycles. But first, what is the t-spine?

Hello spine.

Anatomy

Your spine or vertebral column normally consists of 33 bones. You have seven cervical vertebrae in the neck region, 12 thoracic vertebrae that make up the mid-back, and five lumbar vertebrae that make up the low back. Down at the very bottom you’ve got the sacrum and the coccyx, aka the tailbone. So think of your t-spine as starting from the base of your neck and ending on an even level with the top of your hip bones. So why should you care about this region?

The thoracic spine is built for movement. This part of our spine was made to twist, flex forward and sideways, extend back plus a combination of all the above. But look at the modern Western lifestyle: We sit and we hunch. We hunch at a computer. We hunch over a steering wheel. For fun, we hunch in front of a TV. If we’re cyclists, then we hunch even during our athletic event. If we play golf or softball then we get rotation but generally only in one direction. In other words, the t-spine spine gets very little movement. What are the implications?

Organ function
It’s fairly obvious that most of our internal organs rest near our t-spine. Those organs are innervated by nerves that exit out of the thoracic spine. This means those organs send and receive information to and from the brain by way of the t-spine. Have a look at the chart and notice which organs receive their nerve supply from the t-spine region.

Your organs' sources of nerve innervation

If this part of your spine is immobile then you could have compromised organ function. That could mean anything from hand and wrist pain to breathing issues, thyroid issues, heart dysfunction, kidney dysfunction, digestive trouble, and who-knows-what-else. Thus mobilizing this area may well improve organ function.

Limb function & pain issues (or avoidance thereof)

Proper t-spine movement is tied very strongly to good shoulder and arm function and to good low-back health. (I’ve had personal experience with this, both with my own pain issues and with various clients.) A gunked up t-spine means the shoulders are going to move badly. A tight t-spine will likely result in shoulders that are unstable. Thus the shoulders may pay the cost of poor t-spine movement. Similarly with the low-back.

The lumbar spine is not a terribly mobile part of the body. It has about 6-7 degrees of rotation in each direction. The t-spine however has about 35 degrees of rotation each way. Your entire spine rotates as you walk, run, swim, reach behind you and obviously if you golf, swing a bat or throw a punch. If you lose t-spine rotation then your lumbar spine will likely start to compensate and rotate more than it was designed to. So that low-back pain you keep heating and icing and stretching, etc? It very likely may be caused by poor t-spine movement.

Appearance

Why do most of us work out? We may say “just to be healthy” or “my doctor told me to, but the real honest reason most of us exercise is for looks. There’s nothing bad about looking good! Good t-spine movement and positioning can help you look better instantly.

Remember that we’re a hunched over society. Look around you. How many rounded shoulders do you see? This doesn’t look great. Imagine if people drew themselves up, lifted their collarbone, and lengthened their spines. No question but that we’d look stronger, healthier and more attractive.

Okay, so there’s some info on what your t-spine is and why proper movement is vital. Now it’s time to move! (Please pardon the discrepancy between the audio and video. I’m trying to figure out what the problem is. Youtube is a challenge for some reason.)

Behavior Change & Healthy Choices One Step at a Time

Working out plus eating right: Feel free to choose only one

In my line of work, I often speak with people who have physique goals (most people want to lose weight). Often these folks are eager to exercise. They like to lift heavy objects and sweat. For them this is fun! When the conversation turns to nutrition though, the mood often changes. These enthusiastic exercisers often express mild to severe dread at confronting their various dietary Darth Vaders.

“Yeah… I know I should eat better. I’ve tried but it’s hard…”

Many a New Year Resolution starts with the idea of getting in shape via “eating better.” But what does it mean to “eat better?” Could be any combination of eat more vegetables and fruit, eat less sugar, eat less processed food, eat less gluten, drink less soda and/or booze, eat more “natural” foods, eat more organic foods, eat less meat… “Eating better” can mean a great many things. There are a lot of choices and it’s tough to pick a place to start. If we try to take on all these changes at once then we’re looking at climbing Mt. Everest. Couple this with efforts to “work out more” and now we’re looking at climbing K2 as well. Typically the individual will try hard for a while, fail and then bum out at their defeat. Gloom and doom at the end of another effort to get in shape.

The problem is, we may not be ready to tackle both of these issues-eating better and exercising–at the same time. We may be ready to exercise but we may plain ol’ not be ready to change our eating habits. We may realize the importance of changing our current behaviors, but trying to change too many things at once may be too difficult. The solution: Pick one. Then at some point in the future–when you decide it’s time–start changing the other.

Find easy success first

With regard to eating, instead of trying to “eat better,” which is very general, can you make one single concrete decision on one of your eating habits? Can you pick one single better thing to eat today than you did yesterday? Can you make a specific choice–just one–that’s better than a previous choice you’ve made?

Ideally, it should be an easy choice to make. (Don’t try to give up your favorite food altogether. That never works.) Just today can you get fruit instead of chips with a sandwich? Instead of drinking three sodas today can you drink only two? Can you have dessert only four times this week instead of five? In other words can you make a very small painless yet definite modification to your behavior?

Psychologically, small but definite victories will give you a feeling of success. And these victories actually matter! They’re small steps but they are steps. Deal with the easy stuff first and you’ll develop truly healthy habits that will stick.

“Runners who continue running when they are exhausted unknowingly change their running form, which could be related to an increased risk for injury.”

Runners get injured. I’m a runner and I’ve been injured–a lot. If you’re a runner then you either have been, are or are going to be injured. According to one source, 60-65% of all runners are injured during an average year (by definition, an ‘injury’ is a physical problem severe enough to force a reduction in training).

If you’ve encountered a running injury then you probably know that it’s rarely a simple solution to fix what ails you. From shoe changes to barefoot running to stretching to foam rolling to foot strengthening exercises, to physical therapy to acupuncture to chiropractic to massage and on and on… This is a huge hassle and it would be wonderful to avoid this kind of aggravation! So with some particle of optimism, I present an article from Science Daily that may help us avoid injury: When to End a Run to Avoid Injury: Runners Change Form When Running Exhausted.

The article discusses a study from Indiana University published in the Journal of Biomechanics in November 2010. Researchers observed that subjects demonstrated biomechanical changes as they fatigued during a run. Runners tended to display excessive motion at the hips, knees and ankles.

The study had subjects run on treadmills until they either reached 85 percent of the subject’s heart rate maximum or a score of 17 (out of 20) on the rating of perceived exertion (RPE). By the end of their runs, all of the runners reported an RPE of at least 15 — studies have shown that RPEs between 13-15 indicate fatigue. Here’s what you need to pay attention to. The article states, “Runners’ RPEs could provide some answers, with RPEs of 15-17 indicating runners’ have reached a point where their mechanics have likely begun to change in an undesirable way.”

The RPE scale is shown below.

What does this mean to you the runner? Don’t run to the point of exhaustion. Stop when you’re feeling good and strong, not when you feel beaten to hunched-over death.

I’m going to go out on a limb and suggest that we might take this advice for any type of exercise: lifting weights, cycling, martial arts–whatever. This isn’t to say we should avoid tough workouts but most of our workouts should be comfortably challenging, not torture. (I’ve mentioned this concept in previous posts; look here and here.)

Facial expressions can be very useful in gauging our exertion levels. When I’m working with clients I watch their faces. When a grimace starts to show we stop the set. The “scary face” is a transmission from one human to the other humans that something isn’t going all that well. (Next time you’re in the gym, have a look around and see how many people have a look on their face like they’re being stabbed. Don’t be that person.) It means we’re butting up against certain physiological limitations. If we spend enough time doing this we’ll likely end up in some type of pain. Heed your body’s warnings and you can stop injuries before they start.

The Dangers of Sitting & How to Fight Back With Z-Health

I’m behind on the news here a little bit but a fascinating story appeared recently in the New York Times Magazine. Is Sitting a Lethal Activity discusses the idea that spending too much time sitting is harmful to our health. In fact the article suggests the following:

“Sitting, it would seem, is an independent pathology. Being sedentary for nine hours a day at the office is bad for your health whether you go home and watch television afterward or hit the gym. It is bad whether you are morbidly obese or marathon-runner thin. ‘Excessive sitting,’ Mayo Clinic researcher Dr. James Levine says, ‘is a lethal activity.'”

Okay, so this is no revelation to most of us. We know that moving is generally healthier than sitting. So if we exercise enough then we should be able to counteract the effects of sitting right? Not so fast. The Times article suggests that in fact we may not be able to exercise our way out of the risks of our seated lifestyle. The article states:

“A growing body of inactivity research, however, suggests that this advice makes scarcely more sense than the notion that you could counter a pack-a-day smoking habit by jogging. ‘Exercise is not a perfect antidote for sitting,’ says Marc Hamilton, an inactivity researcher at the Pennington Biomedical Research Center.”

So what does this mean? It seem that according to the evidence in the article, sitting is unhealthy. (Specifically we might say that lack of movement not sitting in and of itself.) If we do too much of it we’ll get sick and die early–whether or not we exercise a lot. This isn’t good! Most of the Western world sits for a living. We sit at computers. Then we sit in cars for transportation. Then for entertainment we sit in front of a television. HOURS and HOURS of sitting is our way of life. So what can we do?

Well, part of the research into this issue by Dr. Levine included the wearing of a special electronically wired “magic underwear” that measured the wearer’s movement. The researchers found that healthier people moved more during the day but it wasn’t necessarily in the form of exercise. They fidgeted more or simply engaged in many small movements throughout the day. Even leaning down and tying a shoe can generate a burst of movement that should ultimately lead to better health. (The term for all this small, non-exercise movement is NEAT or Non-Exercise Activity Thermogenesis. Read more about NEAT here, here and here.)

Z-Health R-Phase joint mobility drills are tailor made to address our modern lack of movement. Any number of these drills directly counter the hours we spend immobilized in chairs. Following are three joint mobility drills that you can perform while seated. Moving our joints in these ways sends bursts of mechanoreceptor signals to the brain and basically lets the nervous system know that we’re still alive.

Avoid Cramping This Spring

The warm weather is trying to break through to us and we’re all itching to run and/or bike. You may be at particularly at risk for cramping at this time of year though. Why? First some background on salts, muscles and muscular contractions.

Salts (aka electrolytes) specifically potassium, sodium, and especially calcium are key components of muscular contractions. Without them we may either experience muscular weakness or uncontrolled muscular contractions–cramping. We get these salts through our food and drink. We tend to lose these salts through sweating. Prolonged exercise and/or exercise in the heat typically requires us to consume more salts than we would during short bouts of exercise or exercise in the cold. Now, on to the particulars of cold-to-warm weather issues.

As it turns from cold to warm weather, our bodies are also adjusting the degree to which we sweat out our salts. During the cold, our bodies will fork over the salt quite readily. We retain more salts during the warm weather. So let’s say we get a nice warm day and we decide to get in a long run or ride. We may be exercising like it’s warm but we may be sweating out salts like it’s cold. This is prime time for cramping.

Here are some ideas to avoid cramps:

Salt your food. You’re an exercising athlete and you need salt. Unless you have high blood pressure, you should be fine.
Keep a sports drink with you. Drink when thirsty and stop when you’re satiated.
Eat a wide variety of fruits and vegetables. These contain electrolytes.
Don’t overhydrate. Too much water will dilute the salts in your body.
Consume dairy products. Calcium is important for bones but it’s also massively important for muscular contractions. It’s rarely found in sports drinks though.
Ease into warm weather activities. Your body will adjust to retain salts if given some time.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach

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