Sunday, April 29, 2012

Stretch Your Way to Better Fitness
by Bob Wells, PES
Since grade school, perhaps from our first physical education class, we have all been taught the importance of stretching. From the casual runner to the elite athlete, we have long believed in the holy grail of the efficacy of stretching on the prevention of injury. Now, researchers are saying that we have it all wrong--that stretching does not prevent injury.
In a recent study on runners by Pereless, Roth, and Thompson half of the nearly 2,800 participants who met prerequisites for age, greater than 13, and mileage, self reported mileage of more than 10 miles run weekly, were given a 3-5 minute stretch protocol to follow prior to each running session. The other half were to follow no such protocol. The purpose of that study was to determine whether or not stretching was a significant preventer of injury. The authors of the study subsequently determined that stretching did not prevent injury.
While their study was indeed a thought provoking one about the efficacy of stretching on injury prevention, no responsible scientist, coach, or fitness professional should draw much from their conclusions. Their study is flawed, and I will focus on two of those reasons here:
1. The lack of a comprehensive assessment. No stretching protocol should be implemented prior to a proper assessment. Functional movement screens would alert a professional to any muscular imbalances and the likelihood of subsequent injuries due to said imbalances.

For example, limited range of motion at one joint or one muscle could be secondary to an issue at a neighboring joint. For example, if the quadriceps are tight, there is an anterior pelvic tilt of the hips. This increases the length of hamstring complex, which in turn decreases the range of motion of hip flexion.

Such information would necessarily alter the focus and duration of the stretching protocol, serving to correct those imbalances, altered biomechanics and arthrokinetic dysfunction (altered forces at the joint that result in abnormal muscular activity and impaired neuromuscular communication at the joint), thus decreasing the risk of injury.

In all fairness, the runners were to report injuries in the 4 months prior to their beginning the study. However, this self reporting does not necessarily allow time for biomechanical errors to manifest physically, since there may have been recent significant changes in their exercise regimen (e.g. duration, intensity). Biomechanical errors are a significant predictor of injury risk. Yet, they are not accounted for in this study, since no assessment for such errors took place.
2. Improper warm-up protocol. This study instituted a 3-5 minute stretch protocol for participants who were to stretch prior to running. However, NASM suggests a 10-20 minute stretch session prior to such activities. The NASM guidelines are supported and followed by the majority of Division I-A athletic programs. Coaches, such as the legendary track coach John McDonnell (42-time national champion at Arkansas) found such a 3-5 minute protocol "...,ineffective, irresponsible..". Typically, prerace routines, like those at Duke University and the University of Florida include a warm up run, usually 800-1200 meters, followed by a round of stretching. This cycle is repeated as necessary.

Other coaches, like Alan Stein, CCS,CSCS, the head strength and conditioning for national power Dematha Catholic, use to great success a dynamic warm up, which mimics many of the actions that the athlete will soon perform. Additionally, it prepares the mind for competition. While there may be disagreement on the which type of warm up is preferable, it is undisputed that one is necessary for optimum performance and prevention of injury.
 Without controlling for these two very important variables, it is no wonder that Pereless, Roth, and Thompson determined that stretching is not a significant preventer of injury. However, even if they had better accounted for these variables, they may not have found a direct link between stretching and the prevention of injury.

The primary benefits of flexibility are improved force production, jump height, and speed (Shrier, 2004), increased range of motion (Porter et al. 2002) (Sherry and Best, 2004), and proper arthrokinetic function (Clark, Essentials of Personal Training).
It is these benefits that improve muscular imbalances, altered arthrokinetics, and neuromuscular efficiency, which can in turn dramatically reduce the risk of injury due to biomechanical errors. While the correlation coefficient between stretching and the prevention of injury may not be statistically significant, it is readily apparent that a stretching protocol can be extremely beneficial when properly implemented.
Therefore, you should not simply eliminate the stretching from a pre-workout routine. Rather, consult a qualified professional (click to email) in order to set up a comprehensive evaluation.

They will then be able to design a 10-15 minute stretching/warm-up program based on that evaluation that will address any deficiencies as well as help you reach your fitness goals, quickly and safely.



Monday, April 23, 2012

Why Good Knees Go Bad
by Bob Wells, PES


As a trainer and running coach, I see my fair share of knee injuries. The most common of these is patellofemoral pain syndrome (PFPS), more commonly known as runner's knee. PFPS sufferers will usually experience pain beneath the kneecap that is usually at its worst after a workout.

"There tend to be three causes of injury to the knee," says Michael Stuart, M.D., vice-chair of orthopedic surgery at the Mayo Clinic, in Rochester, Minnesota, the highest-rated orthopedic department in the country, according to U.S. News and World Report. "Those stemming from acute trauma, those which are degenerative in nature, and overuse."

In fact, between one half and three quarters of all running injuries are related to overuse. Knee problems dominate overuse injuries, with PFPS leading the pack. According to a two-year study of more than 2,000 runners completed in 2002 by the University of British Columbia, for example, most running injuries treated at the center occurred at the knee, with patellofemoral pain syndrome making up nearly half, 46 percent of those injuries. The next most common knee injuries were iliotibial band friction syndrome, meniscal injuries, and patella tendinitis (see "Where Does It Hurt?").

Diagnostically, PFPS produces minor to severe pain that can be elicited after a short distance while running, while under load (e.g. squatting), while unloaded for an extended period of time in the bent position, such as sitting, or after palpation under the lower corner of your knee cap.

This makes sense, "because bending the knee increases the pressure between the patella and its various points of contact with the femur. Patellofemoral pain syndrome is often classified as an overuse injury", says Mark S. Juhn, M.D., D.O. "However, a more appropriate term may be 'overload,' because the syndrome can also affect inactive patients. Repeated weight-bearing impact may be a contributing factor, particularly in runners. Steps, hills and uneven surfaces tend to exacerbate patellofemoral pain. Once the syndrome has developed, even prolonged sitting can be painful (“movie-goer's sign”) because of the extra pressure between the patella and the femur during knee flexion".

PFPS struck women in the British Columbia study twice the rates as men, and struck those under 34 more frequently than it did those who were older. Females appear to be affected more often than males, because the increased width of the gynecoid pelvis leads to results in an exaggerated Q angle--the Q angle is a measurement of the angle between the quadriceps and the patella tendon--which is believed to cause patella tracking issues.

According to conventional wisdom, PFPS happens when a kneecap has pulled to the side of its track and rubbed something where it should be gliding. The reasons given for this 'patella-tracking problem' have long been a mixed bag: the runner is thought to have poor biomechanics or bad bone structure; the runner followed bad training advice or owns bad shoes; the runner doesn't possess adequate quadriceps strength or exhibits excessive hamstring or lateral-tendon tightness.

"For many runners weak or tight muscles are the culprit," says Jordan D. Metzl, M.D of New York City's Hospital for Special Surgery. " If your upper-leg and core muscles are under conditioned, your pelvis will wobble as you run. This stress the knees and can cause runner's knee."

He suggests the following moves to target the upper-leg and core muscles to help make your knees more stable and less prone to injury. Do these and enjoy your next run, pain free.

1. Quadriceps and Hip Flexor Roll (click for video).  Lie facedown on the floor with a foam roller positioned just above your knees. Place your elbows on the floor for support. Roll your body until the roller reaches the top of your thighs. Then slowly roll back and forth.






2. Squat Thrusts (click for video). Stand with your feet hip width apart. Push your hips back and bend your knees. As you squat down, place your hands on the floor.   Kick your legs backward, so that you're now in a push-up position. Quickly bring your legs back to the squat position. Stand up and repeat the movement. Do for 40 seconds, rest, and repeat.



3.Lateral Lunges (click for video) Stand with feet hip width apart, toes forward. Shift your weight to your right leg as you push your hips back. Your lower right leg should remain nearly perpendicular to the floor, and your left heel should be down. Lunge to the left. Alternate back and forth for 40 seconds, rest, and repeat.



















Friday, April 20, 2012

The Cure for Cellulite?
by Bob Wells, PES

As the days tick toward Memorial Day, aka "the unofficial start of summer", beach goers everywhere are increasingly concerned with how they will look in their stylish, new bathing suits. For women, like the one pictured on the right, this concern is particularly salient, because of cellulite, a condition characterized by the cottage cheese like dimples that appear on the back of many thighs.

There has been a lot of information, and misinformation, about cellulite that has confused many around the globe. What are the causes? How do we get rid of it? Let's start at the beginning with what is cellulite, and why does it happen.

Cellulite is the accumulated adipose tissue, fat, that appears as dimple like protrusions on the back of many women's legs. Women's skin, rather their connective tissue is not as thick as men's is, thus allowing the fat to push through the connection tissue to alter the shape of the skin, the dimple like appearance on the skin. This coupled with poor circulation is also a major factor in the development of cellulite, which affects between 80 and 95% of women, according to Fit Sugar.

There are other factors that can affect the size and the appearance of your cellulite. Some of these include:
  • Poor diet- an imbalanced or calorically inappropriate diet can negatively affect the body's metabolic rate, increasing fat deposit. (Click here for more info about diet, or email Organic Experience)
  • Fad dieting- by drastically restricting calories, your body goes into "starvation mode", converting the precious incoming calories into fat.
  • Lack of physical activity-not working out regularly lowers your caloric output, 
  • Dehydration- improper hydration causes the body to store contaminated water subcutaneously, the liver is then diverted from its task of breaking down triglycerides (fats) and instead has to filter the water. 
  • Total body fat- although lean women may have cellulite, reducing your body fat, via resistance training can reduce or potentially eliminate cellulite.
The treatment for cellulite is usually done in one of the following ways:
  1. Massages: Endermologie (pictured on the left), a massage technique developed in the 1980s, is believed to temporarily remove cellulite, by increasing proper blood flow to and from the affected area. These massage treatments require two sessions a week at $75 to $300/hour.
  2. Creams: Another option are creams. Caffeine is in almost every cellulite-reducing cream that shows any benefit, because it helps blood flow to the skin and functions like a diuretic, flushing you out. Another ingredient popular in creams is Retinol. Retinol is believed to work by being able to penetrate the skin, exfoliate it, and increase collagen production, which makes skin thicker and hides the dimpling fat. However, too much can dry out the skin and cause it to redden. For more cream options, check out the line at Sephora.
  3. Laser Treatments: Laser sessions work primarily by reducing fat and increasing blood flow to reduce the size and appearance of cellulite. Treatments can range on average from $500 to $1000 for each session. 
  4. Exercise: Aerobic exercises, like jogging and swimming, and anaerobic (resistance training) help reduce cellulite, albeit in different ways. Aerobic exercises work because they increase blood flow and lymphatic circulation. Anaerobic exercises work because they metabolize fat and convert it to muscle. For sample exercises, check out Four Great Moves to Tone and Firm Your Glutes
However, Catherine Saint Louis writes in the New York Times that " rumors of a cure are greatly exaggerated". She quotes Dr. Molly Wanner of Harvard Medical School, who says that "A lasting remedy would have to address the interplay between skin, fat, connective tissue and underlying muscle". 

The first three options are merely temporary solutions, but exercise, coupled with a good diet (click here for sample plan), is the best option to permanently reduce or remove unwanted cellulite, and keep it away. So, put down the junk food, and pick up the weights. What have you got to lose? Besides unwanted fat.







Tuesday, April 17, 2012

Get Your Butt Ready for Summer!

                                     Four Great Moves to Tone and Firm Your Glutes
by Bob Wells, PES

Summer is coming, the heat and beachwear in tow. Don't fret if you're not yet ready to strut your stuff on the sand, I am here to help. Do the following workout two to three times a week. Warm up with a  5-10 minute jog. Do the following exercises in order, completing the circuit three times, and get ready for a jaw-dropping summer!
Lateral Lunge



1. Lateral Lunges (Click for video).  Start with feet about hip width apart. Lunge to your right. Keep your left leg straight, to put greater emphasis on your inner thigh. Do 12 repetitions, then repeat on the other side.  







Front Squat
2. Front Squat (Click for video.) Start with feet hip width apart, holding barbell or dumbbell as shown. Drop until your thighs are parallel to the floor. Return to the start position. Do 12 repetitions.









3. Dead lift (Click for video.) Start with your feet hip width apart, barbell in front of you. Arms should  be fully extended, back flat and head up, bar gripped firmly with both hands. Stand up, without rounding back. Return to the start position. Do 12 repetitions.









  4. Jumping Squat Thrusts (Click for video.)  Stand with feet shoulder width apart. Quickly squat as low as you can, palms flat on floor shoulder width apart. Kick your legs out behind you, putting you in a push up position. Quickly jump your feet back to the squat position, then jump as high as your can, bringing your hands overhead. Do 12 repetitions. 



Monday, April 16, 2012

Exploring the Relationship between Water and Fat Loss


Numerous studies over the years have shown the many benefits of drinking water, with the most salient one being the prevention of, or the alleviation of dehydration and its insidious side effects. However, it is its purported efficacy on weight loss, or rather more importantly fat loss, that has people closely reexamining their relationship with drinking water.
There is no doubt about the significance of water, especially when we consider that our bodies are comprised of 40-65% water, depending upon our body composition. Fat weight is 18-26% water, whereas muscle is comprised of approximately 72% water. So, the more muscle that we have, the more water that there is in our bodies. Therefore, diets and activities that result in excessive fluid loss will have a significant affect on muscle size, and therefore weight.
However, this weight loss, due to dehydration, should be viewed negatively because of the detrimental effect that is has on athletic performance and metabolic functioning. In other words, dehydration adversely affects our bodies' ability to burn calories both in the short term and long term. It is readily apparent how this is so in the short term, but let us examine the negative effects of dehydration on long term metabolic functioning.
Due to dehydration, the body attempts to store as much water as possible, most of it subcutaneously. This retained water becomes contaminated since your kidneys can't filter out the contaminants properly when you are dehydrated. The liver is then called upon to help process and dispose of the contaminants, which interferes with one of its other main functions, which is breaking down body fat. So, without sufficient water in your body, you are likely to end up bloated, and obese.
The obvious solution then is to remain properly hydrated, but what that entails is unknown to many people. The National Academy of Sports Medicine (NASM) recommends that the average adult female consume at least 72 ounces (9 cups) of water daily and the average male at least 104 ounces (13cups) each day. However, further consideration should be given to strenuous exercise and warm climate, which could necessitate an additional 60 ounces of water intake.
Proper hydration has an added thermogenic effect, burning as much as an additional 100 calories daily. It improves endocrine gland as well as liver functions, increasing the percentage of fat used for energy. The short and long term benefits of hydration are a boon for our attempts to lose fat. So drink--to your health.
Bob Wells is a nationally certified personal trainer, as well as a former Division I athlete and coach. He can be reached at bob.wells@alumni.duke.edu.


Tuesday, April 10, 2012

The Truth about Skinny Fat



The Truth about Skinny Fat (Part 1)
By Bob Wells, PES
April 10, 2012

The phenomenon of skinny fat has become part of our collective consciousness, and the term part of the lexicon of any gym goer or reader of Self, Shape, or Women’s Fitness. But what’s wrong with being skinny fat?

A lot it turns out, including increasing risks of heart disease, stroke, and diabetes. We normally associate such health issues with people who are overweight or obese. (Note the following BMI chart for an example of overweight or obesity.)

Height
Weight Range
BMI
Considered
5' 10"
124 lbs or less
Below 18.5
Underweight
125 lbs to 168 lbs
18.5 to 24.9
Healthy weight
169 lbs to 202 lbs
25.0 to 29.9
Overweight
203 lbs or more
30 or higher
Obese

It is true, according to the most recent research, obese people are more likely to have more cardiovascular risk factors than their slim counterparts. However, in a 2008 report in The Archives of Internal Medicine, the findings indicated that at least 50% of overweight people and one-third of obese people are “metabolically health”. This means that despite their excess weight, they have healthy levels of blood glucose, blood pressure, “good” cholesterol, and other risks for heart disease.

This same study reported that one out of four skinny people, as measured by weight, have at least two risk factors normally associated with obesity. This has led to a paradigm shift about weight as a reliable indicator of overall health. It has instead started to shift the focus to body composition, or percentage body fat.

BMI which determines appropriate weight, relative to height, doesn’t factor in muscularity accounting for extra poundage.

For example, according to BMI charts, the NFL running back, Thomas Jones, pictured left, is considered obese at 5’10, 215lbs, and yes 5% body fat (10-19% is norm for males, 18-26% for females). While BMI doesn’t take into account the person’s build, body fat measures help to give a better, more complete picture of one’s fitness level and potential risk factors.

In a study published in The Journal of the American Medical Association, researchers looked at death rates among nearly 3,000 adults, aged 60 and older over a period of 12 years. It was no surprise that death rates were highest among those with a B.M.I of 35 or more. However, the most striking finding was that fitness level, not B.M.I was the strongest predictor of mortality risk.

So, what’s wrong with being skinny fat? A lot.
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Bob Wells is a nationally certified personal trainer, as well as a former Division I athlete and coach.  He can be reached at bob.wells@alumni.duke.edu

Monday, April 9, 2012

Sculpting the Perfect Body: One Bite at a Time

Sculpting the Perfect Body: One Bite at a Time
By Bob Wells, PES
April 9, 2012

It’s not too early to get ready for spring, and it will be here before you know it. That means seeing the likes of Ryan Reynolds, Beyonce, Ryan Gosling, and Jessica Alba in bathing suits; their amazing bodies on display for the entire world to see, and to be jealous of. But you don’t simply have to admire their bodies; you can build the body of your dreams, and be the object of envy as you stroll down the beach.

There are three primary keys to sculpting a great body: proper training, proper rest and recovery, and proper nutrition. It is this last, crucial component that many neglect, thus limiting and delaying their chance at truly altering their body. So, what is proper nutrition?

Let’s start with the basics. There are three macronutrients that the body needs to function properly. They are carbohydrates, proteins, and fats.

Carbohydrates often get a bad rap, but they are your body’s main source of energy. Each time you consume carbohydrates, your pancreas secretes the hormone insulin. Insulin attaches to amino acids--the building blocks of proteins--and stores them in muscle cells so that they can be used for recovery and repair.

However, excessive amounts of insulin lead to the extra calories being stored as fat, thus creating a fat-storing machine. It is not the carbohydrates themselves, but rather excessive carbohydrate intake that can lead to being overfat. The key then, is to consume the proper amount, and type of carbohydrates at the proper time.

There are two types of carbohydrates, complex and simple. Complex carbohydrates, like whole grains, enter the bloodstream more gradually, thus providing consistent energy throughout the day. Simple carbohydrates, like fruits, enter the bloodstream rapidly, thus providing a quick energy boost. However, if the energy is not needed, the insulin will help to store those calories as fat. As a general rule, more of our carbohydrate intake should be of the complex kind.

The second macronutrient is protein. Proteins are the building blocks of lean muscle tissue. Protein allows the body to build muscle and burn fat efficiently. Protein can help increase your metabolism by 20% each time you consume food containing it. It also time releases carbohydrates in the form of glucose so that you have energy throughout the day.

While protein itself will unlikely be stored as fat, consistent caloric consumption great than needed, will lead to an increase in fat.

The third macronutrient is fat. Fats have two primary functions: They are responsible for joint lubrication. Additionally, hormones are manufactured from fats.

A lack of proper amounts of dietary fat will lead to a drop in hormonal production and numerous chemical reactions will be interrupted. This dysfunction leads to a cessation of the production of lean muscle. Your body will then begin to accumulate additional fat to resume its normal hormonal functioning.

Therefore, in order to maintain an efficient metabolism, you must consume healthy fats. Healthy fats include, but are not limited to mixed nuts, avocados, extra virgin olive oil, fish oil, and ground flax seeds.

We now have a better understanding of the 3 macronutrients, and their effects on the body. We now must determine how much to eat and when to eat each of the macronutrients. A great source for understanding this is “The Essentials of Sport and Exercise Nutrition” by Dr. John Berardi. In it, he advocates for five habits that “…will naturally lead to an improvement in calories control, nutrient timing, and food selection.”

Habit 1: Eat every 2 to 4 hours. Contemporary research shows that regular “feeding intervals” stimulate metabolism, balance blood sugar levels, help prevent overeating as a result of hunger, and help the body burn extra fat mass while maintaining lean mass. This habit also ensures that active people, who have greater caloric demands, can meet those caloric needs without eating calorically dense foods that promote fat storage.

How big should these meals be? Obviously there is variation in people’s body sizes, body fat percentages, and level of activity, so there will be variation in the size of the meals. However, it is not necessary to get bogged down in the details in the inchoate stage of implementing these habits, as meal sizes will naturally fall into place when using all of the 5 Habits.

Habit 2: Eat complete, lean protein with each feeding opportunity. Some good proteins are lean red meat, salmon, eggs, low-fat plain yogurt and supplemental proteins, such as milk protein isolates or whey protein isolates. Some experts claim that additional protein is harmful or unnecessary. However, contemporary research is pretty clear: a high protein diet IS safe, and may be important for achieving the best health, body composition, and athletic performance. By following this habit, you will ensure adequate protein consumption, stimulation of the metabolism, improved muscle mass and recovery, and reduction of body fat.

Habit 3: Eat vegetables with each feeding opportunity. Science has shown us that there are numerous micronutrients (vitamins and minerals) contained in vegetables. Vegetables also contain important phytochemicals (plant chemicals) that are essential for optimal physiological functioning. Vegetables, and fruits for that matter, provide an alkaline load to the blood. This is important considering the following: proteins and grains present acid loads to the blood, so it’s important to balance these acids with alkaline rich foods, such as fruits and vegetables. Too little alkalinity and too much acid lead to the loss of bone strength and muscle mass. Eating two servings of fruit/vegetables at every meal to ensure this balance. This way, you are more likely to get “…10 servings of cancer-fighting, free-radical-destroying, acid-neutralizing, and micronutrient-rich power per day.”

Habit 4. For fat loss, eat “other carbohydrates” only after exercise. This timing strategy works well in those with stubborn and hard-to-remove body fat stores. It also works well for minimizing fat gain in those interested in gaining muscle.

Habit 5. Eat healthy fats daily. As we discussed earlier, some healthy fats include monosaturated fats such as extra virgin olive oil, some nuts, and avocado and polyunsaturated fats, from some nuts, some vegetable oils, and fish oil supplements.

Following the 5 Habits is certainly a step, a big step in fact, in the right direction when it comes to building the body that you dream of. However, like any system, there are shortcomings. The 5 habits don’t provide prescriptive nutrition or exact caloric guidelines. Instead, it relies on nutrient timing and food selection to regulate overall food intake and manage hunger. However, by not requiring calorie counting, this strategy is easy to understand and apply to our daily food choices, guaranteeing a well balanced diet.

Another shortcoming of this method is that carbohydrate intake might be too low for more active individuals. Without proper carbohydrate intake, these individuals might be sapped of strength to conduct their workouts, limiting their ability to reach their fitness goals. This shortcoming is easily solved by individualizing dietary recommendations based on current level of activity and goals, to ensure the proper macronutrient split.

Despite these shortcomings, the 5 habits is a great strategy to implement. We become more aware of what healthy food choices are, and how to incorporate them daily into our lives, on a meal to meal basis. What makes a healthy diet is now demystified, and we can take the next step to an awesome body. One bite at a time.

Bob Wells is a certified personal trainer and former collegiate athlete and coach. Mr. Wells can be reached at bob.wells@alumni.duke.edu