Watching Football With Constantine

My dream began driving Roman Emperor Constantine to the local high school on a Friday night. He is in the passenger side sitting stone-faced as I debrief him the basic intent and rules of American football. He does not appear to care or be paying attention, leaning dramatically when vehicles pass by traveling the opposite direction.

I ramble on, unsure whether or not Constantine understands English much less the procedures I’m describing.

“…And so we sometimes refer to football players as modern day gladiators. Even today we use many words from your time.”

I hand Constantine my Bob’s Subs and Sandwich Shop T-shirt and a pair of khaki dad shorts. I try not to act surprised when he accepts my advice. We begin walking as Constantine breaks the silence.

“This is your stadium?”

Constantine is not impressed. I try to describe how there are perhaps hundreds of larger stadiums that hold three times as many people as his great Coliseum, and why there are thousands of small stadiums like this scattered throughout the land.  I add why we no longer keep slaves for building and upkeep, except for the large stadiums where we still sort of do.

Constantine ducks and puts his arms overhead when first hearing the announcers on the speaker system. He watches the game, and after a while seems to enjoy the battle cries of the drums and brass instruments.

“What nations battle here?” asks Constantine.

“Nations don’t battle in football. These teams are made up of young men between the ages of 16 and 19. They represent their towns and cities, but we’re all part of the same nation.”

“Do they battle to control the land?”

“Definitely not. I know it looks pretty serious; everyone looks serious, but it’s just a game. The players on both teams are supposed to shake hands afterwards, and each returns to his town and family at the end of the night.”

Constantine seemed puzzled.

“Then why don’t they just play dice or backgammon?”

“Yea, you’re right. But everyday life is a lot less physical these days. Most of us don’t battle or work the land or anything like that, so we battle for sport. But everyone gets caught up in it because there’s a lot at stake.”

I go on…

The loyalties are confusing. In most sports these days, the athletes and fans clash violently against each other as hated enemies, then in the next year or sometimes the next weekend they play on the same team. Sometimes it ends up being for individual achievement”

“They have no loyalties or unified cause?”

“Well not really. We don’t have a school belief or religion. People are free to believe and practice what they want. No state religion, Constantine. Since your time we have found out that it makes people ugly and even worse, greatly cheapens the religion. All this freedom is great, but it comes at a cost. We have to put up with a lot of stupid ideas, but they always seem to contain a few good ideas.

Constantine shook his head in amazement.

“Interesting! So there are many religions and values represented within each team? How do you expect the team to function optimally?”

Well, yeah. Exactly. Many of the athletes around here are Christians, but not all of them.

“So the Christians have a team and get along well with each other but not others.”

“Well, you would think. But not exactly. We have denominations.”

Constantine shrugged.

“I know. Sometimes it doesn’t make a lot of sense.”

After a few moments of silence, Constantine asked, “Do your more mature, absolute best gladiators,…er, football players have unified beliefs and vision?

“Not even close…rarely.”

At the end of halfime, the home team played the classic song Sweet Caroline over the loudspeakers.

Constantine listened closely. “Parents, players, coaches and students on both teams are singing! Why do they all pay homage to the Queen at this point.”

“No Constantine. It’s just a recording of the song. We don’t have a queen. But I guess right here is something that everyone agrees on. And every Caroline that I have met is indeed sweet.”

Constantine chuckled. He was beginning to fade and I could tell that our time was drawing to a close.

“Well maybe you should get a king or queen that you all believe in.”

“Yeah, well….we’re not even close there either…”

Constantine cut me off.

You think Romans were crazy, but YOU are. You can’t agree on what you’re for and get triggered about games and have been so watered down with very little to fight for as a team. Hardly any shared beliefs and values. ”

Constantine faded as I replied.

“Maybe singing Sweet Caroline together on a Friday night is as good as it gets. Let’s hope not. In the very least, we can say it’s an ideal and a good place to start. And I’m sure that you cannot beat John Denver playing in the September dusk.”

The last thing that I remember of the dream is sitting in the bleachers completely by myself.

football lights

Fathers Day

Yesterday I made the 2.5 hour drive from my parents house, returning to Mechanicsburg, after visiting my parents for Father’s Day. I love long rides because I have time to think. This idea developed somewhere near the Bedford exit. So I came home and wrote it out on a Facebook Post:

When you’re born, you love your dad. He is YOUR dad and for the rest of your life you will love him no matter what or why.

When you’re a child, you look up to him. Almost everyone does, if dad is around and showing even a hint of affection.
When you’re an adolescent or young adult, you question him. For some it’s outright rebellion and for others it’s a simple matter of exerting some independence. For most, it’s the delicate dance of letting go and holding on.

When you’re an adult, some (definitely fewer) truly admire and respect their dad. What he stands for, values, and believes. The history of how he responds and behaves through life’s ups and downs. There are no shortcuts here, no “hacks” or faking. This one is earned over long years. The truth comes out.
When you get to middle age or older, some basically become their dad. Or very close to it.
I catch myself thinking like and doing many of the same things my dad has done for years. “Wait, where did that come from?” moments. It is the ultimate form of flattery, if dads cared for flattery.
In time, dads reach granddad status. A few of them become legendary. Both of my grandads have been cemented into my mind as some sort of icons, and I now remember only their strengths. But they were and are worthy of it. They were concerned and available and giving through all phases.
Thankful for my dad and granddads as well!

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.