Wednesday, February 28, 2018

Gym Etiquette: The Golden Rules

If there's one place our self absorbed
culture doesn't belong, it's at the gym.
"In my case, self-absorption is completely justified.  I have never discovered any other subject quite so worthy of my attention."  -Jay Dratler

In the natural order of things, important life lessons are passed down from generation to generation.  This paradigm, for it to function, assumes two things; great teachers and great listeners.  Sadly our society is littered with examples of the absence of both.  Take for instance the concept of selflessness.  Those great listeners who had great teachers learned at a very early age to have a greater concern for the needs and wishes of others than for their own.  And while that concept is foreign to many, at the very least we should strive to have an equal concern for the needs and wishes of others.  Yet our society today encourages selfishness in the guise of self-absorption.  This is no more evident than at our modern high volume low dollar gyms.  

I consider myself incredibly fortunate to have been taught the lessons of selflessness by great teachers.  In this case, my parents.  As a young person this broader lesson was specifically practiced in the one place that used to demand it...the weight room.  Thirty-five years ago the weight room that I visited was a different place; dark, dirty, loud, intimidating, and no nonsense.  It was, in fact, all of the things that today's fitness facilities are not.  But what it lacked in polish it more than accounted for with a very simple set of rules.  These rules, by their essence, promoted the life lesson of selflessness.  Modern gym members could make the experience better for everyone by following these simple rules created by the tank top clad lunks of my past.

Rule #1:  Never Obstruct A Mirror
In a weight room, mirrors have a number of uses.  One of them is monitoring exercise technique by providing immediate feedback to body positioning.  This is especially true in a "free weight" area where dumbbells are often combined with adjustable benches to perform specific exercises.  The open chain nature of these exercises makes the constant monitoring of the movement (by watching in the mirror) important to both safety and efficacy.  When you are in the free weight area make sure to pay particular attention to others around you and avoid, at all cost, walking or standing in front of their mirror while they are performing an exercise.  This sometimes means you may need to wait 10-20 seconds or walk an extra 10-20 steps so as not to interrupt the person actively performing an exercise.

Rule #2:  Don't Sit On The Equipment Between Sets
Most fitness facilities have selectorized strength equipment (ie. strength machines) that attempt to target certain muscle groups.  These strength machines are generally organized to be done in a circuit where the user performs one set and then moves to the next machine.  However, certain strength training routines require multiple sets of a particular exercise with very specific rest intervals between sets.  In that case it is proper to perform a set of the exercise and then stand up from the machine to allow someone who is waiting to perform their set while you rest.  This is particularly true if you are using a unique piece of equipment (ie. the only one of it's kind in the facility).  

Rule #3:  Take What You Need And Leave The Rest
It is only physically possible to use one set of dumbbells or one piece of equipment at a time.  Yet in the ultimate act of selfishness, some gym goers cache multiple sets of dumbbells and take residence on multiple pieces of equipment at one time.  Interestingly this tends to be the more "advanced" user who should be setting an example rather than perpetuating the character flaw.  Be considerate of others and use only one set of dumbbells or one piece of equipment at a time.

Finally, there is one additional rule that my father could not have imaged to teach back in the summer of 1983;

Rule #4:  Leave Your Phone At Home
Today's "smart phone" has become a great distraction.  The gym isn't the place to look at cat memes or post selfies sitting on the equipment (see above).  The gym is unique in that it really only has one assumed purpose...for working out.  Anything outside of that simply distracts from that objective, wastes time, and potentially reduces the benefit.  You'll get a better workout, waste less time, and potentially impact others less if you just leave your phone at home.  

Tuesday, February 13, 2018

Do, Try, Skip: Mobility Exercises, Pickle Juice, Ice Baths

Pickle juice contains a
chemical compound that just
may reduce cramps.
This series is intended to provide an informative and entertaining look at common practices in endurance sports.  The views expressed here are my opinions based largely on a combination of professional experience as an exercise physiologist and personal experience as an endurance athlete.

Sports training practices change over time.  Looking back a generation (or more) some things seem preposterous now.  But in their day and time they might have been considered cutting edge.  This "Do, Try, Skip" series will look at current popular training practices and provide guidance based on science (if available) and personal experience.  Today we look at three popular training practices; mobility exercises, pickle juice, and ice baths.

Mobility Exercises: DO
Endurance athletes spend a tremendous amount of time performing repetitive movements as they train for their sport(s).  And while the specificity of training principle states that to be a "better" runner you must run (or cyclist you must cycle), focusing all your attention on these movement patterns can create muscle imbalances that often lead to overuse injuries and time away from training.

Mobility is the ability to move quickly and easily.  It's clearly an important attribute to sport performance.  When we spend adequate amounts of time participating in our sports we develop specific adaptations that improve performance.  Unfortunately, these sport-specific movements (running or cycling) involve relatively limited range of motion in a handful of the articulating joints.  Over time the soft-tissues that support or move the joints can become shortened and dysfunctional.  These imbalances can cause a cascade of problems not the least of which is improper positioning of the joint capsules which may result in a reduced ability to generate force.  And for an endurance athlete this means one or both of two things; 1.) reduced sport performance and 2.) increased risk of injuries.

Adding mobility exercises to your training routine can help to improve soft-tissue and joint dysfunction caused by overused and shortened locomotion muscles.  Do this routine daily to improve mobility and sport performance.  Video courtesy of Kim Nedeau.  Check out her informative video series for endurance athletes.  

Pickle Juice: TRY
Every endurance athlete has had the experience of performance-limiting excruciating muscle cramps during a race.  And interestingly enough these sometimes happen in the context of cool weather and adequate hydration tactics.  In 2011, during my last attempt at the infamously brutal 7 Sisters Trail Race (Amherst, MA) on a cool and overcast day less than four miles from the finish I experienced a double quad cramp the likes that I had never before and not since ever felt.  It was so intense that I came to a complete stop and with legs that failed to bend at the knee fell over to the ground.  At the same time I was trying to fix the problem I was also quickly taking inventory of the possible causes.  The weather was perfect for a May trail race and I had been hydrating and eating like a champ.  This particular trail race, with it's unrelenting ups & downs, can be brutal on the quads.  In my effort to run a sub 2:30 I had hammered the first half attacking the descents with reckless abandon and fury.  All of that eccentric "braking" action during the downhills eventually took it's toll on the way back.

Research into the causes of cramps have recently led scientists to determine that the nervous system is one common and likely cause.  Alpha motor neurons are nerves located in the brain stem and spinal cord.  These nerves direct the skeletal muscles by telling them when to contract.  But when muscles fatigue the activity of these alpha motor neurons increases and stimulates the muscles to maintain a sustained contraction (ie. muscle cramp).  Skeletal muscle fatigue is a complex and multi-faceted event that may involve one or all of the following variables; repetitive muscle contraction, increased exercise intensity, increase exercise duration, environmental conditions (heat/humidity), and lack of training.  It is also suspected that repetitively contracting a skeletal muscle in a shorten state may also lead to increased alpha motor neuron activity.  Not surprisingly, during running the hamstrings, quads, and calves all contract in a shortened state.  These muscles tend to be the most common ones to cramp for this reason.  It's therefore not terribly surprising that my quads cramped after running the first half of 7 Sisters (particularly the descents) much harder than my training had warranted.      

So with some knowledge of why muscle cramps happen, the most important question then is what do I do to fix them?  Pickle juice has recently emerged on the ultra running scene as a somewhat mythical potion.  Athletes have retold stories of how it magically made their cramps disappear but how it works may surprise you.  While it's true that pickle juice is high in electrolytes, once consumed it may take up to 30 minutes for it to empty from the stomach and affect electrolyte levels at the site of muscle cramp.  This fact seems to belie that it works almost immediately.  Evidence now suggests that the feeling that you experience at the back of your throat when you drink this noxious pickle juice may be the secret to it's effectiveness.  

It appears that the chemicals in pickle juice (as well as in chili's, mint, cinnamon, ginger, & mustard) may very well be stimulating what are known as transient receptor channels (TRPs).  These excitable cells in the back of our throats convert chemical messages into electrical signals that help to control a number of sensations like pain, taste, hot, cold, and pressure.  These channels are activated by the chemicals in pickle juice and have the effect of reducing the activity of the alpha motor neurons and therefore relieving the cramp.

While the research is very promising and still evolving, the anecdotal evidence supports giving pickle juice (and similar products) a try.  Ideally it's best to prevent muscle cramps in the first place, but if you find yourself with a hyper-locked double quad cramp and someone offers you a shot of pickle juice...try it.

Ice Baths:  SKIP
We've all been tempted, mostly by peer pressure, to slip into a tub of icy water following a grueling race with the promise of accelerated recovery and reduced muscle soreness.  And despite as much folklore as the practice has received, it's benefits were actually questioned nearly a dozen years ago.  Subsequently there have been competing viewpoints on the subject with both camps (ice baths good vs. ice bath phony) digging in their heels.  

A number of systematic reviews of the literature have been done without a clear consensus on the impact of cold water immersion in endurance athletes resulting in the intended anti-inflammatory response.  In addition, many sports scientists are split on the theory of inflammation with some suggesting it's the root of muscle damage and therefore must be controlled while others suggesting that it is an integral part of the healing process and must be allowed to occur.   

Adding to the confusion are the professional athlete and ice bath advocates like Mo Farah, Ryan Lochte, and Lebron James who all purportedly use the practice.  It's completely conceivable that these and other followers feel a positive difference when they use ice baths.  These and other professional athletes are looking for any tiny advantage they can get as the margins for success are razor thin at that level.  Assuming there aren't any physical risks, if it turns out that the effects of cold water immersion are only placebo (ie. in their minds) then it may still be an advantageous.  

For the endurance athlete tempted to slip into that icy tub for the first time with the hopes that their recovery will be enhanced consider that the practice is not only incredibly uncomfortable, but the until the scientific community can come to a consensus it's best to skip it.

1.  Mobility - Moving Beyond The Buzzword, by Jim Shepherd
2.  6 Exercises For Maximum Mobility, Outside Magazine
3.  Does Pickle Juice Relieve Muscle Cramps?, The Cooper Institute
4.  Holy Cramp!  The Science of Exercise-Associated Cramping
5.  A Recovery Ice Bath Isn't (Always) Such a Great Idea, Outside Magazine   

Tuesday, February 6, 2018

Influenza & The Endurance Athlete

When it comes to the
influenza virus there's almost
nowhere to hide.
"I am sick and tired of being sick and tired."  ~Fannie Lou Hamer

Have you noticed that "something's going around" lately?  There's a better than average chance that you or a training partner has been sidelined with an illness in the last four weeks.  While athletes are generally the healthiest and heartiest in a population, they too are susceptible to catching what's going around and this time of year that generally means the flu.

According to the Center's for Disease Control and Prevention, influenza (the flu) is a contagious respiratory illness caused by influenza viruses.  While there are four types of the virus (A, B, C, & D), human influenza viruses A & B are responsible for seasonal epidemics almost every winter.   Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus;  the hemagglutinin (H) and the neuraminidase (N). There are 18 different hemagglutinin subtypes and 11 different neuraminidase sub types. (H1 through H18 and N1 through N11 respectively.)  Influenza A viruses can be further broken down into different strains. Current subtypes of influenza A viruses found in people are influenza A (H1N1) and influenza A (H3N2) viruses. *adapted from the CDC

The Flu Virus In Action
From the CDC
How It Spreads  
Scientists believe that influenza viruses spread mainly by tiny droplets made when people with the flu cough, sneeze, or talk. These droplets can land in the mouths or noses (ie. respiratory system) of people who are less than six feet away. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or even their eyes.  Most healthy adults may be able to infect other people beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some people can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others.  *adapted from the CDC

What Are The Symptoms?  
People who have the flu often feel some or all of these signs and symptoms that usually start suddenly, not gradually:
  • Fever* or feeling feverish/chills (*not everyone with the flu will have a fever)
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (very tired)
  • Some people may have vomiting and diarrhea, though this is more common in young children than in adults.
*adapted from the CDC

"The Flu Season"
From the CDC
The Impact To Endurance Athletes
While there are no ideal times to be sick, there are certainly times that are worse than others.  According to the CDC, the peak months for flu activity are December through March.  This time period represents important sport-specific preparation for spring events including marathons.  During this time every training unit is critical as volume is gradually increased toward key benchmarks.  Missing a single training unit will have little impact on the accumulation of fitness, but missing a week or more of training may result in a setback and prompt revisions to the training plan and reassessment of goals.  

Preventing The Flu
The CDC recommends a yearly flu vaccine as the initial and most important step in protecting against flu viruses.  As discussed earlier, there are many subtypes of the virus and all can cause influenza.  Scientist develop the vaccine each year to handle what is estimated to be the most common type(s), but it is never a guaranteed measure against getting sick.  Athletes should also consider the following every day practices to reduce the likelihood of getting the flu;

  • Try to avoid close contact with known sick people.
  • Limit the time spent in close contact with large groups of people.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose and mouth.
  • Clean and disinfect surfaces and objects that may be contaminated with germs like the flu.
Once You're Sick
Despite getting the flu shot and practicing good prevention measures, athletes sometimes get sick.  Identifying and dealing with the illness appropriately may lessen the burden on those within your immediate environment and help you return to training safely and effectively.

If during the months of December through March the symptoms listed above come on suddenly following exposure to individuals with known influenza there is a very good chance you have also contracted it.  Although because there are other respiratory illnesses that can also cause flu-like symptoms it's virtually impossible to diagnose the virus without a test.  Therefore, flu-like illnesses in otherwise healthy athletes are essentially handled the same way.

Most athletes with the flu (or other flu-like illnesses) have a mild illness and do not require medical attention or anti-viral medications.  If you do get sick in most cases it's best to stay home, rest, and avoid contact with other people.  Some individuals are considered high risk for developing flu-related complications and should consult their healthcare providers as soon as symptoms develop.  A full list may be found on the CDC website.

In an effort to lessen the burden on others and hasten your return to activity, it's wise to follow these practices when you're sick with flu-like symptoms;

  • While sick, limit contact with others as much as possible to keep from infecting them.
  • If you are sick with flu-like illness, the CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone for 24 hours without the use of a fever-reducing medicine.)
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Remain adequately hydrated.  Urine should be pale yellow color.
  • Hold all training activities for at least 24 hours after your fever is gone or symptoms have subsided.

Returning To Training
Once symptoms have gone and you're feeling back to yourself, the next challenge is determining the safest and most effective way to return to training.  Prolonged bed rest (30 days or greater) may have a profound effect on the cardiovascular, muscular, and skeletal systems.  These changes may include reductions in VO2max, skeletal muscle force production, and bone density.  Any illness causing bed rest of this duration should result in the complete redesign of a training plan to start from square zero.  The initial priority is the safe resumption of every day physical activity to eventually include a very low volume exercise program.  This approach may take up to six months to prepare an athlete to begin a structured and more rigorous training plan.

Most layoffs for endurance athletes however are a week or less in duration.  Nevertheless, the physiologic degradation of the cardiovascular, muscular, and skeletal systems happens on a continuum and should be considered when resuming training.  It may be assumed that early remodeling of the cardiovascular and muscular systems will be of greatest importance to the endurance athlete returning to training.  If you've been "in bed" with flu-like symptoms for a week or less it may be wise to consider the following return to training guidelines;

  • Missed training units should remain missed, do not push them ahead in the plan.
  • The first endurance-type training unit performed after a layoff should be an active recovery or easy training unit.  Avoid higher intensity workouts on the initial day back to training.
  • Strength training may need to be modified to reduce the volume by decreasing the intensity (ie. amount of weight lifted).
It takes a considerable amount of time off from training to result in significant decreases in fitness so many athletes may find their return to training fairly uneventful.  That said, it is still important to lower performance expectations in the 7-14 days following a typical layoff while physiologic adaptations occur.