Quickly I want to congratulate my client Linda Purcell on very successfully deadlifting 135 lbs. for two sets of three reps this evening during our workout. (That’s the barbell with a 45 lb. plate on each side.) Linda is very enthusiastic about lifting and she always enjoys the deadlift–which may be my favorite lift too. Her form was perfect. The lifts were crisp and I think we’re still a long way away from her true maximum lift. Nice job.
Born and Evolved to Run
StandardThis article titled Born and Evolved to Run comes from the New York Times Science section–and you should read it. It’s a Q&A with Daniel Liberman, an evolutionary biologist from Harvard. He’s also a barefoot runner. He’s done a significant bit of research on barefoot running that any and all runners should look into. Beyond our feet, Liberman also discusses some unique characteristics of our necks and why most of our tooth and gum ailments are a result of the modern age. Here’s an exerpt:
Q. Your other specialty is the evolution of the foot. Why this emphasis on the farthest points of our bodies?
A. Actually, I’m interested in the entire body. However, I got into feet because of my interest in heads. Some years ago, I was doing an experiment where I put pigs on treadmills. The goal was to learn how running stressed the bones in the head. One day, a colleague, Dennis Bramble, walked into the lab, watched what was going on, and declared, “You know, that pig can’t hold its head still!”
This was my “eureka!” moment. I’d observed pigs on treadmills for hundreds of hours and had never thought about this. So Dennis and I started talking about how, when these pigs ran, their heads bobbed every which way and how running humans are really adept at stabilizing their heads. We realized that there were special features in the human neck that enable us to keep our heads still. That gives us an evolutionary advantage because it helps us avoid falls and injuries. And this seemed like evidence of natural selection in our ability to run, an important factor in how we became hunters rather than just foragers and got access to richer foods, which fueled the evolution of our big brains.
“Bad Science” is a good read.
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Cures all that ails!!
Unless you live in a sensory deprivation chamber, you know that we’re awash in news stories and advertisements for food products, drugs, pain remedy potions, supplements of various sorts and all kinds of fitness and health fads. White-lab coated doctors appear on popular TV shows extolling the virtues of antioxidants, fiber, raw foods ionized bracelets, colonic cleanses and more.
We’re often told these products are “clinically proven” or that “Studies show” huge life-changing success when we use these products. But what do these terms mean? Are the hard-to-believe claims possibly true? Which if any of these “sciencey” sounding products are worthwhile, effective or even safe? I’m not a scientist, so what should I believe? (I should add that I’ve probably been convinced more than a few times of the worth of some worthless things.)
In an effort to understand some of this stuff, I’m reading Ben Goldacre’s Bad Science, and I’m learning a lot. He discusses in clear terms some of the strange claims made by practitioners of complimentary alternative medicine (CAM) such as homeopaths and nutritional gurus. We learn about the extraordinarily powerful placebo effect and why this effect is often at the core of alternative treatment methods. We get an in-depth look at the shocking and strange situation surrounding the recent HIV/AIDS denial controversy in South Africa. (This was the conflict in which South African president Thabo Mbeki and his cohorts fully ignored all scientific data regarding treatment and prevention of HIV/AIDS. The result was many thousands of premature deaths due to denial of antiretroviral drugs to HIV/AIDS patients in that country. One man, Mathias Rath, a German vitamin pill peddler, profited tremendously from this situation.) Goldacre also takes the pharmaceutical industry to task for various dubious, dangerous practices and manipulation of data. Bad Science is a look inside all sorts of snake oil.
Thus far I’ve found the chapter on nutritionists particularly interesting. We get some history of nutritional quackery. We learn about a man named John Harvey Kellog. You may recognize his last name. He helped create the cornflake. He sold granola bars, ran a sanatorium where patients were treated with “holistic methods,” advocated colonic cleansing which is popular today (By the way, that’s putting stuff in through a very clearly marked exit.), and he campaigned vigorously against masturbation. (He had some particularly stringent views on incorporating pain into circumcision as a way of inhibiting the enjoyment of sex in boys, and he advocated using carbolic acid on the clitoris to similarly dissuade sexual excitement in girls.)
What you start to realize is that ALL this stuff has been around for a long time. Charlatans making outrageous “sciencey” claims have been with us for decades if not centuries. They claim in one breath that cutting edge science is on their side. Yet when their methods and practices are subjected to truly rigorous scrutiny–and their methods are shot full of big holes–they huff and puff (sometimes they sue) and insist that the medical community is against them. Beware of these people. A lot of them–guys like Dr. Oz, Andrew Weil, Deepak Chopra–are very popular and highly respected in some circles including the popular press. They’re entertaining and they deliver very interesting messages. They also run in quite another direction from much of mainstream science.
If we’re looking to summarize the differences between CAM and conventional medicine, the following statement from the site Quackwatch.com says it best:
“Until now, alternative medicine has generally been rejected by medical scientists and educators, and by most practicing physicians. The reasons are many, but the most important reason is the difference in mentality between the alternative practitioners and the medical establishment. The leaders of the establishment believe in the scientific method, and in the rule of evidence, and in the laws of physics, chemistry, and biology upon which the modern view of nature is based. Alternative practitioners either do not seem to care about science or explicitly reject its premises. Their methods are often based on notions totally at odds with science, common sense, and modern conceptions of the structure and the function of the human body. In advancing their claims, they do not appear to recognize the need for objective evidence, asserting that the intuitions and the personal beliefs of patients and healers are all that is needed to validate their methods.”
One statement I found resonated with me, and I think it will help me keep a proper perspective. “There’s a word for alternative medicine that holds up to scientific scrutiny: Medicine.”
Goldacre doesn’t spend all his time bashing CAM, just most of his time. Early in the book he discusses one area where many CAM practitioners outdo their conventional medical counterparts and that’s in listening to the patient. A huge part of a patient’s feeling better relies on the doctor/patient relationship–the doctor’s bedside manner. Many of us have experienced a doctor’s appointment in which we’re rushed through, talked down to, not listened to, and the doc doesn’t do a good job of explaining what’s happening. This does not help us feel better. In contrast, much of the benefit of CAM may lie in the experience of someone taking time to genuinely listen to us, thus calming us and giving us hope that we can feel better.
Bad Science is a fun, snarky read. Goldacre’s criticism of the CAM industry is very direct. At times he’s sarcastic and creatively belittling of alternative medicine. If you’re an advocate of CAM then you might get a little worked up and defensive. If you’re interested in getting a deeper understanding of all the confusing medical and pseudo-medical information around us, please get a copy of Bad Science. You don’t have to be a scientist to understand what Goldacre is saying. For more fun and good information, have a look at Goldacre’s site BadScience.net.
Behavior Change & Healthy Choices One Step at a Time
StandardWorking 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.
My Workouts These Days
StandardI’ve got strength goals and I’ve got endurance goals. Right now I’m leaning toward the endurance goals. I want to race the Run the Rocks 5k in October (my first race in two years). I’ve also been mountain biking a lot and it’s been an enormous amount of fun. Because of this I need to pull back on my lifting.
Overall, I’ll be doing less strength training and more endurance training. I recognize that if I increase exercise stress in one direction, I’ll have to decrease it in another direction. Otherwise I’ll very likely get injured and burnt out. What will this look like?
First, I’m going from lifting three days per week to only two per week. This will permit me to perform a higher volume of endurance work and I’ll be able to recover adequately. Next, I’ll change my goals. Previously I was working on strength and power. Now, I’ll work on strength and strength-endurance. My focus will be on the squat. One workout I’ll do a 3×5 (possibly progressing to a 3×3) routine to increase my strength and the next workout I’ll do a 20-rep set for strength-endurance. I still want to maintain my technique in the barbell clean, so that lift will remain in my workout, but at a reduced intensity and volume from before. Sadly, I will eliminate my beloved deadlift for a while. Finally, as an all over strengthener and a tremendous trunk exercise, the Turkish Get-Up will stay in my workouts every time.
Recognition of Chronic Pain as a Disease
StandardIf you’re suffering from chronic pain, then understanding how pain works is key to overcoming it. The New York Times has a pertinent article regarding this very strange issue from which so many suffer. Giving Chronic Pain a Medical Platform of Its Own highlights a growing understanding of chronic pain by some medical professionals (and a misunderstanding by many more medical pros). The main points are these:
“Among the important findings in the Institute of Medicine report is that chronic pain often outlasts the original illness or injury, causing changes in the nervous system that worsen over time. Doctors often cannot find an underlying cause because there isn’t one. Chronic pain becomes its own disease.
“When pain becomes chronic, when it becomes persistent even after the tissue and injury have healed, then people are suffering from chronic pain,” Dr. Sean Mackey, chief of pain management at the Stanford School of Medicine said. “We’re finding that there are significant changes in the central nervous system and spinal cord that cause pain to become amplified and persistent even after the injury has gone away.”
We see now that in many many cases, pain DOES NOT equal injury. (If you fall and bang your knee, cut your finger, or touch a hot stove then yes, the pain is quite indicative of an injury. These are acute injuries, not chronic pain issues.) Read the rest of the article for some of the latest ideas on pain science. If you want more excellent information on the very strange subject of pain, check out Body In Mind, a blog by pain researchers based at the The Sansom Institute for Health Research at the University of New South Wales in Australia.
Snacking & Weight Loss Psychology
Standard“The average American now consumes about 2,375 calories per day, about a third more than in the ’70s.” – Time Magazine
Snacking
Two articles may help you understand why so many of us are overweight and why it’s tough to lose the fat. First, Time Magazine gives us Snack Attack! Americans Are Eating More Between Meals. The information here comes from a recent study on Americans’ eating habits over the past 30 years. Among the findings:
“Analyzing data from four nutritional surveys conducted between 1977 and 2006 by the U.S. Department of Agriculture and the Centers for Disease Control and Prevention, the study found that Americans went from eating an average 3.8 meals and snacks a day to 4.9 a day over the last three decades — a 29% increase. The average American now consumes about 2,375 calories per day, about a third more than in the ’70s.”
A lot of this makes sense. Look at our opportunities to eat (another factor examined in the study). We’ve had food in the grocery store checkout for years but now we’ve got food at the Bed Bath & Beyond! I can get candy at Home Depot! I can remember when gas stations had a gumball machine and a cigarette machines–and that was it. Now the average gas station is packed to the gills with weird, low-nutrition/high calorie snack food. Garbage is everywhere and we’re eating it.
Your Brain on Weight Loss
The Huffington Post gives us Weight Loss Psychology: Why Your Brain Might Be Holding You Back. I love this stuff because I’m fascinated by brain function especially at it pertains to exercise. Anyone who’s tried to lose weight has discovered several things. First, everyone knows how to do it: Eat less. Exercise more. Easy? No way! The other thing we’ve all learned is that though weight loss is easy in concept, it’s diabolically difficult to pull off. There’s way more than a simple desire to lose weight. Our short-term pleasure typically wins out over our long-term healthy goals. I like this description of the struggle:
“What drives our behavior is not logic but brain biochemistry, habits and addiction, states of consciousness and what we see people around us doing. We are emotional beings with the ability to rationalize — not rational beings with emotions. If we are stressed, depressed or addicted, no matter how good the advice we are given, chances are that we will not be able to act on it. The more primitive, emotional brain generally has precedence over the newer, more rational brain.”
The article also gives suggestions to help address weight loss:
1.) Focus on a change of heart, not a change of mind. Losing weight through changing what and how much you eat doesn’t happen because you rationally decide to lose weight. You have to have a change of heart; that is, you must get in touch with your deepest, heartfelt desires.Your motivation may not be positive. Indeed, it may stem from a fear of loss. For example, you may not want to get sick. Or you may not want to be ostracized. To get in touch with your motivation, think about the negative consequences of not changing as well as the positive ones. Getting fit must become a priority and your life must be organized accordingly. Nobody can change you but you, and once you’ve made the changes, you need to stay focused. Successful individuals keep their motivation in the forefront of their minds all the time.
2.) Practice self-discipline. Self-control is a muscle that, like other muscles, needs exercise and strengthening. Change doesn’t happen because you want it to happen. Each time you resist temptation, you are developing greater self-control. Success breeds success. Facing down temptations builds strength for future decision moments. Some of my clients throw away their favorite food as a symbolic act that shows they have control over the food and not the other way round.
Self-discipline is required for behavior change, but does that mean that the lack of self-discipline causes obesity? No. That would be like saying aspirin helps a headache go away, so headaches are caused by a lack of aspirin — which is nonsense!
3.) Eliminate or reduce sugary, fat-laden foods. Such foods create physical changes at a cellular level that alter how our brains and bodies react. When analyzing your level of addiction, consider both physical dependence (changes at the cellular level) and psychological dependence (the habitual repetition of a behavior in an attempt to satisfy an emotional need). For example, how often do you use a sugary treat to lift your spirits?
What is often misunderstood is that these dependences exist on a continuum. You can be mildly, moderately or severely dependent, and the degree of dependence determines how difficult it will be to change.
4.) Make history your teacher, not your jailer. You can learn from your mistakes. Instead of [beating yourself up] when you fail to keep your promises to yourself, seek to gain self-knowledge so you won’t repeat the error. No one is perfect. Be sure to acknowledge what you are doing right, not just what isn’t working.
5.) Surround yourself with friends, family and colleagues who will support your effort. Getting fit and losing weight absolutely require others. Although you alone can make the changes you need to make, you can’t make the changes alone. Not only in terms of eating, but in all areas of our lives, we are much more influenced by other people than we imagine. One of the most potent forces for positive change is the emotional support of the individuals who surround you.
You must, however, ask for the support you need. Don’t assume that others know what would be most helpful to you. Similarly, you need to avoid those people who aren’t on the same page as you. Social pressure can work for you or against you. Hang out with the right people.
Gluten & Pain
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Several Sources of Gluten: Top: High-gluten wheat flour. Right: European spelt. Bottom: Barley. Left: Rolled rye flakes.
Gluten and ailments related to gluten such as celiac disease and gluten sensitivity have received a lot of press over recent years. It seems that more and more people are experiencing some sort of adverse reaction to gluten. Symptoms vary from mild to severe and may include various digestive issues, breathing issues, skin irritation, joint pain, and lethargy.
Recently I’ve been experimenting with getting the gluten out of my diet. I believe cutting gluten gluten has played a strong role in reducing in my various aches and pains, particularly my Achilles and heel pain. Are You Too Sensitive? is a recent article in Outside Magazine that provides some anecdotal evidence to support my observations.
As I mentioned at the start, gluten seems to cause some degree of distress and inflammation in a good number of people. This may not rise to the level of severe illness but it may be perceived as a threat by the nervous system. So now we’ve got dietary stress. Let’s add that to any number of the other stresses we have including job stress, money stress, or even the normally good stress of exercise. Maybe we’re not sleeping all that well–oh and our seasonal allergies are getting to us. At some point all this stress builds and the nervous system senses a building threat. We’ve got a threshold below which we don’t feel pain. Once our stress hits that threshold, things change. The nervous system which is always looking out for our best interest (survival) wants us to reduce this threat level. The result may be pain–an action signal–that will alert you to reduce your stress. And what better way to get our attention than via a nice efficient pathway such as our old back pain, knee pain or foot pain?
And gluten is everywhere! Bread, pasta, anything with malt or barley like beer, pancakes, pastries… Gluten is often found in sauces, ketchup, marinades, soy sauce and ice cream. It’s often found in processed meat. (Have a look here for a big long list of gluten-containing products.) So we’re swimming in gluten. While this stuff may not be so bad in small amounts, if we’re constantly consuming it then it may build to a toxic level. This chronically elevated gluten may well then contribute to chronic pain.
In addition to reducing my heel and Achilles pain, I believe getting the gluten out has helped me recover after tough workouts and bike rides. I noticed this maybe a week or so after eliminating gluten. Typically it was easy for me to either lift, ride or run to the point that I’d be sore to some degree for a couple of days. The result was my next workout would be inhibited. Now I can say with certainty that I’m simply not as sore as I used to be. This observation is echoed in the Outside Magazine article:
“That’s old news to Robby Ketchell, the director of sports science for the Garmin-Cervélo pro cycling team. Since 2008, riders have experienced improved post-ride recoveries, which Ketchell attributes to the team’s gluten-free diet. ‘When our guys ride, they’re tearing muscle fibers, and that creates inflammation in their bodies,’ says Ketchell. ‘We need to get rid of that inflammation so they can ride strong the next day. The last thing we want is something that causes more inflammation.'”
So if you’re struggling with chronic pain and you’ve tried many methods to address it, addressing your nutrition–and particularly your consumption of gluten–may be a way to move forward.
Threat neuromatrix
StandardBut hold on. How can something we eat contribute to something like Achilles tendon pain or plantar fasciitis? Well, pain does not always equal an injury. It is an action signal though, to change something. Sure, if you sprain your ankle or receive a cut or puncture wound, then the pain is fairly indicative of the injury. The pain may cause you to hobble to help preserve the damaged ankle or to treat the wound you’ve received.
In the case of chronic pain however, the root of the problem is rarely the site of the pain. Pain in a particular region may be there for any number of widely varied reasons. Pain may be present as part of a movement problem, lack of sleep, job stress, or even poor eating habits–or often a combination of these types of stress. I’ll elaborate more in a moment.
Feeling pain is also a skill. It’s like learning to taste wine, hear and play music, or acquiring the visual senses of an artist. Our brain and nervous system become efficient and skilled at doing something if we do it enough. The longer we feel pain in an area, the better we get at feeling pain there. So going forward, if the nervous system needs to get your attention, it will choose to create pain along a smooth, well-known, efficient pathway.
We often feel pain as part of something called the threat neuromatrix. Vital to this concept is understanding any type of perceived threat may generate pain. The brain can produce a pain signal in response to any stimulus or event that threatens our survival. Whether that event is emotional, physical, or even spiritual, if our brain perceives a threat to our survival there is a possibility that we will experience pain or a noxious event of some kind. How does this relate to gluten?
Know When to End Your Run (or Ride or Workout, etc.)
Standard“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.