Why I Say Little About Diet/Something About Diet

I have the opportunity to work with a handful of high level athletes. These individuals (and their parents) regularly make great sacrifices of time and comfort in order to achieve exceptional performance on the athletic field. I hope they learn a process that will stick with them after their athletic careers.

I also train and rehab a few middle-aged folks interested in improving their health, ability to function well, and their general awesomeness. They reserve an hour or two of their busy weekly schedules to spend time with me.

Nutrition is important for both of these groups. In all instances, it would be a shame to spend all that time and effort in training and come up short on the nutrition front. Your diet needs to match your training goals. But rarely do I broach the subject.

One human telling another what and how much they should be eating strikes me as an extreme over-step.  Twenty three year-old fitness gurus do it all the time on social media. In the end,  only -you- will truly know what works best for you. It’s a process that requires months and years of attentive experience.

Besides that, the whole subject is…touchy. What we eat is rooted in culture and expectation, emotion, billions of dollars the food industry spends on marketing (not just talking about fast food, but also “healthy” food chains), a boat load of science and even more quackery. Body image, self confidence, and control issues abound. When something…anything is wrong with your heath or general life, someone will tell you assuredly that the problem is because of your diet (whether or not that may be the case.)

Some people have a predisposition to weight gain, be it good (lean) or bad (fat) weight. Others struggle to gain but have an easy time staying lean. Lastly, everything from genetics to socioeconomic status to personal preference has legitimate implications on what “good” advice would look like.

And finally, this is not my specialty. My expertise is physical rehabilitation and optimizing human movement. Contrary to what the social medias would have you believe, neither a semi-related degree nor a set of abs justify making proscriptive statements on someone else’s diet.

With that being said-here is something about diet. ; )

-For weight loss and weight gain (both optimal performance and getting jacked), diet is critical. Don’t let anyone lead you to believe that a -precision- workout and training plan is the most important thing. Your diet is more important than your exercise regimen.

-The -quality- of weight gain and loss is going to be dictated by what you do. Gaining muscle requires consistent strengthening exercise. Carrying muscle helps tremendously with losing weight (fat) and keeping it off. Having strength, balance, mobility, and a tolerance for discomfort (all from your training program) help you to be capable of doing more, and feeling like doing more during the 98% of life spent outside of your workouts.

-There is a lot ($) to be made in the next diet fad. “Eat this during these specific time intervals, avoid eating that, and make sure to count and monitor this while supplementing your diet with that specific brand of these supplements.”

There is not much money to be made in telling people to get the basics dialed in for at least three months before even considering anything else. The basics?

YOUR 10-POINT CHECKLIST PRIOR TO CONSIDERING ANY SPECIFIC DIET OR SUPPLEMENT REGIMEN:

  1. Choose minimally processed foods when possible.
  2. Load up on fruits, vegetables, and lean proteins.
  3. Limit but do not altogether quit treating yourself. You cannot have it all. But you can and should live a little.
  4. Focus on altering behaviors and patterns far more than specific macros, calories, or ingredients. Commit to a plan for your goals and be mindful
  5. Measure your foods for a short time to get an idea of portion sizes etc. But other than that, quit stressing about it. No measurements for you!
  6. Willpower comes and goes three times a day. Create and lean on good habits to carry you through.
  7. One metric worth the time and effort to track is simple: the ratio of eating well to eating poorly. Most adults will make tremendous progress if they eat well 9 out of 10 times and sometimes eat what they feel like. Tie a string on your fingers if you need to.
  8. Limit your options to a handful of good choices, in just about any way that you see fit. You do not need a 500-page diet book to do this for you! “Bored and satisfied” works a lot better than hungry and always having to think about what you are eating.
  9. Shut the TV and phone off and get some sleep! This is critical for all health and performance goals. Because, hormones and stuff. Plus, your resolve to stick with any goal and plan will be all the greater.
  10. Practice gratitude, for our perspective is truly rare and skewed. Many people throughout most of history ate what and when they could to survive.

[For related reading, I do offer my own Diet System…found here.]

For gaining -lean- bodyweight. Plan ahead to eat a lot of nutrient dense foods often. If you are hitting the weights regularly, between 12 and 25 years of age, and taking in -mostly- quality calories, your body will have a VERY hard time putting on anything but muscle. Treat yourself sporadically, around 10 to 20% of the time, depending on your needs and inclinations.

For losing weight but keeping muscles, dial in your life patterns so that you are not often caught off guard. Don’t obsess over the details, and eat like an adult. Most -good- foods have a mix of protein and fat and carbs. You know what crap is. Paleo or low carb/low sugar bars, cookies and cakes are still crap.  You will find that avoiding crap is a lot easier when you know that you can treat yourself 5 to 10% of the time, depending on your needs and inclinations.

So, there you have it. Remember, I’m just a guy with an opinion ; )

Thanks for asking!

For further reading from a team of legitimate experts, two of my favorite sources are Precision Nutrition and Examine.com. Read these thoroughly before you listen to supplement canisters and the Shaklee or GNC sales reps.

Are Stem Cells Snake Oil?

Stem cells make for great discussion of the modern day marketing of medicine.

For some, stem cell injections are a broad and exciting field of scientific inquiry and pain relief. For others, they are pure snake oil sold for approximately $2000 per vial.

So which one is it?

Whatever the case, the advertising gives an easy “tell.” Is the doctor or medical facility making unreasonable claims and guaranteed promises that play off fear, desperation, and the plain realities of aging? Being more realistic and careful with promises makes for ho-hum marketing. But what kind of outfit would you really want to work with?

When a product or procedure is marketed as a  -new- -miracle cure-  -for everyone with…-  you should be skeptical. This includes physical therapy! A local colleague of mine (rhymes with Schmadden) has built a large profit margin and entire team of physical therapists in part through the advertising slogan “Pain Free [Back/shoulders/knees/feet].”

Either his entire team of physical therapists, including all the new graduates, have far superior clinical skills than I, or there are a LOT of people walking around central PA who are a bit disenchanted because the treatment didn’t live up to the promise of pain free.

People with joint aches and pains frequently ask whether or not stem cells may help their condition.  I’m rarely optimistic about these types of treatments, and I have yet to hear from anyone who has experienced significant or long lasting benefit. That doesn’t mean they are worthless, or that all marketing is bad.

Shouldn’t we be asking some questions first. Why are we doing this? How does it work? How much and for how long is it likely to help? Are there side effects?

Stem cells have been claimed to help cartilage, bone, tendon, and ligament problems. That’s a lot of different tissue, with different metabolism, and different response to hormonal factors and mechanical loading, to begin with. A person with knee pain may not care if the target tissue for treatment is ligament or cartilage, or if the injection is placed inside or outside of the joint capsule. But to scientists, doctors (and physical therapists) this is basic and essential information to define before making any recommendations.

Some literature shows that stem cells can help with specific issues, such as mild to moderate cases of knee osteoarthritis and elbow tendonitis. But when you look closely at the studies, they show much variety in terms of what exactly is being injected, how the formula is produced, and where and how often it is being injected.

If you don’t believe me, that’s what people like this team of researchers in that “bizz” are saying:

We still do not know exactly how and why the injected cells -may- aid in recovery. Are the stem cells integrated into the damaged tissue? Do they provide support or stimulate the existing cells to heal? The research does show that milder the arthritis, the more likely the benefit. Multiple injection into one site leads to increased risk of adverse reactions. When and where the injections are effective, the benefit usually lasts for six to twelve months. One study showed that stem cells are slightly more beneficial than corticosteroid injections.

All that being said, I would like my skepticism to be proven wrong. I have a stiff and sometimes painful arthritic hip. I’m certainly in favor of finding new ways to help people feel and function better. As a physical therapist, my primary problem with Stem Cell injections is that it’s just…so…

Passive.

Joint wear and tear, whether over a day or a lifetime, never exists in isolation. But passive and less-than holistic solutions seem to be the American way.

Imagine two very real scenarios.

34 year old patient suffered a knee sprain 10 years ago, and now shows mild knee arthritis and a tear of the meniscus. He has good alignment, strength, and range of motion at the other joints and is reasonably active, neither an exercise addict nor a couch potato. His pain persists despite refraining from high impact exercise.

54 year old diabetic patient with knee pain is 35 pounds overweight, has inflexible and weak hips, has minimal great toe extension and walks with his feet turned outward which places a twisting force at the knee joints with every step.

Which of these patients has a greater likelihood of experiencing a year of modest benefit from stem cell injections? Doctors and medical centers can and should address these types of challenges when recommending this type of treatment. Some may be realists, and others will advertise like stem cells will fix everything.

As usual, the actual science makes for less than stellar marketing. Until more is known regarding the particulars of stem cell injections, you should probably try to identify and address postural issues and movement dysfunction ; ). If you do, I guarantee health, happiness, fame, and fortune ; )

— – — — — — — —

Further reading-

Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses.
Campbell KA1, Saltzman BM2, Mascarenhas R3, Khair MM2, Verma NN2, Bach BR Jr2, Cole BJ

Arthroscopy. 2015 Nov;31(11):2213-21. doi: 10.1016/j.arthro.2015.03.041. Epub 2015 May 29.
Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses.

World J Stem Cells. 2014 Nov 26; 6(5): 629–636.
Published online 2014 Nov 26. doi: [10.4252/wjsc.v6.i5.629]
PMCID: PMC4178263
PMID: 25426260
Stem cell application for osteoarthritis in the knee joint: A minireview
Kristin Uth and Dimitar Trifonov

J Knee Surg. 2018 Nov 13. doi: 10.1055/s-0038-1675170. [Epub ahead of print]
The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis.

Stem Cell Res Ther. 2016 Sep 9;7(1):131. doi: 10.1186/s13287-016-0394-0.
Secreted trophic factors of mesenchymal stem cells support neurovascular and musculoskeletal therapies.
Hofer HR1, Tuan RS2.

Happy Entropy

…And that is why the Blessed will say “We have never lived anywhere except in Heaven, : and the Lost, “We were always in Hell.” And both will speak truly.”
– – – – -CS Lewis, The Great Divorce

Last week at the Dillsburg Farmers Fair, I looked at a series of dilapidated houses lining Baltimore Street. Normally they would be an eyesore, but they fit perfectly well in October; as if someone went all-in for Halloween.

A rotten faced Jack-o-lantern supervised the street from the porch next to me. My face was literally a battleground between a couple faint tangential sun rays and the crisp breeze. Second-hand cigar smoke overwhelmed the smell of decaying leaves.

‘Tis the season for entropy. It’s a time to consider the rot, rust, cold, and systems winding down to the end of their season. Do we deny the dark? Should we fear God as anti-autumn?

Sometimes Halloween seems like the new (cultural) Christmas. There’s tradition and community togetherness with only a small fraction of the materialism, pressure and obligation. In our small development, neighbors that are seldom outside and drive by without so much as a nod are suddenly welcoming and generous with their time.

Fall is a humbling reminder of our brevity, our limitations, and the ultimate fate of our corporeal being. This is reality, not dabbling in the occult. There is too much evil among the living during all seasons to worry about the Field of Screams and whatnot among the dead.

Must we deconstruct the heebie-jeebies? Shouldn’t apparitions reflect light (to be seen) -or- be able to walk through walls?  Why would they ever be seen in clothing? Does ghost clothing also go to the “other side” and defy the basic laws of matter? The physical form and function of most monsters and zombies would never work anatomically. Something limping and bumbling along like that could easily be avoided before getting close to your brains.

But seasonal affective disorder is very real. And our ability to consider mortality and wonder what’s next – this I take seriously. Have you ever attempted to truly plumb the depths of a rotten jack o’lantern?

To me, the most frightful, hideous idea is a world where entropy is the bottom line, cold, black, and eternal. Winter is indeed coming.

But then so is the light! All you ever need to do is wonder why and from where came the light!

  • – – – –  – – – – –

He has made everything beautiful in its time. He has also set eternity in the human heart; yet[a] no one can fathom what God has done from beginning to end.                                  Ecclesiastes 3:11

 

Firewood Warms You Twice

There is something about the first cold weather front in October that makes me want to collect firewood. It is an almost unconscious move from the deep marrow, something like the “nesting instinct” that many women report late in pregnancy.

I do not own a wood burner or real fireplace. My wife calls our efficient, clean gas fireplace “The Lamp.” Something seems plain wrong about making a fire with the flip of a light switch.

My parents never had to seriously farm or scramble to get by on back-country living. But thirty or so years ago when I became of age, my father asked me to help cut, split, haul, and stack firewood. Two or even three times per year, I drug myself through the boring menial task that stole a few hours of basketball, hanging out, and video games. Being young and foolish, I viewed this task as a barrier to getting to the gym for a real “work out.”

No matter the season, by the time we were sweating in the middle of our labor, dad would repeat what his father told him, and has likely been handed down through generations of our ancestors.

“Firewood warms you twice.”

I often wonder what my great great grandfathers would think of “functional training,” the chops, lifts, lunges, and reaches that I prescribe and demonstrate to my physical therapy clients. Dealing with a downed tree trunk is real work that demands total body strength and balance. Splitting, lifting, carrying, and stacking firewood requires core stability, hip flexibility, balance, and overall endurance.

Imagine doing this type of work daily, without pre-workout protein smoothies, bragging about gains, or posting photos on social media!

Swing, lift, carry, toss, for 10 sets of 20 reps. Perform this on uneven or graded terrain for added proprioceptive challenge. My obvious next step as a small business owner is to create the Lumberjack Training System, complete with various blunt-tipped training implements, blue-tooth compatible composite “wood” blocks, red and black flannel performance apparel, and a 2-day seminar for those who want to officially become certified in LTS.

But in all seriousness, there are a few relevant avenues of perspective here.

Our forefathers had plenty of functional training. But on the whole, they probably did not live better than us. Technology and innovation affords comforts, opportunities, and life expectancy nearly unimaginable in old times. Of course, with progress comes new problems.

Imagine the old-timers response to modern day claims and complaints about sitting.  Most of us would gladly choose a back ache from too much time in a car or computer chair over that from days, weeks, and months of farming. A few days of swinging a heavy ax can easily cause months of stubborn epicondylitis (forearm pain) in even the most physically fit adult.

Moderation was not an option for them. But it is for most of us. And the limited time that we attend to our health and fitness should not be spent sitting on exercise machines. We should be up on our feet, on the ground, and moving in between. Anything but more sitting and leaning on things.

I often encourage my clients to stay away from exercise contraptions in favor of open ended activities that helps us learn to use the body well.  Functional exercise, done well, allows you to simultaneously work on strength, flexibility, and balance. This can usually be accomplished at home with minimal gear and a little creativity. Ease of access is critical, as cost and time are the most often cited barriers to maintaining a regular exercise program.

Functional training does require some know-how, and like anything else, has risks. Most on-line and DVD home workout programs incorporate functional but high impact exercises like scissor jumps, high kicks, and burpees. They encourage you to push yourself with intensity and repetition.

Exercise form easily breaks down when doing high impact activities in a state of fatigue. Even with perfect form, it is entirely possible to do too much too soon. It should be no surprise when the aches and pains arrive. In focusing so much on intense effort and burning calories and feeling the burn, we lose out on what the most valuable aspects of exercise; the brain training that goes along with rehearsing good body control, improving the quality of how we move, and understanding reasonable, progressive challenges.

I’m sure the idea of movement quality is nothing new. In their years of manual labor, did my great grandfathers intuitively hip hinge (lift heavier objects using the legs and maintaining a neutral spine)? Did they grab moderate size branches with a palms up, elbows in arm position to save stress to their rotator cuff and forearms? I’m sure my mantra of “Learn to do it well before doing it a lot” applied to work life back then just as much as it applies to exercising now.

Fitness training should translate to better quality of life outside of the gym. This requires a subtle but important shift in mindset. Your exercise program should be challenging and uncomfortable, but not painful and exhausting. Do not look at exercise simply as a way to burn calories. See it as an opportunity to make you a safer, more effective and resilient human. When you are physically well, more capable, and confident, you will naturally be inclined to do more, to move more, and yes, burn more calories, out in the real world.

Just like fire wood, a good exercise program warms you twice: Once during the workout, and again when you are a physically engaged participant, applying the fruits of your training to the real world.

Education in Physical Therapy and Sports Performance

329AC60C-83C9-4A3D-9EBF-77E1C8F1BB99While searching through the attic last week, I came across a stack of academic honors and awards from my years as an undergraduate and graduate student at Slippery Rock University. Seven years of life’s focus is now in a cardboard box that has done nothing but keep company with Christmas decorations, my high school lettermen’s jacket, and a few dead wasps.

I could bring the plaques and framed certificates out, line a wall with them. At one point I was proud of them.  But they have meant nothing to anybody, including me, for years.

Those achievements say very little about success or what clients are after in the realm of PT and fitness training.

“Do you care?”

“Can you help me?”

“I know what I need to do. Can we make this somewhat fun or at least pallatable?”

Students in this field: You need to be rock solid in foundations of the sciences. Get an appreciation for related fields. But also pay attention to…life. Take your Liberal Arts seriously.  If not, you will earn a degree and box full of awards while knowing very little. You may end up making donations to the Creation Museum in Kentucky because you’re excited to make a difference in the world and have been persuaded it’s a Christianly thing to do.06_DinoGirl1

We all did foolish and embarrassing things in our youth ; ).

Well roundedness will bring you appreciation for the knowledge of others, curiosity, and a creative edge to your work.

Learn to manage your time, be responsible, and exercise discipline. Shoot for excellence and especially virtue. I’m sure that this is going to take something beyond college.

Resolve not to obsess about grades, the perfect GPA. This is foolishness; letting your education get in the way of learning. You’re going to mess up (function less than optimally) and learn at your first real job, anyway.

Most importantly, what kind of person are you developing into through college and beyond?

Because 20 years down the road, the 4.2 GPA and those awards will probably be collecting dust in your attic. Your aspirations and values should have shifted, and there would be something seriously wrong if you need to fall back on an achievement from 20 years ago.

Excuse me while I lead 12 brothers and sisters through discovery this afternoon, in the basement and back yard.

Be students, be teachers
Be politicians, be preachers, yeah (yeah)
Be believers, be leaders
Be astronauts, be champions,

Be truth seekers.

Let the Gains Begin

Thanks for joining me! I’ll be compiling my on-line essays and vids here. I write because I want to take time and effort to clarify my thoughts and to not forget. I realized that I sometimes enjoy typing with no -perceived- pressure from any business or organization that may steer the content that I wish to share.

Good company in a journey makes the way seem shorter. — Izaak Walton

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Getting The Month In

Discomfort will never sale well, but I think it’s a vital ingredient to keeping a healthy mind and body. Now of course, this can be easily taken to unhealthy extremes. We don’t want or need to maximize discomfort. But what are some ways to -optimize- it. Thrill! In August I had the opportunity to experience and think about various forms of the discomfort that we seek, usually in the name of thrill.

The major league coasters at Hershey Park were fun. But while waiting in line I often found myself staring at the trees, visualizing tree challenges and pathways for climbing to roofs and beams.DDDC16EB-7F6D-4976-80BC-88418AE983F3

I bounded around a trampoline park while celebrating my daughters birthday. I usually judge the parents sitting in the chairs along the side. Most of them could be doing -something-. But I always end up pushing the envelope, leave feeling like whiplash. I assume the sedentary parents do not.

One Saturday included five hours of cliff jumping into a lake. This was outstanding. But I grew weary of the scalpels prodding at my 42-year old feet, and marveled at the kids sauntering up and down rocks and gravel.

I loaded a barbell to bodyweight and squatted it 65 times in three minutes. This too was a beautiful hit of adrenaline, growth hormone, challenge, exhaustion, and gains. But I can’t imagine doing it for twenty more years. A few days later, I flew through the woods on a mountain bike, down a perfectly groomed trail with ramps, drops, and banked turns. Now THIS was in my wheelhouse! But again…for how long?

Finally, I jumped in the Atlantic ocean at dusk in a chilly wind. I did venture far in. This was amazing. In the past I’ve jumped into the spring fed-creek in our back yard. These require minimal skill and place practically no strain on the musculoskeletal system. You return to what you were doing, normal adulty responsible things, feeling magnificent. But why?

I think about this stuff; optimizing performance, fitness, and health. That’s what I do. What else am I going to think about? Sales funnels (see previous post)? The government; pro sports; a color to repaint the foyer? Those are not my things.

Children eagerly hit the water every day. They are curious and do not fear discomfort. They are in and out ten times while adults find every opportunity to avoid it. I understand. Cold water hurts.

With age we all become more limited in our skill set and risk tolerance. That’s all the more we need to seek out resiliency and overcome fragility.  Some recommend Floating in body-temperatankture saltwater, in a sound controlled tank which affords complete comfort. This is said to support the immune system, promote relaxation, recovery, pain suppression, release beneficial hormones, and unlock the doors of perception (meet Jim Morrison?), and to expand consciousness itself. But cold water immersion is has been said to fulfill the exact same list of claims.

So then, which should we be doing?

What the literature says: Despite much funding in product design and marketing, there is little evidence concerning the effects of sensory deprivation. The mind is powerful, and we tend to believe what we want to believe.  It feels good to relax and lay down for a nap.

On the other hand, we have legitimate evidence regarding the beneficial effects of cold on the immune system. Full body COLD resulted in increased metabolic rate. It reliably produces a sustained increase in norepinephrine, which substantiates the long-term pain relief touted by cold gurus. Cold has also shown promise for those with chronic fatigue syndrome, chronic heart failure, and even some types of cancers.

We should be supremely thankful when we do not have to endure slavery in exile, long and barren winters or marches through the snow to achieve independence from tyranny. But for many modern lives, comfort, and our quest for it, is killing us at worst and making us numb at best.

We are like a frog boiling in a pot of comfort that has been slowly turned up. And we could use a sensory reset. **Extreme or harsh and prolonged discomfort is unnecessary. What are you, crazy ; ??

We work, live and drive in climate controlled environments. For many of us, even time exercising involves somewhat comfortable exercise machines, massage chairs, televisions, and not even a little bit of dirt. We should not wonder why life stress, physical and mental, perturbs us.

There is nothing “natural” about complete sensory deprivation. Unless, of course, we’re talking about the miracle of sleep, which is free and under utilized. If you want to pay $200 for a nap in warm salt water, have at it. Let me know if it’s truly worthwhile, beyond scheduling an hour of your day to relax and pray and nap. Seriously – I’m listening.

Prescription: Getting the month in

An older acquaintance once told me of his routine that involved jumping into a creek every month. “I always make sure and get the month in.” This has been on my mind for over five years, as the research on the benefits of cold and the marketing for both comfort and discomfort therapies continues.

It’s all fun when the weather is warm and friends are near. But with this essay, I’m committing to Getting The Month In. This is not a fitness challenge or plunge for charity. This is not about recovery from training or competition. It’s simply something that I’ll be doing for health of body and mind, a “sensory reset.”

[The practice of icing immediately after intense training limits the beneficial adaptations involved with recovery. If you did not hear that, please know that extreme cold such as ICING AFTER A WORKOUT ACTUALLY RESTRICTS YOUR GAINS. ]

I will continue to train (and train others) outdoors when possible, in any conditions; 20 minutes or an hour outside in the beautiful and ugly. The discomfort itself is the full dose of an exercise session. Breathe in those gnats for extra gains.

Where thousands will spend time in float tanks and cryotherapy protocols, I will be grateful for the fountain of youth in mA80D519F-F68B-4D91-9CD6-5F73C975641Ey backyard. Soon it will be a rainy day in November, and I will walk bare footed through the grass and sticks. I will ease in and try to stay put for 30 seconds or a minute.

You are welcome to it. Who’s with me?? [crickets] Yeah, I don’t blame you.

But I’ll be paying attention, betting that a -certain- amount of discomfort makes the mind, and possibly the body, more resilient, capable, and even grateful.

…will keep you posted.