Listen Up!

Auditory Acuity of self.

I’ve been around the health and fitness industry a long time, which means I’m getting old, but it has allowed me to personally commit all the mistakes I see patients come into the clinic with.   For the purposes of this article, let’s call the health, fitness, and food industries the wellness industry. The only constant about the wellness industry is that it’s always changing.  Information evolves, trends come and go, and maybe something we thought was “healthy” turns out to be false.  Your circumstances play a significant role in how you apply the information and methods available, which like the topic itself, is in a constant state of flux.

So how do we navigate this chaos?  Start by understanding that it’s a journey.   Be ready to try various methods of self-care, nutrition, and exercise knowing that you’re going to fail and frustrate yourself with things that have worked so well for others.  You’re not everyone and you have to find what works with for you AND your circumstances with wherever you are in your life at that time.   Don’t give up, keep trying new things, keep learning, keep discovering, and push on.

Now I could write a novel covering each of these industry topics, but I want to focus on exercise for this post and more specifically listening to your body.  I have been SO bad at this the past few years and it has been costly.   Low back pain, rib pain, knee pain, shoulder pain, neck pain, waking up every day with some sort of ache or pain and continuing to mindlessly train and push my body past its limits.   This affects how comfortable I am when I work, when I do recreational activity, and when I’m spending time with my kids.

Why? Unless you’re a professional athlete, isn’t the purpose of exercise and training to better your life outside the gym?  Aren’t we supposed to train to build ourselves up not break ourselves down?   Sure, there are going to be workouts and training sessions that push you to your limits and you’re going to be sore and beat up but that should be the exception, not the rule.   I wouldn’t want to see that go away and I don’t think it has to for you to still maintain an effective fitness routine, improve and push yourself to be a better version of your current self.    Intensity and pushing the limits is a critical part of any successful training program.  However, in my opinion, depending on your circumstances (sleep, stress, nutrition, self-care, age, recovery, etc) we must pick and choose our battles.

All too often I have a patient present after starting a new training program that they’ve been going 100mph at since day 1 and their body finally hits the brakes and things start to deteriorate.   Learning to decipher when your body is telling you to slow down because of mental fatigue vs physical fatigue can be tricky.   But if you’ve gone into training 4 days in a row, maxed out your heart rate every session, lifted as heavy as possible, ran as far and as hard as possible, done zero mobility, had no body work done, ate horribly, slept poorly, then chances are that is your nervous system telling you to take it easy.  The reason this warning is so critical is as the window of fatigue widens, so does the vulnerability for injury.   When it’s broken down it sounds like common sense, but when we are in the heat of the moment surrounded by peers and coaches we tend to push it all aside and go through the motions.

One approach that I’ve really been gravitating towards lately is identifying an intended stimulus prior to working out.  Before beginning I take stock on how I’m feeling and try to match my training stimulus to that.  How recovered do I feel?  Do I have any pain or stiffness? How did I eat this week/weekend? How much did or didn’t I sleep?   If the grading on all those questions are positive, then I may attack that workout with full intensity and really push it.    If I feel like I’m falling short on a few or all those topics, then I’ll scrap what was planned and reprogram for what I can handle.   If the scaling or changes you need to make is going to significantly change the workout in a class setting, then you may need to attend an open gym or workout from home that day.  Don’t put yourself in a situation where you’re going to succumb to peer pressure and put yourself at risk for injury or burnout.  But if you can make a few small modifications and still be in your class or group setting then go for it, you’re not going to be letting anyone down!

Start practicing this week.   Take stock of your overall wellness that day or week and come up with an intended stimulus for your training.  Quality movement is going to be the foundation for longevity and nothing derails a training program faster than injury.   I’m still learning from my mistakes and I’m looking forward to continuing my journey, now with more acuity to what my 33-year-old body is telling me.

 

Yours in Health,

Dr. Crane

Prehab for Runners

Spring Into Running

By Daniel Hounjet, Intern, Core Health

As the snow melts and weather turns people are eager to get outside and start running.Because of the climate we live in many people either choose not to run in the winter or they run indoor on a treadmill. So, for the most part individuals who start running are not taking the necessary steps to prepare their bodies for the increased strain on the body and to prevent chronic injuries that come with an increased volume of running. The most common overuse and altered mechanics injuries that seem to plague runners include low back pain, shin splints, Iliotibial band (IT) syndrome, patellofemoral pain syndrome (runners knee) and plantar fasciitis.  I will provide you with a few recommendations to help prevent some of these issues.

The snow has melted, the streets are dry, the trees are blooming and you’re ready to get your running on… But wait, what is the first thing you should do before exercising? Warm up?! You’re absolutely right. A quick 5-minute warm up will go a long way in injury prevention. When we talk about warming up, we don’t want to go and do static stretches. Instead we want to increase blood flow to the body by increasing our heartrate and go through similar motions as when we’re running. Here are a few exercises that will help warm up properly.

-Butt kickers

-High knees

-Heel walk/Toe walk

-Lunges

 

Warmup

Each exercise should be done for 20-30 feet, 1-2 times. Once we’ve gone through these exercises it’s a good idea to do 2-3 short sprints to really get your HR up. Now that you’re ready to hit the road be sure that your starting with a distance and pace that is significantly below what you ended the previous season. Our bodies are highly adaptable to stresses placed upon it, so it important for injury prevention to slowly build back up to where you where the previous season. By slowly increasing our duration and intensity we are allowing our bodies to adapt to the stresses placed on our body, from the increased strain on our joint, our tendons and even to regain our oxygen capacity.

Cool Down

Our post run recovery is just as important as our preparation and the run itself. That is why there 3 aspects should be incorporated post run. First off, we want to slowly bring out heart-rate down. It may be difficult to do with our busy lives, but having a proper cool down will prevent blood from pooling in our extremities and the unwanted potential for dizziness and or loss of consciousness. Cooling down will also help flush out the metabolite (lactic acid) build up in your legs. Try walking or even a low intensity dynamic stretch will be great to slowly bring that HR back down. Once you’ve cooled down we want to stretch and or roll (foam roller, lacrosse ball etc.) the area that worked the most during the run; calves, lumbar musculature, hip flexors and gluteus maximus and medius. Here are a few stretches to consider.

-Pigeons stretch

-Lunge stretch

-standing calf stretch

-Hamstring stretch

-Stiff leg good mornings

 

Remember that these stretches and rolling these areas are for preventative measures and may not be the right stretches if you have altered body mechanics or are injured. If you suspect you have altered mechanics, (loss of mobility of a joint, hypermobility/ instability and/or loss of motor control) a good general tip to know, if there is an underlying issue and the pain or stiffness is only on one side of the body there is likely something that isn’t working the way it should. If you think you may have a compensation or would like to be evaluated consider seeking professional advice from a chiropractor or Physical therapist.

Advances in Functional Training Excerpt

 

Refueling

Lastly, we want to ensure we are refueling and replenishing lost nutrients. If you are running long distances with a duration greater than 90 minutes at moderate intensity it’s important to replenish our glycogen stores as they will be depleted after an intense distance run. That being said a balanced refuel is essential, consider 4:2:1 ratio of carbohydrates: protein: fat. We want to consume the carbohydrates to restore glycogen levels (glycogen is the muscles energy source for sustained activity). Protein to repair any damage to the muscle due to the increased intensity and lastly fats, which will slow digestion and allow for less of a blood sugar spike post workout. We also want to replenish any fluid losses. Water and a good electrolyte drink will go a long way in minimizing stiffness and soreness. If you are running for a shorter duration under 90 minutes, you are likely not depleting your glycogen stores. Therefore, rehydration and your regular diet will suffice. Research suggests that it is a myth that we need to consume protein within an hour post exercise, and that a balanced meal prior to activity will carry you through your run and even into your recovery. https://jcdfitness.com/2016/09/should-you-eat-fat-in-your-post-workout-meal/